Stress and work-related mental illness among working adults with ADHD: a qualitative study

What about neurodiversity among nurses? A cross-sectional exploration of work environment and health among nurses with ADHD and/or autism

BackgroundEmployees who have ADHD and/or autism frequently encounter difficulties in their workplace and with their health. Nevertheless, there is a dearth of research focusing on nurses who have ADHD and/or autism, even though the nursing profession presents various significant organizational and social challenges that may potentially have an impact on nurses with ADHD and/or autism.ObjectiveThe aim of the present study was to describe and examine associations between work environment, perceived health and satisfaction with given care among nurses who have ADHD and/or autism.MethodsRecruitment of participants took place through Swedish social media groups, and data collection was carried out via a web-based questionnaire. A total of 99 nurses who self-reported a diagnosis of ADHD and/or autism were included in the study. Descriptive statistics, binary correlations and linear regression analyses were conducted to analyze the data.ResultsThe nurses reported high quantitative demands at work, low sense of social community and managerial social support, low perceived health and high satisfaction with given care. Regarding associations between variables, nurses with more inattention (ADHD trait) reported higher quantitative demands at work, and nurses with more social anxiety (autistic trait) reported lower perceived health.ConclusionsAmong nurses with ADHD and/or autism, the organizational and social work environment and health are challenging, and these challenges seem to be partly connected to the ADHD and autistic traits. However, patient care was perceived to work well. More research is needed to evaluate how the perceived health of nurses with ADHD/autism can be improved.

"A one-stop shop": Real-world use and app-users' experiences of a psychoeducational smartphone app for adults with ADHD

Objective

Smartphone apps have the potential to be accessible tools to provide psychoeducation for adults with Attention-Deficit/Hyperactivity Disorder (ADHD). The Adult ADHD App aims to provide psychoeducation about ADHD and supports available in Ireland. The present study aimed to investigate acceptability and user engagement of the Adult ADHD App by auditing real-world use data and gaining qualitative feedback from app users.

Methods

App analytical data was audited from the Google Analytics platform. Fourteen app-users, nine of whom identified as women and five as men, with an age range of 26-65 (M = 40.29, SD = 11.14), participated in semi-structured interviews. Reflexive thematic analysis was employed to develop themes on app-users' experiences.

Results

The audit of app analytics indicated that over a period of one year, 12,000 people actively used the app and 6400 users returned after their initial use. We developed four themes from the interviews: 'An evidence-based tool for understanding adult ADHD' highlighted that the Adult ADHD App provides trustworthy psychoeducation on ADHD. 'Recommendations for ADHD-friendly adaptations' identified modifications to improve usability of the app. 'Meeting the needs of different stages in the ADHD journey' showed that while the app significantly benefitted adults new to their ADHD, adults who were familiar with their ADHD sought an app that would help them in moments of challenge. 'Perception of public services impacts app experience' suggested that people's attitudes and experiences of the public health system in Ireland affected their views of app content.

Conclusion

The Adult ADHD App appears to meet its aims of providing psychoeducation on adult ADHD. Elements can be modified to improve usability. Digital health tools created by public health organisations should consider how people's previous experiences with healthcare services can impact how they perceive the information in the tools.

Conceptualizing adult ADHD with the DSM alternative model of personality disorder

Personality traits and personality disorders are related to ADHD and indicate dysfunction in clinical populations. The goals of this study were to examine how the DSM-5 Alternative Model of Personality Disorder (AMPD) a) indicates the presence of ADHD and b) communicates information about dysfunction over and above ADHD diagnosis. A sample of 330 adult psychiatric patients with and without ADHD (60% female; mean age 33 years) were assessed for ADHD symptoms, personality impairment, maladaptive personality traits, and functional life impairment domains. The maladaptive personality domain Disinhibition and particularly the lower order facet of Distractibility distinguished between individuals with psychiatric difficulties with and without ADHD. Distractibility is strongly related to the ADHD symptom dimension Inattentiveness, and Antagonism to Hyperactivity/impulsivity. General personality impairment augmented ADHD diagnosis in predicting life impairments. The AMPD has utility in ADHD assessments for diagnosis and prognosis.

Feeling like an untapped resource. Experiences of working life among nurses with ADHD and/or autism: An interview study

BACKGROUND

ADHD and autism are common and increasing neurodevelopmental disorders in the world and also occur among nurses. However, almost nothing is known about nurses with these diagnoses. To promote high-quality care provision and well-being in the nursing workforce, it is important to discover more about these nurses. Therefore, in the present study, we aimed to describe how nurses with ADHD and/or autism experience their working life.

METHODS

The study was descriptive in design. Nurses were invited via Swedish Facebook groups targeting nurses. Semi-structured individual interviews were conducted with 17 nurses with ADHD and/or autism, online or by telephone. Data were analyzed using qualitative content analysis.

RESULTS

One overarching theme and seven subthemes emerged from the analysis. The theme "feeling like an untapped resource" reflected the subthemes: 1) Being passionate about one's job, 2) having strengths and talents to use in working life, 3) a stressful and disturbing work environment inhibits personal strengths, 4) managers show goodwill but lack knowledge and resources, 5) feeling appreciated but socially different among colleagues, 6) using a variety of strategies to facilitate working life and 7) toward an uncertain future.

CONCLUSION

Nurses with ADHD and/or autism experience having abilities and talents that are useful in the nursing profession. However, they feel that the physical and organizational working conditions and lack of managerial support entail challenges that prevent them from making optimal use of their strengths.

Patient, supporter and primary healthcare professional perspectives on health risks in over 16s with attention deficit hyperactivity disorder (ADHD) in England: a national survey study

BACKGROUND

Current research suggests that people with attention deficit hyperactivity disorder (ADHD) are at higher risk of physical and mental health disorders. This study aimed to explore these health risks in ADHD from the perspectives of multiple stakeholders.

METHODS

This study forms part of the 'Managing young people with ADHD in Primary care (MAP) study'. A survey developed by the study team was distributed to over 16 year olds with ADHD, their supporters, primary healthcare professionals and health commissioners across England, via social media and through patient/clinical networks (September-October 2022). This survey contained two questions on health risks. Question one asked about views on health risks in ADHD (free text). Question two asked about advice given (options list and free text). Descriptive statistics summarised responses to questions one and two, and qualitative analysis (reflexive thematic analysis) was used to explore free text responses from question one.

RESULTS

782 participants responded to the MAP survey. Of these, 206 healthcare professionals, 157 people with ADHD and 88 supporters answered question one. The most mentioned perceived risks were substance misuse, sleep disorders, weight management and smoking. More people with ADHD reported disordered eating as a health risk (n = 32) than healthcare professionals (n = 5). Generated themes included perceived health risks, impact of living with ADHD, lack of adequate healthcare, and need for ADHD awareness. In respect to advice given (question two), based on responses from 258 professionals, 162 people with ADHD and 100 supporters, the most common advice discussed in consultation was mental health (n = 149, n = 50 and n = 17 respectively). High numbers of respondents reported not giving/receiving advice on wider health (n = 38, n = 88 and n = 61 respectively).

CONCLUSIONS

Findings demonstrate that respondents perceived a range of physical and mental health risks posed by ADHD. These related to difficulties with activities of daily living, as well as healthcare interactions and the impact of core features of ADHD (e.g. impulsivity, emotional dysregulation). These risks are not currently explicitly addressed in United Kingdom national guidance on ADHD. More work is needed to examine and address the broader health outcomes of people with ADHD.

Executive function deficits mediate the relationship between employees' ADHD and job burnout

Adults with Attention-Deficit/Hyperactivity Disorder (ADHD) often face significant deficits in executive function and adverse work-related outcomes. This study aimed to explore the role of executive function deficits in job burnout of employees with ADHD. We hypothesized that employees with ADHD, relative to employees without ADHD, will experience higher levels of job burnout and deficits in executive function. We also hypothesized that the ADHD-job burnout relationship would be mediated through executive function deficits, specifically by self-management to time and self-organization/problem-solving. A field study with 171 employees provided support for the research hypotheses and mediation model in which the employees' ADHD-job burnout relationship was mediated through executive function deficits. Additional mediation analyses indicated that the specific executive function of self-management to time and self-organization/problem-solving mediated the effect of ADHD on job burnout and its facets. Specifically, for physical fatigue, the mediation was realized through self-management to time, and for emotional exhaustion and cognitive weariness, the mediation was significant through self-organization/problem-solving. The present findings shed light on the relevance of referring ADHD among employees, their vulnerability to job burnout, and the role of executive function deficits in job burnout of employees with ADHD.

A study protocol of a randomized controlled study of internet-based cognitive behavioral therapy for adult attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by hyperactivity, impulsivity and lack of attention. It can have a major impact on everyday life and result in negative consequences for one's personal, academic, and work situation. For individuals with symptoms of ADHD, increased levels of anxiety and depression are common, and an overall reduction of quality of life is often present. This study protocol describes a clinical trial of internet-based cognitive behavioral therapy (iCBT), using a randomized controlled study design, with the primary aim to increase quality of life, as well as to reduce symptoms of ADHD, anxiety, depression, and stress. A second aim is to investigate, by qualitative means, what aspects of treatment were perceived as helpful and hindering when it comes to completing iCBT. Two hundred participants with symptoms of ADHD will be included and randomized to two conditions (treatment and wait-list control). The treatment period is comprised of a maximum of ten weeks, with two mandatory modules and ten modules from which the participants can choose freely. Self-report measures will be completed by the participants at baseline and end of treatment, as well as at a six-month follow-up. The treatment is guided by therapists and consists of weekly correspondence with the participants. The study will utilize an intention to treat design, with ANOVAs and Reliable Change Index to evaluate treatment effects. The qualitative part of the project will be interview-based and employ thematic analysis. Lastly, a psychometric evaluation of a common instrument for determining ADHD-symptoms will also be made. The results will hopefully contribute to the evidence base for iCBT for individuals with symptoms of ADHD and help disseminate potentially effective interventions.