ADHD and Self-Control
Evidence Based Answers
How does ADHD affect self-control?
Charles Li, MD
May 16, 2023
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Studies have found that those with ADHD often struggle with inhibition and self-control on cognitive tests.
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Difficulties with self-control have been linked with issues at work and home.
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There is some evidence that treating ADHD can help with the effects of ADHD on employment outcomes.
While difficulty with attention and hyperactivity define ADHD, experts increasingly recognize the important role of executive function in ADHD:
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Many clinicians mistakenly continue to
think of this as a behavior disorder characterized
by hyperactivity in children and excessive restlessness or impulsivity in adults. In fact, ADD/ADHD
is essentially a cognitive disorder, a developmental
impairment of executive functions (EFs), the self management system of the brain.
Executive function refers to our higher-level thought processes, and these include self-control:
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There is general agreement that there are three core EFs....inhibition [inhibitory control, including self-control (behavioral inhibition) and interference control (selective attention and cognitive inhibition)], working memory (WM), and cognitive flexibility (also called set shifting, mental flexibility, or mental set shifting and closely linked to creativity). From these, higher-order EFs are built such as reasoning, problem solving, and planning
This article will dive into the data behind self-control and ADHD and the effects of poor self-control in ADHD.
The article below has more information on ADHD and executive function:
The link between ADHD and self-control
Many studies have examined self-control in ADHD with cognitive tests.
These tests challenge participants’ ability to control themselves in a standardized and reproducible manner. They allow researchers to compare self-control abilities between those with and without ADHD.
The ability to control and inhibit one’s self was found to be one of the most consistent executive functions according to one meta-analysis of 83 studies.
Over 80% of the studies that included tests of self-control found that those with ADHD had significantly more difficulty controlling and inhibiting themselves:
Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review
Another meta-analysis found similar results. Their analysis identified difficulty with inhibition as one of the strongest and most consistent cognitive deficits in ADHD:
The effects of self-control on life outcomes
Cognitive deficits in self-control, associated with ADHD, have been linked to many more challenges in life. One study looking at career and job outcomes among those with ADHD found that adults with ADHD and particular difficulty controlling themselves held fewer jobs. In their jobs, they experienced more issues with behavior and hostility.
A study on executive function, ADHD, and employment outcomes, found that those with poor inhibition held fewer jobs, had more trouble with behavior, and quit more jobs due to hostility.
ADHD and self-control in young adulthood
Poor self-control in ADHD can lead to significant impacts in young adulthood.
While many ADHD symptoms do persist into adulthood, studies have shown that ADHD tends to get better over time:
Among young adults who still struggle with many of the ADHD symptoms they had in childhood, studies have found evidence of significant challenges at school and work.
Young with ADHD were significantly more likely to quit or be fired from a job.
They were also less likely to have finished a four-year degree than their counterparts without ADHD.
One study in Norway found that treatment with stimulant medication may be able to specifically help with some of the issues around ADHD and employment.
Adults with ADHD treated with stimulant medication were much more likely to have a job than those who were not treated.
Occupational Outcome in Adult ADHD: Impact of Symptom Profile, Comorbid Psychiatric Problems, and Treatment
Key Takeaways
Difficulties with self-control are common in ADHD. ADHD affects your executive function, manifesting as difficulties with inhibition and self-control. Studies have found consistent deficits in self-control among adults and teens with ADHD. Fortunately, treatment has been linked with better outcomes. If you or your loved one has ADHD, talk to your healthcare provider. There are treatment options that can help with ADHD symptoms, including self-control.