The association between substance use and attention-deficit/hyperactivity disorder and borderline personality disorder in undergraduate students - An exploratory study

Q: What were the main objectives of the exploratory study?

The study aimed to examine the association between substance use and ADHD/BPD traits in undergraduate students, estimate prevalence of ADHD, BPD, SU, and impulsivity, characterize substance types students commonly use, and evaluate relationships between impulsivity traits and ADHD/BPD/SU.

Q: How was substance use disorder and psychiatric traits assessed in participants?

A cross-sectional sample of 887 undergraduates (18–26) completed standardized instruments: ASRS-v1.1 for ADHD, MSI-BPD for borderline personality disorder, BIS-11 for impulsivity, and DSM-5 criteria for substance use disorder.

Q: Did the study identify impulsivity as a shared factor?

Yes. Impulsivity was reported in 71% of individuals with ADHD, 64% with BPD, and 51% with substance use, supporting impulsivity as a common underlying factor across ADHD, BPD, and SU.

Sep 29, 2026

Uploaded by MrHarris58

Background and purpose focus on how Attention-Deficit/Hyperactivity Disorder (ADHD) and borderline personality disorder (BPD) relate to substance use (SU), including alcohol, tobacco, and illicit drugs. The study examines associations between SU and ADHD/BPD traits among undergraduates in Eastern Odisha, estimates prevalence of ADHD, BPD, SU, and impulsivity, characterizes substance patterns, and tests links between impulsivity traits and SU alongside ADHD and BPD.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Introduction

ADHD and BPD: clinical features and shared impulsivity

Substance use disorders and co-occurring risks

Methods

Study design and participants

Measurement instruments and criteria

Statistical analysis

Results

Prevalence of ADHD, BPD, and substance use

Impulsivity prevalence across conditions

Associations between ADHD/BPD and SUD

Substance pattern differences

Conclusion

ORIGINAL ARTICLE The association between substance use and attention‑deficit/hyperactivity disorder and borderline personality disorder in undergraduate students: An exploratory study Jamuna Das, Jitendriya Biswal1, Manika Bose2, Rakesh Mohanty1 Clinical Psychology, Department of Psychiatry, IMS and SUM Hospitals, Departments of 1Psychiatry, and 2Pharmacology, IMS and SUM Hospitals, SOA Deemed to be University, Bhubaneswar, Odisha, India ABSTRACT Background: Attention‑Deficit/Hyperactivity Disorder (ADHD) and borderline personality disorder (BPD) are psychiatric conditions commonly associated with impulsivity and substance use. Both disorders are linked to substance use (SU), which includes patterns of consumption of substances such as alcohol, tobacco, and illicit drugs. Objective: The primary objective is to examine the association between SU and the presence of ADHD and BPD traits among undergraduate students in Eastern Odisha. Additionally, this study aims to estimate the prevalence of ADHD, BPD, SU, and impulsivity within this population; investigate the patterns and types of substances commonly used by students; and evaluate the relationship between impulsivity traits and ADHD, BPD, and SU. Methods: A cross-sectional study was conducted involving 887 undergraduate students aged 18–26 at a university in Bhubaneswar, Eastern Odisha. Participants completed standardized instruments, including the Adult ADHD Self-Report Scale (ASRS-v1.1), the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD), the Barratt Impulsiveness Scale (BIS-11), and the DSM-5 criteria for substance use disorder (SUD) . Associations were analyzed using Chi-square tests and odds ratios. Results: The findings indicated a prevalence of ADHD at 3%, BPD at 5%, and SU at 18% . Impulsivity was highly prevalent, reported in 71% of individuals with ADHD, 64% with BPD, and 51% with SU. ADHD was significantly associated with substance use disorder (SUD) (OR = 10.57, 95% CI: 4.68–23.83), with 68% of individuals with ADHD screening positive for SUD (P < 0.001) . Similarly, BPD was significantly correlated with SU (OR = 4.54, 95% CI: 2.44–8.43; P < 0.001) . Substance use patterns differed between ADHD and BPD, with tobacco and cannabis most strongly linked to BPD, while alcohol showed modest diagnostic specificity. Conclusion: The current study found that substance use was prevalent among undergraduates, with strong associations observed between ADHD and SU, as well as between BPD and SU. These findings highlight distinct SU patterns linked to each disorder. Impulsivity was identified as a common underlying factor across ADHD, BPD, and SU. Key words: ADHD, BPD, impulsivity, substance use Das, et al.: Substance use patterns in undergraduates: Links to ADHD and BPD INTRODUCTION Attention Deficit Hyperactivity Disorder (ADHD) is characterized by symptoms such as inattention, hyperactivity, and impulsivity.[1] borderline personality disorder (BPD) is a personality disorder characterized by unstable, intense interpersonal relationships, a persistently fragile self-image, and difficulties with anger management.[2] Impulsivity is a core feature linking ADHD, BPD, and substance use disorder (SUD) . Although categorized separately in the DSM-5, ADHD and BPD share overlapping traits such as emotional dysregulation, poor impulse control, unstable relationships, low self-esteem, and vulnerability to substance misuse. When SUD co-occurs, it exacerbates psychological, social, and physical challenges, further diminishing quality of life.[3,4] ADHD is a disorder characterized by impulsivity, difficulty sustaining attention, and hyperactivity. Symptoms persist throughout life in approximately 60% of cases.[5] Students with ADHD and BPD face higher risks due to impulsivity and emotional dysregulation, underscoringtheneedfortargetedprevention,andintervention strategies in academic settings.[6] BPD is characterized by pervasive patterns of

FAQs

What were the main objectives of the exploratory study?

The study aimed to examine the association between substance use and ADHD/BPD traits in undergraduate students, estimate prevalence of ADHD, BPD, SU, and impulsivity, characterize substance types students commonly use, and evaluate relationships between impulsivity traits and ADHD/BPD/SU.

How was substance use disorder and psychiatric traits assessed in participants?

A cross-sectional sample of 887 undergraduates (18–26) completed standardized instruments: ASRS-v1.1 for ADHD, MSI-BPD for borderline personality disorder, BIS-11 for impulsivity, and DSM-5 criteria for substance use disorder.

What associations did the study find between ADHD/BPD and substance use?

ADHD was significantly associated with substance use disorder (OR = 10.57; 95% CI: 4.68–23.83; P < 0.001), and BPD was also significantly correlated with substance use (OR = 4.54; 95% CI: 2.44–8.43; P < 0.001).

Did the study identify impulsivity as a shared factor?

Yes. Impulsivity was reported in 71% of individuals with ADHD, 64% with BPD, and 51% with substance use, supporting impulsivity as a common underlying factor across ADHD, BPD, and SU.

Sep 29, 2026

Uploaded by MrHarris58