J Atten Disord [JOURNAL]
Sun
200 papers
Cannabis Use in a Community-Based Sample of Adults Diagnosed With ADHD: Prevalence, Impact on Symptoms, and Stimulant Side Effects.
Ryan JE, Herens A, Fruchtman M … +3 more , Veliz P, Kelly EL, Worster B
J Atten Disord · 2026 Mar · PMID 40874736 · Publisher ↗
AIM: Assess prevalence and correlates of cannabis use in adults with attention-deficit/hyperactivity disorder (ADHD) and explore its impact on comorbidities, symptoms, and side effects of prescription stimulants. METHODS...
AIM: Assess prevalence and correlates of cannabis use in adults with attention-deficit/hyperactivity disorder (ADHD) and explore its impact on comorbidities, symptoms, and side effects of prescription stimulants. METHODS: An anonymous online survey (April to July 2023) was emailed to 9,274 potential adult participants with a documented ADHD diagnosis, based on ICD-10 codes in the electronic medical record, which was secondarily verified by self-report. A total of 900 participants completed the survey. The 46-item survey covered demographics, medical history, prescription stimulant use, cannabis use, and its impact on ADHD symptoms and prescribed stimulant side effects, prescription stimulant misuse, cannabis use disorder, and health-related quality of life. RESULTS: In this large sample of adults diagnosed with ADHD, 75% reported ever using cannabis, with 41% reporting prior 30-day use. Groups of cannabis users were categorized into three groups; (1) no recent use (including never; = 458); (2) non-daily use (<30 days in past month; = 256); and (3) daily use (≥30 days in past month; = 112). Compared to non-daily cannabis users, daily cannabis users showed comparable rates of prescription stimulant misuse (29% vs. 37%, OR = 1.39, 95% CI [0.87, 2.23], = .166), and substance use disorder diagnoses (2% vs. 4%, OR = 1.54, 95% CI [0.43, 5.58], = .508), but higher rates of cannabis use disorder (38% vs. 62%, OR = 2.67, 95% CI [1.69, 4.22], < .001). Daily cannabis users were more likely to report fair or poor general health compared to non-daily cannabis users (24% vs. 11%, OR = 2.58, 95% CI [1.44, 4.64], = .001). Daily cannabis users were more likely to report a comorbid diagnosis of anxiety (70% vs. 48%, OR = 2.55, 95% CI [1.59, 4.10], < .001), depression (54% vs. 35%, OR = 2.24, 95% CI [1.42, 3.53], < .001), bipolar disorder (15% vs. 5%, OR = 3.345, 95% CI [1.56, 7.15], = .002), and post-traumatic stress disorder (PTSD) (30% vs. 14%, OR = 2.752, 95% CI [1.61, 4.71], < .001), compared to non-daily cannabis users. Among participants who ever used cannabis, 278 (42%) reported they had used cannabis to manage their ADHD symptoms. Compared to non-daily cannabis users, daily cannabis users were significantly more likely to report that cannabis use improved ADHD symptoms of mental frustration (OR = 2.39, 95% CI [1.36, 4.19], = .002) and impulsivity (OR = 1.69, 95% CI [1.07, 2.69], = .026). Daily cannabis users were more likely to report that cannabis use worsened ADHD symptoms of inattention (OR = .59, 95% CI [0.36, 0.98], = .043) compared to non-daily cannabis users. Participants reported mixed effects of cannabis use on anxiety: 156 noted improvements, while 34 reported worsening. CONCLUSION: In this sample of adults diagnosed with ADHD, cannabis use was prevalent, with daily users showing higher rates of cannabis use disorder and co-morbid psychiatric diagnoses compared to non-daily users, highlighting the need for clinicians to screen for cannabis use disorder and psychiatric comorbidities. Cannabis users reported mixed effects of cannabis on ADHD symptoms and anxiety. Further research is warranted to understand the complex relationship between cannabis use, ADHD symptoms, and mental health.
Self-Reported ADHD Diagnosis and Illicit Drug Use and Prescription Medication Misuse Among U.S. Working-Age Adults.
London AS, Antshel KM, Grove J … +2 more , Gutin I, Monnat SM
J Atten Disord · 2025 Dec · PMID 40852961 · Full text
OBJECTIVE: To estimate differences by self-reported lifetime ADHD diagnosis status in the percentage of U.S. working-age (18- to 64-year-old) adults in 2023 who report lifetime and past-year use or misuse of 11 different...
OBJECTIVE: To estimate differences by self-reported lifetime ADHD diagnosis status in the percentage of U.S. working-age (18- to 64-year-old) adults in 2023 who report lifetime and past-year use or misuse of 11 different categories of illicit drugs and prescription medications, overall and among those without a self-reported drug use disorder (DUD). METHOD: We analyze data from the 2023 National Wellbeing Survey (total sample unweighted = 7,044; no DUD sample unweighted = 6,484) to estimate lifetime and past-year use of seven illicit drugs (marijuana, powder cocaine, crack cocaine, methamphetamine, heroin, fentanyl, and hallucinogens) and misuse of four prescription medications (opioids, tranquilizers, sedatives, and stimulants) among working-age adults, by self-reported lifetime ADHD diagnosis status, sex, age, race/ethnicity, nativity, education, and rural-urban residence. Weighted descriptive and multivariable logistic regression model estimates are obtained for the total population and for the subpopulation without a self-reported DUD. RESULTS: In 2023, lifetime and past-year use or misuse of all 11 categories of drugs and medications was significantly higher among working-age adults with ADHD than among those without ADHD. Statistically significant differences by self-reported ADHD status persisted in multivariable models that controlled for demographic characteristics, with adjusted odds ratios (AORs) ranging from 1.77 for lifetime misuse of prescription sedatives to 3.08 for lifetime misuse of prescription stimulants, and from 1.63 for past-year use of crack cocaine to 3.33 for past-year misuse of prescription stimulants. Among those with no DUD, results indicated significantly higher lifetime use or misuse among persons with ADHD than among persons without ADHD for all 11 categories of drugs and mediations, with AORs ranging from 1.69 for misuse of prescription opioids to 2.87 for prescription stimulants. Past-year use or misuse among working-age adults never diagnosed with a DUD was significantly higher for 7 of 11 categories of drugs and medications among persons with ADHD relative to persons without ADHD, with statistically significant AORs ranging from 1.54 for use of heroin to 3.48 for misuse of prescription stimulants. CONCLUSION: Results suggest that ADHD is a risk factor for higher illicit drug use and prescription medication misuse among U.S. working-age adults, even in the absence of a DUD. Clinicians working with adults with ADHD should assess use and misuse of a broad range of drugs and medications regardless of whether the person with ADHD has a co-occurring DUD diagnosis, and engage in therapeutic interventions when appropriate. Future national data collection efforts that include measures of drug use and medication misuse (e.g., NSDUH, NHIS, and BRFSS) should include measures of lifetime and current ADHD diagnosis, symptoms, and treatment history.
Utilization of Mental Health Care Services Among Children and Adolescents with ADHD in Germany: Treatment Satisfaction and Factors Influencing Access.
Kaman A, Gilbert M, Devine J … +9 more , Möller S, Schlack R, Beyer AK, Romanos M, Jans T, Berner A, Weyrich S, INTEGRATE-ADHD Study Group, Ravens-Sieberer U
J Atten Disord · 2025 Dec · PMID 40796511 · Full text
BACKGROUND: ADHD is one of the most common mental disorders in children and adolescents. While international research on health service utilization, barriers to care, and treatment satisfaction is growing, evidence from...
BACKGROUND: ADHD is one of the most common mental disorders in children and adolescents. While international research on health service utilization, barriers to care, and treatment satisfaction is growing, evidence from Germany remains limited. This study aimed to examine the utilization of mental health care services in a sample of German children and adolescents with an administrative ADHD diagnosis registered with their health insurance company. Treatment satisfaction, belief in treatment efficacy and factors influencing mental health care utilization were examined. METHODS: As part of the consortium project INTEGRATE-ADHD, data from 4,948 children and adolescents were analyzed. Parents of 7- to 17-year-olds participated in an online survey answering questions about their child's ADHD health care utilization, treatment satisfaction and efficacy, and factors influencing utilization using established instruments. Sociodemographic factors, geographic characteristics, ADHD symptom severity, and parental psychopathology were also assessed. Descriptive analyses and multivariate logistic regressions were conducted. RESULTS: Approximately 40% of the children and adolescents with an administrative ADHD diagnosis were currently receiving ADHD treatment. The majority of parents (76%) were satisfied with the treatment, and 85% considered the treatment effective. Children with more severe ADHD symptoms had a threefold higher likelihood of receiving treatment, while youths with a migration background were less likely to receive mental health care. The most common reasons for not utilizing mental health care included the treatment having already ended, a lack of available treatment options, long waiting times, a lack of motivation among children, or the inability to continue treatment due to the COVID-19 pandemic. CONCLUSIONS: To overcome the identified barriers in ADHD treatment, we recommend improving access to evidence-based ADHD treatment and expanding its implementation to prevent undertreatment and the associated individual suffering and societal costs.
Marginalized Identities and Intersectionalities that Contribute to College Students' Mental Health Challenges and Use of Psychological Services.
Kim SA, Rhinehart LV
J Atten Disord · 2026 Feb · PMID 40787724 · Full text
OBJECTIVE: The rates of college students experiencing mental health challenges are increasing. Students with marginalized identities such as women, first generation college students (FGCS), or students with disabilities...
OBJECTIVE: The rates of college students experiencing mental health challenges are increasing. Students with marginalized identities such as women, first generation college students (FGCS), or students with disabilities may be more at risk, and having multiple marginalized identities can impose added challenges. This study examined students' identities that contribute to college students with psychological disorders': (1) severity of mental health challenges, and (2) use of on-campus psychological services. METHODS: A nationwide survey was used to draw a sample of college students with psychological disorders ( = 5,120). RESULTS: For students with psychological disorders, being a woman was associated with heightened mental health challenges, even when other identities were accounted for (i.e., FGCS status, disability status, dual identities). Having ADHD was also associated with heightened mental health challenges when dual identities were not accounted for. Additionally, when students with ADHD's dual identity as a FGCS was accounted for, students with psychological disorders and ADHD who are also FGCS were found to experience heightened psychological challenges. Moreover, FGCS were less likely to utilize mental health services on campus, even when other identities were accounted for. CONCLUSION: Findings highlight the role marginalized identities play for college students with psychological disorders and the importance of considering students' intersectionality when it comes to mental health and seeking professional support.
Mechanisms of Learning in Adults With ADHD During an Ecologically-Valid Visual Discrimination Task.
Kuznetsova E, Tammi T, Postnova N … +2 more , Palomäki J, Cowley BU
J Atten Disord · 2026 Jan · PMID 40776557 · Full text
OBJECTIVE: Learning unfolds in distinct stages-acquisition, consolidation, and maintenance-shaped by cognitive mechanisms such as saliency processing, interference control, and sustained attention. ADHD in adults is asso...
OBJECTIVE: Learning unfolds in distinct stages-acquisition, consolidation, and maintenance-shaped by cognitive mechanisms such as saliency processing, interference control, and sustained attention. ADHD in adults is associated with deficits in these cognitive processes, which in turn might lead to learning difficulties. METHOD: Using a novel protocol that incorporates a visual attention task with gestalt-image targets and primer distractors, we investigated these cognitive mechanisms across different stages of learning in 53 adults diagnosed with ADHD and 18 neurotypical Controls. RESULTS: Our findings reveal that adults with ADHD exhibit reduced neural activations in the occipital and parietal areas, indicating diminished bottom-up visual processing and challenges in handling distractions. Nevertheless, individuals with ADHD demonstrate increased frontal activity in the late stages of visual processing, suggesting compensatory mechanisms employed by the group. Behaviorally, both groups achieve comparable performance, though ADHD participants do so at the expense of greater variability and attentional lapses. Furthermore, while Controls reach the plateau already after the acquisition phase, the ADHD group is gradually improving its performance throughout the experiment. CONCLUSION: These findings demonstrate that adults with ADHD can acquire and retain new skills but do so through different-and usually more effortful-pathways. By mapping neural and behavioral dynamics onto learning stages, this study offers a more nuanced framework for learning in ADHD and supports the development of phase-specific intervention strategies.
Multinutrients Decrease Oxidative Stress in Children With ADHD: Mediation/Moderation Analysis of Randomized Controlled Trial Data.
Robinette LM, Hatsu IE, Adetona O … +8 more , Wu CM, Johnstone JM, Bruton AM, Ast HK, Odei JB, Ziouzenkova O, Leung BMY, Arnold LE
J Atten Disord · 2025 Dec · PMID 40772654 · Full text
BACKGROUND: ADHD is associated with oxidative stress (OS), possibly stemming from deficiencies in essential nutrients. Previous randomized controlled trials (RCTs), including Micronutrients for ADHD in Youth (MADDY), dem...
BACKGROUND: ADHD is associated with oxidative stress (OS), possibly stemming from deficiencies in essential nutrients. Previous randomized controlled trials (RCTs), including Micronutrients for ADHD in Youth (MADDY), demonstrated improved symptoms in response to treatment with multinutrients compared to placebo. It remains unknown whether multinutrient supplementation influences antioxidant status and OS, and if these factors contributed to improvements observed in children with ADHD in the MADDY RCT. OBJECTIVES: Utilizing samples from the MADDY RCT, (1) compare the change in antioxidant (AO) and OS biomarkers after 8 weeks of multinutrient supplementation vs placebo, and (2) evaluate these biomarkers at baseline, and their change after 8 weeks, as moderators/mediators of treatment response. METHODS: Activity of glutathione peroxidase (GPx) and glutathione reductase (GR) enzymes, plus oxidative stress index (OSI) based on ratio of reactive oxygen metabolites (ROM) to biological antioxidant potential (BAP), were measured in plasma at baseline and week 8. Differences between groups were determined using two-sample -test or Mann-Whitney -test. Logistic regression models assessed AO/OS biomarkers for mediation/moderation of treatment response. RESULTS: Plasma from 77 children (aged 9.9 ± 1.7 years; 71% male) treated with multinutrients ( = 45) or placebo ( = 32) was analyzed. After 8 weeks, ROM decreased with multinutrients and increased with placebo (-14.3 vs. +26.8 Carratelli units, = .017); but no significant differences in OSI, BAP, GPx, and GR between groups. None of the baseline AO/OS biomarker levels were moderators of treatment response. Eight-week change in both OSI and ROM trended toward mediation of treatment response (OR = 0.00058, 95% CI [0.000, 2.30], = .078 and OR = 0.985, 95% CI [0.968, 1.002], = 0.086, respectively) but did not reach significance. CONCLUSIONS: Eight weeks of multinutrient supplementation in children with ADHD reduced ROM without significant change in antioxidant status, suggesting decrease in oxidative stress. Given the preliminary signals associating a decrease in OS with symptom improvement following multinutrient supplementation, future research is warranted to understand OS in ADHD pathogenesis. CLINICAL TRIAL REGISTRY: NCT03252522.
Examining the Link Between ADHD Symptoms and Menopausal Experiences.
Chapman L, Gupta K, Hunter MS … +1 more , Dommett EJ
J Atten Disord · 2025 Dec · PMID 40738484 · Full text
OBJECTIVES: Interest in the role of female hormones in ADHD has grown in recent years and, with an increasing number of women diagnosed with ADHD later in life, it is important hormonal changes across the lifespan are co...
OBJECTIVES: Interest in the role of female hormones in ADHD has grown in recent years and, with an increasing number of women diagnosed with ADHD later in life, it is important hormonal changes across the lifespan are considered. This exploratory study examines the relationships between ADHD status (diagnosis and medication use) and symptoms, and menopause stage (pre/peri/post) and symptoms. METHODS: Employing a cross-sectional approach, we recruited a sample of 656 women aged 45 to 60 years, of which 245 had an existing diagnosis of ADHD. Women completed several questionnaires assessing their ADHD symptoms (Adult Self-Report Scale, ASRS) and menopausal experiences (Women's Health Questionnaire, WHQ; Menopause-Specific Quality of Life Questionnaire, MENQoL; Hot Flush Rating Scale, HFRS; Hot Flush Related Daily Interference Scale, HFDIS). RESULTS: ANCOVA revealed no significant effects of an ADHD diagnosis or interaction effects between diagnosis and menopause stage after applying an FDR correction. Similarly, when medication was considered (i.e., non-ADHD, ADHD with medication, and ADHD without medication) there were no main effects of group or interaction effects with menopause stage. CONCLUSIONS: These results indicate women with ADHD do not experience greater menopausal complaints than women without at any menopausal stage. However, there were significant correlations between ADHD symptoms and menopausal complaints across all participants but at a group level, these were less prominent in those with ADHD, which could indicate different attribution of symptoms in women with ADHD. Future research should further explore menopause in women with ADHD considering longitudinal designs and qualitative studies to examine potential overlap of symptoms and symptom attribution.
Equity-Centered Development of a Community Health Worker Intervention to Improve Engagement in Care for ADHD.
Spencer AE, Loubeau JK, Sikov J … +16 more , Zolli N, Lejeune J, Baul T, Kobayashi I, Pena K, Vanegas J, Hansen-Erraziqi M, Kim J, Nawreen F, Wong G, Dayal R, Faber-Rico B, Fortuna LR, Borba C, Garg A, Silverstein M
J Atten Disord · 2026 May · PMID 40737052 · Publisher ↗
OBJECTIVE: Barriers to engagement perpetuate inequities in ADHD care for children. Community Health Worker (CHW) interventions could improve treatment engagement and reduce inequities. We describe the development of a no...
OBJECTIVE: Barriers to engagement perpetuate inequities in ADHD care for children. Community Health Worker (CHW) interventions could improve treatment engagement and reduce inequities. We describe the development of a novel, manualized, 5-module CHW intervention for ADHD called START (SupporT for ADHD and Related Treatment) to increase engagement with ADHD care. METHOD: We developed START based on perspectives from racial and ethnic minoritized families with feedback from a community advisory board, and conducted a single arm, adaptive pilot feasibility study of START for primary caregivers of children aged 6 to 12 years with newly diagnosed ADHD. We collected process data, pre- and post-intervention survey data, and qualitative data via caregiver exit interviews. RESULTS: Eighteen families enrolled, 15 completed START, and 16 completed study questionnaires. Median intervention duration was six sessions (IQR = 5-6) over 5 weeks (IQR = 4-8). All caregivers reported satisfaction with the quality of the intervention and materials provided and reported they would recommend START to another caregiver. Most caregivers reported that START made them more likely to consider medications (69%), therapy (75%), and school services (88%) for their ADHD. From pre- to post-intervention, median number of outpatient treatments increased from 1.0 (IQR = 1.5) to 2.0 (IQR = 0.5; = .0034), ADHD knowledge increased ( < .0001), and median scores for 16 of 17 intervention objectives increased ( < .05). CONCLUSION: START showed excellent feasibility and acceptability and treatment utilization increased post-intervention. We refined START based on feedback from caregivers, including enhanced personalization and expanding to six modules, to prepare for testing in a clinical trial.
Pink Noise and a Pure Tone Both Reduce 1/ Neural Noise in Adults With Elevated ADHD Traits: A Critical Appraisal of the Moderate Brain Arousal Model.
Rijmen J, Senoussi M, Wiersema JR
J Atten Disord · 2026 Jan · PMID 40731084 · Publisher ↗
The moderate brain arousal (MBA) model posits that individuals with (elevated traits of) ADHD have lower levels of neural noise and that auditory random noise can elicit stochastic resonance (SR) and increase neural nois...
The moderate brain arousal (MBA) model posits that individuals with (elevated traits of) ADHD have lower levels of neural noise and that auditory random noise can elicit stochastic resonance (SR) and increase neural noise, which improves their cognitive performance. Indeed, research shows that auditory random noise, such as white noise, improves cognitive performance in individuals with (elevated traits of) ADHD. However, the assumptions regarding neural noise in ADHD and the requirement of SR have been insufficiently examined due to a lack of studies incorporating both a second non-random auditory condition and an index of neural noise. Therefore, 69 neurotypical adults completed the ASRS to assess ADHD traits and underwent eyes-closed resting-state EEG, subdivided into three 2-min blocks: silence, continuous auditory pink noise (a random signal), and a continuous 100 Hz pure tone (a non-random signal). We then analyzed the aperiodic slope of the EEG power spectral density, a proposed direct measure of neural noise. Pink noise affected the aperiodic slope differently based on ADHD traits; specifically, it increased the slope in individuals with elevated ADHD traits, indicating a decrease in neural noise. Crucially, the same effect was observed for the pure tone. These findings challenge the MBA model by demonstrating that both random (pink noise) and non-random (pure tone) signals reduce neural noise in individuals with elevated ADHD traits, contradicting the proposed mechanism of stochastic resonance, as well as the direction of effects suggested by the MBA model. These findings warrant further investigation, also in a clinical ADHD sample.
Why Are Individuals With ADHD More Prone to Boredom? Examining Attention Control and Working Memory as Mediators of Boredom in Young Adults With ADHD Traits.
Orban SA, Blessing JS, Sandone MK … +2 more , Conness B, Santer J
J Atten Disord · 2026 Jan · PMID 40730822 · Publisher ↗
OBJECTIVE: Proneness to boredom has been reported in ADHD populations; however, no study to date has examined potential mediators of ADHD-related boredom. The current study investigated whether individuals with ADHD trai...
OBJECTIVE: Proneness to boredom has been reported in ADHD populations; however, no study to date has examined potential mediators of ADHD-related boredom. The current study investigated whether individuals with ADHD traits exhibit higher levels of boredom propensity relative to their peers without ADHD traits and explore if attention control and working memory mediate the relationship between ADHD and proneness to boredom. METHOD: Young adults ( = 19.1, = 1.3) with ( = 31) and without ( = 57) ADHD traits completed self-report measures (i.e., boredom proneness, current ADHD symptoms, and childhood indicators of ADHD) and six counterbalanced performance-based cognitive measures (i.e., three attention control and three working memory tasks). RESULTS: Young adults with ADHD traits exhibited large magnitude effect size differences in proneness to boredom relative to their peers without ADHD traits ( = 2.09). In addition, proneness to boredom and ADHD trait group status were related to worse performance on attention control and working memory factors. Both attention control and working memory factors partially mediated the relation between ADHD and boredom, accounting for 5.8% and 6.4% of the variance in ADHD-related boredom, respectively. CONCLUSION: Executive attention processes related to difficulty controlling attention and using working memory may provide a partial explanation for why individuals with ADHD traits experience boredom.
ADHD in Youth With Major Depressive Disorder in the Texas Youth Depression and Suicide Research Network (TX-YDSRN): Clinical Correlates and Moderators.
Upshaw BM, Spencer SD, Pinciotti CM … +17 more , Zhyrov V, Minhajuddin A, Castillo AA, Abacan A, Slater H, Walker RA, Blader JC, Martin SL, Shahidullah JD, Soares JC, Harper RA, Guerra M, Goodman LC, Goodman WK, Wakefield SM, Trivedi MH, Storch EA
J Atten Disord · 2025 Nov · PMID 40709711 · Full text
OBJECTIVE: Depression is a major public health concern with a 19% lifetime prevalence in youth, often precipitating other concerns, including suicidal behavior, poor school performance, and worsened peer relationships. A...
OBJECTIVE: Depression is a major public health concern with a 19% lifetime prevalence in youth, often precipitating other concerns, including suicidal behavior, poor school performance, and worsened peer relationships. ADHD is also common among youth and frequently presents alongside major depressive disorder (MDD), with this comorbidity associated with increased impairment. More research is needed to elucidate the clinical characteristics of this comorbidity (MDD + ADHD), especially as it relates to youth with MDD and no ADHD (MDD - ADHD). The present study examined the clinical correlates of MDD + ADHD in youth and the presence of an ADHD diagnosis as a moderator of the relationship between depressive symptoms and suicidality, peer relationships, and school functioning, respectively. METHODS: Our sample included 797 youth with MDD ages 8 to 20 years ( = 15.5 years) with and without ADHD. RESULTS: Youth with MDD + ADHD experienced more severe depressive symptoms, higher levels of suicidality, impulsivity, and irritability, and worse academic performance compared to those with MDD - ADHD. ADHD diagnosis did not moderate the relationships between depression severity and suicidality, peer relationships, or school functioning, respectively, suggesting that having an ADHD diagnosis may not affect these outcomes in depressed youth in this way. CONCLUSION: Findings shed light on the impact of ADHD in depressed youth, which may allow for earlier and more tailored intervention efforts aimed at identifying and targeting depression, suicidality, peer relationships, and school functioning.
What Can Adults With ADHD Tell Us About Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda.
Rosenthal EA, Mitchell JT, Weisner TS … +6 more , Silverstein N, Yi C, Arnold LE, Hechtman LT, Hinshaw SP, Jensen PS
J Atten Disord · 2025 Nov · PMID 40685894 · Full text
OBJECTIVES: Although ADHD has its roots in childhood, significant symptoms persist into adulthood for more than half of individuals. Adults with ADHD are heterogeneous in terms of symptom presentations, impairment domain...
OBJECTIVES: Although ADHD has its roots in childhood, significant symptoms persist into adulthood for more than half of individuals. Adults with ADHD are heterogeneous in terms of symptom presentations, impairment domains, and relative strengths. Consequently, it is essential to better understand the diverse self-perceptions and experiences of adults with ADHD; qualitative methods are a valuable complement to quantitative work in this area. Our aim is to provide a scoping review of qualitative studies on adults with ADHD to articulate the current status of the field and establish future research directions. METHOD: We review 41 studies, separating findings into four subpopulations: (1) adults with childhood ADHD, (2) college students with ADHD, (3) adults diagnosed with ADHD in adulthood, and (4) other studies (unspecified age of diagnosis). RESULTS: Qualitative research on all four subgroups identifies recurring themes: substance use, decisions about medication for ADHD, perceived domains of impairment, factors that promote or hinder success, and concerns about identity and stigma. Notably, the relative emphasis of each theme varies as a function of sample type. Specifically, qualitative research among adults with a childhood ADHD diagnosis focuses principally on substance use and treatment desistance, whereas studies of individuals diagnosed with ADHD as adults often examine emotional responses to receiving the diagnosis. For college students with ADHD, themes frequently relate to struggles with the increased independence demanded by post-secondary educational environments and the adoption of accommodations or coping strategies. For future studies of adult ADHD, we highlight key domains for which mixed-methods strategies will be critical: (a) similarities and differences between multiple reporters of functioning, (b) willingness to receive treatment, (c) women, (d) participants from diverse racial and ethnic groups, and (e) middle age and older adults. CONCLUSION: In all, we highlight the value of qualitative and mixed-methods approaches to ensure that research captures the beliefs, intentions, experiences, emotions, and self-perspectives of people with ADHD.
ADHD and Differences in Brain Function as Measured by EEG: Cause or Effect?
Ahn K, Jean J, Norman LJ … +1 more , Shaw P
J Atten Disord · 2025 Oct · PMID 40681989 · Publisher ↗
OBJECTIVES: Although extensive research has documented associations between Attention-Deficit/Hyperactivity Disorder (ADHD) and differences in resting-state electroencephalography (EEG) oscillatory activity, the causal n...
OBJECTIVES: Although extensive research has documented associations between Attention-Deficit/Hyperactivity Disorder (ADHD) and differences in resting-state electroencephalography (EEG) oscillatory activity, the causal nature of these relationships remains uncertain. This study aimed to determine whether there is a causal relationship between resting-state EEG activity and ADHD using genetic methods. METHODS: We performed a bidirectional two-sample Mendelian Randomization analysis using summary-level genome-wide association study data. EEG data were obtained from the ENIGMA-EEG consortium, including resting-state EEG spectral power measurements from 7,983 subjects. ADHD genome-wide association study summary statistics were derived from 225,534 individuals, alongside data for six additional psychiatric disorders from the Psychiatric Genomics Consortium. Mendelian Randomization analysis was used to test for causal relationships in both directions between EEG activity and ADHD. RESULTS: We identified a significant unidirectional causal relationship, with genetic variants influencing resting alpha-band EEG activity conferring risk for ADHD (odds ratio = 0.89, 95% confidence interval [0.82, 0.96], p = 1.52 × 10⁻³). No evidence was found for reverse causation from ADHD liability to alpha EEG power band activity (odds ratio = 1.07, 95% confidence interval [0.88, 1.30], p = .52). CONCLUSIONS: Our findings provide genetic evidence that reduced resting-state alpha power is not merely correlated with ADHD but may causally predispose individuals to developing the disorder. This supports previous observational studies linking lower alpha activity to ADHD and establishes a causal pathway from altered EEG activity to ADHD risk, with important implications for understanding ADHD pathophysiology and potential biomarker development.
What Are the Experiences of Adults With ADHD of Engaging in ADHD Medication Treatment? A Systematic Review and Meta-Ethnography.
Reeves L, Tickle A
J Atten Disord · 2025 Oct · PMID 40665716 · Publisher ↗
BACKGROUND: This review aimed to systematically review and synthesize qualitative evidence of the experiences of adults with ADHD who engage in stimulant medication treatment. A secondary aim was to establish the factors...
BACKGROUND: This review aimed to systematically review and synthesize qualitative evidence of the experiences of adults with ADHD who engage in stimulant medication treatment. A secondary aim was to establish the factors that influence adherence behavior regarding stimulant medication treatment for ADHD and appraise the quality of existing research. METHODS: Psych Info, Academic Search Complete, Embase, and Medline were searched between the 20th and 28th June 2024 for qualitative studies that explored the experiences of adults who had been prescribed stimulant medication for ADHD. A modified Critical Appraisal Skills Programme checklist was used to assess the risk of bias in included studies and a meta-ethnographic approach was used to synthesize the results. RESULTS: Forty-seven second-order constructs were identified from the 13 included papers (263 participants). Four third-order themes were identified: 1. Fitting in with society: Performance. 2. The impact of ADHD versus the side effects of stimulants. 3. Fitting in with society: Social functioning. 4. Difficulty accessing medication and specialist care. Further synthesis of these themes highlighted that access to a specialist doctor who was willing to "tweak" medication and dosage was both a key stimulus that triggered adherence behavior and a factor that influenced other stimuli for adherence behavior. DISCUSSION: Adults consistently found ADHD medications to be effective at reducing symptoms of ADHD, but their experience of taking the medications varied greatly due to the range of social, psychological, and physical side effects that could occur. All participants spoke about their experiences of taking ADHD medications in the context of "fitting in" with society: Being able to perform academically and in the workplace, as well as being able to meet familial and friendship obligations. However, "fitting in" could be both a motivation for adherence and non-adherence to medication. Societal perceptions and stigma around ADHD and ADHD medications was also discussed as important context regarding "fitting in" and medication adherence. When the results were viewed through the lens of the Health Belief Model, it was highlighted that the four themes identified could be considered stimuli for adherence behavior. A potential methodical limitation of the review was the weighted synthesis approach, which prevented themes being generated from lower quality, less relevant studies. However this approach could also be considered a strength.
Attention Problems in Childhood and Subsequent Health Risk Behaviors in Adolescence.
Casseus M, Corman H, Noonan K … +1 more , Reichman NE
J Atten Disord · 2025 Oct · PMID 40657682 · Full text
OBJECTIVE: This study used a large U.S. population-based dataset to examine associations between childhood attention problems and adolescent substance use, sexual risk behavior, and delinquency. METHODS: This prospective...
OBJECTIVE: This study used a large U.S. population-based dataset to examine associations between childhood attention problems and adolescent substance use, sexual risk behavior, and delinquency. METHODS: This prospective cohort study used data from the Future of Families and Child Wellbeing Study ( = 2,716). Bivariate statistics, multivariable logistic regression, and negative binomial models assessed associations between attention problems at age 9 years and subsequent use of cigarettes, alcohol, and marijuana, engagement in sex without a condom, and delinquency at age 15 years. RESULTS: Nearly one-fifth (18.3%) of adolescents had elevated scores (more than 1 standard deviation above the sample mean) for attention problems at age 9 years. Adolescents with elevated attention problem scores in childhood were more likely than adolescents who did not have elevated scores to have ever smoked an entire cigarette (9% vs. 4%) and ever tried marijuana (24% vs. 20%). Elevated attention problem scores were associated with higher odds of ever having smoked an entire cigarette (adjusted odds ratio [AOR] = 2.06, 95% CI [1.39, 3.05], < .01) and higher delinquent behavior scores (incidence rate ratio [IRR] = 1.30, 95% CI [1.11, 1.53], < .01). In adjusted models, there were no significant associations between elevated attention problem scores and ever having tried marijuana, consumed alcohol, or engaged in unprotected sex. CONCLUSIONS: This study found that elevated attention problem scores in childhood were associated with higher risk of cigarette smoking and delinquent behaviors in adolescence. Results provide support for screening for attention problems among elementary school-age children and early intervention strategies to prevent health risk behaviors in adolescence.
Work and Occupational Performance in ADHD (WOPA): Initial Validation of an ADHD Work Performance Measure in a Large Community Sample.
Fuermaier ABM, Guo N, Steggemann C … +2 more , Tucha O, Keller AC
J Atten Disord · 2025 Nov · PMID 40657677 · Publisher ↗
OBJECTIVES: Work performance is a critical aspect of daily living, significantly impacted by the characteristics of ADHD. However, current research lacks sophisticated, theoretically, and empirically supported instrument...
OBJECTIVES: Work performance is a critical aspect of daily living, significantly impacted by the characteristics of ADHD. However, current research lacks sophisticated, theoretically, and empirically supported instruments for assessing work performance in this context. Therefore, this study aimed to develop a comprehensive and psychometrically sound self-report instrument for assessing the work performance of adults with ADHD and related disorders. METHODS: An initial set of 40 work performance items was developed based on a multifactorial model, various preexisting questionnaires, and input from an interdisciplinary working group. Extensive psychometric analyses were conducted on a community sample of 714 participants engaged in paid work for at least 9 hr a week, randomly split into two subsamples. RESULTS: Confirmatory factor analyses (CFA) validated the 7-factor structure of the work performance scale. The initial set of items was reduced by 10 based on internal consistency and item redundancy, resulting in a final set of 30 items which we called Work and Occupational Performance in ADHD (WOPA). The WOPA was further evaluated for floor and ceiling effects, internal consistency, and item-rest correlation. Additionally, associations of work performance were examined concerning work characteristics, ADHD symptom severity, indicators of functional impairments, executive function deficits, and internal emotional states. DISCUSSION: The 30-item WOPA was developed based on empirically informed models, clinical considerations, and robust psychometric foundations. Subsequent clinical application is necessary to demonstrate its utility in clinical practice.
The Long-Term Impact of ADHD on Children and Adolescents' Health-Related Quality of Life: Results From a Longitudinal Population-Based Australian Study.
Le HND, Keily C, Coghill D … +1 more , Gold L
J Atten Disord · 2025 Dec · PMID 40657667 · Full text
BACKGROUND: ADHD is the most common neurodevelopmental disorder. While much is known about the functional and academic impacts of ADHD, impacts on long-term health-related quality of life (HRQoL) are less well-documented...
BACKGROUND: ADHD is the most common neurodevelopmental disorder. While much is known about the functional and academic impacts of ADHD, impacts on long-term health-related quality of life (HRQoL) are less well-documented. AIMS: To explore, in children aged 4 to 17 years, associations between clinical ADHD symptoms and (1) children's HRQoL; (2) whether internalizing or externalizing problems attenuate this association; and (3) factors contributing to this association. METHODS: Data were drawn from the Longitudinal Study of Australian Children at child ages 4 to 17 years ( = 4,194). Clinical ADHD symptoms (e.g., score >8) were measured using the hyperactivity scale from the Strengths and Difficulties Questionnaire (SDQ). Internalizing or externalizing problems were classified as children with scores ≥5 on the Emotional Problems and scores ≥4 on the Conduct Problems scale on the SDQ, respectively. Children's HRQoL was measured using the Pediatric Quality of Life Inventory (PedsQL). Linear mixed models were used, adjusting for child and family factors. RESULTS: Compared to those with no ADHD symptoms, children with ADHD symptoms had significantly lower HRQoL across all domains from 4 to 17 years (mean difference = 7.65, 95% CI [6.09, 9.19]). Internalizing and externalizing problems slightly attenuated the association between ADHD symptoms and children's HRQoL (mean difference = 4.91, 95% CI [3.40, 6.43]). Being a female or having autism or other medical conditions, or taking ADHD/ADD medication or caregiver having mental health problems was associated with poorer HRQoL while having two or more siblings was associated with better HRQoL. CONCLUSION: ADHD clinical symptoms are associated with poorer children's HRQoL from 4 to 17 years. Given that co-occurring medical conditions and poor caregiver mental health are associated with poorer child HRQoL, ADHD treatment needs to identify and address co-occurring conditions and parental mental health.
Correlates of Functional Impairment in Adolescents with ADHD: Delineating the Relationship Between Cognitive Disengagement Syndrome and Dissociation.
Meral Y, Gökler ME, Albayrak ZS … +4 more , Kırışman Keleş H, Serdengeçti N, Seçen Yazıcı M, Tarakçıoğlu MC
J Atten Disord · 2025 Sep · PMID 40600507 · Publisher ↗
OBJECTIVE: There is substantial evidence supporting the distinction between cognitive disengagement syndrome (CDS) and attention-deficit/hyperactivity disorder (ADHD), particularly from the inattentive subtype. However,...
OBJECTIVE: There is substantial evidence supporting the distinction between cognitive disengagement syndrome (CDS) and attention-deficit/hyperactivity disorder (ADHD), particularly from the inattentive subtype. However, despite proposed etiological and phenomenological similarities, the relationship between CDS and dissociation remains underexplored. This study investigates the relationship between CDS and dissociation and evaluates their combined impact on functional impairment while accounting for comorbid internalizing and externalizing problems in adolescents with ADHD. METHOD: A total of 103 adolescents with ADHD (aged 11-17, = 14.15, = 1.71) and their parents participated in this multicenter, cross-sectional study. ADHD diagnosis was established using the Best Estimate Clinical Diagnosis method. Standardized assessments included the Adolescent Dissociative Experiences Scale (A-DES) and the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) for self-report, while parents completed the modified version of Sluggish Cognitive Tempo Scale (SCT-S), Strengths and Difficulties Questionnaire-Parent Form (SDQ-P), and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P). RESULTS: No significant correlations were observed between the parent-reported CDS Modified Total and the adolescent-reported A-DES Total score ( = -.024, = .811), or any of its subdomains, after controlling for anxiety symptoms. Regression analyses revealed that CDS Modified Total (β = .0121, = .032), and A-DES Absorption & Imaginative Involvement (β = .0085, = .042) were independent predictors of parent-reported functional impairment along with SDQ-P Emotional Symptoms (β = .0399, = .040), SDQ-P Conduct Problems (β = .0752, < .001), RCADS-CV Separation Anxiety Disorder (β = .0245, = .017). The dominance analysis indicated that the parent-reported SDQ Conduct Problems subscale had the highest average contribution ( = 0.1625) while the parent-reported CDS Modified Total demonstrated the lowest average contribution across models ( = 0.0498). CONCLUSION: The findings suggest that CDS and dissociation represent distinct constructs, at least when rated by different informants, and that both may have significant and independent contributions to functional impairment in adolescents with ADHD. These results highlight the need to consider a broader range of contributing factors beyond symptom severity alone for the effective management of ADHD.
Influence of National Traumatic Events on Inattention and Hyperactivity/Impulsivity Symptoms in Young Adults With and Without ADHD.
Erdinast T, Katabi G, Weizman A … +2 more , Manor I, Shahar N
J Atten Disord · 2025 Sep · PMID 40586359 · Full text
OBJECTIVE: Previous studies indicate that national traumatic events, particularly terror attacks, have a broad impact on the general population, including individuals not directly exposed. However, research on how such e...
OBJECTIVE: Previous studies indicate that national traumatic events, particularly terror attacks, have a broad impact on the general population, including individuals not directly exposed. However, research on how such events affect inattention and hyperactivity/impulsivity symptoms in individuals with ADHD remains limited. METHOD: This study examined the impact of the October 7 terror attack in Israel on ADHD-related symptoms. Young adults with and without ADHD (43 ADHD and 42 control) completed assessments of current and childhood ADHD symptoms, as well as anxiety, at two time-points: before and after the national traumatic event. Participants also reported their level of exposure to the October 7 attack and the subsequent war. RESULTS: The control group showed a substantial increase in inattention and hyperactivity/impulsivity symptoms after the attack, whereas the ADHD group exhibited no such increase and instead showed a slight reduction in symptom severity. Changes in symptoms in both groups were not influenced by direct exposure to an immediate threat. The increase in symptom severity tended to decline over time and was positively correlated with heightened anxiety symptoms. CONCLUSION: These results suggest that national traumatic events can temporarily increase inattention and hyperactivity/impulsivity symptoms among young adults without an ADHD diagnosis, even if they were not directly exposed to the events. This increase tends to return to baseline over time. Conversely, individuals diagnosed with ADHD did not experience a worsening of symptoms and instead showed a slight reduction in severity, particularly in inattention, following the traumatic event. Future research should further explore the functional capabilities of individuals with ADHD under acute stress to deepen the understanding of this relationship.
The Conversations of Children With ADHD: Structural and Pragmatic Language Use in Children With and Without ADHD.
Samniya H, Taylor S, Tatsuki MO … +1 more , Tripp G
J Atten Disord · 2025 Aug · PMID 40577344 · Publisher ↗
OBJECTIVES: Children with ADHD obtain lower scores than their peers on standardized language measures but less is known about their conversational language skills. We tested the ability of children with and without ADHD...
OBJECTIVES: Children with ADHD obtain lower scores than their peers on standardized language measures but less is known about their conversational language skills. We tested the ability of children with and without ADHD to monitor and repair their language during a conversation (social discourse) with a young adult. METHODS: Forty-nine 9- to 14-year-old children previously diagnosed with ADHD (17 in partial remission) and an age and sex-matched sample of typically developing (TD) children engaged in a conversation with a young adult. Their conversations were recorded, transcribed, and coded for structural and pragmatic language use. Language error and correction rates were compared across the two groups, for the whole sample and for those meeting full criteria for ADHD. RESULTS: The ADHD group made significantly more structural language errors, specifically morphosyntactic mistakes and word repetitions. In their pragmatic language use, children with ADHD were more likely to make unrelated utterances and were less successful in repairing dysfluent responses. The adult conversational partners made more attempts to keep TD participants engaged in conversation and rated them as more likable. CONCLUSIONS: Subtle differences were identified in the structural and pragmatic language use of children with and without ADHD during social discourse. Conversation partners were more engaged in their interactions with TD children and appeared to experience these interactions more positively. The language skills of children with ADHD, including their conversation skills, should be monitored and considered as targets for intervention.
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