Is it me, or my ADHD?
I used to go around saying that I was just a person with lots of hobbies. Turns out it’s ADHD. I used to say that I get bored easily so always need to keep busy. Turns out it’s ADHD. I used to say that I’m impatient and want results as soon as possible. Guess what? Also ADHD.
Firstly, this blog today is based on a YouTube video I put out. If you would prefer to watch instead of read, you can find the video here:
Now before I go into today’s post I do have to do the usual disclaimer. This post is not about diagnosing anyone with ADHD. I am not qualified to do so but also there’s a standardised diagnostic criteria that people use to diagnose ADHD and that’s not even close to what I’m talking about today.
Instead, I’ve been reminiscing about my university days by searching google scholar and scrolling through references to find other papers to help me find the answer to what is really a very introspective question.
But in order to get to the meat of this question and ask what is ADHD and what is me, first I need to answer the question: How does ADHD affect our personality?
I actually have some recordings of me talking about what are in hindsight traits of my ADHD a few months before I got really into questioning myself. Here’s one for you:
“I learn things that I am genuinely interested in. When you are genuinely interested it gets you to dive in more”
Sounds like an interest based attention system, right? How about this one:
“I’m a person that’s interested in many different things and I don’t do anything by halves so I kind of throw myself into a lot of different areas”
and then I listed like 10 different hobbies or interests that I do.
You can find this podcast episode here.
I remember being a teenager and talking about the “crazes” as I called them at the time that I went through, when I would obsess over some part of pop culture for months and then pick up a new one, which is exactly how my hyperfixations still work.
But there’s also parts of my personality that aren’t ADHD related at all. Often people with ADHD really benefit from a routine but struggle to keep one up, but I go like clockwork. And if you’re thinking: “that sounds like autism”, then I am aware of that too.
So what I guess I’m saying at this point is that ADHD is very closely intertwined with my personality and I am a bit too close to the inside of my own head to be able to untangle it myself. So I did what any mathematician would do, turn to science.
I want to start off by talking about two studies from 2013 and 2016 that look at personality traits and adult ADHD from two different personality measuring techniques.
Adult ADHD Symptoms and Five Factor Model Traits in a Clinical Sample: A Structural Equation Modelling Approach looks at what I’ve always heard of being referred to as The Big Five personality traits, but from the papers it looks like that’s just the stage name of the Five Factor Model.
The Five Factor Model was arrived at simultaneously by multiple sets of researchers in the 90s and is made up, as the name suggests, of five traits for which we all fall on a continuum. Those five traits are:
Extraversion - outgoing and gregarious, Conscientiousness - organised and self-disciplined, Agreeableness - friendly and compassionate, Neuroticism - sensitive and nervous, and Openness to experience shown by curiosity and inventiveness.
Typically these traits are assessed by a self-report or someone reporting our personality based on their perception of us, rather than there being an objective measure. This is important, because it means that any results are affected by the reporter’s perception of the reportee.
The problem with self-report questionnaires is the inherent bias when taking them. It’s impossible to be completely objective about ourselves.
It’s also important to note certain features of the test population. The study was done on people who were medicated for ADHD but still struggling enough with the symptoms to require further treatment. They were also 84% college educated.
And I’d just like to take a moment to point this out because so many ADHD kids are written off as not being able to achieve academically because of our ADHD when many of us do get degrees and even more probably would with the right support!
But I digress, it’s important to acknowledge that all of these aspects of the sample size can affect the results, as can the fact that 90% of the sample was also white.
The study then looked at three different aspects of ADHD, inattentiveness, hyperactivity and impulsiveness, individually to see how they correlated with personality factors.
I actually really like that they did this. As we all know, people with ADHD aren’t some uniform, monolithic group and like with personality factors, we all sit on different places on the continuum of each of these ADHD traits. The results are super interesting.
The first thing that they noted was that the mean score for conscientiousness for ADHD adults was more than two standard deviations below the standard mean. This is a huge difference and if I’m honest, actually puts me on the defensive. I feel like this is something ADHDers get shamed for; not being organised, not living up to our potential, not “working hard enough”.
On a personal level, despite my struggle with household chores, I’m a bit of a workaholic so I immediately want to be contrarian here. But let’s dive in a little further..
Chores are not my forte, but I don’t let that doubt my conscientiousness.
Because the effect of ADHD on conscientiousness really depends on the set of ADHD symptoms you are looking at. The study found that while inattentiveness correlated with lower conscientiousness, they actually found the opposite for hyperactivity - hyperactive ADHD traits actually positively predicted conscientiousness.
The paper also noted that inattentive symptoms are “most strongly associated with impairment in adults seeking treatment for ADHD”, ie the things we’re most likely to struggle with and seek out treatment for. There’s also a suggestion that this gap in conscientiousness could come from the executive function struggles that are so common with ADHD. But more about that later.
The next largest personality difference between the ADHD group and the standard norms was neuroticism which was shown to be significantly higher in the ADHD group. What’s interesting is that this too was found to be predicted by inattention and not by say impulsivity, which my intuition would have suggested as the culprit due to emotional dysregulation.
This immediately makes me wonder about a cause and affect here - is it the way that we grow up in a society that really looks down on our inattentive symptoms that is causing us to become more neurotic?
ADHDers were also found to have a higher openness to experience, although this was not found to vary with ADHD symptoms.
There was a small effect on agreeableness with ADHDers being less agreeable than the norm. This was linked entirely to the impulsivity traits of ADHD, something they speculate as being caused by emotional dysregulation.
The last link they found was that hyperactivity seemed to be correlated with higher extraversion, although there doesn’t seem to be sufficient evidence to indicate that ADHDers are more extraverted on the whole.
It paints an interesting picture, a suggestion that conscientiousness and neuroticism are both highly affected not only by our ADHD but our particular flavour of symptoms.
Now I just talked through a lot of info and it was actually kind of confusing when I was going through this paper to work out what the actual results are so I’m going to put up a summary I created here:
A summary of results from Adult ADHD Symptoms and Five Factor Model Traits in a Clinical Sample: A Structural Equation Modeling Approach.
The first column are the personality traits of the Five Factor model, the second is how the group of ADHD scored adults compared to the standard and then the next three columns are how each personality trait correlates with each ADHD trait where a positive correlation means the two increase together and a negative correlation means that when one increases, the other decreases.
The second paper I dived into on this topic was called Personality profiles in adults with attention deficit hyperactive disorder (ADHD) by Perroud et al, published in 2016.
This paper comes out the gate strong with its literature review:
“Earlier studies in this field revealed that adults with ADHD tend to be more pessimistic, introverted, rebellious, and aggressive, show high levels of psychological distress, dissatisfaction, low capacity to be organized and self-disciplined, and are less sociable, altruistic and sympathetic to others.”
I don’t know about you but reading this immediately put me on the defensive. It feels a bit like a bad school report or maybe even a personal attack. It also plays into the narrative that I hate which is that everything about ADHD is bad, so I really need to put my personal biases aside to tackle this paper.
But before I do, I do want to note that despite being published three years after the previous paper, it doesn’t reference this paper at all.
Instead of the Five Factor Model used in the previous paper, this paper uses the Temperament and Character Inventory, called the TCI, which is also a self-report questionnaire.
I did do a bit of research to see whether TCI was directly comparable to the Five Factor Model but found this 2012 paper that suggested that most were moderately correlated with one more more of the Big Five dimensions, but the differences outweighed the similarities, suggesting they are inconsistent measurements of personality with each other.
So let’s take a look at the TCI. It has four dimensions of temperament given by Novelty Seeking, Harm Avoidance, Reward Dependence and Persistance, and three dimensions of character given by Self-Directedness, Cooperativeness and Self-Transcendence.
Previous studies on this topic have suggested that adults and children with ADHD have high Novelty Seeking, which they define as impulsive and irritable instead of rigid and stoical, high Harm Avoidance, defined as pessimistic and anxious instead of optimistic and risk-taking.
They also suggest low Persistence, defined as persevering and ambitious versus easily discouraged and indolent, and low Reward Dependence defined as sociable and warm versus aloof and cold.
On the character side, they suggested low Self-Directedness defined as a tendency towards being blaming and inept, low Cooperativeness associated with hostility and opportunism and high Self-Transcendence, associated with being intuitive and insightful.
The study then goes on to say that this supports the idea of low psychological functioning. I find this sentence pretty offensive considering I got the highest mark on my whole masters program but let’s continue.
The term low functioning has received a lot of pushback due to it being offensive, but also many of us who are neurodivergent go on to achieve big things completely at odds with this idea of “low functioning”.
The study decided to investigate these qualities themselves. In contrast with out previous paper, it looked at a majority (75%) unmedicated group and also controlled for other psychiatric comorbidities among the ADHD group, although not the control group.
They found that ADHD was correlated with higher Novelty Seeking, higher Harm Avoidance and higher Self-Transcendence, but lower Self-Directedness and Cooperativeness.
Similarly to the previous paper, this paper split predominantly inattentive ADHD presentations from combined or predominantly hyperactive-impulsive presentations, of which the latter two groups were combined due to the sample size being too small for predominantly hyperactive-impulsive presentations.
Interestingly enough, they found that inattentiveness was actually correlated with lower Novelty Seeking. It was also correlated with higher harm avoidance and lower self-directedness. Hyperactivity was positively correlated with novelty seeking and self-transcendence.
It also made a distinction between severity of current ADHD, the more severe the more novelty seeking, reward dependence and self-transcendence, but the less self-directedness.
From there, the paper gets a little contradictory. For example, it comments on Novelty Seeking being associated with spontaneity and extraversion in social situations but then goes on to say that their studies find people with ADHD tend to be shy and socially reserved.
Another contradiction is the finding that people with ADHD tend to be “easily worried” and fearful (due to the Harm Avoidance trait) but also “satisfied” according to the self-transcendence trait.
The conclusion of the paper ends with suggesting that “ADHD is associated with specific personality traits which may reflect poor mental health outcomes” which is probably very valid, we do tend to be a group that unfortunately struggles with mental health issues.
I do appreciate that they do acknowledge that they haven’t considered environmental issues that are known to affect various personality dimensions and that it is unclear whether these characteristics precede or are caused by ADHD development.
They also acknowledge that inattentive and hyperactive-impulsive seem to have different personality correlations which agrees with the previous paper and suggest longitudinal studies to understand the complexities of personality and ADHD over time.
Again, this is quite a lot to take in so in a summary graphic:
A summary of results from Personality profiles in adults with attention deficit hyperactivity disorder (ADHD).
When I compare this to the previous study, I think it’s interesting to note the samples used in each study. They both have a similar small number of participants, 117 for the Five Factor Model study and 89 for the TCI study. But it’s interesting to note that the TCI study uses language suggesting that people with ADHD have “low psychological functioning” whereas the sample for the Five Factor Model was 84% college educated.
Now of course these two things aren’t the same thing and you’re not “low functioning” or whatever that means if you didn’t go to college, but I do think these two papers come to ADHD from two very different directions and the results should be evaluated with that in mind.
One more thing that has been going through my mind as I read these two studies is the fact that these personality assessments are always done via self-report questionnaires. One thing that is on my mind, especially with this second paper, is that people with ADHD often tend to have lower self-esteem and so when it comes to self-report I can see us ranking ourselves lower on some aspects because of that lower self- esteem.
As I was writing this script, I took a lunch break to watch “Doctor B”, Raffael Boccamazzo, PSYD on a How to ADHD episode where he speaks about a similar concept.
In the context of discussions of relationship abuse for people who are neurodivergent, he says:
“So many of us have been chastised our entire lives and told well you clearly don’t understand what’s going on socially till eventually so many of us just adopt this message of well God I must not understand what’s going on socially and I must be in the wrong.”
And I would argue that self-report questionnaires are picking up on this aspect. For example, when we look at conscientiousness. So many people with ADHD have been told they’re lazy, that they don’t work hard enough, that they’re not reliable, that they’re not ambitious. So of course we internalise it and so when asked to rank ourselves on the conscientiousness scale, of course we’re going to rank ourselves lower.
I would consider this to be both a bias in the methodology of assessing personalities and an exclusion of environmental factors that are at play here.
On a similar topic, I wanted to refer to a third study from 2020 called Executive Functions, Personality Traits and ADHD symptoms in adolescents: A mediation analysis by Krieger and colleagues which looked at the linkage between ADHD, the Five Factor Model and Executive Function.
I actually really liked this paper for a number of reasons, the first being that it has a fantastic explanation of Executive Function at the start but also that it reflected on how ADHD and personality interact in different ways through different stages of life, something that both previous papers have mentioned a need for more studies on at the end.
The study looked at three aspects of Executive Function: Working Memory, Inhibition and Flexibility. Immediately when I see this and the inclusion of flexibility in there my brain goes to: “What about executive function and autism as well?” but this paper is just focused on ADHD, so let’s continue.
I’m not going to go into as much detail about this study and I really recommend you take a look at this paper, but the conclusion I wanted to draw out is as follows:
“Higher scores on Conscientiousness were related to higher scores on cognitive EF performances, which in turn were related to lower scores of inattentive symptoms”
In a nutshell, what this is saying is that the lower conscientiousness and by extension the traits related to this in the TCI model, is explained by executive functioning differences! The whole reason we rank ourselves lower in this personality trait is precisely because of one of the biggest struggles with ADHD.
And in my mind this is super important. Because when I think of low conscientiousness I think of the implication of not being hard working. But the amount of work that we put into trying to work around our executive function challenges IS HARD WORK. It’s just not seen that way because it’s work neurotypicals don’t have to do. So we get told it’s that we’re not conscientious and we internalize this message.
Most of us have invested so much time, money and energy into building strategies to help solve our executive function issues.
Honestly, this topic is fascinating to me. Based on these studies, there do seem to be some consistent personality traits that are shared among people with ADHD according to their presentations, and while I do think some biases and interpretations should be questioned here, there’s enough evidence for me to believe there’s some substance of shared traits.
So with that question in mind… how much of my personality is my ADHD, and how much of that is me?
However, that’s a topic for next week as this post is long enough but I’m really excited to get into it.
If this resonates with you and feel you would be interested in talking to an adhd and autism-friendly coach, feel free to get in touch. If you’re looking for more blog posts, you can find them here.
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