Understanding ADHD with context | Mental Health Update

This excerpt explores the influence of work on young adults’ ADHD symptoms through interviews.

So, how does work environment play a role in understanding the realities of having ADHD?

More than half of adults with attention deficit hyperactivity disorder (ADHD) find their symptoms change depending on their environment according to new findings of young adults with the diagnosis.

• Subjects view ADHD symptoms as context-dependent, improving in stimulating jobs.
• Subjects desired highly-stimulating work environments.
• Subjects experience ADHD as an interaction between themselves and their environment.
• Context is important in our understanding and treatment of ADHD.
• Does changing context play a role in the decline in ADHD symptoms in adulthood?

Insufficient research has explored the functioning of adults with ADHD. As adults, individuals with ADHD have significantly more latitude to control aspects of their day-to-day environments.

Does having a new context for ADHD in young adults alter their experience?

Are there particular occupational or educational contexts in which young adults report functioning better than others?

To examine this issue, we conducted semi-structured interviews at four North American sites in 2010–11 with 125 young adults, originally diagnosed with ADHD as children, regarding their work and post-secondary educational environments.

The participants, 90% white and 24% women, enrolled in a longitudinal study between ages 7-9, and follow-up occurred at 2-year intervals up to 16 years after enrollment.

• Many subjects describe their symptoms as context-dependent. In some contexts, participants report feeling better able to focus; in others, their symptoms—such as high energy levels—become strengths rather than liabilities.

Modal descriptions included tasks that were stressful and challenging, novel and required multitasking, busy and fast-paced, physically demanding or hands-on, and/or intrinsically interesting.

Consistent with a developmental psychopathology framework, ADHD is experienced as arising from an interaction between our subjects and their environments.

These findings demonstrate the need to account for the role of context in our understanding of ADHD as a psychiatric disorder, especially as it manifests in young adulthood.

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