Occupational experiences of college students with ADHD: A qualitative study

Background: College students with attention deficit hyperactivity disorder (ADHD) face difficulties with occupational performance in many functional domains. Despite the broad literature on academic and psychosocial functions, there is a gap in knowledge regarding how these students experience participation in their various daily functions. Objective: Gaining a deeper understanding of the occupational experiences of college students with ADHD and exploring factors that facilitate or impede their occupational performance. Method: Twenty college students with ADHD were interviewed using the Occupational Performance History Interview (OPHI-II). Qualitative content analysis was employed. Results: Six themes were found in relation to varied occupational domains: (1) Eating and meal preparation: Too little or too much; (2) Sleep: Not enough to ‘recharge batteries’; (3) Medication management: Intense ambivalence; (4) Studying: Too hard, too effortful (5) Work: Need it and love it; and (6) Leisure: Desired yet absent. Each theme contained categories related to factors that influenced performance. Impeding factors included occupational demands, ADHD biological attributes, and personal beliefs. Facilitating factors included self-awareness, executive strategies, adaptive routines, and enabling social context. Conclusions: College students with ADHD experience profound difficulties in occupational performance, yet variation occurs across domains, attributable to occupational, biological, psychological, and social factors. Results can inform tailored interventions supporting occupational performance in this population.