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What Can Adults with ADHD Tell Us about Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda

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Title: What Can Adults with ADHD Tell Us about Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda
Language: English
Authors: Emily A. Rosenthal (ORCID 0000-0001-9296-7427), John T. Mitchell (ORCID 0000-0002-9586-3823), Thomas S. Weisner, Natalie Silverstein, Christopher Yi, L. Eugene Arnold, Lily T. Hechtman, Stephen P. Hinshaw (ORCID 0000-0001-6497-1082), Peter S. Jensen (ORCID 0000-0003-2387-0650)
Source: Journal of Attention Disorders. 2025 29(13):1190-1212.
Availability: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
Peer Reviewed: Y
Page Count: 23
Publication Date: 2025
Document Type: Journal Articles
Information Analyses
Education Level: Higher Education
Postsecondary Education
Descriptors: Adults, Attention Deficit Hyperactivity Disorder, Qualitative Research, Research Methodology, Research Needs, Substance Abuse, Drug Therapy, Severity (of Disability), Self Concept, Social Bias, Emotional Response, Clinical Diagnosis, College Students, Coping, Academic Accommodations (Disabilities), Females, Minority Groups, Older Adults, Early Experience
DOI: 10.1177/10870547251352589
ISSN: 1087-0547
1557-1246
Abstract: 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.
Abstractor: As Provided
Entry Date: 2025
Accession Number: EJ1485155
Database: ERIC
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  Value: <anid>AN0188320983;gs001nov.25;2025Oct01.06:51;v2.2.500</anid> <title id="AN0188320983-1">What Can Adults With ADHD Tell Us About Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda </title> <p>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: (<reflink idref="bib1" id="ref1">1</reflink>) adults with childhood ADHD, (<reflink idref="bib2" id="ref2">2</reflink>) college students with ADHD, (<reflink idref="bib3" id="ref3">3</reflink>) adults diagnosed with ADHD in adulthood, and (<reflink idref="bib4" id="ref4">4</reflink>) 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.</p> <p>Keywords: qualitative research; adults; ADHD</p> <hd id="AN0188320983-2">Introduction</hd> <p>ADHD is a neurodevelopmental condition characterized by developmentally atypical levels of inattention and/or hyperactivity-impulsivity contributing to limitations and impairments in multiple settings ([<reflink idref="bib1" id="ref5">1</reflink>]). Although ADHD begins in childhood, (a) many girls and women are not recognized and diagnosed until later in development (e.g., [<reflink idref="bib24" id="ref6">24</reflink>]) and (b) the majority of affected individuals continue to experience elevated and impairing levels of symptoms into adulthood ([<reflink idref="bib64" id="ref7">64</reflink>]). Many do not continue treatment as adults ([<reflink idref="bib72" id="ref8">72</reflink>]) and experience poorer educational, occupational, emotional, and substance-use outcomes than those without the disorder ([<reflink idref="bib21" id="ref9">21</reflink>]). Adult interpersonal and romantic relationships are also often areas of challenge for those with ADHD ([<reflink idref="bib45" id="ref10">45</reflink>]; [<reflink idref="bib56" id="ref11">56</reflink>]; [<reflink idref="bib79" id="ref12">79</reflink>]).</p> <p>This knowledge has emanated largely from quantitative research. Indeed, <emph>quantitative</emph> research into the cognitive, academic, and social functioning of individuals with ADHD has been foundational to the field. At the same time, complementary methods utilizing a <emph>qualitative</emph> approach, which features analysis of open-ended responses to provide contextual understanding of respondents' experiences, may allow for new insights into salient areas not identified or expanded upon by existing quantitative measures. Qualitative and quantitative methods each have unique limitations and strengths ([<reflink idref="bib76" id="ref13">76</reflink>], [<reflink idref="bib77" id="ref14">77</reflink>]), and both can enrich our understanding of ADHD in adulthood. For instance, in addition to the potential under-reporting of "stigmatized" behaviors, such as substance use, in quantitative relative to qualitative reports (e.g., [<reflink idref="bib78" id="ref15">78</reflink>]), qualitative methods can capture and expand upon the phenomenological experience of living with ADHD. Idiographic narrative accounts provided by participants in qualitative interviews can provide a personal story that can aid understanding of their behaviors and thoughts. A qualitative approach to understanding such experiences can inform theoretical frameworks surrounding adults with ADHD that can then be tested using quantitative methods, ensuring that findings are more clinically meaningful than if either approach is used in isolation ([<reflink idref="bib77" id="ref16">77</reflink>]).</p> <p>The social model of disability argues that impairment is related to a mismatch between individual differences (e.g., developmentally atypical levels of ADHD symptoms) and the sociocultural or environmental contexts in which individuals reside ([<reflink idref="bib9" id="ref17">9</reflink>]). As such, a purely deficit-focused approach to ADHD is incomplete: the contexts and situations in which the individual functions must also be appreciated, as well as how these individuals understand and perceive these environments. Indeed, a symptom that is problematic in one context may be innocuous in another (e.g., [<reflink idref="bib49" id="ref18">49</reflink>]). For instance, some individuals with ADHD report that symptoms are not impairing if they are in environments that "fit with" their proclivities or interests (e.g., [<reflink idref="bib33" id="ref19">33</reflink>]). For related perspectives, the growing neurodiversity movement has provided important insights ([<reflink idref="bib19" id="ref20">19</reflink>]; [<reflink idref="bib29" id="ref21">29</reflink>]; [<reflink idref="bib68" id="ref22">68</reflink>]).</p> <p>For adults with a childhood diagnosis of ADHD, conceptualization of the diagnosis and descriptions of the disorder as part of who they are may change over time. For example, some adults may report that they no longer have ADHD; others may report that it is just part of their personality or is still there but manageable. For these and other reasons, many adults with childhood-diagnosed ADHD do not persist in seeking out services, at least in early adulthood ([<reflink idref="bib72" id="ref23">72</reflink>]). Although adoption of qualitative or mixed-methods approaches has occurred for questions related to self-perceptions of symptoms, impairment, and treatment in youth with ADHD and their parents (see [<reflink idref="bib54" id="ref24">54</reflink>] for a review), such research approaches among <emph>adults</emph> with ADHD are underutilized, and a critical review of the extant literature is needed to highlight important areas for future inquiry.</p> <p>A rapid review by [<reflink idref="bib16" id="ref25">16</reflink>] summarized existing qualitative literature on adults with ADHD and highlighted recurrent themes, including being diagnosed as an adult, ADHD symptoms and adaptations to such symptoms, substance use, interactions with society, and perceptions of the self and one's diagnosis ([<reflink idref="bib16" id="ref26">16</reflink>]). <emph>Extending this work, we aim to discuss the current state of qualitative literature on adults with ADHD, focusing on the diverse and heterogeneous lived experiences of adults with ADHD</emph> (e.g., adults diagnosed with ADHD in childhood, college students with ADHD, and adults first diagnosed in adulthood) <emph>and with an eye toward important directions for future research</emph>. Regarding the former, ADHD in adults is characterized by extreme heterogeneity in symptom presentation and associated impairment (e.g., [<reflink idref="bib39" id="ref27">39</reflink>]; [<reflink idref="bib64" id="ref28">64</reflink>]). For example, the strengths, coping strategies, and experiences of college-enrolled young adults with ADHD may not be representative of those with ADHD not enrolled in post-secondary school (e.g., [<reflink idref="bib28" id="ref29">28</reflink>]). Although it is crucial to understand why individuals with ADHD who attend college often perform more poorly than their peers academically ([<reflink idref="bib52" id="ref30">52</reflink>]), such information may not translate well to individuals with ADHD who are struggling in the workforce. Additionally, adult symptom severity/impairment, self-construals, and coping strategies may differ considerably between those first diagnosed in childhood versus adulthood. For instance, those with childhood-diagnosed ADHD may no longer have clinically significant symptoms as adults—or may continue to struggle with ADHD-related impairment ([<reflink idref="bib64" id="ref31">64</reflink>]). In contrast, those recently diagnosed with ADHD as adults are highly likely to endorse clinically significant symptoms. Unfortunately, previous reviews of the qualitative literature on ADHD do not parse the unique perspectives and experiences of these distinct subsets of adults with ADHD (e.g., [<reflink idref="bib16" id="ref32">16</reflink>]).</p> <p>In sum, to better understand and contextualize the unique phenomenological and lived experiences of diverse adults with ADHD, we separately review qualitative findings from four subgroups: (<reflink idref="bib1" id="ref33">1</reflink>) adults with a childhood diagnosis of ADHD, (<reflink idref="bib2" id="ref34">2</reflink>) college students with ADHD (some but not all of whom were diagnosed in childhood or adolescence), (<reflink idref="bib3" id="ref35">3</reflink>) adults diagnosed with ADHD in adulthood, and (<reflink idref="bib4" id="ref36">4</reflink>) other samples for which age of diagnosis is not specified. We argue that heightened understanding of adult ADHD requires pluralistic methods and diverse samples to reflect the heterogeneity of the disorder.</p> <hd id="AN0188320983-3">Methods</hd> <p>PsycInfo, Google Scholar, Web of Science, and AnthroSource were searched to identify relevant qualitative articles. Abstracts were searched for the following terms: (ADHD OR attention deficit* OR hyperactiv* OR inattent*) AND (Qualitative* OR elicitation OR entification* OR phenomenography OR discourse* OR grounded theory* OR identity OR theme* OR thematic* OR focus group* OR Dedoose OR invivo OR LIWC OR atlas). Results were refined to include only articles that were human studies, peer-reviewed, and available in English. Titles were scanned for relevance; subsequently, we scanned abstracts. Excluded were articles on children or adolescents (age < 18 years), those that focused on ADHD symptoms (but <emph>not</emph> a diagnosis), those that did not focus on ADHD, those on perspectives other than adults with ADHD (e.g., only parents or teachers), those focusing the impact of a specific pharmacological or nonpharmacological intervention, case studies, reviews, and studies without qualitative components. References cited by relevant empirical and review articles of qualitative research on adults with ADHD were also considered to ensure a comprehensive representation of the literature.</p> <p>Ultimately, we identified 41 relevant empirical articles. Five discussed qualitative findings from adults with ADHD who were diagnosed in childhood, 9 had samples of college students with ADHD, 11 explored perspectives of adults who were diagnosed with ADHD in adulthood, and 16 articles either did not specify or had mixed ages of diagnosis. Thirteen used some degree of mixed qualitative and quantitative methods. Twenty-seven studies based findings upon information gathered during individual semi-structured interviews. Among the remainder, nine had other or unspecified types of interviews, three utilized focus groups, one utilized both focus groups and individual semi-structured interviews, and two used some other method to obtain qualitative perspectives (see Table 1).</p> <p>Table 1. Characteristics of Qualitative Studies of Adults With ADHD Included in the Review.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /><col align="char" char="." /></colgroup><thead><tr><th align="left">Study and country</th><th align="center"><italic>N</italic></th><th align="center">Demographics</th><th align="center">Qualitative methods</th><th align="center">Diagnosis</th><th align="center">Focus/major conclusions</th></tr></thead><tbody><tr><td colspan="6">Adults with childhood-diagnosed ADHD</td></tr><tr><td><xref ref-type="bibr" rid="bibr30">Jensen et al. (2018)</xref><xref ref-type="table-fn" rid="tfn4">a</xref><bold>Country:</bold> United States</td><td>30</td><td><bold>Sex (% Female):</bold> 20%<bold>Age (Mean):</bold> 24.9 years<bold>Race/Ethnicity:</bold> –<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Childhood diagnosis based on impairment and parent- and teacher-reported symptoms<xref ref-type="table-fn" rid="tfn5">b</xref><bold>When:</bold> Age 7.0–9.9 years</td><td>Reasons for and precipitants of SU; role of turning points and role models for abstainers, persistent substance users, and desistent substance users with and without ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr33">Lasky et al. (2016)</xref><xref ref-type="table-fn" rid="tfn4">a</xref><bold>Country:</bold> United States</td><td>125</td><td><bold>Sex (% Female):</bold> 24%<bold>Age (Mean):</bold> 24.4 years (<italic>SD</italic> = 1.17)<bold>Race/Ethnicity:</bold> 72% White, 10% African American, 12% Mixed, 6% Other<bold>Education:</bold> 54% ≤ high school; 31% some college or associates/technical degree; 13% bachelor's degree; 2% graduate degree</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Childhood diagnosis based on impairment and parent- and teacher-reported symptoms<xref ref-type="table-fn" rid="tfn5">b</xref><bold>When:</bold> Age 7.0–9.9 years</td><td>Impact of ADHD in the workplace/school as well as environments that promote positive or negative functioning. Discussed the context-dependence of ADHD symptoms and impairment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr44">Mitchell et al. (2018)</xref><xref ref-type="table-fn" rid="tfn4">a</xref><bold>Country:</bold> United States</td><td>70</td><td><bold>Sex (% Female):</bold> 26%<bold>Age (Mean):</bold> 24.4 years (<italic>SD</italic> = 1.8)<bold>Race/Ethnicity:</bold> 77% White, 10% Black, 10% Mixed, 3% Other<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Childhood diagnosis based on impairment and parent- and teacher-reported symptoms<xref ref-type="table-fn" rid="tfn5">b</xref><bold>When:</bold> Age 7.0–9.9 years</td><td>Emotion-related motivations for and perceptions/consequences of SU for persistent and non-persistent substance users with and without ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr73">Swanson et al. (2018)</xref><xref ref-type="table-fn" rid="tfn4">a</xref><bold>Country:</bold> United States</td><td>125</td><td><bold>Sex (% Female):</bold> 23.4%<bold>Age (Range):</bold> 21.1–25.3 years<bold>Race/Ethnicity:</bold> 27.4% non-White<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Childhood diagnosis based on impairment and parent- and teacher-reported symptoms<xref ref-type="table-fn" rid="tfn5">b</xref><bold>When:</bold> Age 7.0–9.9 years</td><td>Motivations for using alcohol, marijuana, and other drugs; differences between persistent and non-persistent substance users with and without ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr78">Weisner et al. (2018)</xref><xref ref-type="table-fn" rid="tfn4">a</xref><bold>Country:</bold> United States</td><td>125</td><td><bold>Sex (% Female):</bold> 24%<bold>Age (Mean):</bold> 24.4 years (<italic>SD</italic> = 1.2)<bold>Race/Ethnicity:</bold> 72% White, 10% African American, 1% Asian, 12% Mixed Race, 4% Non-Black Hispanic, 2% Other<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Childhood diagnosis based on impairment and parent- and teacher-reported symptoms<xref ref-type="table-fn" rid="tfn5">b</xref><bold>When:</bold> Age 7.0–9.9 years</td><td>Reasons for SU persistence or desistence and perceived relation between ADHD, ADHD medication, and SU.</td></tr><tr><td colspan="6">College students with ADHD</td></tr><tr><td><xref ref-type="bibr" rid="bibr18">Goffer et al. (2022)</xref><bold>Country</bold>: Israel</td><td>20</td><td><bold>Sex (% Female):</bold> 65%<bold>Age (Mean):</bold> 25.3 years (<italic>SD</italic> = 3.7, Range = 20–32)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 100% in college</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Reported receiving an ADHD diagnosis from a neurologist or psychiatrist; confirmed via self-reported ASRS<bold>When: —</bold></td><td>Experiences of college students with ADHD in work, academics, leisure, and activities of daily living; impairment and factors that promoted or impeded success in these areas.</td></tr><tr><td><xref ref-type="bibr" rid="bibr34">Lefler et al. (2016)</xref><bold>Country:</bold> United States</td><td>36</td><td><bold>Sex (% Female):</bold> 33.3%<bold>Age (Mean):</bold> 21.8 years (<italic>SD</italic> = 4.6, Range = 18–39)<bold>Race/Ethnicity:</bold> 88.9% Caucasian<bold>Education:</bold> 100% in college (94.4% undergraduate, 5.5% graduate)</td><td>Focus group interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Prior ADHD diagnosis (50% by doctoral-level psychologist; 36% by physician; 13.9% by other); clinically significant ADHD symptoms (BAARS-IV)<bold>When:</bold> 5.5 years (average) pre-study</td><td>College students with ADHD's perceived consequences of the diagnosis, impairment (including academically), and management of ADHD/treatment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr37">Loe and Cuttino (2008)</xref><bold>Country:</bold> United States</td><td>16</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Mean):</bold> 20.8 years (Range = 19–22)<bold>Race/Ethnicity:</bold> 100% White<bold>Education:</bold> 100% in college</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Diagnosed with ADHD and prescribed treatment in the form of prescription stimulants at some point in their lives"<bold>When:</bold> —</td><td>Self-perceptions of college students with ADHD who were prescribed medication; identity, attitudes, and behavior related to medication use.</td></tr><tr><td><xref ref-type="bibr" rid="bibr42">Meaux et al. (2009)</xref><bold>Country:</bold> United States</td><td>15</td><td><bold>Sex (% Female):</bold> 40%<bold>Age (Range):</bold> 18–21 years<bold>Race/Ethnicity:</bold> 87% Caucasian, 6.7% African American, 6.7% Hispanic<bold>Education:</bold> 100% in college</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Self-reported ADHD diagnosis prior to high school; self-reported CAARS score indicating persistent symptoms<bold>When:</bold> Prior to high school</td><td>Factors that promote or prevent success (e.g., in academics, activities of daily living, etc.) during the transition to college for students with ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr43">Meaux et al. (2006)</xref><bold>Country:</bold> United States</td><td>15</td><td><bold>Sex (% Female):</bold> 40%<bold>Age (Range):</bold> 18–21 years<bold>Race/Ethnicity:</bold> 86.7% Caucasian, 6.7% Black, 6.7% Hispanic<bold>Education:</bold> 100% in college</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Self-reported ADHD diagnosis prior to high school; self-reported CAARS score indicating persistent symptoms<bold>When:</bold> 87% elementary school; 13% seventh to ninth grade</td><td>Historical experiences, benefits/side effects, and decisions about use, non-use, or misuse of stimulants among college students with ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr57">Schaefer et al. (2017)</xref><bold>Country:</bold> United States</td><td>10</td><td><bold>Sex (% Female):</bold> 30%<bold>Age (Mean):</bold> 19 years (<italic>SD</italic> = 0.5)<bold>Race/Ethnicity:</bold> 80% Caucasian, 20% African American<bold>Education:</bold> 100% in college</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Reported prior ADHD diagnosis; current prescription for ADHD medication<bold>When:</bold> Adolescence (<italic>M</italic> = 15.7 years)</td><td>College freshmen with ADHD who were prescribed medication discussed their experiences with medication, including the transition to independent ADHD management and reasons for adherence or non-adherence.</td></tr><tr><td><xref ref-type="bibr" rid="bibr67">Sibley and Yeguez (2018)</xref><bold>Country:</bold> United States</td><td>13</td><td><bold>Sex (% Female):</bold> 42.9%<bold>Age (Mean):</bold> 19.7 years (<italic>SD</italic> = 1, Range = 18–21)<bold>Race/Ethnicity:</bold> 21.4% Non-Hispanic White, 64.3% Hispanic (any race), 14.3% Mixed/Other<bold>Education:</bold> 21.4% not enrolled, 14.3% completing high school credits, 42.9% enrolled in community college, 21.4% enrolled at university</td><td>Interview, implemented constructivist skills<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Diagnosed with ADHD at a university clinic in adolescence. Met DSM-IV-TR diagnostic criteria per the DISC and parent- and teacher-reported symptoms and impairment (DBDRS and IRS); confirmed by a clinical psychologist. Persistence assessed using the DSM-5 ADHD Rating Scale.<bold>When:</bold> Ages 11–15 years</td><td>Described motivational, skills-related, and environmental factors that helped or impeded the post-secondary transition according to young adults with ADHD and their parents.</td></tr><tr><td><xref ref-type="bibr" rid="bibr70">Stevens et al. (2024)</xref><bold>Country:</bold> United States</td><td>11</td><td><bold>Sex (% Female):</bold> 64%<bold>Age (Mean):</bold> 19.4 years (<italic>SD</italic> = 0.7, Range = 18–20)<bold>Race/Ethnicity:</bold> 91% White, 9% Biracial<bold>Education:</bold> 100% in college</td><td>Open-ended Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Report existing ADHD diagnosis (81.8% by a physician; 18.2% by a psychologist); ACDS to confirm diagnosis; reported current and childhood DSM-5 ADHD symptoms<bold>When:</bold> Ages 6–17 years (<italic>M</italic> = 10.5)</td><td>Described the nature and effects of parental support as well as the need to re-negotiate the parent-child relationship for first- and second-year college students with ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr75">Waite and Tran (2010)</xref><bold>Country:</bold> United States</td><td>27</td><td><bold>Sex (% Female):</bold> 59%<bold>Age (Range):</bold> 18–45+ years<bold>Race/Ethnicity:</bold> 26% Hispanic, 30% African American, 7% American Indian, 15% Asian, 19% Other, 4% Not Reported<bold>Education:</bold> 82% 4-year college; 18% 2-year college (community college)</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Self-report and written confirmation by a licensed health care provider<bold>When:</bold> 55% <18 years; 34% ages 18–60+ years, 11% did not report</td><td>Perceptions and understanding of ADHD as well as help-seeking behavior among diverse students with ADHD. Emphasis on perceived cause, symptoms, and impairment; perceived internal and external influences on symptoms; and treatment decisions and experiences.</td></tr><tr><td colspan="6">Adult-diagnosed ADHD</td></tr><tr><td><xref ref-type="bibr" rid="bibr2">Aoki et al. (2020)</xref><bold>Country:</bold> Japan</td><td>12</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Mean):</bold> 36.5 years (Range = 23–55)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 16.7% in college; not reported for others in the sample</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Received a diagnosis of ADHD in adulthood (aged 17 years or older)"<bold>When:</bold> Age 17+ years (<italic>M</italic> = 33.5 years)</td><td>Psychiatric outpatients diagnosed with ADHD as adults discussed identity (difficulty accepting the diagnosis relief, identity concerns/stigma, acceptance) and symptoms/impairment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr14">Fleischmann and Miller (2013)</xref><bold>Country:</bold> United States</td><td>40</td><td><bold>Sex (% Female):</bold> —<bold>Age (Mean):</bold> —<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Online narratives<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Adults who were [formally] diagnosed with either attention deficit disorder (ADD) or ADHD [after adolescence] and who accepted their diagnosis"<bold>When:</bold> Adulthood</td><td>Explored websites and online narratives of adults with ADHD who were diagnosed in adulthood. Themes included emotional responses and changing self-views following diagnosis and impairment in early life that led to evaluation.</td></tr><tr><td><xref ref-type="bibr" rid="bibr20">Hansson Halleröd et al. (2015)</xref><bold>Country:</bold> Sweden</td><td>21</td><td><bold>Sex (% Female):</bold> 52.4%<bold>Age (Mean):</bold> 32.2 years (<italic>SD</italic> = 9.2, Range = 20–57)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Open-ended Interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Diagnosed with ADHD at a Psychiatric Outpatient Clinic<bold>When:</bold> 7.5 months prior to the study (average, Range = 3–27 months)</td><td>Adults diagnosed with ADHD in adulthood described the impact of the diagnosis on their emotions, identities, and lives (including help-seeking, future possibilities, and discrimination).</td></tr><tr><td> Henry and Hill-Jones (2011) <bold>Country:</bold> United States</td><td>9</td><td><bold>Sex (% Female):</bold> 100%<bold>Age (Range):</bold> 62–91 years<bold>Race/Ethnicity:</bold> 78% Caucasian, 22% Hispanic<bold>Education:</bold> 33% some college; 56% high school; 44% elementary school/junior high</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Diagnosed with ADHD after age 60; referred by a psychiatrist at a mental health organization<bold>When:</bold> ≥Age 60 years; all diagnosed 1–2 years prior to study entry</td><td>Experiences of older adult women diagnosed with ADHD as adults, including impairment (especially prior to diagnosis), positives of the disorder, and identity/self-acceptance.</td></tr><tr><td><xref ref-type="bibr" rid="bibr25">Holthe and Langvik (2017)</xref><bold>Country:</bold> United States</td><td>5</td><td><bold>Sex (% Female):</bold> 100%<bold>Age (Range):</bold> 32–50 years<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 100% college graduates</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Diagnosed with ADHD in adulthood by a medical professional"<bold>When:</bold> Adulthood</td><td>Experiences of women diagnosed with ADHD as adults, including challenges prior to diagnosis, identity and emotions post-diagnosis, ADHD-related impairment, experiences with stigma, management of ADHD, and perceived strengths.</td></tr><tr><td><xref ref-type="bibr" rid="bibr48">Nielsen (2017)</xref><bold>Country:</bold> Denmark</td><td>13</td><td><bold>Sex (% Female):</bold> 61.5%<bold>Age (Range):</bold> 26–45 years<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Diagnosed with ADHD in adulthood"<bold>When:</bold> Adulthood</td><td>Individuals diagnosed with ADHD as adults' identification with the diagnosis, explanations for the disorder, and decisions about treatment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr50">Nyström et al. (2020)</xref><bold>Country</bold>: Sweden</td><td>10</td><td><bold>Sex (% Female):</bold> 70%<bold>Age (Mean):</bold> 57 years (Range = 51–74)<bold>Race/Ethnicity: —</bold><bold>Education:</bold> 20% compulsory school, 30% secondary school, 10% adult education, 40% university</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Reported prior diagnosis of ADHD<bold>When:</bold> Adulthood (90% diagnosed age 40+)</td><td>Explored the experiences of adults 50+ with ADHD including impairment (emotional, social, work, etc.), feelings of otherness, as well as skills/strategies used to manage ADHD in daily life.</td></tr><tr><td><xref ref-type="bibr" rid="bibr61">Sedgwick et al. (2019)</xref><bold>Country:</bold> England</td><td>6</td><td><bold>Sex (% Female):</bold> 0%<bold>Age (Range):</bold> 30–65 years<bold>Race/Ethnicity: —</bold><bold>Education:</bold> —</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Recently diagnosed with ADHD and prescribed medication;" recruited from NHS tertiary service<bold>When:</bold> Adulthood</td><td>Investigated ADHD-related strengths according to "successful" males, including cognitive dynamism, courage, energy, humanity, resilience, and transcendence.</td></tr><tr><td><xref ref-type="bibr" rid="bibr69">Stenner et al. (2019)</xref><bold>Country:</bold> United Kingdom</td><td>16</td><td><bold>Sex (% Female):</bold> 100%<bold>Age (Mean):</bold> —<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Reported having ADHD; 56.3% self-diagnosed; 43.8% formally diagnosed<bold>When:</bold> Among the seven with a formal diagnosis, 71.4% as adults, 28.6% as teens</td><td>Explored the nature of ADHD identity, including challenges prior to diagnosis (both during childhood and adulthood) and emotions/reflection following the diagnosis.</td></tr><tr><td><xref ref-type="bibr" rid="bibr74">Toner et al. (2006)</xref><bold>Country:</bold> Australia</td><td>10</td><td><bold>Sex (% Female):</bold> 0%<bold>Age (Range):</bold> 30–57 years<bold>Race/Ethnicity: —</bold><bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Clinically diagnosed by a psychiatrist; meet DSM-IV-TR criteria for ADHD as an adult (prior to the study)<bold>When:</bold> Adulthood</td><td>Adults with ADHD discussed impairment, strategies used to cope with symptoms, and experiences with the diagnosis itself (emotional reactions, stigma, treatment, etc.).</td></tr><tr><td><xref ref-type="bibr" rid="bibr81">Young et al. (2008)</xref><bold>Country:</bold> England</td><td>8</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Mean):</bold> 39 years (Range = 21–50)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Previously diagnosed with ADHD; met DSM-IV criteria per comprehensive psychiatric evaluation that included a semi-structured interview, self-report, supplemental questioning or documentation, and parent-reported childhood symptoms (CGI-P)<bold>When:</bold> Adulthood</td><td>Explored past feelings of otherness/lack of belonging prior to diagnosis, the emotional impact of being diagnosed with ADHD as an adult, and how the diagnosis and its treatment shaped future plans/outlook.</td></tr><tr><td colspan="6">Other/mixed studies of adults with ADHD</td></tr><tr><td><xref ref-type="bibr" rid="bibr6">Brod et al. (2012)</xref><bold>Country:</bold> Canada, France, Germany, Italy, Netherlands, United Kingdom, and United States</td><td>108</td><td><bold>Sex (% Female):</bold> 47.2%<bold>Age (Mean):</bold> 36 years (Range = 18–62)<bold>Race/Ethnicity</bold><italic>(for n = 65 participants)</italic>: 73.9% Caucasian, 3.1% African Caribbean, 3.1% Latino/Hispanic, 1.5% Asian/Pacific Islander, 1.5% Native American/Alaskan Native, 13.8% Other/Mixed Race, 3.1% Declined to Answer<bold>Education:</bold> 13% graduate school; 36.1% college; 40.7% secondary, technical school, or equivalency diploma; 9.3% less than secondary school, 0.9% no response</td><td>Semi-structured focus groups<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> "Medical diagnosis of ADHD"<bold>When:</bold> Adulthood (57%), childhood (27%), or not reported (16%)</td><td>In a cross-national sample of adults with ADHD, researchers explored the burden of ADHD; discussed experiences with the diagnosis, decisions surrounding medication, current and historical challenges.</td></tr><tr><td><xref ref-type="bibr" rid="bibr7">Canela et al. (2017)</xref><bold>Country:</bold> Switzerland</td><td>32</td><td><bold>Sex (% Female):</bold> 43.8%<bold>Age (Range):</bold> 9.4% ≤25 years; 28.1% 26–35 years; 28.1% 36–45 years; 34.4% 46+ years<bold>Race/Ethnicity:</bold> —<bold>Education:</bold>15.6% in college; not reported for others</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Diagnosis of ADHD according to the ICD-10; identified by treating psychiatrists<bold>When:</bold> 12.5% < age 16 years; 87.5% age 16+ years</td><td>Explored strategies used to manage ADHD symptoms prior to diagnosis (organizational, motoric, attentional, social, psychopharmacological), self-perceptions, and perceived benefits of ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr11">Ek and Isaksson (2013)</xref><bold>Country:</bold> Sweden</td><td>12</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Range):</bold> 21–38 years<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> ADHD Diagnosis; recruited from a neuropsychiatric clinic<bold>When:</bold> —</td><td>Factors, supports, and/or accommodations that promote completion of daily activities in adults with ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr15">Ginapp et al. (2023)</xref><bold>Country:</bold> United States, Australia, Suriname, Czech Republic, and United Kingdom</td><td>43</td><td><bold>Sex (% Female):</bold> 84%<bold>Age (Median):</bold> 29 years, Range = 18–35<bold>Race/Ethnicity:</bold> 72% White, 14% Asian, 9% Black, 5% Hispanic/Latino<bold>Education:</bold> 88% Some College or more</td><td>Focus groups and semi-structured interviews<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Diagnosis of ADHD by a clinician; score of ≥23/30 on the ASRS; confirmed by documentation or discussion with a medical provider<bold>When:</bold> Ages 5–34 years (Median = 22)</td><td>Adults with ADHD's interactions with online communities, including feeling similar to other neurodivergent individuals, stigma, and perceived benefits and risks of online communities.</td></tr><tr><td><xref ref-type="bibr" rid="bibr31">Kronenberg et al. (2014)</xref><bold>Country:</bold> Netherlands</td><td>11</td><td><bold>Sex (% Female):</bold> 27%<bold>Age (Mean):</bold> 43<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Current DSM-IV diagnosis of ADHD<bold>When:</bold> —</td><td>Adults with ADHD and SUD discussed motivations for using substances, effects and consequences of substance use, and the role of structure in supporting daily functioning.</td></tr><tr><td><xref ref-type="bibr" rid="bibr32">Kronenberg et al. (2015)</xref><bold>Country:</bold> Netherlands</td><td>9</td><td><bold>Sex (% Female):</bold> 11.1%<bold>Age (Mean):</bold> 36 years (Range = 29–57)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 33.3% college educated</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Current DSM-IV diagnosis of ADHD (confirmed using medical records)<bold>When:</bold> —</td><td>Adults with ADHD and SUD discussed contributing factors to substance use, emotions following ADHD diagnosis, goals of SU treatment, and strategies to reorganize their lives following SU treatment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr35">Liebrenz et al. (2016)</xref><bold>Country:</bold> Switzerland</td><td>20</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Mean):</bold> 39 (<italic>SD</italic> = 9.6, Range = 25–54)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Complete evaluation of ADHD using the WRI, WURS-k, and ADHD-SB<bold>When:</bold> —</td><td>Individuals with ADHD and current/past nicotine dependence discussed experiences with smoking cessation or withdrawal, motivation to participate in a nicotine cessation program, and perceived role of ADHD in treatment.</td></tr><tr><td><xref ref-type="bibr" rid="bibr36">Liebrenz et al. (2014)</xref><bold>Country:</bold> Switzerland</td><td>12</td><td><bold>Sex (% Female):</bold> 58.3%<bold>Age (Mean):</bold> 40 years (Range = 25–53)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> ADHD evaluated using the WRI, SCL-90-R, WURS-k, and ADHD-SB<bold>When:</bold> —</td><td>Beliefs about the relation between ADHD and tobacco use (self-medication, social, and the role of prescription drugs) among adults with ADHD and tobacco use.</td></tr><tr><td><xref ref-type="bibr" rid="bibr40">Lyhne et al. (2021)</xref><bold>Country:</bold> Denmark</td><td>8</td><td><bold>Sex (% Female):</bold> 50%<bold>Age (Range):</bold> 19–30 years<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 100% secondary school; 12.5% vocational education</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> Previous confirmed ADHD Diagnosis (ICD-10: F90); verified using the DIVA<bold>When:</bold> —</td><td>Work experiences among young adults with ADHD, particularly the benefits, features that promote success, and strategies that support completion of activities in daily living/work.</td></tr><tr><td><xref ref-type="bibr" rid="bibr41">Matheson et al. (2013)</xref><bold>Country:</bold> England</td><td>30</td><td><bold>Sex (% Female):</bold> 56.7%<bold>Age (Mean):</bold> 34.9 years (<italic>SD</italic> = 14.6, Range = 18–57)<bold>Race/Ethnicity:</bold> 80% Caucasian, 10% White other, 3.3% Asian, 3.3% Black, 3.3% Other<bold>Education:</bold> 23.3% ≥ postgraduate degree, 26.7% undergraduate, 23.3% A-level of equivalent, 26.7% GCSE or equivalent</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Self-reported ADHD diagnosis; current symptoms assessed using the ASRS<bold>When:</bold> 50% childhood or adolescence; 50% adulthood (M = 26 years, <italic>SD</italic> = 16.8, Range = 6–57)</td><td>Compared/contrasted experiences of adults with ADHD diagnosed in childhood and adulthood. Discussed barriers to care and treatment adherence, impairment, pros/cons of ADHD medication, and benefits of non-pharmacological treatment for ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr47">Nehlin et al. (2015)</xref><bold>Country:</bold> Sweden</td><td>14</td><td><bold>Sex (% Female):</bold> 57.1%<bold>Age (Mean):</bold> 29.6 years (<italic>SD</italic> = 7.8, Median = 25.5)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "ADHD diagnosis or under investigation because of severe ADHD symptoms" (85.7% diagnosed with ADHD, 7.1% with ADD, and 7.1% under investigation)<bold>When:</bold> —</td><td>Experiences of individuals with ADHD and current/former drug/alcohol abuse problems, including motivation for, function of, and consequences of SU as well as the perceived link between ADHD and SU.</td></tr><tr><td><xref ref-type="bibr" rid="bibr51">Oscarsson et al. (2022)</xref><bold>Country</bold>: Sweden</td><td>20</td><td><bold>Sex (% Female):</bold> 75%<bold>Age (Mean):</bold> 41.9 years (<italic>SD</italic> = 8.6, Range = 23–60)<bold>Race/Ethnicity: —</bold><bold>Education:</bold> 60% >3 years university; 25% ≤ 3 years university; 15% high school</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Have a diagnosis of ADHD"<bold>When:</bold> —</td><td>Working adults with ADHD discussed impairment, need for/use of workplace supports and accommodations, experiences with disclosure, and perceived strengths associated with ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr53">Redshaw and McCormack (2022)</xref><bold>Country:</bold> Australia</td><td>9</td><td><bold>Sex (% Female):</bold> 55.6%<bold>Age (Mean):</bold> 39 years (Range = 29–54)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Semi-structured interview<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Formal diagnosis of ADHD"<bold>When:</bold> Ages 5–45 (33.3% 5–13 years, 44.4% 25–31 years, 22.2% 45 years)</td><td>Adults with combined type ADHD discussed feelings of otherness, experiences with medication, strategies to manage ADHD, identity, and perceived positives of ADHD.</td></tr><tr><td><xref ref-type="bibr" rid="bibr58">Schippers et al. (2022)</xref><bold>Country:</bold> Netherlands</td><td>206</td><td><bold>Sex (% Female):</bold> 62.6%<bold>Age (Mean):</bold> 46.6 years (<italic>SD</italic> = 12.8)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> —</td><td>Open-ended online questionnaire<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> Report current ADHD diagnosis<bold>When:</bold> —</td><td>Perceived positives or strengths associated with ADHD among Dutch adults with the disorder.</td></tr><tr><td><xref ref-type="bibr" rid="bibr59">Schreuer and Dorot (2017)</xref><bold>Country:</bold> Israel</td><td>11</td><td><bold>Sex (% Female):</bold> 100%<bold>Age (Mean):</bold> 33.5 years (<italic>SD</italic> = 6.6)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 100% with post-secondary education; Mean of 15.8 years of education</td><td>Semi-structured interview<bold>Mixed methods?</bold> Yes</td><td><bold>How:</bold> "Documented diagnosis of ADHD from a neurologist or psychiatrist"<bold>When:</bold> —</td><td>Working women with ADHD discussed challenges managing job demands and coping strategies/accommodations that contributed to workplace success.</td></tr><tr><td><xref ref-type="bibr" rid="bibr60">Schrevel et al. (2016)</xref><bold>Country:</bold> Netherlands</td><td>52</td><td><bold>Sex (% Female):</bold> 54%<bold>Age (Mean):</bold> 43 years (<italic>SD</italic> = 9.5, Range = 23–55)<bold>Race/Ethnicity:</bold> —<bold>Education:</bold> 13% college; 73% vocational education, 10% high school, 4% other</td><td>Focus groups<bold>Mixed methods?</bold> No</td><td><bold>How:</bold> "Primary ADHD diagnosis"<bold>When:</bold> — (median of 2 years prior to interview)</td><td>Adults with ADHD discussed feelings of powerlessness and impairment in daily life, self-image, stigma/lack of understanding by close others, and aspirations for the future.</td></tr></tbody></table> </ephtml> </p> <p>1 <emph>Note.</emph> If the sample consisted of individuals with and without ADHD, demographics and results reflect only the subset of individuals with ADHD. Papers were considered mixed methods if they incorporated both qualitative and quantitative components into analyses, such as discussing the percentage of people who endorsed each theme, responses on questionnaires in comparison to qualitative responses, etc.</p> <ulist> <item>2 SU = substance use; SUD = substance use disorder; ACDS = Adult ADHD Clinical Diagnostic Scale; ADHS-SB = Attention-Deficit/Hyperactivity Self-Report Scale (German); ASRS = Adult ADHD Self-Report Scale; BAARS-IV = Barkley Adult ADHD Rating Scale IV; CAARS = Conners' Adult ADHD Rating Scale; CGI-P = Conners' Global Index-Parent Scale; DISC = Diagnostic Interview Schedule for Children; DIVA = Diagnostic Interview for ADHD in Adults; DBDRS = Disruptive Behavior Disorder Rating Scale; ICD-10 = 10th revision of the International Classification of Diseases; IRS = Impairment Rating Scale; SCL-90-R = Symptom Checklist 90-Revised (German); WRI = Wender-Reimherr Interview (German); WURS-k = Wender Utah Rating Scale (German).</item> <item>3 —indicates that this information was not reported in the text.</item> <item>4 [<reflink idref="bib30" id="ref37">30</reflink>], [<reflink idref="bib33" id="ref38">33</reflink>], [<reflink idref="bib44" id="ref39">44</reflink>], [<reflink idref="bib73" id="ref40">73</reflink>], and [<reflink idref="bib78" id="ref41">78</reflink>] all use data from the qualitative follow-up of the Multimodal Treatment of ADHD Study.</item> <item>5 [<reflink idref="bib46" id="ref42">46</reflink>].</item> </ulist> <hd id="AN0188320983-4">Results</hd> <p>Upon review, several recurrent themes emerged across multiple studies, including substance use; ADHD medications; areas of impairment; factors that promote success/coping strategies; identity, stigma, and disclosure; and perceived positives of ADHD. Some of these themes were repeatedly highlighted during semi-structured interviews, whereas others emerged from open-ended interviews, depending on the study. Key findings organized by adult ADHD subsample (childhood diagnosis, college students, adult diagnosis, other) are included in Tables 2 to 5.</p> <p>Table 2. Themes/Insights From Qualitative Studies of Adults With ADHD Diagnosed in Childhood.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /></colgroup><thead><tr><th align="left">Theme</th><th align="center">Key Findings/Insights</th></tr></thead><tbody><tr><td>Substance use</td><td>Reasons for use (cannabis): Self-medication for ADHD, stability, improve mood/reduce negative mood<xref ref-type="table-fn" rid="tfn6">a</xref>,<xref ref-type="table-fn" rid="tfn8">c</xref>,<xref ref-type="table-fn" rid="tfn9">d</xref>,<xref ref-type="table-fn" rid="tfn10">e</xref>, social motivation<xref ref-type="table-fn" rid="tfn6">a</xref>• Reported fewer reasons not to use substances than peers without ADHD<xref ref-type="table-fn" rid="tfn6">a</xref>Beliefs/Perceived effects: improved ADHD symptoms<xref ref-type="table-fn" rid="tfn8">c</xref>; persistent users (regardless of ADHD diagnosis) reported more positive and negative effects of substances than abstainers<xref ref-type="table-fn" rid="tfn6">a</xref></td></tr><tr><td>ADHD medications</td><td>Growing up, felt different from peers because took ADHD medications<xref ref-type="table-fn" rid="tfn10">e</xref> Diverse beliefs about impact on ADHD medication for future use<xref ref-type="table-fn" rid="tfn10">e</xref></td></tr><tr><td>Areas of impairment</td><td>Employment<xref ref-type="table-fn" rid="tfn7">b</xref><italic>Other domains of impairment not explicitly discussed</italic></td></tr><tr><td>Factors that promote success</td><td>Workplace fit: Work environments that were busy, fast-paced, physically demanding, novel, and interesting were conducive/reduced symptoms<xref ref-type="table-fn" rid="tfn7">b</xref>• Lack of fit in the workplace caused challenges/more impairing symptoms<xref ref-type="table-fn" rid="tfn7">b</xref></td></tr><tr><td>Identity, stigma, and disclosure</td><td>Identity: diverse perspectives, for example, ADHD as part of their personality; ADHD as continuing to impact functioning; ADHD-related impairment as context-dependent<xref ref-type="table-fn" rid="tfn7">b</xref></td></tr><tr><td>Positives</td><td><italic>Not discussed</italic></td></tr></tbody></table> </ephtml> </p> <ulist> <item>6 [<reflink idref="bib30" id="ref43">30</reflink>].</item> <item>7 [<reflink idref="bib33" id="ref44">33</reflink>].</item> <item>8 [<reflink idref="bib44" id="ref45">44</reflink>].</item> <item>9 [<reflink idref="bib73" id="ref46">73</reflink>].</item> <item>10 [<reflink idref="bib78" id="ref47">78</reflink>].</item> </ulist> <p>Table 3. Themes/Insights From Qualitative Articles of College Students With ADHD.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /></colgroup><thead><tr><th align="left">Theme</th><th align="center">Key Findings/Insights</th></tr></thead><tbody><tr><td rowspan="2">Substance use</td><td>Reasons for use: Used licit (caffeine) and illicit (marijuana) substances to manage ADHD symptoms on some tasks<xref ref-type="table-fn" rid="tfn17">g</xref>; believed nicotine improved ADHD symptoms<xref ref-type="table-fn" rid="tfn14">d</xref></td></tr><tr><td>Consequences of use: Addictive behavior (in this case, alcohol abuse and video games) had negative consequences<xref ref-type="table-fn" rid="tfn14">d</xref></td></tr><tr><td>ADHD medications</td><td>Took medication with variable regularity—some took daily, whereas others took inconsistently or "as needed"<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn15">e</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref>Perceived benefits of ADHD medication:• Improved focus/concentration (impact on academics, driving)<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn13">c</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn15">e</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref>• Not meeting "academic potential" despite using medication<xref ref-type="table-fn" rid="tfn12">b</xref>Negative Consequences/barriers to ADHD medication adherence:• Side effects (e.g., loss of appetite, fatigue, insomnia, etc.)<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn15">e</xref>,<xref ref-type="table-fn" rid="tfn16">f</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref>• Concerns about addiction<xref ref-type="table-fn" rid="tfn19">i</xref>• Erroneous beliefs about ADHD, for example, they would outgrow the disorder<xref ref-type="table-fn" rid="tfn16">f</xref>• Identity concerns—feel sense of self differs/less authentic when on meds, dislike how they feel when taking, feel less social, frustrated that they needed medication to succeed<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn13">c</xref>,<xref ref-type="table-fn" rid="tfn15">e</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref>• Difficulty finding the appropriate meds/dose<xref ref-type="table-fn" rid="tfn11">a</xref>Pressures toward medication diversion from peers<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn16">f</xref>Parents continued to play a role in obtaining/managing medication<xref ref-type="table-fn" rid="tfn16">f</xref>,<xref ref-type="table-fn" rid="tfn18">h</xref></td></tr><tr><td>Areas of impairment</td><td>Academic (and occupational) functioning/skills/achievement<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn13">c</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn16">f</xref>Life skills/management (e.g., time management, eating, meal prep, sleep)<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>Emotions/Emotion regulation (may be due to co-occurring difficulties)<xref ref-type="table-fn" rid="tfn17">g</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref></td></tr><tr><td>Factors that promote success/coping strategies</td><td>Factors that promoted success:• Environmental: reasonable demands<xref ref-type="table-fn" rid="tfn17">g</xref>, high quality teachers/instruction (or characteristics of lesson/class, such as small class sizes)<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>; environmental fit• Strategies: setting alarms/reminders, removing distractions, scheduling, self-talk<xref ref-type="table-fn" rid="tfn14">d</xref>, study skills, organizational/time-management skills (e.g., note taking during class, organizational system, breaks when studying, etc.)<xref ref-type="table-fn" rid="tfn17">g</xref>• Motivational: goals<xref ref-type="table-fn" rid="tfn17">g</xref>, intrinsic and extrinsic motivation<xref ref-type="table-fn" rid="tfn17">g</xref>, experiencing natural consequences<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>• Support (or accountability) from friends, family, or teachers<xref ref-type="table-fn" rid="tfn11">a</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>• Medication<xref ref-type="table-fn" rid="tfn13">c</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>Academic Accommodations: some found helpful; others did not use due to lack of knowledge of eligibility, stigma/shame, feeling their symptoms were not severe enough<xref ref-type="table-fn" rid="tfn12">b</xref>,<xref ref-type="table-fn" rid="tfn14">d</xref>,<xref ref-type="table-fn" rid="tfn16">f</xref>,<xref ref-type="table-fn" rid="tfn17">g</xref>,<xref ref-type="table-fn" rid="tfn19">i</xref></td></tr><tr><td>Identity, stigma, and disclosure</td><td>Etiology: viewed as biological (by most), but with environmental/parental contributors by some<xref ref-type="table-fn" rid="tfn19">i</xref>Identity: complicated/conflicted relationship with the diagnosis—benefits but also stigma/embarrassment upon receiving diagnosis<xref ref-type="table-fn" rid="tfn12">b</xref>Disclosure/Stigma: concerns about stigma led to hesitancy to disclose or to use academic accommodations<xref ref-type="table-fn" rid="tfn12">b</xref></td></tr><tr><td>Positives</td><td>ADHD helped with "innovativeness" and "tendency to prefer nontraditional ways of working and doing things"<xref ref-type="table-fn" rid="tfn19">i</xref></td></tr></tbody></table> </ephtml> </p> <ulist> <item>11 [<reflink idref="bib18" id="ref48">18</reflink>].</item> <item>12 [<reflink idref="bib34" id="ref49">34</reflink>].</item> <item>13 [<reflink idref="bib37" id="ref50">37</reflink>].</item> <item>14 [<reflink idref="bib42" id="ref51">42</reflink>].</item> <item>15 [<reflink idref="bib43" id="ref52">43</reflink>].</item> <item>16 [<reflink idref="bib57" id="ref53">57</reflink>].</item> <item>17 [<reflink idref="bib67" id="ref54">67</reflink>].</item> <item>18 [<reflink idref="bib70" id="ref55">70</reflink>].</item> <item>19 [<reflink idref="bib75" id="ref56">75</reflink>].</item> </ulist> <p>Table 4. Themes/Insights From Qualitative Articles of Adults Diagnosed With ADHD in Adulthood.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /></colgroup><thead><tr><th align="left">Theme</th><th align="center">Key Findings/Insights</th></tr></thead><tbody><tr><td>Substance use</td><td>Reasons for use: self-medication for ADHD (especially prior to diagnosis)<xref ref-type="table-fn" rid="tfn29">j</xref>, relaxation (cigarettes or alcohol)<xref ref-type="table-fn" rid="tfn29">j</xref></td></tr><tr><td>ADHD medications</td><td>Perceived benefits of ADHD medications:• Reduced ADHD symptoms, improved focus and functioning<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn25">f</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn20">j</xref>,<xref ref-type="table-fn" rid="tfn21">k</xref>• Reduced negative emotionality/anxiety/rumination<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>• Side effects/concerns: anxiousness<xref ref-type="table-fn" rid="tfn24">e</xref>• Symptoms quickly returned after medication wore off<xref ref-type="table-fn" rid="tfn30">k</xref> or medication not sufficient to counteract impairment<xref ref-type="table-fn" rid="tfn25">f</xref></td></tr><tr><td>Areas of impairment</td><td>Emotion regulation<xref ref-type="table-fn" rid="tfn24">e</xref>Social relationships<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn23">d</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Academic/Employment: struggles with academic/occupational functioning and performance; history of employment changes/unemployment<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn23">d</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Daily life: for example, difficulty with financial management<xref ref-type="table-fn" rid="tfn26">g</xref>, parenting<xref ref-type="table-fn" rid="tfn24">e</xref>, risky behavior/driving<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>, time management<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>; household management<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>, etc.</td></tr><tr><td>Factors that promote success/coping strategies</td><td>Social Support<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Physical Activity/Spending time outdoors<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Structured environment/tasks and detailed instructions<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>Creating routines<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>Calendars, reminders, alarms, organizers, lists etc.<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Environmental/occupational fit/interest<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn23">d</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>Workplace accommodations (following disclosure)<xref ref-type="table-fn" rid="tfn20">a</xref>Professional intervention, for example, Medication<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>; formal coaching/groups<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn23">d</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref></td></tr><tr><td>Identity, stigma, and disclosure</td><td>Etiology: often viewed as biological<xref ref-type="table-fn" rid="tfn25">f</xref>Identity: diverse ways in which ADHD was (or was not) incorporated into identity following diagnosis• Many viewed ADHD as part of their identity<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn25">f</xref>,<xref ref-type="table-fn" rid="tfn28">i</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>• Identity confusion following diagnosis (especially initially)<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref> ○ Some questioned the accuracy of the diagnosis or had difficulty accepting it<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn22">c</xref>,• Others viewed their ADHD as separate from themselves<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn25">f</xref>Emotional reaction to diagnosis (often mixed)• Reduced self-blame/relief, optimism<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn28">i</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>• Hopelessness/anxiety, confusion, etc.<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>Many wished for earlier diagnosis (resulting in anger/sadness)<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn25">f</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>Stigma:• Self-stigma<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>• Stigma by media or friends/family<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>Disclosure of diagnosis:• Stigma and fears of judgment limited disclosure<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref>• Disclosure of diagnosis to [only] close others (e.g., close friends/family; diverse decisions about whether to disclose to employers)<xref ref-type="table-fn" rid="tfn20">a</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn29">j</xref>,<xref ref-type="table-fn" rid="tfn30">k</xref></td></tr><tr><td>Positives</td><td>Creativity<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref>Hyper-focus<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn26">g</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref>High energy<xref ref-type="table-fn" rid="tfn21">b</xref>,<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref>• <italic>For some, excess energy was viewed as a negative</italic><xref ref-type="table-fn" rid="tfn26">g</xref>Adventurousness<xref ref-type="table-fn" rid="tfn24">e</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref>Divergent thinking<xref ref-type="table-fn" rid="tfn22">c</xref>,<xref ref-type="table-fn" rid="tfn27">h</xref></td></tr></tbody></table> </ephtml> </p> <ulist> <item>20 [<reflink idref="bib2" id="ref57">2</reflink>].</item> <item>21 [<reflink idref="bib14" id="ref58">14</reflink>].</item> <item>22 [<reflink idref="bib20" id="ref59">20</reflink>].</item> <item>23 [<reflink idref="bib22" id="ref60">22</reflink>]</item> <item>24 [<reflink idref="bib25" id="ref61">25</reflink>].</item> <item>25 [<reflink idref="bib48" id="ref62">48</reflink>].</item> <item>26 [<reflink idref="bib50" id="ref63">50</reflink>].</item> <item>27 [<reflink idref="bib61" id="ref64">61</reflink>].</item> <item>28 [<reflink idref="bib69" id="ref65">69</reflink>].</item> <item>29 [<reflink idref="bib74" id="ref66">74</reflink>].</item> <item>30 [<reflink idref="bib81" id="ref67">81</reflink>].</item> </ulist> <p>Table 5. Themes/Insights From Qualitative Articles of Adults With ADHD With Unspecified/Mixed Ages of Diagnosis.</p> <p>Graph</p> <p> <ephtml> <table><colgroup><col align="left" /><col align="char" char="." /></colgroup><thead><tr><th align="left">Theme</th><th align="center">Key Findings/Insights</th></tr></thead><tbody><tr><td>Substance use</td><td>Reasons for use: improved ADHD symptoms (self-medication), enhanced concentration/focus, relaxation/sleep, relief from restlessness/agitation/emotions<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn35">e</xref>,<xref ref-type="table-fn" rid="tfn36">f</xref>,<xref ref-type="table-fn" rid="tfn38">h</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref>• Discussed substances including caffeine, alcohol, cocaine, THC, nicotine, and amphetamines• Social benefits of/motivation for substance use<xref ref-type="table-fn" rid="tfn38">h</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref></td></tr><tr><td>ADHD medications</td><td>Took medication with variable regularity—some took daily, many took "as needed"<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Perceived benefits: reduced ADHD symptoms and agitation, improved focus and functioning <xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn36">f</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>• For some, secondary emotional benefits<xref ref-type="table-fn" rid="tfn40">j</xref>• For those with comorbid SUD, some believed it helped to remain abstinent<xref ref-type="table-fn" rid="tfn36">f</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref>• Variable beliefs about impact of stimulants on cigarette/tobacco use<xref ref-type="table-fn" rid="tfn37">g</xref>Negative consequences/barriers to ADHD medication adherence:• Side effects<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>• Forgetfulness<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>• Opposition to taking medication generally<xref ref-type="table-fn" rid="tfn31">a</xref> or concerns about potential for addiction<xref ref-type="table-fn" rid="tfn41">k</xref>• Identity concerns, for example, felt it made them a "zombie" or reduced creativity or sociability<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>• Lack of access<xref ref-type="table-fn" rid="tfn40">j</xref>• Medication not effective or not sufficient to mitigate impairment<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref></td></tr><tr><td>Areas of impairment</td><td>Occupational (or academic) functioning<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>Activities of Daily Living/Life skills<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn35">e</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>Risk taking (e.g., reckless driving, substance misuse, etc.)<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>Social Relationships<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn34">d</xref>,<xref ref-type="table-fn" rid="tfn35">e</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Emotions/Emotion regulation<xref ref-type="table-fn" rid="tfn35">e</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref></td></tr><tr><td>Factors that promote success/coping strategies</td><td>[Adaptive] technology (e.g., to improve organization, make checklists, give reminders, record meetings, etc.)<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Organizational strategies (e.g., checklists, planners, to-do lists, etc.)<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Structure (e.g., well-defined task, systemized, routines, etc.)<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn35">e</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Clear goals/expectations<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Competition/rewards for task completion<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>Social support (instrumental—e.g., reminding, talking through, delegating)<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn34">d</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Physical activity<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>Environmental/occupational fit/selection—job selection based on skills/interests; optimal level of stimuli in the environment; interesting/novel/demanding tasks; etc.<xref ref-type="table-fn" rid="tfn32">b</xref>,<xref ref-type="table-fn" rid="tfn33">c</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>Professional intervention, for example, ADHD medication<xref ref-type="table-fn" rid="tfn36">f</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn41">k</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>; therapy/coaching<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>; support groups<xref ref-type="table-fn" rid="tfn45">o</xref></td></tr><tr><td>Identity, stigma, and disclosure</td><td>Identity: some attribute some parts of their personality/behavior to ADHD<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref> and felt that receiving the diagnosis was validating<xref ref-type="table-fn" rid="tfn34">d</xref>• Some felt loss of identity when taking medication<xref ref-type="table-fn" rid="tfn40">j</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>• Regret/anger over not being diagnosed earlier<xref ref-type="table-fn" rid="tfn36">f</xref>,<xref ref-type="table-fn" rid="tfn40">j</xref>Disclosure and stigma: Variable experiences with and decisions about disclosure<xref ref-type="table-fn" rid="tfn42">l</xref>• Anticipated stigma contributed to unwillingness to disclose<xref ref-type="table-fn" rid="tfn34">d</xref>,<xref ref-type="table-fn" rid="tfn39">i</xref>• Some noted negative experiences with disclosure<xref ref-type="table-fn" rid="tfn34">d</xref>• Others received support or workplace accommodations following disclosure<xref ref-type="table-fn" rid="tfn39">i</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>• Stigma/negative attitudes by healthcare providers<xref ref-type="table-fn" rid="tfn40">j</xref></td></tr><tr><td>Positives</td><td>Creativity<xref ref-type="table-fn" rid="tfn31">a</xref>,<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn44">n</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>Problem-solving<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn44">n</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>,<xref ref-type="table-fn" rid="tfn46">p</xref>Hyper-focus<xref ref-type="table-fn" rid="tfn42">l</xref>,<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn44">n</xref>High Energy<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn44">n</xref>,<xref ref-type="table-fn" rid="tfn45">o</xref>Adventurousness<xref ref-type="table-fn" rid="tfn43">m</xref>,<xref ref-type="table-fn" rid="tfn44">n</xref>• Some reported few advantages to ADHD<xref ref-type="table-fn" rid="tfn42">l</xref></td></tr></tbody></table> </ephtml> </p> <ulist> <item>31 [<reflink idref="bib6" id="ref68">6</reflink>].</item> <item>32 [<reflink idref="bib7" id="ref69">7</reflink>].</item> <item>33 [<reflink idref="bib11" id="ref70">11</reflink>].</item> <item>34 [<reflink idref="bib15" id="ref71">15</reflink>].</item> <item>35 [<reflink idref="bib31" id="ref72">31</reflink>].</item> <item>36 [<reflink idref="bib32" id="ref73">32</reflink>].</item> <item>37 [<reflink idref="bib35" id="ref74">35</reflink>].</item> <item>38 [<reflink idref="bib36" id="ref75">36</reflink>].</item> <item>39 [<reflink idref="bib40" id="ref76">40</reflink>].</item> <item>40 [<reflink idref="bib41" id="ref77">41</reflink>].</item> <item>41 [<reflink idref="bib47" id="ref78">47</reflink>].</item> <item>42 [<reflink idref="bib51" id="ref79">51</reflink>]</item> <item>43 [<reflink idref="bib53" id="ref80">53</reflink>]</item> <item>44 [<reflink idref="bib58" id="ref81">58</reflink>].</item> <item>45 [<reflink idref="bib59" id="ref82">59</reflink>].</item> <item>46 [<reflink idref="bib60" id="ref83">60</reflink>].</item> </ulist> <hd id="AN0188320983-5">Adults With Childhood ADHD</hd> <p>Five studies discussed qualitative and mixed methods outcomes among adults diagnosed with ADHD in childhood. All used the same dataset—a qualitative follow up to the Multimodal Treatment Study of Children with ADHD (MTA; [<reflink idref="bib46" id="ref84">46</reflink>]). In childhood, 579 youth with the combined type of ADHD were assigned to treatment with either medication, behavioral therapy, their combination, or treatment-as-usual in the community for 14 months. Along with a normative sample without ADHD, these youth were followed into adulthood as part of an observational, longitudinal assessment phase. As young adults, a subset (<emph>n</emph> = 125 with ADHD, <emph>n</emph> = 58 without ADHD) participated in extensive semi-structured qualitative interviews about their life experiences. Researchers oversampled for individuals with a history of ADHD and a history of persistent substance use, in order to fill a 2 × 2 design (ADHD diagnosis × persistent substance use). The interviews touched on a number of domains: views about their life, family, work, educational, and relationship experiences; self-perceptions of ADHD; and a number of questions about substance use ([<reflink idref="bib30" id="ref85">30</reflink>]; [<reflink idref="bib33" id="ref86">33</reflink>]; [<reflink idref="bib44" id="ref87">44</reflink>]; [<reflink idref="bib73" id="ref88">73</reflink>]; [<reflink idref="bib78" id="ref89">78</reflink>]). For some participants, additional data were collected from their parents (in separate interviews) about perceptions of their child's life, whether they think they still have ADHD, relationships, medication use, and perceived need for and use of ADHD treatment (these latter variables have not yet been published).</p> <p>In these articles, some findings differed as a function of ADHD diagnosis. For example, relative to the comparison sample, young adults with ADHD reported fewer positive and more negative role models in their lives. They also expressed fewer reasons <emph>not</emph> to use substances ([<reflink idref="bib30" id="ref90">30</reflink>]). Individuals with ADHD who persistently used substances were more likely than those without ADHD to report using marijuana to achieve "stability" (e.g., reduced stress, self-medication, etc.), although the two subgroups did not significantly differ on other motivations for use ([<reflink idref="bib73" id="ref91">73</reflink>]). Individuals with ADHD who persistently used substances often used cannabis to reduce negative mood; the majority of those individuals believed that cannabis improved their ADHD symptoms ([<reflink idref="bib44" id="ref92">44</reflink>]). Additionally, [<reflink idref="bib78" id="ref93">78</reflink>] explored beliefs about links between ADHD symptoms, substance use, and ADHD medication use, finding that most of the individuals with ADHD who persistently used substances did not believe that ADHD medication was related to later substance use ([<reflink idref="bib78" id="ref94">78</reflink>]).</p> <p>Both qualitative and quantitative data analyses revealed that young adults with and without ADHD often reported similar reasons for their decisions to use or abstain from substances ([<reflink idref="bib78" id="ref95">78</reflink>]). For individuals with and without ADHD, those who abstained (i.e., those with no drug or heavy alcohol use) reported higher self-efficacy and a greater number of supportive people in their lives than did those who persistently used substances ([<reflink idref="bib30" id="ref96">30</reflink>]). Furthermore, relative to those who had desisted from substance use, those who used substances reported more consequences (both positive and negative) associated with substance use, plus more social motivations for using substances ([<reflink idref="bib30" id="ref97">30</reflink>]). Regardless of ADHD diagnosis, those who used substances persistently believed that cannabis enhanced positive mood, with this positive impact outweighing any perceived negative consequences ([<reflink idref="bib44" id="ref98">44</reflink>]).</p> <p>An additional paper from the same dataset examined occupational outcomes in young adults with ADHD, particularly the perceived relation between work contexts and ADHD symptoms ([<reflink idref="bib33" id="ref99">33</reflink>]). Young adults with ADHD reported fewer symptoms when engaged in stimulating work environments, described as busy, fast-paced, stressful, challenging, physically demanding, novel, and/or intrinsically interesting. In contrast, work environments lacking these features were often perceived to exacerbate symptoms. Some young adults with ADHD reported intentionally selecting jobs with stimulating work environments or found that they fit well in such settings once employed ("niche-picking"). Young adults also varied in how they viewed ADHD as part of who they are: Some described it as part of their character/personality; some used trait descriptions; and others described it as an external and past diagnosis (e.g., "I used to have it") or something in between (e.g., "I still have ADHD but manage it when I need to").</p> <p>As summarized in Table 2, young adults with ADHD (diagnosed in childhood) often use substances in an effort to improve their mood or their ADHD symptoms ([<reflink idref="bib30" id="ref100">30</reflink>]; [<reflink idref="bib44" id="ref101">44</reflink>]; [<reflink idref="bib73" id="ref102">73</reflink>]) and report that the degree of their occupational impairment varies as a function of the suitability of or "fit" with their environment ([<reflink idref="bib33" id="ref103">33</reflink>]). These narratives provide insight into adults' understanding and self-construals of their ADHD and how they place such perceptions into contemporary contexts in their lives.</p> <p>Preliminary analyses in a subsample of women with ADHD from the same dataset suggest that most young adult women have relatively positive outlooks on their lives (satisfaction, productivity) although many also report continued ADHD symptoms and few coping strategies for dealing with stress or ADHD ([<reflink idref="bib55" id="ref104">55</reflink>]).</p> <hd id="AN0188320983-6">College Students With ADHD</hd> <p>Approximately 5.6% to 7.4% of college freshmen in the US have ADHD ([<reflink idref="bib27" id="ref105">27</reflink>]; [<reflink idref="bib71" id="ref106">71</reflink>]). Understanding how these individuals navigate college is essential to helping parents, instructors, and universities best support them and promote academic and social success. Nine studies provided insight into the qualitative experiences of college students with ADHD, with sample sizes ranging from 10 to 36 (<emph>M</emph> = 18). Five such studies used semi-structured interviews, one used focus groups, and the remaining used other or unspecified interviews. In the only dual-informant qualitative study of its kind (with the exception of preliminary analyses using MTA data (with the exception of preliminary analyses using MTA data, [<reflink idref="bib55" id="ref107">55</reflink>]), [<reflink idref="bib67" id="ref108">67</reflink>] interviewed a diverse sample (21% Non-Hispanic White, 64% Hispanic, and 14% Mixed/Other) of both college students with ADHD (<emph>n</emph> = 13) and their parents to better understand factors that promoted and impaired success with the transition to college. Intrinsic and extrinsic motivation, self-efficacy, personal values, goals, and natural consequences served as powerful motivators for academic/vocational achievement. Viewed as particularly helpful were environments that fit the young adult, defined as "minimizing the impact of deficits and drawing on protective strengths such as high IQ, agreeable personality traits, or talents"—and those conveying reasonable demands ([<reflink idref="bib67" id="ref109">67</reflink>]). Also perceived as helpful were educational resources, social support, and a balance of autonomy and support from families. Of the subsample taking stimulant medications, all found the medications helpful yet many also held reservations (see elaboration below). Both parents and young adults identified difficulties with organization, time management, self-awareness, and self/emotional control as salient. Young adults and parents reported that life stressors, change, excessive leisure activities, and comorbid anxiety/mood disorders exacerbated ADHD symptoms ([<reflink idref="bib67" id="ref110">67</reflink>]).</p> <p>More broadly, college students with ADHD discussed widespread challenges, including life skills (e.g., financial management, organization, eating habits, sleep, time management; [<reflink idref="bib18" id="ref111">18</reflink>]; [<reflink idref="bib34" id="ref112">34</reflink>]; [<reflink idref="bib75" id="ref113">75</reflink>]) and academic skills/achievement ([<reflink idref="bib18" id="ref114">18</reflink>]; [<reflink idref="bib34" id="ref115">34</reflink>]), as well as occupational, social, and emotional difficulties ([<reflink idref="bib67" id="ref116">67</reflink>]; [<reflink idref="bib75" id="ref117">75</reflink>]). The independence required upon college entry, regarding both time and medication management, is often a considerable departure from pre-college expectations ([<reflink idref="bib57" id="ref118">57</reflink>]; [<reflink idref="bib70" id="ref119">70</reflink>]). Factors thought to exacerbate challenges during the college transition included persistent ADHD symptoms, addictive behaviors, lack of social support ([<reflink idref="bib42" id="ref120">42</reflink>]), time management difficulties ([<reflink idref="bib57" id="ref121">57</reflink>]), stress ([<reflink idref="bib42" id="ref122">42</reflink>]; [<reflink idref="bib67" id="ref123">67</reflink>]), parental over-involvement ([<reflink idref="bib70" id="ref124">70</reflink>]), and co-occurring mental health challenges ([<reflink idref="bib67" id="ref125">67</reflink>]). Participants also noted resources facilitating their success. In addition to formal psychosocial/organizational/academic interventions/groups for ADHD ([<reflink idref="bib34" id="ref126">34</reflink>]), specific strategies included alarm setting ([<reflink idref="bib18" id="ref127">18</reflink>]; [<reflink idref="bib42" id="ref128">42</reflink>]), positive self-talk ([<reflink idref="bib42" id="ref129">42</reflink>]), studying with friends ([<reflink idref="bib18" id="ref130">18</reflink>]), academic accommodations, and ADHD medication ([<reflink idref="bib18" id="ref131">18</reflink>]; [<reflink idref="bib43" id="ref132">43</reflink>], [<reflink idref="bib42" id="ref133">42</reflink>]; [<reflink idref="bib67" id="ref134">67</reflink>]). Support from friends and parents was also viewed as critical ([<reflink idref="bib42" id="ref135">42</reflink>]; [<reflink idref="bib67" id="ref136">67</reflink>]; [<reflink idref="bib70" id="ref137">70</reflink>]).</p> <p>Across samples, participants reported that ADHD medication was often taken inconsistently or "as needed" but was also seen as helpful or necessary in achieving academic success ([<reflink idref="bib37" id="ref138">37</reflink>]; [<reflink idref="bib43" id="ref139">43</reflink>], [<reflink idref="bib42" id="ref140">42</reflink>]; [<reflink idref="bib57" id="ref141">57</reflink>]; [<reflink idref="bib67" id="ref142">67</reflink>]; [<reflink idref="bib75" id="ref143">75</reflink>]). Concerns about stimulants included side effects (appetite loss, sleep problems, fatigue, social relations, etc.), lack of medication efficacy, feeling guilt/powerlessness for relying on medication to manage symptoms ([<reflink idref="bib18" id="ref144">18</reflink>]), and feeling a loss of one's usual personality when on medication ([<reflink idref="bib37" id="ref145">37</reflink>]; [<reflink idref="bib43" id="ref146">43</reflink>]). A belief that one can outgrow ADHD also contributed to non-adherence among young adults ([<reflink idref="bib57" id="ref147">57</reflink>]). In a number of cases, college students with ADHD resumed taking medication after off-medication periods because of the high demands of college ([<reflink idref="bib43" id="ref148">43</reflink>]). Despite impairment related to ADHD symptoms, use of academic accommodations was low ([<reflink idref="bib75" id="ref149">75</reflink>]). In fact, some participants reported that accommodations and support were critical for success, whereas others were unaware of their eligibility or feared stigma ([<reflink idref="bib34" id="ref150">34</reflink>]; [<reflink idref="bib42" id="ref151">42</reflink>]; [<reflink idref="bib67" id="ref152">67</reflink>]).</p> <p>In terms of perspectives on the diagnosis, most participants viewed the etiology of ADHD as largely biological ([<reflink idref="bib75" id="ref153">75</reflink>]). [<reflink idref="bib34" id="ref154">34</reflink>] found that some saw benefits to having the diagnostic label, whereas others felt stigmatized and embarrassed about the diagnosis. Many were reluctant to tell other people about their ADHD because of the fear of being perceived as "wanting drugs" ([<reflink idref="bib43" id="ref155">43</reflink>]). Crucially, college students often felt pressured to share stimulants with others ([<reflink idref="bib57" id="ref156">57</reflink>]).</p> <p>In summary, qualitative and mixed-methods studies reveal that college students with ADHD report a wide range of experiences, many different adaptations to manage the disorder, and diverse beliefs about what ADHD means for their college life (Table 3). Other themes involve struggles with independence along with core life and academic skills ([<reflink idref="bib18" id="ref157">18</reflink>]; [<reflink idref="bib34" id="ref158">34</reflink>]; [<reflink idref="bib37" id="ref159">37</reflink>]; [<reflink idref="bib42" id="ref160">42</reflink>]; [<reflink idref="bib57" id="ref161">57</reflink>]). Sampled individuals often noted inconsistent usage of ADHD medications as well as complex feelings regarding both academic benefits and side effects ([<reflink idref="bib18" id="ref162">18</reflink>]; [<reflink idref="bib34" id="ref163">34</reflink>]; [<reflink idref="bib37" id="ref164">37</reflink>]; [<reflink idref="bib43" id="ref165">43</reflink>], [<reflink idref="bib42" id="ref166">42</reflink>]; [<reflink idref="bib57" id="ref167">57</reflink>]; [<reflink idref="bib67" id="ref168">67</reflink>]; [<reflink idref="bib75" id="ref169">75</reflink>]). Academic accommodations appeared to be underutilized ([<reflink idref="bib34" id="ref170">34</reflink>]; [<reflink idref="bib42" id="ref171">42</reflink>]; [<reflink idref="bib67" id="ref172">67</reflink>]; [<reflink idref="bib75" id="ref173">75</reflink>]).</p> <hd id="AN0188320983-7">ADHD Diagnosis in Adulthood</hd> <p>Eleven studies examined the qualitative experience of receiving an ADHD diagnosis in adulthood, with samples ranging from 5 to 40 participants (<emph>M</emph> = 13.6). Five obtained data using semi-structured interviews, five used other unspecified or open-ended interviews, and one utilized online narratives.</p> <p>Participants commonly wished for an earlier diagnosis and felt anger, regret, or sadness about the time prior to their diagnosis ([<reflink idref="bib20" id="ref174">20</reflink>]; [<reflink idref="bib25" id="ref175">25</reflink>]; [<reflink idref="bib69" id="ref176">69</reflink>]; [<reflink idref="bib74" id="ref177">74</reflink>]; [<reflink idref="bib81" id="ref178">81</reflink>]). Many felt "different" from others while growing up without knowing why ([<reflink idref="bib20" id="ref179">20</reflink>]; [<reflink idref="bib22" id="ref180">22</reflink>]; [<reflink idref="bib48" id="ref181">48</reflink>]; [<reflink idref="bib69" id="ref182">69</reflink>]; [<reflink idref="bib74" id="ref183">74</reflink>]; [<reflink idref="bib81" id="ref184">81</reflink>]). Following diagnosis, many sought additional information about ADHD (e.g., [<reflink idref="bib2" id="ref185">2</reflink>]; [<reflink idref="bib74" id="ref186">74</reflink>]) and believed the disorder was linked to biological causes ([<reflink idref="bib48" id="ref187">48</reflink>]).</p> <p>An adult diagnosis of ADHD may well be met with conflicting emotions ([<reflink idref="bib25" id="ref188">25</reflink>]; [<reflink idref="bib81" id="ref189">81</reflink>]). Many participants accepted the diagnostic label and thought it fostered help-seeking, experiencing relief and reduced self-blame post-diagnosis ([<reflink idref="bib25" id="ref190">25</reflink>]). Some now viewed ADHD as a part of their identity and believed the disorder was associated with both positive and negative traits ([<reflink idref="bib2" id="ref191">2</reflink>]; [<reflink idref="bib20" id="ref192">20</reflink>]; [<reflink idref="bib48" id="ref193">48</reflink>]; [<reflink idref="bib69" id="ref194">69</reflink>]; [<reflink idref="bib81" id="ref195">81</reflink>]). For some, ADHD was described as a distinct part of themselves but not one that was "broken" ([<reflink idref="bib48" id="ref196">48</reflink>]). Perceived strengths associated with ADHD included creativity, hyper-focus, energy, and adventurousness ([<reflink idref="bib14" id="ref197">14</reflink>]; [<reflink idref="bib25" id="ref198">25</reflink>]; [<reflink idref="bib50" id="ref199">50</reflink>]; [<reflink idref="bib61" id="ref200">61</reflink>]). In contrast, others reacted to their new diagnosis with hopelessness, expressed fears about ADHD limiting their future possibilities, or found the label itself confusing or difficult to accept ([<reflink idref="bib2" id="ref201">2</reflink>]; [<reflink idref="bib14" id="ref202">14</reflink>]; [<reflink idref="bib20" id="ref203">20</reflink>]; [<reflink idref="bib22" id="ref204">22</reflink>]; [<reflink idref="bib25" id="ref205">25</reflink>]; [<reflink idref="bib48" id="ref206">48</reflink>]; [<reflink idref="bib74" id="ref207">74</reflink>]; [<reflink idref="bib81" id="ref208">81</reflink>]). In some cases, it forced individuals to grapple with their identity ([<reflink idref="bib69" id="ref209">69</reflink>]) and with what was their "personality" versus their "ADHD" ([<reflink idref="bib2" id="ref210">2</reflink>]). Self-stigma was common ([<reflink idref="bib2" id="ref211">2</reflink>]; [<reflink idref="bib25" id="ref212">25</reflink>]). In addition, stigmatizing messages in the media and by close others discouraged disclosure ([<reflink idref="bib20" id="ref213">20</reflink>]; [<reflink idref="bib25" id="ref214">25</reflink>]; [<reflink idref="bib74" id="ref215">74</reflink>]; [<reflink idref="bib81" id="ref216">81</reflink>]). Still, some felt confident disclosing their diagnosis to close friends/family ([<reflink idref="bib2" id="ref217">2</reflink>]; [<reflink idref="bib74" id="ref218">74</reflink>]; [<reflink idref="bib81" id="ref219">81</reflink>]).</p> <p>Among those diagnosed with ADHD in adulthood, participants believed that ADHD contributed to impairment in many domains, including life skills (e.g., financial management, disorganization; [<reflink idref="bib50" id="ref220">50</reflink>]), emotion regulation ([<reflink idref="bib14" id="ref221">14</reflink>]; [<reflink idref="bib25" id="ref222">25</reflink>]), and relationships ([<reflink idref="bib14" id="ref223">14</reflink>]; [<reflink idref="bib22" id="ref224">22</reflink>]; [<reflink idref="bib50" id="ref225">50</reflink>]; [<reflink idref="bib74" id="ref226">74</reflink>]). In an all-female sample, concerns about parenting and passing ADHD onto one's children were raised ([<reflink idref="bib25" id="ref227">25</reflink>]). Factors believed to exacerbate difficulties included ADHD symptoms, comorbidities, academic underachievement, lack of fit in the workplace, and poor self-esteem ([<reflink idref="bib74" id="ref228">74</reflink>]). To manage ADHD, helpful strategies noted by participants included acquiring coping skills (e.g., setting alarms and writing things down, [<reflink idref="bib2" id="ref229">2</reflink>]), creating structure/routines ([<reflink idref="bib25" id="ref230">25</reflink>]), receiving detailed instructions ([<reflink idref="bib50" id="ref231">50</reflink>]), workplace accommodations following disclosure ([<reflink idref="bib2" id="ref232">2</reflink>]), physical activity/outdoor activities ([<reflink idref="bib50" id="ref233">50</reflink>]; [<reflink idref="bib74" id="ref234">74</reflink>]), and social support (emotional and instrumental, [<reflink idref="bib25" id="ref235">25</reflink>]; [<reflink idref="bib50" id="ref236">50</reflink>]). Work environments that were creative, challenging, and required changing locations were perceived to diminish symptoms or their impact ([<reflink idref="bib50" id="ref237">50</reflink>]). Medication to manage ADHD was believed to reduce symptoms and improve functioning, and in some cases were perceived to have secondary benefits for increasing one's coping and decreasing one's anxiety ([<reflink idref="bib2" id="ref238">2</reflink>]; [<reflink idref="bib25" id="ref239">25</reflink>]; [<reflink idref="bib50" id="ref240">50</reflink>]; [<reflink idref="bib74" id="ref241">74</reflink>]; [<reflink idref="bib81" id="ref242">81</reflink>]).</p> <p>In summary, for many, receiving an ADHD diagnosis as an adult may have a distinct impact on self-perceptions and require identity re-negotiation. As might be expected in samples characterized by healthcare-seeking adults, individuals diagnosed with ADHD in adulthood often wished they had been diagnosed sooner ([<reflink idref="bib14" id="ref243">14</reflink>]; [<reflink idref="bib20" id="ref244">20</reflink>]; [<reflink idref="bib22" id="ref245">22</reflink>]; [<reflink idref="bib25" id="ref246">25</reflink>]; [<reflink idref="bib48" id="ref247">48</reflink>]; [<reflink idref="bib69" id="ref248">69</reflink>]; [<reflink idref="bib74" id="ref249">74</reflink>]; [<reflink idref="bib81" id="ref250">81</reflink>]) and reacted to the diagnostic label with a wide range of emotions ([<reflink idref="bib2" id="ref251">2</reflink>]; [<reflink idref="bib14" id="ref252">14</reflink>]; [<reflink idref="bib20" id="ref253">20</reflink>]; [<reflink idref="bib22" id="ref254">22</reflink>]; [<reflink idref="bib25" id="ref255">25</reflink>]; [<reflink idref="bib48" id="ref256">48</reflink>]; [<reflink idref="bib69" id="ref257">69</reflink>]; [<reflink idref="bib74" id="ref258">74</reflink>]; [<reflink idref="bib81" id="ref259">81</reflink>]). Irrespective of the integration of ADHD into one's identity, those with adult-diagnosed ADHD reported considerable functional impairment (e.g., [<reflink idref="bib22" id="ref260">22</reflink>]; [<reflink idref="bib25" id="ref261">25</reflink>]; [<reflink idref="bib50" id="ref262">50</reflink>]; [<reflink idref="bib74" id="ref263">74</reflink>]) and adopted a variety of coping strategies, including medication ([<reflink idref="bib2" id="ref264">2</reflink>]; [<reflink idref="bib20" id="ref265">20</reflink>]; [<reflink idref="bib25" id="ref266">25</reflink>]; [<reflink idref="bib48" id="ref267">48</reflink>]; [<reflink idref="bib50" id="ref268">50</reflink>]; [<reflink idref="bib74" id="ref269">74</reflink>]; [<reflink idref="bib81" id="ref270">81</reflink>]).</p> <hd id="AN0188320983-8">Other Studies</hd> <p>Finally, 16 studies, which appear to comprise 14 unique samples, did not differentiate between those diagnosed with ADHD as children and those diagnosed as adults. These studies had sample sizes ranging from 8 to 206 (<emph>Mean</emph> = 37; <emph>Median</emph> = 17). Eleven used semi-structured interviews, two used focus groups, one used both semi-structured interviews and focus groups, one used an online questionnaire, and another used an unspecified form of interview.</p> <p>In one of the largest samples of its kind, [<reflink idref="bib6" id="ref271">6</reflink>] conducted focus groups with 108 participants across seven countries to explore the experience of ADHD and its impact on various life domains. Only 27% of such participants were diagnosed with ADHD in childhood. Adult symptoms were believed to influence many domains of life, including work, financial management, and social relationships, which contributed to low self-esteem ([<reflink idref="bib6" id="ref272">6</reflink>]). Risky behaviors (e.g., risky driving, substance misuse, eating disorders) were also commonly observed. Most participants had a history of trying ADHD medications, though many stopped due to perceived side effects or lack of efficacy ([<reflink idref="bib6" id="ref273">6</reflink>]). Some self-medicated with alcohol or drugs for ADHD symptoms. Many viewed ADHD as "part of who they are."</p> <p>Individuals with comorbid substance use disorder (SUD) and ADHD reported that "jumbled" thoughts and emotions contributed to substance use ([<reflink idref="bib31" id="ref274">31</reflink>], [<reflink idref="bib32" id="ref275">32</reflink>]). Similarly, many viewed nicotine or other substances as "self-medication" to reduce restlessness and promote concentration/relaxation ([<reflink idref="bib36" id="ref276">36</reflink>]; [<reflink idref="bib47" id="ref277">47</reflink>]). Interestingly, many reported that smoking cessation worsened ADHD symptoms after physical symptoms of withdrawal stopped ([<reflink idref="bib35" id="ref278">35</reflink>]). Individuals diagnosed with both SUD and ADHD often believed that ADHD medication helped them to remain abstinent ([<reflink idref="bib32" id="ref279">32</reflink>]); those addicted to nicotine had more varied beliefs about the impact of stimulants on the risk of later nicotine use ([<reflink idref="bib36" id="ref280">36</reflink>]).</p> <p>In the literature more broadly, individuals with ADHD believed that the disorder contributed to interpersonal challenges (conflict, inconsistent communication, etc.; [<reflink idref="bib15" id="ref281">15</reflink>]; [<reflink idref="bib41" id="ref282">41</reflink>]; [<reflink idref="bib51" id="ref283">51</reflink>]), stress (e.g., [<reflink idref="bib51" id="ref284">51</reflink>]), sleep problems ([<reflink idref="bib41" id="ref285">41</reflink>]), and emotion dysregulation ([<reflink idref="bib41" id="ref286">41</reflink>]; [<reflink idref="bib51" id="ref287">51</reflink>]). A number of studies reported that individuals with ADHD find it difficult to manage job demands ([<reflink idref="bib11" id="ref288">11</reflink>]; [<reflink idref="bib40" id="ref289">40</reflink>]; [<reflink idref="bib41" id="ref290">41</reflink>]; [<reflink idref="bib51" id="ref291">51</reflink>]; [<reflink idref="bib59" id="ref292">59</reflink>]), especially jobs with repetitive and boring tasks as well as those lacking in structure, organization, and managerial support ([<reflink idref="bib51" id="ref293">51</reflink>]).</p> <p>Adults with ADHD endorsed a variety of strategies to cope with disorder-related challenges, including technology, creating routines and structure, physical activity, and selecting environments without distractions ([<reflink idref="bib7" id="ref294">7</reflink>]; [<reflink idref="bib11" id="ref295">11</reflink>]; [<reflink idref="bib15" id="ref296">15</reflink>]; [<reflink idref="bib31" id="ref297">31</reflink>]; [<reflink idref="bib40" id="ref298">40</reflink>]; [<reflink idref="bib51" id="ref299">51</reflink>]; [<reflink idref="bib59" id="ref300">59</reflink>]; [<reflink idref="bib60" id="ref301">60</reflink>]). Social compensatory strategies and the use of prescribed (e.g., stimulants) and other substances (e.g., alcohol, cocaine, etc.) were also discussed ([<reflink idref="bib7" id="ref302">7</reflink>]). Within the workplace, in addition to medication, adapted environments or expectations ([<reflink idref="bib11" id="ref303">11</reflink>]; [<reflink idref="bib51" id="ref304">51</reflink>]; [<reflink idref="bib59" id="ref305">59</reflink>]), clear and well-defined goals, structure, breaks, assistive technology ([<reflink idref="bib11" id="ref306">11</reflink>]), and social support/motivation ([<reflink idref="bib11" id="ref307">11</reflink>]; [<reflink idref="bib40" id="ref308">40</reflink>]; [<reflink idref="bib51" id="ref309">51</reflink>]; [<reflink idref="bib59" id="ref310">59</reflink>]) were perceived as promotive of success.</p> <p>Medication was viewed as valuable for managing symptoms ([<reflink idref="bib51" id="ref311">51</reflink>]; [<reflink idref="bib53" id="ref312">53</reflink>]; [<reflink idref="bib59" id="ref313">59</reflink>]). For some, it was necessary but not sufficient to reduce impairment ([<reflink idref="bib41" id="ref314">41</reflink>]). Barriers to adherence included forgetfulness, side effects, uncertainty about effectiveness, and fears of/inner conflict about loss of identity/authenticity on medication ([<reflink idref="bib41" id="ref315">41</reflink>]; [<reflink idref="bib53" id="ref316">53</reflink>]). Externally, difficulty accessing medical services for diagnosis or treatment contributed to nonadherence for some ([<reflink idref="bib41" id="ref317">41</reflink>]).</p> <p>Self-acceptance for adults with ADHD was facilitated by increasing self-knowledge, effective communication, and gaining an understanding of their positive characteristics ([<reflink idref="bib60" id="ref318">60</reflink>]). However, experiences regarding acceptance from others varied—some participants chose not to disclose their diagnosis because loved ones did not understand or take the disorder seriously ([<reflink idref="bib15" id="ref319">15</reflink>]) or because of prior negative experiences with workplace disclosure ([<reflink idref="bib51" id="ref320">51</reflink>]). Although some individuals reported few if any advantages to ADHD ([<reflink idref="bib51" id="ref321">51</reflink>]), in other samples, most adults with ADHD noted at least one positive feature of the disorder ([<reflink idref="bib58" id="ref322">58</reflink>]).[<reflink idref="bib8" id="ref323">8</reflink>] These strengths included problem-solving ([<reflink idref="bib51" id="ref324">51</reflink>]; [<reflink idref="bib53" id="ref325">53</reflink>]; [<reflink idref="bib58" id="ref326">58</reflink>]; [<reflink idref="bib59" id="ref327">59</reflink>]; [<reflink idref="bib60" id="ref328">60</reflink>]), creativity ([<reflink idref="bib6" id="ref329">6</reflink>]; [<reflink idref="bib51" id="ref330">51</reflink>]; [<reflink idref="bib58" id="ref331">58</reflink>]; [<reflink idref="bib59" id="ref332">59</reflink>]; [<reflink idref="bib60" id="ref333">60</reflink>]), high energy ([<reflink idref="bib53" id="ref334">53</reflink>]; [<reflink idref="bib58" id="ref335">58</reflink>]; [<reflink idref="bib59" id="ref336">59</reflink>]), adventurousness/spontaneity ([<reflink idref="bib53" id="ref337">53</reflink>]; [<reflink idref="bib58" id="ref338">58</reflink>]), and hyper-focus ([<reflink idref="bib51" id="ref339">51</reflink>]; [<reflink idref="bib53" id="ref340">53</reflink>]; [<reflink idref="bib58" id="ref341">58</reflink>]).</p> <p>In summary, many studies either did not specify the age of diagnosis or had mixed samples with some recently diagnosed as adults and others diagnosed in childhood (often weighted toward the former; see Table 5). Persistent symptoms were perceived as contributing to continued impairment in many domains, including work ([<reflink idref="bib6" id="ref342">6</reflink>]; [<reflink idref="bib7" id="ref343">7</reflink>]; [<reflink idref="bib40" id="ref344">40</reflink>]; [<reflink idref="bib51" id="ref345">51</reflink>]; [<reflink idref="bib60" id="ref346">60</reflink>]). Finally, those with ADHD and substance use challenges often viewed ADHD symptoms as contributing to substance use ([<reflink idref="bib6" id="ref347">6</reflink>]; [<reflink idref="bib7" id="ref348">7</reflink>]; [<reflink idref="bib31" id="ref349">31</reflink>], [<reflink idref="bib32" id="ref350">32</reflink>]; [<reflink idref="bib36" id="ref351">36</reflink>]; [<reflink idref="bib47" id="ref352">47</reflink>]).</p> <hd id="AN0188320983-9">Discussion</hd> <p>We review the qualitative literature on ADHD in adulthood among four different subgroups: those with a childhood ADHD diagnosis; college students with ADHD; those diagnosed with ADHD in adulthood; and mixed/other. Some themes were noted across some subgroups, including substance use (perceptions of and reasons for use); use of stimulant medication to manage ADHD symptoms (perceptions of and frequency of use); life domains negatively affected by symptoms; strategies and accommodations used to manage symptoms, including selecting conducive environments; perceptions of ADHD as an identity and beliefs about/experiences with stigma and disclosure; and perceived positive aspects of ADHD. Tables 2 to 5 present summaries of qualitative findings related to these major themes for each subgroup.</p> <p>All qualitative studies of <emph>adults with childhood-diagnosed ADHD</emph> were from the MTA and many emphasized reasons for substance use (often stability and abating ADHD symptoms or negative mood; [<reflink idref="bib30" id="ref353">30</reflink>]; [<reflink idref="bib44" id="ref354">44</reflink>]; [<reflink idref="bib73" id="ref355">73</reflink>]). Other studies highlighted reduced levels of self-reported impairment in conducive environments ([<reflink idref="bib33" id="ref356">33</reflink>]). Future research on this subpopulation should explore (a) why many of those diagnosed with ADHD in childhood no longer pursue treatment as adults; (b) why some individuals continue to identify with the ADHD diagnosis whereas others do not, and the relation between this identification (or lack thereof) and well-being; and (c) the types of interventions, discussions, or psychoeducation that may contribute to continued, effective, and independent management of ADHD into young adulthood and beyond.</p> <p>Next, qualitative research highlights that <emph>college students with ADHD</emph> experience impairment in many domains ([<reflink idref="bib18" id="ref357">18</reflink>]; [<reflink idref="bib34" id="ref358">34</reflink>]; [<reflink idref="bib67" id="ref359">67</reflink>]; [<reflink idref="bib75" id="ref360">75</reflink>]) and that both specific strategies—particularly social support plus environmental "fit"—are believed to facilitate success ([<reflink idref="bib18" id="ref361">18</reflink>]; [<reflink idref="bib42" id="ref362">42</reflink>]; [<reflink idref="bib67" id="ref363">67</reflink>]). Although ADHD medication was viewed as crucial for some students, medication was taken with variable regularity and yielded mixed emotions ([<reflink idref="bib18" id="ref364">18</reflink>]; [<reflink idref="bib34" id="ref365">34</reflink>]; [<reflink idref="bib43" id="ref366">43</reflink>], [<reflink idref="bib42" id="ref367">42</reflink>]; [<reflink idref="bib67" id="ref368">67</reflink>]; [<reflink idref="bib75" id="ref369">75</reflink>]). Similarly, academic accommodations were viewed as necessary by some students but were unused by many others ([<reflink idref="bib34" id="ref370">34</reflink>]; [<reflink idref="bib42" id="ref371">42</reflink>]; [<reflink idref="bib57" id="ref372">57</reflink>]; [<reflink idref="bib67" id="ref373">67</reflink>]; [<reflink idref="bib75" id="ref374">75</reflink>]). Outside of qualitative research, the efficacy of many ADHD-related accommodations has received decidedly inconsistent support ([<reflink idref="bib38" id="ref375">38</reflink>]). Further investigation is required regarding (a) the qualitative and quantitative factors earlier in development that predict college enrollment, retention, and success among individuals with ADHD—with emphasis on contextual or motivational factors that can be targets of future interventions; (b) contributors to the lack of uptake in academic accommodations among college students with ADHD, as well as potentially modifiable factors that cause difficulty in navigating college life; (c) motivations, attitudes, and beliefs about the benefits of medication (and psychological) treatments; and (d) ways in which colleges and universities can leverage supports/motivations that are salient for individuals with ADHD (for instance, those discussed by [<reflink idref="bib67" id="ref376">67</reflink>]).</p> <p>Third, for those <emph>diagnosed with ADHD in adulthood</emph>, qualitative studies often focused on how the diagnostic label was viewed and incorporated into one's identity, sometimes leading to re-negotiation of identity, re-interpretation of past behaviors, and mixed emotions (but often relief; [<reflink idref="bib2" id="ref377">2</reflink>]; [<reflink idref="bib25" id="ref378">25</reflink>]; [<reflink idref="bib69" id="ref379">69</reflink>]; [<reflink idref="bib81" id="ref380">81</reflink>]). Similar to ADHD detected earlier in life, ADHD diagnosed in adulthood contributed to challenges in emotional and social functioning, among other domains ([<reflink idref="bib22" id="ref381">22</reflink>]; [<reflink idref="bib50" id="ref382">50</reflink>]; [<reflink idref="bib51" id="ref383">51</reflink>]; [<reflink idref="bib53" id="ref384">53</reflink>]). It is notable that in these studies, some or all participants actively sought out this ADHD diagnosis as an adult, implying significant adult impairment, knowledge of ADHD, and access to healthcare resources. Thus, these individuals' attitudes, feelings, and treatment-seeking behaviors may diverge from those who received the diagnosis as children. For individuals diagnosed with ADHD as adults, future qualitative research should explore (a) the presenting problem(s) motivating individuals to seek out the psychological/psychiatric services that result in diagnosis (e.g., ADHD symptoms? Co-occurring mental health conditions? Was a child of theirs diagnosed with ADHD?); (b) how and why strategies, conceptions, and treatment decisions related to ADHD (and co-occurring symptoms) are similar to or different from those with ADHD who were diagnosed earlier in life.</p> <hd id="AN0188320983-10">Gaps and Areas for Future Research</hd> <p>We highlight underexplored areas where we believe it is important for future research to incorporate a qualitative approach. These areas are crucial to better understand the experience of adults with ADHD and inform treatment of ADHD.</p> <hd id="AN0188320983-11">Multiple Reporters</hd> <p>Past quantitative research on ADHD suggests that, both in childhood and beyond, those with ADHD may underestimate the degree of their symptoms and impairment relative to close others (e.g., parents, teachers, or spouses; [<reflink idref="bib4" id="ref385">4</reflink>]; [<reflink idref="bib5" id="ref386">5</reflink>]; [<reflink idref="bib65" id="ref387">65</reflink>]). Indeed, diagnostic best practices highlight the importance of obtaining reports of symptoms from multiple raters/informants to ensure the diagnosis is accurate, particularly in adulthood (e.g., [<reflink idref="bib66" id="ref388">66</reflink>]). Only one study obtained qualitative accounts from multiple reporters in adults with ADHD ([<reflink idref="bib67" id="ref389">67</reflink>]). This study compared a group of post-secondary students with ADHD and a group of their parents but did not explore potential (dis) agreement within each dyadic parent/child pair ([<reflink idref="bib67" id="ref390">67</reflink>]). <emph>Obtaining and comparing interviews from multiple perspectives may be crucial to understanding daily functioning and well-being in adults with ADHD, as well as the extent or efficacy of coping strategies.</emph> These alternate reporters need to be individuals who see the participant regularly—and in settings where symptoms may be evident. Such additional perspectives may provide a more comprehensive understanding of the experiences of adults with ADHD and additional insight into the nature of and the factors contributing to inter-reporter discrepancies in adulthood.</p> <hd id="AN0188320983-12">Children With ADHD as Adults</hd> <p>Only <emph>5</emph> of the 41 studies reviewed (12.2%) focus on adults who had received a childhood ADHD diagnosis, and all of these used qualitative data from the MTA study. This unique subpopulation is not fully captured by qualitative investigations into college students with ADHD or adults who receive an ADHD diagnosis in adulthood. College students with ADHD may have levels of academic achievement or support that are not representative of all adults who grew up with ADHD. As such, their perceptions may not generalize to those with ADHD who did not pursue a four-year degree. Furthermore, many studies emphasize how receiving a new ADHD diagnosis as an adult leads to redefining past experiences and reconsidering future expectations, suggesting that this experience is phenomenologically distinct. Qualitative research on college students may benefit from distinguishing among those who were diagnosed in childhood versus during college or young adulthood, as these subgroups may reflect quite different experiences navigating college life, healthcare systems, and educational accommodations.</p> <p>Topics related to identity and self-understanding were sparse in qualitative studies of adults with ADHD who were diagnosed as children. Identity and self-perceptions change across life and have an immense impact on how individuals set expectations for the future and derive meaning from their experiences ([<reflink idref="bib10" id="ref391">10</reflink>]). It is important for future work to elucidate (a) how individuals who grew up with an ADHD diagnosis and associated symptoms and stigma navigate adulthood, (b) how this process may relate to decisions about why and whether to (dis) engage with treatment, and (c) what interventions or supports during adolescence would encourage empowerment, self-management, and treatment engagement in adulthood for those who have grown up with ADHD.</p> <hd id="AN0188320983-13">Experiences of Women With ADHD</hd> <p>As reviewed by [<reflink idref="bib24" id="ref392">24</reflink>], girls and women have been and continue to be underrepresented in the ADHD literature both qualitatively and quantitatively. Concerns about birth control, parenting, and pregnancy may be important to women with ADHD, and decisions about whether and when to take medication may reflect considerations of reproductive and parenting intentions. Although both parents must be responsible for caring for and raising a child, disproportionate levels of household work are often placed on women in romantic or marital relationships ([<reflink idref="bib8" id="ref393">8</reflink>]). Tackling these important life tasks and challenges may be particularly salient and difficult for women with ADHD. Besides female-specific concerns, recent work in science generally and ADHD specifically has emphasized that the experiences of males/men cannot be considered the default, and those who identify as women have unique and valuable experiences that must be represented in research (see also [<reflink idref="bib24" id="ref394">24</reflink>]; [<reflink idref="bib80" id="ref395">80</reflink>]). As well, the lived experiences of gender diverse and transgender individuals with ADHD are completely understudied ([<reflink idref="bib17" id="ref396">17</reflink>]), even though these individuals have unique perspectives shaped by their intersecting identities and resulting experiences. Navigation of life cycle transitions, treatment decisions, and overall daily functioning for women, nonbinary, gender fluid, and transgender individuals with ADHD are nuanced and complex, with the potential to be uniquely captured by qualitative approaches.</p> <hd id="AN0188320983-14">Diverse Demographic Groups</hd> <p>People who identify as members of historically marginalized racial or ethnic groups may have unique experiences with ADHD and its treatment, although these perspectives have not been well-captured in either qualitative or quantitative research. Only 39.0% of reviewed studies reported the racial/ethnic breakdown of their samples (<reflink idref="bib16" id="ref397">16</reflink>); among these, only 2 (12.5%) analyzed samples that were not ≥70% non-Hispanic White. In the United States, white youth are disproportionately likely to receive an ADHD diagnosis and treatment, which is thought to reflect unmet needs rather than true underlying racial differences in the rate of ADHD ([<reflink idref="bib63" id="ref398">63</reflink>]).</p> <p>Structural barriers combined with intersecting marginalized identities are likely to affect the meaning-making process related to ADHD, including attitudes about oneself and the disorder, treatment/accommodation-seeking behavior, and willingness to disclose one's diagnosis ([<reflink idref="bib3" id="ref399">3</reflink>]; [<reflink idref="bib12" id="ref400">12</reflink>]; [<reflink idref="bib23" id="ref401">23</reflink>]). They may also influence how healthcare systems and close others perceive, interpret, and respond to one's ADHD symptoms and efforts to cope ([<reflink idref="bib3" id="ref402">3</reflink>]; [<reflink idref="bib12" id="ref403">12</reflink>]; [<reflink idref="bib23" id="ref404">23</reflink>]).</p> <p>Cross-cultural and international studies of how ADHD is clinically and culturally defined can highlight differences in how ADHD is identified, understood, described, and treated by international medical systems/communities. These should include qualitative and ethnographic research methods. In sum, understanding the experiences, attitudes, and strengths of diverse adults with ADHD both in the US and abroad is a crucial gap for future qualitative and mixed-methods work to fill.</p> <hd id="AN0188320983-15">Wider Age Range of Adults With ADHD</hd> <p>Although ADHD was once thought of as a childhood-limited disorder, in recent decades, the disorder's continued impact into adulthood has been increasingly acknowledged (e.g., [<reflink idref="bib64" id="ref405">64</reflink>]). Prior quantitative work has highlighted the continuity of ADHD symptoms into older adulthood ([<reflink idref="bib62" id="ref406">62</reflink>]) as well as continued ADHD-related impairment, which may interact with normative age-related challenges (for a review, see [<reflink idref="bib13" id="ref407">13</reflink>]). However, on the whole, older adults (50+) with ADHD have been understudied in both the qualitative and quantitative literature. Although two of the reviewed studies specifically highlighted the experiences of older adults with ADHD ([<reflink idref="bib22" id="ref408">22</reflink>]; [<reflink idref="bib50" id="ref409">50</reflink>]; all diagnosed age 40+), continued qualitative research can and should explore how individuals with ADHD navigate the disorder across the lifespan and into old age. It will be important to understand how older adults with ADHD deal with age-related changes in physical and cognitive abilities; decisions about retirement; (for some) roles as parents or grandparents; and an ever-changing landscape of government benefits and health insurance. This work may highlight areas where additional support and services can be provided to promote health-related quality of life among older adults with ADHD and their families.</p> <hd id="AN0188320983-16">Conclusions and Implications</hd> <p>Qualitative and mixed-methods research on ADHD has contributed greatly to our understanding of the impact, coping strategies, treatment decisions, and complex identities of adults with ADHD in ways that complement and extend existing quantitative research. Identity, decisions about disclosure, and perceived symptoms/domains of impairment show both important similarities as well as differences with respect to the timing of diagnosis (e.g., childhood vs. adulthood diagnosis) and sample composition (e.g., college students vs. general adults). Clinically, it is important to consider and explore how and whether individuals identify with the disorder and the degree to which they believe symptoms are present and impairing, as such perceptions have marked implications for willing-ness to seek out and engage with treatment. Highlighting developmentally specific ADHD-related concerns, for instance, while navigating college, parenting, retirement, menopause, and the menstrual cycle, will be critical for future qualitative and quantitative research to further individualize therapeutic treatment.</p> <p>Future research incorporating qualitative methods should extend current work by emphasizing (<reflink idref="bib1" id="ref410">1</reflink>) multiple reporters; (<reflink idref="bib2" id="ref411">2</reflink>) individuals who were diagnosed with ADHD as children, and their perspectives and healthcare needs as adults; (<reflink idref="bib3" id="ref412">3</reflink>) experiences of women and gender-diverse individuals; and (<reflink idref="bib4" id="ref413">4</reflink>) demographically diverse samples (in terms of culture, race/ethnicity, and age). These foci will be essential to increasing the field's knowledge of the impact of ADHD on adults in ways that can inform the implementation of treatments, coping strategies, and accommodations that are more accessible, evidence-based, and helpful for adults with ADHD, most of whom continue to struggle with the disorder despite positive aspects and strengths.</p> <ref id="AN0188320983-17"> <title> Footnotes </title> <blist> <bibl id="bib1" idref="ref1" type="bt">1</bibl> <bibtext> EAR, PSJ, JTM, and TW conceived of the project. JTM, TW, and PSJ provided feedback on searches and project scope, as did LTH and LGA. EAR developed the search strategy, conducted searches, wrote the manuscript, edited the manuscript, and supervised CY and NS. NS conducted searches, extracted information, and provided feedback on the manuscript. CY extracted data from papers and produced tables. JTM, TW, PSJ, LTH, LGA, and SPH reviewed and provided feedback on the manuscript as well as supervision. All authors reviewed the manuscript.</bibtext> </blist> <blist> <bibl id="bib2" idref="ref2" type="bt">2</bibl> <bibtext> This review paper relied on published papers, which are available via their journal websites.</bibtext> </blist> <blist> <bibl id="bib3" idref="ref3" type="bt">3</bibl> <bibtext> The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SPH receives grant support from the National Institute of Mental Health as well as book royalties from Oxford University Press, St. Martin's Press, Wiley, Guilford, and Ballantine. JTM acknowledges research support, consulting, and/or royalties from Guilford Press, Lumos Labs, MindFit, and Keller Postman LLC over the past 2 years. No other authors have competing interests to disclose.</bibtext> </blist> <blist> <bibl id="bib4" idref="ref4" type="bt">4</bibl> <bibtext> The author(s) received no financial support for the research, authorship, and/or publication of this article.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref386" type="bt">5</bibl> <bibtext> As this is a review and synthesis of existing publications, this project did not require ethical approval.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref68" type="bt">6</bibl> <bibtext> Not applicable.</bibtext> </blist> <blist> <bibl id="bib7" idref="ref69" type="bt">7</bibl> <bibtext> Emily A. Rosenthal</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0001-9296-7427 John T. Mitchell</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0002-9586-3823 Stephen P. Hinshaw</bibtext> </blist> <blist> <bibtext>Graph</bibtext> </blist> <blist> <bibtext>https://orcid.org/0000-0001-6497-1082 Peter S. Jensen</bibtext> </blist> <blist> <bibtext>Graph https://orcid.org/0000-0003-2387-0650</bibtext> </blist> <blist> <bibl id="bib8" idref="ref323" type="bt">8</bibl> <bibtext> We highlight that these are <emph>perceived</emph> strengths that are attributed to ADHD by adults with the disorder. Absent additional evidence from other sources, we are unable to say if these are <emph>objective</emph> strengths, <emph>relative</emph> strengths, or factors that differentiate individuals with ADHD from the general population. Nor can we conclude that ADHD per se is a causal factor in these individual differences should they exist. For instance, creativity was an oft-mentioned strength by adults with ADHD; however, a review found that adults with ADHD do not show enhanced performance on measures of convergent thinking and that ADHD symptoms (but not diagnosis) are linked to improved performance on measures of divergent thinking ([26]). A full discussion of self-perceptual biases in adults with ADHD is beyond the scope of this review, but we note that overestimation of one's abilities is not uncommon for youth (especially boys) with ADHD. 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Journal of Attention Disorders, 11(4), 493–503. https://doi.org/10.1177/1087054707305172</bibtext> </blist> </ref> <aug> <p>By Emily A. Rosenthal; John T. Mitchell; Thomas S. Weisner; Natalie Silverstein; Christopher Yi; L. Eugene Arnold; Lily T. Hechtman; Stephen P. Hinshaw and Peter S. Jensen</p> <p>Reported by Author; Author; Author; Author; Author; Author; Author; Author; Author</p> <p></p> <p>Emily A. Rosenthal, MA, is a Clinical Science PhD student at the University of California, Berkeley, and a member of the Hinshaw Lab. Her work focuses understanding the developmental consequences and trajectory of ADHD across the lifespan using both qualittive and quantitative methods. She is currently completing her predoctoral internship at Duke University School of Medicine.</p> <p>John T. Mitchell is an Associate Professor of Psychiatry and Behavioral Sciences at Duke University School of Medicine and the Duke ADHD Program. His research interests include ADHD across the lifespan and treatment development, including the application of mindfulness-based interventions and community-partnered research.</p> <p>Thomas S. Weisner, PhD, is a distinguished professor of anthropology, Emeritus, in the Departments of Psychiatry and Anthropology, University of California, Los Angeles (UCLA). His research interests are in culture and human development, families and children at risk, mixed research methods, and evidence-informed policy. His books include Discovering Successful Pathways in Human Development, and Higher Ground (with Greg Duncan and Aletha Huston).</p> <p>Natalie Silverstein, BA, JD, completed her undergraduate degree in Psychology at the University of California, Berkeley, and worked as a research assistant in the Hinshaw Lab during this time. She recently graduated from the University of Pennsylvania Carey Law School.</p> <p>Christopher Yi, BA, completed his undergraduate degree in Psychology at the University of California, Berkeley and is a research assistant in the Hinshaw Lab.</p> <p>L. Eugene Arnold, MD, MEd (deceased), was an emeritus professor at Ohio State University where he previously served as the director of the division of child psychiatry and vice-chair of the department of psychiatry. His extensive research legacy includes involvement in the NIMH Multimodal Treatment Study of Children with ADHD, and in studies of alternative and complementary treatments for neurodevelopmental disorders.</p> <p>Lily T. Hechtman, MD, FRCP, is a tenured Professor in the departments of Psychiatry and Pediatrics at Mcgill University, Head of ADHD Fellowship program at Mcgill University, Director of Research for the division of Child and Adolescent Psychiatry at Mcgill University, and the Director of ADHD Child and Adolescent Psychiatry Services at Montreal Children's Hospital.</p> <p>Stephen P. Hinshaw, PhD, is a Distinguished Professor of Psychology at the University of California, Berkeley, and Professor of Psychiatry and Behavioral Sciences at the University of California, San Francisco. His research focuses on longitudinal trajectories of and mechanism-focused clinical trials for youth with ADHD, as well as models of stigma reduction for mental and neurodevelopmental conditions.</p> <p>Peter S. Jensen, MD, is a professor of Psychiatry in the College of Medicine at the University of Arkansas for Medical Sciences and is Board Chair and Founder of the REACH Institute, a non-profit organization dedicated to transforming U.S. children's mental health services with evidence-based assessment and treatment practices. Prior to founding REACH, he served as the associate director, National Institute of Mental Health, for Child & Adolescent Research, and the Ruane Professor of Child Psychiatry, Columbia University. With scholarly publications numbering more than 300 articles and chapters, and 22 books, his current research focuses on implementation and dissemination of evidence-based practices.</p> </aug> <nolink nlid="nl1" bibid="bib24" firstref="ref6"></nolink> <nolink nlid="nl2" bibid="bib64" firstref="ref7"></nolink> <nolink nlid="nl3" bibid="bib72" firstref="ref8"></nolink> <nolink nlid="nl4" bibid="bib21" firstref="ref9"></nolink> <nolink nlid="nl5" bibid="bib45" firstref="ref10"></nolink> <nolink nlid="nl6" bibid="bib56" firstref="ref11"></nolink> <nolink nlid="nl7" bibid="bib79" firstref="ref12"></nolink> <nolink nlid="nl8" bibid="bib76" firstref="ref13"></nolink> <nolink nlid="nl9" bibid="bib77" firstref="ref14"></nolink> <nolink nlid="nl10" bibid="bib78" firstref="ref15"></nolink> <nolink nlid="nl11" bibid="bib49" firstref="ref18"></nolink> <nolink nlid="nl12" bibid="bib33" firstref="ref19"></nolink> <nolink nlid="nl13" bibid="bib19" firstref="ref20"></nolink> <nolink nlid="nl14" bibid="bib29" firstref="ref21"></nolink> <nolink nlid="nl15" bibid="bib68" firstref="ref22"></nolink> <nolink nlid="nl16" bibid="bib54" firstref="ref24"></nolink> <nolink nlid="nl17" bibid="bib16" firstref="ref25"></nolink> <nolink nlid="nl18" bibid="bib39" firstref="ref27"></nolink> <nolink nlid="nl19" bibid="bib28" firstref="ref29"></nolink> <nolink nlid="nl20" bibid="bib52" firstref="ref30"></nolink> <nolink nlid="nl21" bibid="bib30" firstref="ref37"></nolink> <nolink nlid="nl22" bibid="bib44" firstref="ref39"></nolink> <nolink nlid="nl23" bibid="bib73" firstref="ref40"></nolink> <nolink nlid="nl24" bibid="bib46" firstref="ref42"></nolink> <nolink nlid="nl25" bibid="bib18" firstref="ref48"></nolink> <nolink nlid="nl26" bibid="bib34" firstref="ref49"></nolink> <nolink nlid="nl27" bibid="bib37" firstref="ref50"></nolink> <nolink nlid="nl28" bibid="bib42" firstref="ref51"></nolink> <nolink nlid="nl29" bibid="bib43" firstref="ref52"></nolink> <nolink nlid="nl30" bibid="bib57" firstref="ref53"></nolink> <nolink nlid="nl31" bibid="bib67" firstref="ref54"></nolink> <nolink nlid="nl32" bibid="bib70" firstref="ref55"></nolink> <nolink nlid="nl33" bibid="bib75" firstref="ref56"></nolink> <nolink nlid="nl34" bibid="bib14" firstref="ref58"></nolink> <nolink nlid="nl35" bibid="bib20" firstref="ref59"></nolink> <nolink nlid="nl36" bibid="bib22" firstref="ref60"></nolink> <nolink nlid="nl37" bibid="bib25" firstref="ref61"></nolink> <nolink nlid="nl38" bibid="bib48" firstref="ref62"></nolink> <nolink nlid="nl39" bibid="bib50" firstref="ref63"></nolink> <nolink nlid="nl40" bibid="bib61" firstref="ref64"></nolink> <nolink nlid="nl41" bibid="bib69" firstref="ref65"></nolink> <nolink nlid="nl42" bibid="bib74" firstref="ref66"></nolink> <nolink nlid="nl43" bibid="bib81" firstref="ref67"></nolink> <nolink nlid="nl44" bibid="bib11" firstref="ref70"></nolink> <nolink nlid="nl45" bibid="bib15" firstref="ref71"></nolink> <nolink nlid="nl46" bibid="bib31" firstref="ref72"></nolink> <nolink nlid="nl47" bibid="bib32" firstref="ref73"></nolink> <nolink nlid="nl48" bibid="bib35" firstref="ref74"></nolink> <nolink nlid="nl49" bibid="bib36" firstref="ref75"></nolink> <nolink nlid="nl50" bibid="bib40" firstref="ref76"></nolink> <nolink nlid="nl51" bibid="bib41" firstref="ref77"></nolink> <nolink nlid="nl52" bibid="bib47" firstref="ref78"></nolink> <nolink nlid="nl53" bibid="bib51" firstref="ref79"></nolink> <nolink nlid="nl54" bibid="bib53" firstref="ref80"></nolink> <nolink nlid="nl55" bibid="bib58" firstref="ref81"></nolink> <nolink nlid="nl56" bibid="bib59" firstref="ref82"></nolink> <nolink nlid="nl57" bibid="bib60" firstref="ref83"></nolink> <nolink nlid="nl58" bibid="bib55" firstref="ref104"></nolink> <nolink nlid="nl59" bibid="bib27" firstref="ref105"></nolink> <nolink nlid="nl60" bibid="bib71" firstref="ref106"></nolink> <nolink nlid="nl61" bibid="bib38" firstref="ref375"></nolink> <nolink nlid="nl62" bibid="bib65" firstref="ref387"></nolink> <nolink nlid="nl63" bibid="bib66" firstref="ref388"></nolink> <nolink nlid="nl64" bibid="bib10" firstref="ref391"></nolink> <nolink nlid="nl65" bibid="bib80" firstref="ref395"></nolink> <nolink nlid="nl66" bibid="bib17" firstref="ref396"></nolink> <nolink nlid="nl67" bibid="bib63" firstref="ref398"></nolink> <nolink nlid="nl68" bibid="bib12" firstref="ref400"></nolink> <nolink nlid="nl69" bibid="bib23" firstref="ref401"></nolink> <nolink nlid="nl70" bibid="bib62" firstref="ref406"></nolink> <nolink nlid="nl71" bibid="bib13" firstref="ref407"></nolink>
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  Label: Title
  Group: Ti
  Data: What Can Adults with ADHD Tell Us about Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: <searchLink fieldCode="AR" term="%22Emily+A%2E+Rosenthal%22">Emily A. Rosenthal</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-9296-7427">0000-0001-9296-7427</externalLink>)<br /><searchLink fieldCode="AR" term="%22John+T%2E+Mitchell%22">John T. Mitchell</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9586-3823">0000-0002-9586-3823</externalLink>)<br /><searchLink fieldCode="AR" term="%22Thomas+S%2E+Weisner%22">Thomas S. Weisner</searchLink><br /><searchLink fieldCode="AR" term="%22Natalie+Silverstein%22">Natalie Silverstein</searchLink><br /><searchLink fieldCode="AR" term="%22Christopher+Yi%22">Christopher Yi</searchLink><br /><searchLink fieldCode="AR" term="%22L%2E+Eugene+Arnold%22">L. Eugene Arnold</searchLink><br /><searchLink fieldCode="AR" term="%22Lily+T%2E+Hechtman%22">Lily T. Hechtman</searchLink><br /><searchLink fieldCode="AR" term="%22Stephen+P%2E+Hinshaw%22">Stephen P. Hinshaw</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0001-6497-1082">0000-0001-6497-1082</externalLink>)<br /><searchLink fieldCode="AR" term="%22Peter+S%2E+Jensen%22">Peter S. Jensen</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0003-2387-0650">0000-0003-2387-0650</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22Journal+of+Attention+Disorders%22"><i>Journal of Attention Disorders</i></searchLink>. 2025 29(13):1190-1212.
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  Data: SAGE Publications. 2455 Teller Road, Thousand Oaks, CA 91320. Tel: 800-818-7243; Tel: 805-499-9774; Fax: 800-583-2665; e-mail: journals@sagepub.com; Web site: https://sagepub.com
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  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 23
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2025
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles<br />Information Analyses
– Name: Audience
  Label: Education Level
  Group: Audnce
  Data: <searchLink fieldCode="EL" term="%22Higher+Education%22">Higher Education</searchLink><br /><searchLink fieldCode="EL" term="%22Postsecondary+Education%22">Postsecondary Education</searchLink>
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: <searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Attention+Deficit+Hyperactivity+Disorder%22">Attention Deficit Hyperactivity Disorder</searchLink><br /><searchLink fieldCode="DE" term="%22Qualitative+Research%22">Qualitative Research</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Methodology%22">Research Methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Research+Needs%22">Research Needs</searchLink><br /><searchLink fieldCode="DE" term="%22Substance+Abuse%22">Substance Abuse</searchLink><br /><searchLink fieldCode="DE" term="%22Drug+Therapy%22">Drug Therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Severity+%28of+Disability%29%22">Severity (of Disability)</searchLink><br /><searchLink fieldCode="DE" term="%22Self+Concept%22">Self Concept</searchLink><br /><searchLink fieldCode="DE" term="%22Social+Bias%22">Social Bias</searchLink><br /><searchLink fieldCode="DE" term="%22Emotional+Response%22">Emotional Response</searchLink><br /><searchLink fieldCode="DE" term="%22Clinical+Diagnosis%22">Clinical Diagnosis</searchLink><br /><searchLink fieldCode="DE" term="%22College+Students%22">College Students</searchLink><br /><searchLink fieldCode="DE" term="%22Coping%22">Coping</searchLink><br /><searchLink fieldCode="DE" term="%22Academic+Accommodations+%28Disabilities%29%22">Academic Accommodations (Disabilities)</searchLink><br /><searchLink fieldCode="DE" term="%22Females%22">Females</searchLink><br /><searchLink fieldCode="DE" term="%22Minority+Groups%22">Minority Groups</searchLink><br /><searchLink fieldCode="DE" term="%22Older+Adults%22">Older Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Early+Experience%22">Early Experience</searchLink>
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1177/10870547251352589
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1087-0547<br />1557-1246
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: 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.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2025
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1485155
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1485155
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1177/10870547251352589
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 23
        StartPage: 1190
    Subjects:
      – SubjectFull: Adults
        Type: general
      – SubjectFull: Attention Deficit Hyperactivity Disorder
        Type: general
      – SubjectFull: Qualitative Research
        Type: general
      – SubjectFull: Research Methodology
        Type: general
      – SubjectFull: Research Needs
        Type: general
      – SubjectFull: Substance Abuse
        Type: general
      – SubjectFull: Drug Therapy
        Type: general
      – SubjectFull: Severity (of Disability)
        Type: general
      – SubjectFull: Self Concept
        Type: general
      – SubjectFull: Social Bias
        Type: general
      – SubjectFull: Emotional Response
        Type: general
      – SubjectFull: Clinical Diagnosis
        Type: general
      – SubjectFull: College Students
        Type: general
      – SubjectFull: Coping
        Type: general
      – SubjectFull: Academic Accommodations (Disabilities)
        Type: general
      – SubjectFull: Females
        Type: general
      – SubjectFull: Minority Groups
        Type: general
      – SubjectFull: Older Adults
        Type: general
      – SubjectFull: Early Experience
        Type: general
    Titles:
      – TitleFull: What Can Adults with ADHD Tell Us about Their Experiences? A Review of Qualitative Methods to Map a New Research Agenda
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Emily A. Rosenthal
      – PersonEntity:
          Name:
            NameFull: John T. Mitchell
      – PersonEntity:
          Name:
            NameFull: Thomas S. Weisner
      – PersonEntity:
          Name:
            NameFull: Natalie Silverstein
      – PersonEntity:
          Name:
            NameFull: Christopher Yi
      – PersonEntity:
          Name:
            NameFull: L. Eugene Arnold
      – PersonEntity:
          Name:
            NameFull: Lily T. Hechtman
      – PersonEntity:
          Name:
            NameFull: Stephen P. Hinshaw
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          Name:
            NameFull: Peter S. Jensen
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          Dates:
            – D: 01
              M: 11
              Type: published
              Y: 2025
          Identifiers:
            – Type: issn-print
              Value: 1087-0547
            – Type: issn-electronic
              Value: 1557-1246
          Numbering:
            – Type: volume
              Value: 29
            – Type: issue
              Value: 13
          Titles:
            – TitleFull: Journal of Attention Disorders
              Type: main
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