The relationship between ADHD symptoms in college students and core components of maladaptive personality
Introduction
Attention Deficit Hyperactivity Disorder (ADHD) is a common developmental disorder and occurs in about 7% of children (Faraone, 2005). Many children with ADHD grow out of their symptoms of inattention, hyperactivity and impulsivity, but the symptoms sometimes persist into young adulthood (Brassett-Grundy and Butler, 2004a, Brassett-Grundy and Butler, 2004b; Faraone, 2005). It is estimated that up to 4.4% of adults meet the diagnostic criteria for ADHD (Kessler et al., 2006), whilst others are partly in remission (Young & Gudjonsson, 2008). Psychiatric co-morbidity, delinquency, and psychosocial problems are commonly reported and some children are at risk of the development of psychiatric problems and antisocial personality disorder in adulthood (Bernstein et al., 1996, Biederman et al., 1991, Brassett-Grundy and Butler, 2004a, Loeber et al., 2002, Young et al., 2003), as well as offending and drug use (Barkley, Fischer, Smallish, & Fletcher, 2004). Gudjonsson, Sigurdsson, Young, Newton, and Peersen (2009b) suggest that high emotionality commonly found in people with ADHD symptoms may function to exacerbate existing propensities for poor behavioural inhibition and offending.
Maedgen and Carlson (2000) found that children with ADHD had impaired social functioning in comparison with controls, but differences existed between ADHD subgroups. The ADHD combined type was significantly impaired both in terms of social performance and emotional regulation, whereas the predominantly inattentive type only displayed deficits in social knowledge and social passivity. This suggests that it is important to differentiate inattentive from hyperactivity/impulsivity symptoms in research when focusing on functional deficits associated with core maladaptive personality traits.
Young and Gudjonsson (2008) examined the association between ADHD symptom remission and three areas of performance/adaptive functioning – neuropsychological, clinical and psychosocial. They found that ADHD may be a risk for poor adjustment in adult life irrespective of the presence of full symptoms in adulthood. Residual ADHD symptoms in adulthood are significantly associated with dissatisfaction with life (Gudjonsson, Sigurdsson, Eyjonfsdottir, Smari, & Young, 2009a). The reason is that people with a history of ADHD symptoms are likely to experience repeated failures and difficulties, which has undermined their general satisfaction with life (Young & Bramham, 2007). Part of the problem of adults with ADHD is that they have impaired capacity to problem solve and plan activities required for everyday living, which Young, Morris, Toone, and Tyson (2007) suggest is due to the failure to inhibit interfering responses when confronted with problem solving tasks.
The purpose of the present paper is to extend this work by investigating the relationship between ADHD symptoms and core components of maladaptive personality using the Severity Indices of Personality Problems (SIPP; Andrea et al., 2007, Verheul et al., 2008). This is a recently developed self-report questionnaire, which focuses on (mal) adaptive capacities of relevance to personality disorders but is subject to change during therapeutic interventions. The emphasis is on adaptive or maladaptive functions or capacities rather than diagnostic categories, which are categorised into five core or higher-order domains (Self-Control, Responsibility, Identity Integration, Relational Functioning and Social Concordance). The Responsibility domain is directly relevant to impaired planning capacity and goal setting in everyday living, whereas the Self-Control domain is principally related to impaired emotional regulation and poor behavioural control. These are the two domains that are most theoretically related to ADHD symptoms. Our theoretical orientation is that poor personality functioning (i.e., functional impairment) is the outcome of ADHD (Young et al., 2009).
We also included the Reasoning and Rehabilitation (R&R) ADHD Training Evaluation Scale (RATE; Young & Ross, 2007) in view of its relevance to the evaluation of ADHD therapy programmes and the potential importance in relation to life dissatisfaction (Gudjonsson et al., 2009a).
It is hypothesized that ADHD symptoms in adulthood will be significantly correlated with all core components of SIPP, but the Responsibility domain will be the best predictor of ADHD symptoms in view of its direct links with impaired planning activity, followed by the Self-Control domain. In addition, we hypothesise that ADHD symptoms are associated with Responsibility above and beyond Self-Control and that inattention is a better predictor of impaired capacity to set and achieve realistic goals than hyperactivity/impulsivity; the latter are typically more associated with antisocial behaviour and poor self-control (Babinski et al., 1999, Colledge and Blair, 2001, Young, 2007).
Section snippets
Participants
The participants were 397 students from five different further educational establishments in Iceland (two colleges and three universities). There were 141 (35.5%) males and 256 (64.5%) females. The average age for the males was 23.0 years (range 16–57, SD = 7.3) and 23.7 years for the females (range 16–58, SD = 8.2). Five further participants either refused to participate in the study or handed in incomplete questionnaires, which resulted in a completion rate of 99% of all students in class at the
Mean scores
Table 1 shows the mean scores on the ADHD DSM-IV, RATE scales and SIPP domains. The scores are given separately for males and females. The table also shows the t-values between males and females, and Cronbach alpha for all the measures. Significant differences emerged on several of the measures. Females obtained lower scores than males on the ADHD (DSM-IV) childhood measure and RATE Antisocial Behaviour Scale, and higher than males on three of the SIPP domains: Responsibility, Relational
Discussion
The findings in the present study support our hypothesis of a significant association between ADHD symptoms and core maladaptive personality problems as measured by the SIPP. The correlations with the SIPP domains were consistently higher for the adult than childhood ADHD symptoms, but the pattern of correlations across the SIPP domains was similar for the childhood and adult symptoms, suggesting a consistency in the findings in relation to the individual maladaptive personality domains (in the
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