Results from one study indicated that "... a substantial minority of American adults are reluctant to interact, or to have their children interact, with children described in ways consistent with ADHD and depression.  Specifically, about 1 in 5 adults was unwilling to have these children living next door, in his or her child's class, or as his or her child's friend.

Although this study highlighted the challenges that children with ADHD, and their parents, can face because of negative attitudes towards the disorder, it provides no direct information on whether adults with ADHD confront similar stigma.  This important issue was addressed in a study published in the Journal of Attention Disorders [Canu et. al. (2008).  Social Appraisal of Adult ADHD. Journal of Attention Disorders, 11, 700-710

Method

Participants were 257 undergraduates enrolled at a public university in the Midwest.  Each participant was provided with pictures of 6 same-age peers - 3 males and 3 females, that were accompanied by a brief description.  These descriptions included a mention that the individual had 1 of 3 difficulties, ADHD, a medical issue such as asthma and allergies, or a more ambiguous difficulty such as being a perfectionist. In relation to ADHD, all that was mentioned was that the individual was diagnosed with the disorder, specific symptoms and behavioral difficulties were not noted. Other aspects of the description included innocuous information about family, hobbies, interests, employment status, etc.

After reviewing each description, participants were asked to rate on a scale of 1 (very unlikely) to 6 (very likely) how likely they would be to want to work with the individual on a group project, get to know him or her better, and to become friends. For targets of the same sex, e.g., males rating males, participants rated the likelihood that they would get along as roommates and interact well at a job.  For targets of the opposite sex, they rated the likelihood of initiating a date and having a serious dating relationship.

All pictures were tested in advance to make sure that they were regarded as statistically equivalent in terms of attractiveness.  The difficulty mentioned in each description was also randomized across pictures, so that each picture was equally likely to be accompanied by each of the 3 difficulties.  As a result, any differences in the desirability ratings of the individuals described could be attributed to whether those individuals were described as having ADHD vs. one of the other difficulties, and not to differences in their attractiveness or other elements contained in their brief bio sketch.

Results

Participants' ratings provided clear evidence of stigma towards young adults diagnosed with ADHD.  Averaged across the different contexts rated (e.g., desirability as a work partner, friend, etc.) males rated females with ADHD as less desirable than females with a medical issue or an ambiguous difficulty. Similar findings applied to their ratings of males with ADHD.  Ratings made by female participants followed a similar pattern. 

In general, the magnitude of the differences was not exceptionally large, indicating that the bias against individuals with ADHD is not extreme.  However, it was consistently present.

The authors also examined ratings made for the individual interaction contexts to obtain a more fine-grained understanding of the circumstances where individuals with ADHD are most likely to experience stigma. 

Across all gender of rater by gender of target pairings, i.e., males rating males, males rating females, females rating males, and females rating females, individuals with ADHD were rated as substantially less desirable to have as a work partner on a group project. 

Male raters did not show bias towards ADHD females in relation to becoming friends, going on a date, or becoming seriously involved with. However, their ratings indicated less willingness to "get to know" females with ADHD in comparison to other females. When rating males they rated individuals with ADHD as being less desirable to have as a roommate or as a work colleague. They also indicated less interest in getting to know them better.

Female raters were not biased towards females with ADHD in relation to getting to know them better, being friends with, or being roommates with. However, they rated ADHD females as less desirable to have as a work colleague. When rating male targets, their ratings demonstrated stigma in every domain: getting to know better, being friends with, going on a date with, and having as a serious dating partner.

Summary and Implications

Results from this study indicate that college students appraise individuals with ADHD negatively as compared to peers without ADHD, even though ADHD was described only by its diagnostic label and not by actual behaviors that would be experienced as problematic. Because the attractiveness of targets was controlled, and other elements of the brief descriptions were consistent, these findings suggest that the "...mere association with ADHD in emerging adulthood is stigmatizing."  Given that these findings were obtained with a college undergraduate population, who are likely to be more open-minded than the general population, this is especially concerning.

Although participants were more reluctant to engage with individuals with ADHD in most of the contexts examined, there were differences across context and gender that are worth noting. Overall, both males and females were most negative about having an individual with ADHD as a work partner, i.e., contexts that involve academic or professional teamwork. This suggests a bias towards assuming that a work partner with ADHD will be disorganized, unprepared, and make minimal effective contributions to the group.  Clearly, this could be a difficult and discouraging obstacle for individuals with ADHD to overcome.

There was also consistent evidence indicating less interest in getting to know individuals with ADHD in relation to others; only in the case of females rating female peers was this bias not evident. Thus, learning that someone one has recently met has ADHD is likely to diminish one's interest in getting to know that person better.

Finally, findings indicate that males with ADHD were judged more harshly than their female counterparts.  Male raters regarded males with ADHD as less desirable partners in 4 of the 5 domains rated; females rated them as less desirable in every domain.  In contrast, both males and females rated females with ADHD were rated as less desirable in only 2 of 5 domains.

Results from this study highlight that stigma towards ADHD among young adults can contribute to both social and occupational difficulties in young adults with ADHD.  Because no behavioral symptoms of ADHD were described in this study, it appears that this may be the case even for young adults whose symptoms are being effectively managed. In social settings others may often be reluctant to try getting to know them better. In work settings, they are prone to be regarded as ineffective and undesirable team partners.  Unfortunately, it is not difficult to imagine how this could make it more difficult from them to advance in their career.

An important question raised by the researchers concerns the implications of these findings in relation to whether young adults with ADHD should disclose their diagnosis to others.  They note that although strict secrecy about having ADHD would be problematic and contribute to increasing stigmatization early and premature disclosure may - - or not - lead to undesirable outcomes.  Thus, even though there is no reason to be ashamed or embarrassed about having ADHD, letting others know about this too early has the potential to create problems. In future work, it would be interesting to learn whether  disclosing one's diagnosis later in a relationship, after others have gotten to know the person with ADHD, helps to reduce or even eliminate the stigma reported here.

While aspects of these findings are discouraging, it is important to note that many participants in the study did not demonstrate any tendency to be biased towards individuals with ADHD.  Thus, while this tendency was present on average, it was far from a universal phenomenon.  Nonetheless, the findings highlight the importance of ongoing efforts to better educate the public about a variety of issues related to ADHD and to reduce the stigma associated with this condition.