The Subjective Well-Being of Adults with ADHD: The Contribution of Self-Differentiation, Self-Esteem and Self-Determination

Advisors: Prof. Liora Findler & Dr. Ayelet Gur

Attention Deficit Hyperactivity Disorder (ADHD), is a neurodevelopmental disorder characterized by hyperactivity, impulsiveness and distraction behaviors. Research has provided evidence about the deficits of children and adolescents with ADHD and the relationship between ADHD and their functional and cognitive abilities. However, there are only a few studies on the effects of ADHD on adults. Even more scarce are those that have examined the emotional and social aspects involved in ADHD in adults.

This study investigated several aspects of ADHD in adults (diagnosis of ADHD, severity of symptoms, and age of diagnosis), self-differentiation, self-esteem, and self-determination and their relationships with subjective well-being. The theoretical framework chosen for this study is based on two main theories in the rehabilitation field, which have not been examined in the context of ADHD, and among adults with ADHD in particular. First, is the subjective well-being homeostasis theory, which focuses on the resilience factors protecting people's well-being and keeping their subjective well-being at its average set-point. Second, is the self-determination theory, which focuses on the three basic psychological needs of competence, relatedness and autonomy. The theory maintains that fulfilling these needs contributes to subjective well-being. 

The study's aims are to examine the differences in the research variables between adults with and without ADHD, and to test a mediation model for the subjective well-being of adults with ADHD, based on the ADHD factors, self-differentiation, self-esteem, and self-determination. The sample for this quantitative research was collected using comfort and snowball sampling methods. The sample included 274 men and women, aged 18 and above, 135 with ADHD (the research group), and 139 without ADHD (the control group). The data were collected with an online questionnaire, distributed via social media platforms such as WhatsApp and Facebook, and were analyzed by SPSS (Statistical Package for the Social Sciences) and AMOS (Analysis of Moment Structures). 

The results show that adults with ADHD report significantly lower levels of self-differentiation, self-esteem, self-determination, general subjective well-being, and emotional and psychological subjective well-being compared to adults without ADHD. Thus, adults with ADHD are at risk of experiencing various emotional and social difficulties and challenges, such as over sensitivity, negative self-perception, feelings of having less ability and being a failure, social distancing, dependency, and lower life satisfaction. Despite the compensatory mechanisms they have managed to adapt during their life and their accomplishments in education and employment, adults with ADHD reported struggling with these feelings on a daily basis, highlighting the risks in dealing with ADHD.

In addition, the results indicate a direct connection between self-esteem and subjective well-being among adults with ADHD only, underscoring the importance of self-esteem as a significant personal resource for this population. We can assume that childhood experiences that contribute to the building of self-concept in adolescence and adulthood are more significant for people with ADHD. In addition, these adults are more likely to experience failure, further harming their self-esteem.

The results of the mediation model highlight that the relationship between self-esteem and self-differentiation with subjective well-being among adults with ADHD is defined by the fulfillment of their three basic psychological needs. Those who feel that they have high level skills, that they belong to their society and see it as supporting their autonomy, and those who can distinguish between cognition and emotion and have a more positive attitude towards themselves, are the people who will also have a higher level of subjective well-being. However, given that people with ADHD have difficulty identifying and understanding social cues, it is possible that even into adulthood, adults with ADHD will continue to feel that their basic psychological needs are not fulfilled. Even those who do receive support from their social environment still feel that their self-determination is limited, which, in turn, reduces their subjective well-being.

This research contributes to the knowledge on ADHD by presenting an innovative model to explain the subjective well-being of adults with ADHD based on aspects of ADHD, self-differentiation, self-esteem and self-determination. The mediation model sheds light on the importance of self-determination and the fulfillment of the basic psychological needs as mediators in the relationship between self-differentiation and self-esteem with subjective well-being among adults with ADHD.

This study is also innovative in examining theories and factors that have never been associated with ADHD. The results may improve our understanding of the social and emotional factors that affect adults with ADHD. Having identified these factors, we may be able to develop unique treatment methods for adults with ADHD, as this population is dealing with a wide range of challenges, which did not get a sufficient experimental attention so far.