Risk-Taking and Psychosocial Functioning of Adults with Attention-Deficit/Hyperactivity Disorder
Degree GrantorUniversity of Canterbury
Degree NameDoctor of Philosophy
ADHD is a persistent psychological disorder with far-reaching effects on many facets of an individual’s development. Despite this, there are a number of developmental outcomes that have not been extensively researched. Among these topics; is whether there is a risk of harm that may be inherent in life-course persistent ADHD symptomatology. Based on an integrated theory of ADHD phenotypology; this thesis contains a study comprising of four phases that explore the relationship between ADHD and four risk-laden outcomes. The sample for this study consisted of 67 adults from Christchurch, New Zealand (average age 33) of whom a sample of 35 adults met criteria for ADHD, which persisted into adulthood. The group of adults with ADHD were matched across demographic factors with a control group of adults with whom they were compared across a raft of psychosocial variables. The first phase illustrates the relationship between ADHD and self-destructive behaviours including self-harm and suicidal ideation and attempts, which were found to be significantly mediated by coping behaviour and psychological comorbidity. The second phase reports on the relationship between ADHD and a range of risk-taking behaviours including: violence risk, nicotine use and sexual risk-taking, and the mediating role of motivational variances, including reward sensitivity and temporal discounting. The third phase illustrates the moderating effect of childhood abuse victimisation on ADHD in increasing the vulnerability of the development of mood disorders in adulthood. A fourth phase explores a range of physical health outcomes including diet, exercise, chronic illness and disability which were not found to be significantly associated with ADHD in adulthood. Based on the literature previewed below, it is theorised in this thesis that ADHD symptomatology may act as a diathesis that, coupled with comorbid psychosocial stressors, may contribute to an individual’s level of risk to themselves and others. Overall, this research suggests that ADHD symptomatology that persists into adulthood may pose a significant risk to some individuals, in the form of deliberate and non-deliberate forms of harm. These findings may challenge previously held beliefs regarding the innocuousness of ADHD as a psychological disorder and highlight the need to consider risk and safety issues in the assessment and treatment of adult ADHD.