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Adolescents and adults who have ADHD often experience social skills deficits and have poorly developed communication skills. Accurately reading and interpreting social cues (body language, facial expression), a crucial component of developing good social skills, are often challenging to individuals who have ADHD. Their distractibility, impulsivity, sensitivity, overreactivity, self-focus, and poor self-regulation can interfere with learning these important skills. Children who have ADHD often miss the important details involved in mastering social skills through observing, copying, practicing, and receiving feedback. Adults may have learned some of these skills but have often missed important pieces and may not even know they are missing them. As children, many tend to be socially neglected, living on the periphery of the peer group (those who are primarily inattentive) or actively teased and rejected (those who are hyperactive). Females tend to be more negatively impacted by poor social interactions, as they typically have a greater need for peer affiliation than do males (Nadeau). Many studies have documented social skills deficits in children who have ADHD (Frederick & Olmi; Landau & Moore), and several clinicians have even designed specific social skills training programs to teach them (Cohen), but there has been little research on adult social skills deficits in ADHD. Novotni focused on identifying and understanding the impact of social skills deficits on the relationships of such adults. She raises the important issue of attribution and misattribution. Many individuals who have ADHD have suffered from social isolation or rejection because their ADHD behaviors were misattributed to selfishness, lack of caring, thoughtlessness, laziness, stupidity, or craziness. For example, when an individual who has ADHD is late, others tend to attribute this to a lack of caring or selfishness, rather than understanding that time management is a chronic problem for many who have attention deficit disorder (ADHD).
Low self-esteem is a contributing factor to the development of relationship deficits in individuals who have ADHD. Many have experienced a life replete with broken relationships. They have often felt disliked by parents, teachers, and peers. Many of their problematic behaviors, such as tantrums, arguments, and poor anger management, are indicators of relationship problems that continue into adulthood in the form of loud, angry arguments with family, friends, and even bosses. When growing up, children who have ADHD were frequently bombarded with countless criticisms of behaviors that bother adults, with little or no focus on what the child needs. Others typically do not understand how an individual who has ADHD experiences the world, and thus they often do not feel heard or understood. A parent’s understanding of the difficulty adolescents have in doing their chores, starting their homework, turning off the television or video game, going to bed, and getting out of bed in the morning may make it more likely that parents and their children will engage in problem solving, rather than blaming, criticizing, and arguing. Parents who have ADHD typically compound the problem through their own difficulties: tuning in to social cues, being distracted, and generally being busy, hurried, and disorganized. This cycle of frustration, blame, criticism, and lack of understanding forms the core experience of many individuals who have ADHD in relationships with others, beginning in childhood and continuing though adulthood. Other environmental and family impacts can contribute to the relationship problems an individual has. One example is that some individuals who have ADHD must maintain an orderly and clutter-free home environment in order to function effectively. Without it, they experience significant anxiety about losing control—not seeing important bills and papers among the piles of clutter, forgetting critical events, or losing key items. A boisterous family’s typical noise and chaos can be overstimulating for many who have ADHD. Likewise, stressful home environments in which there are high levels of conflict, tension, or depression can exacerbate already challenged executive functioning and overload highly sensitized receptors. Another common family stressor is the tendency to take on too many activities, with resulting stressful overscheduling. These overcommitments can intensify ADHD difficulties with time management, lateness, and forgetfulness, as well as leave no down time to recuperate from life’s daily stresses. These issues illustrate the bilaterality of the relationship impact of individuals who have ADHD and those who share their environment.
ADHD Behaviors That Impact Relationships
Impulsive behavior can also significantly impact relationships. There appears to be little mediation between the impulse to do something and the logical brain centers that allow us to slow down and think it through first. It is challenging for people who have ADHD to learn to "put on the brakes" or "stop, look, and listen" before acting. The resulting impulsive behaviors can take many forms, such as crossing the street or changing lanes without looking, taking on too many activities, making plans or purchases without consulting spouse or family, and making poor decisions. Impulsive spending can be a huge problem in many families affected by ADHD, potentially leading to bankruptcy and/or divorce. The combination of poor self-control, stimulation seeking, and self-medication can lead to compulsive or addictive behaviors as well.
Executive dysfunction creates yet another set of interpersonal behavior difficulties.
Organizational and memory problems contribute to relationship conflicts, both
within couples and between adolescents and parents. Disorganization and forgetfulness
lead to piles of unfinished laundry, clutter, chronic lateness, lost keys,
missed events, and unpaid bills. These behaviors decay trust over time; the
individual who has ADHD cannot be depended on to "execute." Disappointment
sets in and often causes the spouse to feel unimportant. Halverstadt, writing
about the impact of ADHD on romantic relationships, emphasizes the importance
of significance—"the quality of feeling valuable, important, and
loved" (p. 106). He posits that most conflicts are about significance
and the need to know that we are "significant enough to each other that
our wants, needs, and desires are being heard." It is more important
to have our significance needs met through good communication than to be right
or get our way.
Reflection Exercise #5
Karalunas, S. L., Gustafsson, H. C., Fair, D., Musser, E. D., & Nigg, J. T. (2019). Do we need an irritable subtype of ADHD? Replication and extension of a promising temperament profile approach to ADHD subtyping. Psychological Assessment, 31(2), 236–247.