Prevalence of Self-Reported ADHD Symptoms Among Collegiate Athletes

Purpose: Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disorder that impacts an individual's ability to maintain attention span and focus their concentration at a normal level. While ADHD is one of the most well studied behavioral disorders, multiple researchers have stated the need for further research on the effects of ADHD on participation in sports. Therefore, the purpose of this study was to describe the prevalence of self-reported ADHD symptoms among collegiate student-athletes at an NCAA institution. A secondary purpose was to determine differences in self-reported ADHD symptoms based on demographic information and history of concussion. Methods: Subjects were selected for this study by retrospective review of pre-participation medical paperwork of the student-athletes of an NCAA Division II institution (n=418). A total of 110 student-athletes opened and completed the voluntary survey as part of pre-participation medical paperwork (access and response rate = 26.3%). Subjects were sent an electronic survey via email that collected demographic information and asked them to rate self-reported symptoms of ADHD using the Adult ADHD Self-Report Scale (ASRS). Results: Individuals who reported having been previously diagnosed with Attention Deficit Disorder (ADD) or ADHD reported significantly higher scores on the first six questions of the ASRS than those who had not (ADD or ADHD Diagnosis = 21.8 +/- 3.9, No ADD or ADHD Diagnosis = 14.4 +/- 5.0, t(108) = 5.85, p <.001). Individuals who exceeded the threshold of 15 or higher reported significantly higher scores on the first six questions of the ASRS than those who did not report a score of 15 or higher (15 or higher = 18.7 +/- 3.4, Less than 15 = 10.6 +/- 2.4, t(91) = -13.45, p < .001). Of the individuals who had not been diagnosed with ADD or ADHD, 43 reported scores on the first six questions of the ASRS of 15 or higher (n=43, 46.2%). Individuals who reported English as their first language reported significantly higher scores on the first six questions of the ASRS (English as first language = 15.9 +/- 5.5, English not as first language = 12.3 +/- 4.5, t(108) = 2.09, p =0.039). We did not identify any significant differences in severity of self-reported ADHD symptoms between groups for sport, gender, academic year, athletic year, race, ethnicity, nationality, or history of concussion in the past 12 months. Conclusions: A substantial portion of the collegiate student-athletes surveyed reported symptoms that warrant further evaluation for ADD and ADHD despite never being diagnosed with either condition. ADHD has been shown to increase prevalence of concussion and musculoskeletal injury. Within the athletic population, ADHD often goes undiagnosed throughout childhood and early adolescence. When caring for large populations of athletes, a screening instrument for ADHD symptoms can be a valuable tool for clinicians seeking to identify patients who may require further evaluation. Better recognition of ADHD symptoms may lead to improvements in diagnosing and treating the condition.