Diagnosis Identity Perception in Adolescents with ADHD and Its Relationship to Executive Functions, Self-Management, and Quality of Life

TL;DR

This study explores how adolescents with ADHD view their diagnosis and finds that positive identity perceptions are linked to better self-management and quality of life.

Contribution

The study introduces a novel framework linking diagnosis identity dimensions to executive functions, self-management, and quality of life in adolescents with ADHD.

Findings

Adolescents with ADHD showed higher identity Acceptance scores compared to Rejection, Engulfment, and Enrichment.

The Engulfment dimension of diagnosis identity was strongly associated with executive dysfunction and lower quality of life.

Self-monitoring, social quality of life, and self-evaluation explained 45% of the variance in ADHD diagnosis identity.

Abstract

What are the main findings?
•Adolescents with ADHD reported significantly higher identity Acceptance scores compared to Rejection, Engulfment, and Enrichment, F (2.38, 149.89) = 32.41, p < 0.001.•The total diagnosis identity score was strongly associated with self-management (r = 0.61, p < 0.001).•The Engulfment dimension showed strong and consistent associations with both executive dysfunction and lower quality of life, despite the absence of correlations at the total score level.•Regression analyses indicated that self-monitoring, social QoL, and self-evaluation together explained 45% of the variance in ADHD diagnosis identity. The Engulfment dimension of identity was a significant negative predictor of executive functioning (R2 = 0.15), self-management (R2 = 0.35), and QoL (R2 = 0.17).

Adolescents with ADHD reported significantly higher identity Acceptance scores compared to Rejection, Engulfment, and Enrichment, F (2.38, 149.89) = 32.41, p < 0.001.

The total diagnosis identity score was strongly associated with self-management (r = 0.61, p < 0.001).

The Engulfment dimension showed strong and consistent associations with both executive dysfunction and lower quality of life, despite the absence of correlations at the total score level.

Regression analyses indicated that self-monitoring, social QoL, and self-evaluation together explained 45% of the variance in ADHD diagnosis identity. The Engulfment dimension of identity was a significant negative predictor of executive functioning (R2 = 0.15), self-management (R2 = 0.35), and QoL (R2 = 0.17).

What are the implications of the main findings?
•The findings underscore the complex relationship between diagnosis identity and emotional as well as functional outcomes in adolescents with ADHD.•Negative perceptions of one’s diagnosis identity predict poorer executive functioning, self-management, and QoL, while core aspects of self-management and social well-being also significantly shape how adolescents with ADHD perceive their diagnosis.•The results highlight the need for holistic, individualized interventions that address both the development of positive diagnosis identity and the strengthening of executive and self-management skills of adolescents with ADHD.•Promoting a positive diagnosis identity may improve functional and emotional outcomes, which in turn may reinforce a more adaptive and accepting view of the diagnosis itself.

The findings underscore the complex relationship between diagnosis identity and emotional as well as functional outcomes in adolescents with ADHD.

Negative perceptions of one’s diagnosis identity predict poorer executive functioning, self-management, and QoL, while core aspects of self-management and social well-being also significantly shape how adolescents with ADHD perceive their diagnosis.

The results highlight the need for holistic, individualized interventions that address both the development of positive diagnosis identity and the strengthening of executive and self-management skills of adolescents with ADHD.

Promoting a positive diagnosis identity may improve functional and emotional outcomes, which in turn may reinforce a more adaptive and accepting view of the diagnosis itself.

Background/Objectives: This study aimed to describe how adolescents with attention-deficit/hyperactivity disorder (ADHD) perceive their diagnosis identity and examine its correlation with executive functions (EFs), self-management abilities, and quality of life (QoL). Methods: A total of 66 adolescents with ADHD, aged 12 to 18 years (M = 15.21, SD = 1.84), completed self-report questionnaires, including the Illness Identity Questionnaire, Behavior Rating Inventory of Executive Function, Self-Control and Self-Management Scale, and Pediatric QoL Inventory. We used ANOVA with Bonferroni post hoc tests to assess differences in diagnosis identity domains and Pearson correlations to examine correlations between diagnosis identity, EFs, self-management, and QoL. Results: Adolescents reported significantly higher ADHD Acceptance feelings compared to Rejection, Engulfment, and Enrichment, F (2.38, 149.89) = 32.41, p < 0.001. Total diagnosis identity score was strongly associated with self-management (r = 0.61, p < 0.001). While no significant correlations were found with overall EF or QoL, significant associations did emerge with their sub-scores. Regression analyses indicated that self-monitoring, social QoL, and self-evaluation together explained 45% of the variance in diagnosis identity. The Engulfment dimension of identity was a significant negative predictor of executive functioning (R2 = 0.15), self-management (R2 = 0.35), and QoL (R2 = 0.17). Conclusions: Promoting a positive diagnosis identity may improve functional and emotional outcomes in adolescents with ADHD. In turn, better functional and emotional outcomes may help them embrace a diagnosis identity that is more positive.