ADHD and Its Impact on Interpersonal Relationships

ADHD and Its Impact on Interpersonal Relationships

Ambika Kathju
Copyright: © 2021 |Pages: 17
DOI: 10.4018/978-1-7998-5495-1.ch011
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This chapter is an attempt to discuss the interpersonal difficulties encountered by adults with ADHD. ADHD is one of the most common psychiatric disorders, while adult ADHD still remains the most undiagnosed one due to its comorbidity with other psychiatric disorders. It was until recently that the importance of adult ADHD was recognized to have an impact on the interpersonal difficulties faced by them. The core symptoms of ADHD in the form of behavioral and cognitive impairments along with social skill deficits are associated with maladjustments in their social and personal relationships that often lead to marital discord, problems with peers, family dysfunction, and parent-child conflicts.
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Attention Deficit and Hyperactivity Disorder (ADHD) was perceived as a childhood disorder until the 1970s when rigorous work on the topic paved the path for a better understanding of the core symptoms of ADHD that were thought to disappear in adulthood (Retz and Klein, 2010). The reason for this bigotry was the focus on only one aspect of the disorder, that was, hyperactivity, which was supposed to dissipate during adolescence. However, unlike the assumption, the child does not outgrow his symptoms, but the symptoms manifest in different ways due to maturation, for instance, hyperactivity is likely to be experienced as tension and restlessness in adulthood (Resnick, 2005).

Many individuals are diagnosed for the first time during their adulthood, making adult ADHD as the most common and undiagnosed psychiatric disorder of adult life. The common symptoms of adult ADHD, like procrastination, low motivation, fluctuating mood, anxiety, low self-esteem, and unpredictable behavior, are shared with other psychiatric disorders that have better awareness (Goldman, Genel, Bezman, and Slanetz, 1998; Wender, 1998). Therefore, when these symptoms are presented without a childhood diagnosis of ADHD, it is mostly diagnosed as either generalized anxiety disorder (GAD), bipolar disorder, or depression (Biederman, 2004; Murphy and Adler, 2004). Also, at times adult ADHD is misdiagnosed because its symptoms are comorbid with other disorders like depression, substance abuse, anxiety, and marital distress. One of the researches by Able, Johnston, Adler, and Swindle (2007), concluded that individuals with undiagnosed ADHD have to undergo higher functional and psychosocial difficulties than the ones who are negatively screened for ADHD, thereby, posing a severe burden to adults even when clinically undiagnosed. Thus, the impaired functioning due to ADHD symptoms and availability of appropriate treatment plans are often not known to them, thereby, leaving them with poor quality of living, disorganized life, substance abuse, interpersonal conflicts, trouble at work, and difficulty in forming and sustaining friendships (Koemans, Vroenhoven, Karrenman and Bekker, 2015).

A vast array of literature on ADHD indicates that people who have ADHD possess deficits in social and emotional domains (Barkley, 1997; American Psychiatric Association, 2013) that create obstacles in having healthy interpersonal interactions. Barkely (1997), one of the pioneers in the field of ADHD, predicted that many socially relevant behaviors in ADHD individuals are affected by deficits in behavioral inhibitions, which are ultimately linked to executive functioning. He further predicted that ADHD individuals have a precise perceptual awareness of interpersonal cues but are unable to act on it because of impaired inhibition. The decreased ability to delay their response to the cues heightens their emotional reactivity, diminishes the frustration tolerance, and mars their ability to consider and implement appropriate behaviors; thus, disrupting interpersonal interaction. Some researchers suggest that a range of other emotional and social disruptions are related to non-executive functions like inattention and inability to recognize facial affect. Inattention can cause the ADHD individual to miss a crucial emotional cue that causes them to disregard the information necessary for a meaningful conversation. Also, the subtle visuospatial deficits may cause them to distort the interpersonal cues of others. Moreover, the inability to recognize other’s facial affect incapacitates them to respond appropriately; as a result, their interpersonal skills may be doubly hindered due to inaccurate reading and interpretation of the available cues (Rapport, Friedman, Tzelepis, and Voorhis, 2002).

Therefore, the lack of social skills, executive dysfunctions, and the typical ADHD symptoms makes it even more difficult for them to form a significant interpersonal relationship. Their impulsivity, distractibility, impaired self-regulation often comes in their way to clearly express themselves, leaving them misunderstood and socially neglected. Females tend to be more negatively impacted by this deficit as they typically have a greater need for affiliation than males (Nadeau, 1999). This chapter discusses the ADHD symptoms and its impact on interpersonal relationships in the form of marital discords, parenting capabilities, dating, and sexual behavior.

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