Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by inattention, hyperactivity, and impulsivity. Traditionally, research and clinical practice have focused on the challenges and deficits associated with ADHD.
However, adopting a strengths-based perspective, which recognizes and emphasizes the positive attributes and abilities of individuals with ADHD, may offer a more balanced and empowering approach.
By shifting the focus towards the unique strengths and talents that often accompany ADHD, such as creativity, hyperfocus, and resilience, individuals with ADHD can be supported in harnessing their potential and improving their overall well-being.
This perspective also challenges the stigma surrounding ADHD and promotes a more inclusive and supportive environment for those living with the condition.
Schippers, L. M., Greven, C. U., & Hoogman, M. (2024). Associations between ADHD traits and self-reported strengths in the general population. Comprehensive Psychiatry, 130, Article 152461. https://doi.org/10.1016/j.comppsych.2024.152461
Key Points
- This study investigated the relationship between self-reported strengths and ADHD traits in a general population sample using quantitative measures.
- Positive correlations were found between ADHD traits and hyperfocus, sensory processing sensitivity, and cognitive flexibility.
- The study used a large, diverse sample and assessed multiple strengths simultaneously, allowing for investigation of interactions between strengths.
- Limitations include reliance on self-report measures, potential issues with measurement scales, and lack of cultural diversity in the sample.
Rationale
ADHD research has historically focused on symptoms and deficits. However, recent qualitative studies have identified various strengths that people with ADHD self-report as being related to their condition (Mahdi et al., 2018; Sedgwick et al., 2019; Schippers et al., 2022).
While these qualitative studies have been important for generating hypotheses, the strengths need to be confirmed in quantitative studies, and it remains unclear whether they are only found in those with an ADHD diagnosis or are also related to ADHD traits in the general population.
Previous quantitative research has focused on single strengths like creativity (Hoogman et al., 2020) and hyperfocus (Hupfeld et al., 2019) in relation to ADHD.
This study builds upon prior qualitative work by Schippers et al. (2022) to quantitatively investigate multiple self-reported strengths and their associations with ADHD traits in a large population-based sample.
Method
The study used a cross-sectional design, administering questionnaires in two waves to optimize attention.
Correlational analyses were performed between ADHD traits and each of the ten strength measures. Exploratory analyses included factor analysis and network analysis.
Procedure
Participants completed questionnaires assessing ADHD traits and ten strengths (empathy, sociability, humor, sensory processing sensitivity, hyperfocus, enthusiasm, grit, curiosity, flexibility, and “up for anything”) that were previously identified in qualitative research. The questionnaires were administered online in two waves.
Sample
694 participants aged 18-60 from the general UK population were included in wave 1, with 496 of those completing wave 2. The sample was gender-balanced, and approximately 3% reported an ADHD diagnosis, in line with population prevalence estimates.
Measures
ADHD traits were assessed with the Adult ADHD Self-Report Scale (ASRS). This scale was used to assess ADHD traits, containing 18 questions related to DSM-V ADHD symptoms, divided into two subscales: inattentiveness and hyperactivity/impulsivity.
The ten strengths were measured with validated scales such as:
- Toronto Empathy Questionnaire (TEQ): The TEQ was employed to measure empathy, which is the ability to understand and share the feelings of others.
- Adult Hyperfocus Questionnaire (AHQ): The AHQ was used to assess hyperfocus, a state of heightened and focused attention that is often associated with ADHD.
- Highly Sensitive Person Scale (HSP): This scale was used to measure sensory processing sensitivity, which refers to an individual’s sensitivity to subtle stimuli in their environment.
Other questionnaires and scales were used.
Statistical Measures
Spearman correlations were used to assess relationships between ADHD traits and strengths. Factor analysis and network analysis were conducted for exploratory purposes.
Group comparisons between diagnosed and undiagnosed participants were made using t-tests or non-parametric alternatives.
Results
Significant positive correlations were found between ADHD traits and hyperfocus (r=0.31), sensory processing sensitivity (r=0.36), and cognitive flexibility (r=0.20).
Significant negative correlations were found with sociability, enthusiasm, “up for anything,” and perseverance.
No significant correlations emerged for empathy, humor, or curiosity.
Those with self-reported ADHD diagnoses scored higher on ADHD traits, hyperfocus, and sensitivity while scoring lower on perseverance compared to those without a diagnosis.
Insight
This study provides quantitative evidence that certain strengths are associated with ADHD traits in the general population, not just in those with diagnosed ADHD.
The positive correlations with hyperfocus, sensory processing sensitivity, and cognitive flexibility suggest these may be strengths inherent to the ADHD trait continuum.
In contrast, the negative correlations or lack of association for other strengths like perseverance hint that some perceived strengths may actually arise as coping mechanisms from living with ADHD rather than being core features.
The network analysis highlighted the importance of investigating multiple strengths simultaneously, as they appear to interact rather than represent totally distinct constructs.
Future research could further unravel these relationships and explore the potential of strength-based approaches in ADHD intervention.
Strengths
The study had several methodological strengths:
- The study benefited from a large, representative sample size (N=694 in wave 1, N=496 in wave 2) that was diverse in terms of age (18-60 years old) and included individuals spanning the full range of ADHD traits, enhancing the generalizability of the findings to the broader population.
- The researchers used a feature in Prolific to balance the sex distribution, resulting in a gender-balanced sample that was 50% female and 50% male, helping to mitigate potential sex-related biases in the results.
- Unlike previous studies that focused on single strengths in isolation, this study assessed ten different strengths within the same sample, allowing for a more comprehensive understanding of the relationships between various strengths and ADHD traits, as well as the exploration of potential interactions among the strengths themselves.
- The choice of which strengths to measure was based on prior qualitative work that identified these strengths as being relevant to individuals with ADHD, enhancing the ecological validity of the findings by grounding the selection of variables in the lived experiences of people with ADHD.
Limitations
Some limitations should be noted:
- The study relied solely on self-report questionnaires to assess both ADHD traits and strengths, without the inclusion of objective cognitive tests or third-party reports, which may influence the accuracy of the data due to potential biases such as social desirability or lack of insight.
- While the study used validated scales to assess strengths, it is possible that some of these scales did not fully capture the nuances of the strength constructs as conceptualized by participants in prior qualitative research, and further refinement of strength measures tailored to the ADHD population could enhance future research.
- The study sample was limited to residents of the United Kingdom, which may limit the generalizability of the findings to other cultural contexts, as perceptions of strengths and their relationship to ADHD traits may vary across different countries and cultural backgrounds.
- The study employed a cross-sectional design, collecting data at a single point in time, which is useful for establishing correlational relationships but does not allow for causal inferences, and longitudinal studies that track the development of strengths and their relationship to ADHD traits over time could provide a more comprehensive understanding of these associations.
Implications
Finding quantitative evidence for certain strengths associated with ADHD could help provide a more balanced view of the condition beyond deficits alone.
Strength-based elements could be incorporated into psychoeducation, reducing stigma and improving self-esteem.
When adapted appropriately, emphasizing strengths could also inform ADHD interventions, workplace accommodations, or career guidance to improve outcomes.
However, more research is needed to determine which strengths are inherent versus compensatory and to establish how to optimize them in support of people with ADHD.
References
Primary reference
Schippers, L. M., Greven, C. U., & Hoogman, M. (2024). Associations between ADHD traits and self-reported strengths in the general population. Comprehensive Psychiatry, 130, Article 152461. https://doi.org/10.1016/j.comppsych.2024.152461
Other references
Hoogman, M., Stolte, M., Baas, M., & Kroesbergen, E. (2020). Creativity and ADHD: A review of behavioral studies, the effect of psychostimulants and neural underpinnings. Neuroscience & Biobehavioral Reviews, 119, 66-85. https://doi.org/10.1016/j.neubiorev.2020.09.029
Hupfeld, K. E., Abagis, T. R., & Shah, P. (2019). Living “in the zone”: hyperfocus in adult ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 191-208. https://doi.org/10.1007/s12402-018-0272-y
Mahdi, S., Viljoen, M., Massuti, R., Selb, M., Almodayfer, O., Karande, S., de Vries, P. J., Rohde, L., & Bölte, S. (2017). An international qualitative study of ability and disability in ADHD using the WHO-ICF framework. European child & adolescent psychiatry, 26, 1219-1231. https://doi.org/10.1007/s00787-017-0983-1
Schippers, L. M., Horstman, L. I., Velde, H. V. D., Pereira, R. R., Zinkstok, J., Mostert, J. C., Greven, C. U., & Hoogman, M. (2022). A qualitative and quantitative study of self-reported positive characteristics of individuals with ADHD. Frontiers in Psychiatry, 13, 922788. https://doi.org/10.3389/fpsyt.2022.922788
Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(3), 241-253. https://doi.org/10.1007/s12402-018-0277-6
Keep Learning
Here are some questions for a college class to discuss this paper:
- How might the findings inform strength-based approaches to ADHD intervention? What elements would you incorporate and why?
- Are there potential downsides to emphasizing strengths associated with ADHD? How could these be mitigated?
- The study suggests some perceived strengths may arise as coping mechanisms rather than being inherent to ADHD itself. How could future research tease apart this distinction and why does it matter?
- Cultural factors likely influence perceptions of what constitutes a “strength.” How might the results differ in samples from other countries or backgrounds?
- Based on the network analysis showing strengths clustering together, what are some hypotheses for how different strengths interact? How would you design a study to test these relationships?
