Are Negative Automatic Thoughts Associated with ADHD in Adulthood?

Abstract

Recent randomized controlled trials indicate that cognitive-behavioral therapy (CBT) for adults with attention-deficit/hyperactivity disorder (ADHD) is an efficacious treatment. Although treatments for adults with ADHD target negative automatic thoughts, there is a lack of empirical evidence demonstrating that such cognitions are associated with ADHD. The goal of this study was to assess the relationship between ADHD and negative automatic thoughts typically associated with depression in a group of adults diagnosed with ADHD (n = 81). Across the sample, self, collateral, and clinician ratings of inattentive ADHD symptom severity, but not hyperactive-impulsive symptom severity, were significantly associated with negative automatic thoughts after considering the role of current depressive symptom severity. Subsequent categorical analyses were conducted by subdividing the ADHD sample into those with (n = 34) and without (n = 47) a comorbid depression diagnosis, and adding a control group (n = 43). Analyses indicated that (a) the ADHD group with comorbid depression reported significantly more negative automatic thoughts than both controls and the ADHD group without comorbid depression, and (b) the ADHD group without comorbid depression reported significantly more negative automatic thoughts than controls. These findings provide an empirical basis for adult ADHD CBT to target negative automatic thoughts, which share a relationship with ADHD even after accounting for the confounding role of depression. Modification of negative automatic thoughts may be a mechanism of change in adult ADHD CBT and should be considered in future research. attention-deficit/hyperactivity disorder | cognitive-behavioral therapy | negative

Depression in Adults with Attention-Deficit/Hyperactivity Disorder (ADHD): The Mediating Role of Cognitive-Behavioral Factors

“…Direct empirical support for this hypothesis in children with ADHD has recently been accumulating (McQuade et al 2011; Ostrander and Herman 2006). In adults, a recent chart review study of 81 patients diagnosed with ADHD found that inattentive symptoms were associated with negative automatic thoughts even after accounting for depression symptom severity, although patients with comorbid ADHD and depression showed even higher levels of negative automatic thoughts than patients with ADHD alone (Mitchell et al 2013). These findings support further consideration of maladaptive cognitive processes in depression in adults with ADHD.…”

Development and Evaluation of the ADHD Cognitions Scale for Adults

“…Targeting such patterns of negative maladaptive thoughts is important since there is strong evidence that ADHD in adults is associated with increased risk for depression and anxiety disorders and, more specifically, that ADHD in adults is also associated with the patterns of negative and distorted thinking associated with these disorders (Abramovitch & Schweiger, 2009; Knouse, Zvorsky, & Safren, 2013; Mitchell, Benson, Knouse, Kimbrel, & Anastopoulos, 2013; Strohmeier, Rosenfield, DiTomasso, & Ramsay, 2016). However, there is growing recognition that maladaptive patterns of thinking are not restricted to these “negative” thinking styles in adult ADHD (Knouse & Mitchell, 2015).…”

Incautiously Optimistic: Positively Valenced Cognitive Avoidance in Adult ADHD

“…After a lifetime of perceived failure and negative feedback from others, it stands to reason that adults with ADHD are likely to develop patterns of negative, self-defeating thoughts that undermine their behavior change efforts (Safren, Perlman, Sprich, & Otto, 2005). Such cognitions are elevated in adult ADHD samples (Mitchell, Benson, Knouse, Kimbrel, & Anastopoulos, 2013) and may put them at-risk for depression (Knouse, Zvorsky, & Safren, 2013). Yet, clinically, we have observed that our adult patients with ADHD report another flavor of cognition that can be just as problematic in its relationship with skill use, for example:

“I'm a good person, so things are just going to work out for me.”

…”