Relationship Between Comorbid Disorders and Work Features Among Adults With Attention Deficit Hyperactivity Disorder (ADHD)

PURPOSE: This study aimed to: (1) Compare sensory and motor comorbid characteristics and work features of adults with and without attention deficit hyperactivity disorder (ADHD); (2) Examine the relationship among these characteristics and cognitive and work efficiency among adults with ADHD. A diagnosis of ADHD is a common disorder found in about 10% of the adult population and has a major influence on their daily occupations, including work participation (de Graaf et al., 2008; Mather, 2013). However, knowledge about the sensory and motor comorbid disorders of adults with ADHD and their relationship with cognitive characteristics and work features is sparse.

DESIGN: This cross-sectional study included 122 currently working adults, aged 21 to 46 years (M = 32.93, SD = 6.44) including 69 adults with ADHD and 53 matched controls, recruited via social media. Participants with ADHD were included based on: (1) existing physician diagnoses, which was supported by their Brown Attention Deficit Disorder Scales (BROWN-ADD) scores (total score>39); (2) Executive Functions (EF) deficits according to Behavioral Rating Inventory of Executive Functions -Adult- BRIEF-A (at least one scale score > 64). Control group participants were included based on: (1) low risk for ADHD, according to BROWN-ADD scores (total score<40); (2) without EF deficits, according to BRIEF-A (< 65 all scales scores ).

METHOD: In addition to the two screening measures, all participants completed a demographic questionnaire, the Adolescent/Adult Sensory Profile (AASP) and the Adult Developmental motor Coordination Disorders Checklist (ADC). Participants completed work features questionnaire and absenteeism and presentism questions of the World Health Organization’s Health and Work Performance Questionnaire (HPQ-short), which evaluate diligent at work and work efficiency. Chi-square tests, independent t-tests and multivariate analyses of variance (MANOVA) were used to identify group differences in sensory (AASP) and motor (ADC) characteristics and work features (work q., HPQ-short). Pearson correlations and regression predictive models were used to examine the relationships between pre-evaluated cognitive characteristics, and sensory and motor characteristics and work features of adults with ADHD.

RESULTS: Compared to the controls, adults with ADHD were significantly at a higher risk of having characteristics of comorbid sensory and motor disorders and were less diligent and efficient in their work. Results in the ADHD group indicated: (1) Significant correlation between behavioral regulation index (BRIEF-A) and a tendency to sensitivity and low registration patterns (AASP) (r= .401; r= .514 p< .01); (2) Medium correlation between metacognition abilities (BRIEF-A) and a tendency towards low registration patterns (AASP) (r= .337**, p< .01). Findings showed a correlation between cognitive (BRIEF-A) and motor (ADC) deficits (r= .545**, p< .01). A regression analysis revealed that cognitive (metacognition abilities) and sensory (low registration) characteristics significantly predicted 32.4% of the variance of work efficiency among adults with ADHD.

CONCLUSION: The results contribute to a deeper understanding of the unique characteristics of comorbid disorders among adults with ADHD, in addition to identifying the relationship between cognitive difficulties and deficient sensory and motor patterns. The results highlight the relationship between cognitive and sensory difficulties with work efficiency in this population.

IMPACT STATEMENT: Comprehensive evaluation of characteristics of adults with ADHD, together with knowledge about the relationship between these characteristics and work efficiency, could contribute to developing work context, self-tailored, occupational-based interventions.

References

de Graaf, R., Kessler, R. C., Fayyad, J., Have, M. t., Alonso, J., Angermeyer, M., . . . Posada-Villa, J. (2008). The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: Results from the WHO world mental health survey initiative. Occupational and Environmental Medicine, 65(12), 835-842. doi:10.1136/oem.2007.038448

Mather, B. A. (2013). Early career experiences of young adults with attention deficit hyperactivity disorder (Unpublished doctoral dissertation). Fielding Graduate University, California.