ADHD, chronotype, and circadian preference in a multi‐site sample of college students

Abstract

SummaryAttention‐deficit/hyperactivity disorder and an evening chronotype are both common among college students, and there is growing interest in understanding the possible link between attention‐deficit/hyperactivity disorder and circadian function. However, mixed findings have been reported, and many of the existing studies have used small samples that were unable to examine chronotype across attention‐deficit/hyperactivity disorder presentations. Participants were 4751 students (73% female; 80% White), aged 18–29 years (M = 19.28, SD = 1.50), from five universities who completed measures assessing attention‐deficit/hyperactivity disorder, depressive and anxiety symptoms, as well as the Morningness–Eveningness Questionnaire to assess chronotype (categorical) and circadian preference (dimensional). Participants with either attention‐deficit/hyperactivity disorder predominantly inattentive presentation or attention‐deficit/hyperactivity disorder combined presentation had higher rates of being an evening type (47.2% and 41.5%, respectively) than participants without elevated attention‐deficit/hyperactivity disorder (28.5%), and participants with attention‐deficit/hyperactivity disorder predominantly inattentive presentation also had higher rates of being an evening type than participants with attention‐deficit/hyperactivity disorder predominantly hyperactive–impulsive presentation (30.7%). Dimensional analyses indicated that attention‐deficit/hyperactivity disorder inattentive symptoms were more strongly associated than hyperactive–impulsive symptoms with eveningness preference. Finally, greater eveningness preference strengthened the association between attention‐deficit/hyperactivity disorder inattention and depressive symptoms but not anxiety symptoms. This is the largest study to document that college students with elevated attention‐deficit/hyperactivity disorder symptoms are more likely to be evening types than other college students, and inattentive symptoms in particular are associated with later circadian preference.