Abstract
Adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) commonly experience impairments in multiple domains of daily living. Work has a central role in daily life and is susceptible to ADHD due to its cognitive demands. The present study seeks to examine the nature of work-related problems and impairments of adults with ADHD, and explores the association to ADHD symptoms and neuropsychological test performance. A community sample of 1231 individuals took part in this study and completed a set of questionnaires assessing ADHD symptoms and work-related problems. Furthermore, a clinical sample of 134 adults diagnosed with ADHD were recruited from an ADHD outpatient clinic, who completed the same set of questionnaires. A subsample of 51 patients with ADHD additionally performed a neuropsychological assessment using tests of attention and executive functions. Work-related problems were found both in individuals of the community sample with symptoms of ADHD and individuals diagnosed with ADHD. Individuals with ADHD reported work related problems particularly in not meeting their own standards and perceived potential, yet it less commonly manifests in negative performance evaluations at work or job loss. ADHD symptoms, in particular symptoms of inattention, were found to be strongly associated with work-related problems, whereas neuropsychological test performance was no meaningful predictor of functioning at work. This study emphasizes the susceptibility of individuals’ functioning at work to ADHD symptoms and impairments associated with ADHD. ADHD related difficulties at work should be considered in the clinical evaluation and targeted screening at the work place to provide support when indicated.
Highlights
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental childhood disorder that persists into adulthood in a sizable number of patients and affects about 1.2–7.3% of adults world-wide (American Psychiatric Association 2013; Fayyad et al 2007)
This study aims to disentangle the role of attention-deficit/hyperactivity disorder (ADHD) symptoms for work-related problems by examining a large community sample (n > 1200) with no established diagnoses of ADHD as well as a clinical sample of individuals diagnosed with ADHD from an ADHD outpatient clinic
A larger variation in work-related problems was observed in individuals diagnosed with ADHD, with 20 to 23% of patients with ADHD reporting impairments in items #5 (“getting fired from work”), #7 (“problems with your attendance”), and #11 (“poor performance evaluations”), whereas up to 55 to 69% of patients with ADHD reported impairments in items #2 (“problems with getting your work done efficiently”) and #10 (“problems working to your potential”)
Summary
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental childhood disorder that persists into adulthood in a sizable number of patients and affects about 1.2–7.3% of adults world-wide (American Psychiatric Association 2013; Fayyad et al 2007). Impairments in educational achievement and occupational performance seem to be likely in ADHD due to the relatively high cognitive demands of many aspects of education and at the work place (Barkley and Murphy 2010). Cross-sectional and longitudinal research revealed that work performance is impaired in individuals with ADHD as compared to typically developing individuals. It has been shown that individuals with ADHD perform more poorly at work and quit (200% increase in risk), or have been fired from their job (66% increase in risk) more often than typically developing individuals (Murphy and Barkley 1996; Kessler et al 2005). Longitudinal research demonstrated that ADHD in adolescence is associated with lower work performance more than 10 years later in adulthood (Brook et al 2013). In a consensus report, Adamou et al (2013) noted that adults with ADHD experience impairments in all aspects related to employment, ranging from the initial job search, the interview and in employment itself
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