Exploring Emotional Regulation, Depression, Impulsivity, and Anxiety Connected to Attention Deficit Hyperactivity Disorder with Substance Use

Background: Emotional regulation difficulties, depression, impulsivity, and anxiety are psychological factors that frequently co-occur with substance use in attention deficit hyperactivity disorder. These factors contribute to maladaptive coping strategies, increasing vulnerability to substance use patterns. Objective: To explore the psychological factors of the co-occurrence of ADHD with substance use, with a specific focus on emotional regulation, depression, impulsiveness, and anxiety. Methods: This cross-sectional study, conducted from September 2023 to September 2024 at a university in Eastern Odisha, explored psychological factors among undergraduate students aged 18–26 with ADHD and co-occurring substance use. Data collection utilizes validated tools, including ASRS-V1.1, ASSIST, HAM-D, HAM-A, DERS, and BIS. Results: The study analyzed 1,310 undergraduate students, showing 8.2% with ADHD, of which 52.3% reported substance use (SU). Impulsivity was significantly associated with SU, with higher impulsivity reported in SU individuals. Anxiety also showed a strong association with SU. However, emotional dysregulation and depression were not significantly linked to SU. These findings highlight key psychological factors influencing substance use in ADHD. Conclusions: This study underscores the significant role of impulsiveness and anxiety in the co-occurrence of substance use (SU) among individuals with ADHD, while emotional dysregulation and depression were not found to have a significant association. These findings highlight the need for targeted interventions addressing impulsiveness and anxiety to mitigate the risk of SU in this population.