Skip to main content
Top
Published in: BMC Psychiatry 1/2021

01-12-2021 | Attention Deficit Hyperactivity Disorder | Research

Adult ADHD and emerging models of maladaptive personality: a meta-analytic review

Authors: Peter Jacobsson, Christopher J. Hopwood, Bo Söderpalm, Thomas Nilsson

Published in: BMC Psychiatry | Issue 1/2021

Login to get access

Abstract

Background

ADHD is a highly consequential disorder that is estimated to affect 2.5% of the adult population. Emerging models of psychopathology posit that disorders like ADHD can be usefully situated within general models of individual differences in personality, such as those recently implemented in the DSM and ICD for the diagnosis of personality disorder. Previous research and systematic reviews have linked adult ADHD to the personality traits Conscientious Inhibition and Negative Emotionality. However, there have been some inconsistencies in the literature and research embedding ADHD-personality connections in the DSM-5 and ICD-11 personality disorder models has been limited. The goal of this paper was to systematically review associations between adult ADHD and personality traits, organized within a maladaptive five factor framework.

Method

A comprehensive literature search yielded 13 papers whose effects were meta-analyzed.

Results

Results supported associations between ADHD and low Conscientious Inhibition and high Negative Emotionality. However, interesting patterns of variability were observed, potentially related to issues such as instrumentation and facet variation.

Conclusion

Results support the clinical application of personality assessment for suggesting risk for ADHD symptoms, and point to important directions for further research.
Literature
2.
go back to reference Nylander L, Holmqvist M, Gustafson L, Gillberg C. ADHD in adult psychiatry. Minimum rates and clinical presentation in general psychiatry outpatients. Nordic J Psychiatr. 2009;63(1):64–71.CrossRef Nylander L, Holmqvist M, Gustafson L, Gillberg C. ADHD in adult psychiatry. Minimum rates and clinical presentation in general psychiatry outpatients. Nordic J Psychiatr. 2009;63(1):64–71.CrossRef
3.
go back to reference Deberdt W, Thome J, Lebrec J, Kraemer S, Fregenal I, Ramos-Quiroga JA, et al. Prevalence of ADHD in nonpsychotic adult psychiatric care (ADPSYC): A multinational cross-sectional study in Europe. BMC Psychiatr. 2015;15:242–015–0624-5.CrossRef Deberdt W, Thome J, Lebrec J, Kraemer S, Fregenal I, Ramos-Quiroga JA, et al. Prevalence of ADHD in nonpsychotic adult psychiatric care (ADPSYC): A multinational cross-sectional study in Europe. BMC Psychiatr. 2015;15:242–015–0624-5.CrossRef
9.
go back to reference Matthies SD, Philipsen A. Common ground in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD)-review of recent findings. Borderline Personal Disord Emot Dysregul. 2014;1:3 6673-1-3. eCollection 2014. Matthies SD, Philipsen A. Common ground in Attention Deficit Hyperactivity Disorder (ADHD) and Borderline Personality Disorder (BPD)-review of recent findings. Borderline Personal Disord Emot Dysregul. 2014;1:3 6673-1-3. eCollection 2014.
11.
go back to reference Bo Bach MS, Huxley E. Related personality disorders located within an elaborated externalizing psychopathology Spectrum. The Wiley Handbook of Disruptive and Impulse-Control Disorders. 2017;2021/01:103–23.CrossRef Bo Bach MS, Huxley E. Related personality disorders located within an elaborated externalizing psychopathology Spectrum. The Wiley Handbook of Disruptive and Impulse-Control Disorders. 2017;2021/01:103–23.CrossRef
14.
go back to reference American Psychiatric Association. American Psychiatric Association.,DSM-5 Task Force.,. Diagnostic and statistical manual of mental disorders : DSM-5. Arlington, VA: American Psychiatric Association; 2013.CrossRef American Psychiatric Association. American Psychiatric Association.,DSM-5 Task Force.,. Diagnostic and statistical manual of mental disorders : DSM-5. Arlington, VA: American Psychiatric Association; 2013.CrossRef
15.
go back to reference World Health Organization (WHO). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Genève: World Health Organization; 1993. World Health Organization (WHO). The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research. Genève: World Health Organization; 1993.
19.
go back to reference Gomez R, Van Doorn G, Watson S, Gomez A, Stavropoulos V. Cloninger's personality dimensions and ADHD: A meta-analytic review. Personality and Individual Differences 2017. 2017;107:219–27.CrossRef Gomez R, Van Doorn G, Watson S, Gomez A, Stavropoulos V. Cloninger's personality dimensions and ADHD: A meta-analytic review. Personality and Individual Differences 2017. 2017;107:219–27.CrossRef
22.
go back to reference McCrae RR, Costa PT Jr. NEO inventories, Professional Manual: PAR; 2010. McCrae RR, Costa PT Jr. NEO inventories, Professional Manual: PAR; 2010.
27.
go back to reference McCrae RR, Löckenhoff CE, Costa PT Jr. A step toward DSM-V: cataloguing personality-related problems in living. Eur J Pers. 2020;19(4):269–86 2005 06/01.CrossRef McCrae RR, Löckenhoff CE, Costa PT Jr. A step toward DSM-V: cataloguing personality-related problems in living. Eur J Pers. 2020;19(4):269–86 2005 06/01.CrossRef
28.
go back to reference Widiger TA. The Oxford handbook of the five factor model; 2017. Widiger TA. The Oxford handbook of the five factor model; 2017.
29.
go back to reference Decuyper M, De Pauw S, De Fruyt F, De Bolle M, De Clercq BJ. A meta-analysis of psychopathy-, antisocial PD- and FFM associations. Eur J Pers. 2020;23(7):531–65 2009 11/01.CrossRef Decuyper M, De Pauw S, De Fruyt F, De Bolle M, De Clercq BJ. A meta-analysis of psychopathy-, antisocial PD- and FFM associations. Eur J Pers. 2020;23(7):531–65 2009 11/01.CrossRef
35.
go back to reference Samuel DB, Gore WL. Maladaptive Variants of Conscientiousness and Agreeableness. J Pers. 2020;80(6):1669–96 2012 12/01.CrossRef Samuel DB, Gore WL. Maladaptive Variants of Conscientiousness and Agreeableness. J Pers. 2020;80(6):1669–96 2012 12/01.CrossRef
38.
go back to reference John O, Naumann L, Soto C. Paradigm shift to the integrative big five trait taxonomy: History, measurement, and conceptual issues; 2008. p. 114–58. John O, Naumann L, Soto C. Paradigm shift to the integrative big five trait taxonomy: History, measurement, and conceptual issues; 2008. p. 114–58.
39.
go back to reference Livesley WJ, Jackson DN. Manual for the Dimensional Assessment Of Personality Pathology — Basic Questionnaire. Port Huron: Sigma Press; 2009. Livesley WJ, Jackson DN. Manual for the Dimensional Assessment Of Personality Pathology — Basic Questionnaire. Port Huron: Sigma Press; 2009.
42.
go back to reference Conway CC, Forbes MK, Forbush KT, Fried EI, Hallquist MN, Kotov R, et al. A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research. Perspect Psychol Sci 2019 05/01. 2020;14(3):419–36.CrossRef Conway CC, Forbes MK, Forbush KT, Fried EI, Hallquist MN, Kotov R, et al. A Hierarchical Taxonomy of Psychopathology Can Transform Mental Health Research. Perspect Psychol Sci 2019 05/01. 2020;14(3):419–36.CrossRef
43.
go back to reference Hopwood C, Bagby R, Gralnick T, Ro E, Ruggero C, Mullins-Sweatt S, et al. Integrating Psychotherapy With the Hierarchical Taxonomy of Psychopathology (HiTOP). J Psychotherapy Integration. 2020;30:477–97.CrossRef Hopwood C, Bagby R, Gralnick T, Ro E, Ruggero C, Mullins-Sweatt S, et al. Integrating Psychotherapy With the Hierarchical Taxonomy of Psychopathology (HiTOP). J Psychotherapy Integration. 2020;30:477–97.CrossRef
44.
go back to reference Hopwood CJ. A framework for treating DSM-5 alternative model for personality disorder features. Personality and Mental Health 2018 05/01. 2020;12(2):107–25.CrossRef Hopwood CJ. A framework for treating DSM-5 alternative model for personality disorder features. Personality and Mental Health 2018 05/01. 2020;12(2):107–25.CrossRef
49.
go back to reference Wallace A, Ullsperger JM, Nikolas MA. Do personality traits explain the association between childhood attention-deficit hyperactivity disorder symptoms and substance use and problems in young adults? Personality and Individual Differences. 2016;92:22–8.CrossRef Wallace A, Ullsperger JM, Nikolas MA. Do personality traits explain the association between childhood attention-deficit hyperactivity disorder symptoms and substance use and problems in young adults? Personality and Individual Differences. 2016;92:22–8.CrossRef
51.
go back to reference Jacob CP, Gross-Lesch S, Reichert S, Geissler J, Jans T, Kittel-Schneider S, et al. Sex- and Subtype-Related Differences of Personality Disorders (Axis II) and Personality Traits in Persistent ADHD. J Attention Disord. 2016;20(12):1056–65.CrossRef Jacob CP, Gross-Lesch S, Reichert S, Geissler J, Jans T, Kittel-Schneider S, et al. Sex- and Subtype-Related Differences of Personality Disorders (Axis II) and Personality Traits in Persistent ADHD. J Attention Disord. 2016;20(12):1056–65.CrossRef
52.
go back to reference Koerting J, Pukrop R, Klein P, Ritter K, Knowles M, Banzhaf A, et al. Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder. J Attention Disord. 2016;20(8):715–24.CrossRef Koerting J, Pukrop R, Klein P, Ritter K, Knowles M, Banzhaf A, et al. Comparing Dimensional Models Assessing Personality Traits and Personality Pathology Among Adult ADHD and Borderline Personality Disorder. J Attention Disord. 2016;20(8):715–24.CrossRef
58.
go back to reference Perroud N, Hasler R, Golay N, Zimmermann J, Prada P, Nicastro R, et al. Personality profiles in adults with attention deficit hyperactivity disorder (ADHD). BMC Psychiatr. 2016;16:199.CrossRef Perroud N, Hasler R, Golay N, Zimmermann J, Prada P, Nicastro R, et al. Personality profiles in adults with attention deficit hyperactivity disorder (ADHD). BMC Psychiatr. 2016;16:199.CrossRef
60.
go back to reference Anckarsäter H, Stahlberg O, Larson T, Hakansson C, Jutblad S, Niklasson L, et al. The impact of ADHD and autism spectrum disorders on temperament, character, and personality development. Am J Psychiatry. 2006;163(7):1239–44.CrossRefPubMed Anckarsäter H, Stahlberg O, Larson T, Hakansson C, Jutblad S, Niklasson L, et al. The impact of ADHD and autism spectrum disorders on temperament, character, and personality development. Am J Psychiatry. 2006;163(7):1239–44.CrossRefPubMed
61.
go back to reference Mesrobian SK, Villa AEP, Bader M, Gotte L, Lintas A. Event-related potentials during a gambling task in young adults with attention-deficit/hyperactivity disorder. Front Hum Neurosci. 2018;12:79.CrossRefPubMedPubMedCentral Mesrobian SK, Villa AEP, Bader M, Gotte L, Lintas A. Event-related potentials during a gambling task in young adults with attention-deficit/hyperactivity disorder. Front Hum Neurosci. 2018;12:79.CrossRefPubMedPubMedCentral
63.
go back to reference Suurmond R, van Rhee H, Hak T. Introduction, comparison, and validation of Meta-Essentials: A free and simple tool for meta-analysis. Res Syn Meth 2017 12/01. 2020;8(4):537–53.CrossRef Suurmond R, van Rhee H, Hak T. Introduction, comparison, and validation of Meta-Essentials: A free and simple tool for meta-analysis. Res Syn Meth 2017 12/01. 2020;8(4):537–53.CrossRef
67.
go back to reference Whiting P, Rutjes AWS, Reitsma JB, Bossuyt PMM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3(1):25.CrossRefPubMedPubMedCentral Whiting P, Rutjes AWS, Reitsma JB, Bossuyt PMM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3(1):25.CrossRefPubMedPubMedCentral
68.
go back to reference Cohen J. Statistical Power Analysis. Curr Dir Psychol Sci 1992 06/01. 2020;1(3):98–101.CrossRef Cohen J. Statistical Power Analysis. Curr Dir Psychol Sci 1992 06/01. 2020;1(3):98–101.CrossRef
69.
go back to reference Sawilowsky S. New Effect Size Rules of Thumb. J Modern Appl Stat Methods. 2009;8:597–9.CrossRef Sawilowsky S. New Effect Size Rules of Thumb. J Modern Appl Stat Methods. 2009;8:597–9.CrossRef
70.
go back to reference Subgroup Analyses. Introduction to Meta-Analysis 2009 03/13; 2020. p. 149–86. Subgroup Analyses. Introduction to Meta-Analysis 2009 03/13; 2020. p. 149–86.
71.
go back to reference Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. 4th ed. New York; New York: The Guilford Press; The Guilford Press; 2015. Barkley RA. Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment. 4th ed. New York; New York: The Guilford Press; The Guilford Press; 2015.
72.
go back to reference Brown TE. ADHD comorbidities: handbook for ADHD complications in children and adults. Washington, DC: American Psychiatric Pub; 2009. Brown TE. ADHD comorbidities: handbook for ADHD complications in children and adults. Washington, DC: American Psychiatric Pub; 2009.
75.
go back to reference Hopwood CJ, Morey LC. Emotional Problems Suppress Disorder/Performance Associations in Adult ADHD Assessment. J Psychopathol Behav Assessment. 2008;30(3):204–10.CrossRef Hopwood CJ, Morey LC. Emotional Problems Suppress Disorder/Performance Associations in Adult ADHD Assessment. J Psychopathol Behav Assessment. 2008;30(3):204–10.CrossRef
78.
go back to reference Smith TE, Martel MM. Trait-Based Profiles of ADHD in Adolescents and Young Adults. J Clin Child Adolescent Psychol. 2018;53:1–15. Smith TE, Martel MM. Trait-Based Profiles of ADHD in Adolescents and Young Adults. J Clin Child Adolescent Psychol. 2018;53:1–15.
80.
go back to reference Bodemer N, Hanoch Y, Katsikopoulos KV. Heuristics: foundations for a novel approach to medical decision making. Internal and Emergency Med. 2015;10(2):195–203.CrossRef Bodemer N, Hanoch Y, Katsikopoulos KV. Heuristics: foundations for a novel approach to medical decision making. Internal and Emergency Med. 2015;10(2):195–203.CrossRef
Metadata
Title
Adult ADHD and emerging models of maladaptive personality: a meta-analytic review
Authors
Peter Jacobsson
Christopher J. Hopwood
Bo Söderpalm
Thomas Nilsson
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-021-03284-1

Other articles of this Issue 1/2021

BMC Psychiatry 1/2021 Go to the issue