ADHD in context: Young adults' reports of the impact of occupational environment on the manifestation of ADHD.
Does changing context play a role in the decline in ADHD symptoms in adulthood? Insufficient research has explored the functioning of adults with ADHD. As adults, individuals with ADHD have significantly more latitude to control aspects of their day-to-day environments. Do the new contexts young adults find themselves in alter their experience of ADHD? Are there particular occupational or educational contexts in which young adults report functioning better than others? To examine this issue, we conducted semi-structured interviews at four North American sites in 2010-11 with 125 young adults, originally diagnosed with ADHD as children, regarding their work and post-secondary educational environments. Many subjects describe their symptoms as context-dependent. In some contexts, participants report feeling better able to focus; in others, their symptoms-such as high energy levels-become strengths rather than liabilities. Modal descriptions included tasks that were stressful and challenging, novel and required multitasking, busy and fast-paced, physically demanding or hands-on, and/or intrinsically interesting. Consistent with a developmental psychopathology framework, ADHD is experienced as arising from an interaction between our subjects and their environments. These findings demonstrate the need to account for the role of context in our understanding of ADHD as a psychiatric disorder, especially as it manifests in young adulthood.
David Geffen School of Medicine and Department of Anthropology, University of California, Los Angeles, USA. Electronic address: alasky@mednet.ucla.edu.
Arielle K
AK
Lasky
Departments of Psychiatry and Anthropology, University of California, Los Angeles, USA. Electronic address: tweisner@ucla.edu.
Thomas S
TS
Weisner
Department of Psychiatry, University of Arkansas for Medical Sciences, USA. Electronic address: PSJensen@uams.edu.
Peter S
PS
Jensen
Department of Psychology, University of California, Berkeley, USA. Electronic address: hinshaw@berkeley.edu.
Stephen P
SP
Hinshaw
Department of Psychiatry, McGill University, Canada. Electronic address: lily.hechtman@mcgill.ca.
Lily
L
Hechtman
Department of Psychiatry, Ohio State University, USA. Electronic address: L.Arnold@osumc.edu.
L Eugene
LE
Arnold
Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, USA. Electronic address: desireew@email.unc.edu.
Desiree
D
W Murray
Department of Pediatrics, University of California, Irvine, USA. Electronic address: jmswanso@uci.edu.
James M
JM
Swanson
D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000523:psychology*; D005260:Female; D062489:Health Impact Assessment; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016272:Occupational Health / Q000592:standards*; D036301:Qualitative Research; D017132:Workplace / Q000523:psychology / Q000592:standards*
Adult ADHD; Attention deficit hyperactivity disorder; Environmental context; North America; Occupation; Psychiatry; Qualitative research