Journal of Attention Disorders最新文献

{"title":"The Relationship Between Inhibitory Control of Attention and fMRI Functional Connectivity in Children With and Without ADHD.","authors":"Kelsey Harkness, Matthias Wilms, Kate J Godfrey, Signe Bray, Kara Murias","doi":"10.1177/10870547261419585","DOIUrl":"10.1177/10870547261419585","url":null,"abstract":"<p><strong>Introduction: </strong>Attention abilities can be represented within the population as a spectrum from low to high ability. Attention deficits are present in a number of neurodevelopmental disorders, including as a primary symptom of ADHD. When evaluating the relationship between brain networks and attention abilities, it is important to know whether this relationship is mediated by diagnosis to understand processes that contribute to disability and to determine if attention can appropriately be studied transdiagnostically. Functional connectivity (FC) within the brain has been studied in association with inhibitory attention and ADHD diagnosis separately, but it is unclear whether the relationship between inhibitory attention and FC is altered in individuals with ADHD.</p><p><strong>Methods: </strong>We evaluated whether the relationship between inhibitory attention, as measured by the Flanker Inhibitory Control and Attention test, and FC was impacted by ADHD diagnostic status in children age 9 to 10 using the Adolescent Brain and Cognitive Development (ABCD) database.</p><p><strong>Results: </strong>We found that, although there were significant associations between FC and both ADHD diagnosis and attention, the interaction between attention and diagnostic group was not significantly associated with functional connectivity.</p><p><strong>Conclusion: </strong>These results support that the relationship between attention and FC is not mediated by ADHD diagnosis and thus provides evidence for a transdiagnostic-dimensional relationship between FC and inhibitory attention.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"784-794"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Attention Deficit Hyperactivity Disorder and Obstructive Sleep Apnea in Children: A Systematic Review and Meta-Analysis.","authors":"Bryan Hao Wei Leow, Claire Jing-Wen Tan, Brian Sheng Yep Yeo, Noelle Na En Ng, Seraphina Cheng Yong Low, Adele Chin Wei Ng, Oon Hoe Teoh, Song Tar Toh, Ellen Ghim Hoon Tay","doi":"10.1177/10870547261426094","DOIUrl":"10.1177/10870547261426094","url":null,"abstract":"<p><strong>Background: </strong>Obstructive Sleep Apnea (OSA) and Attention Deficit Hyperactivity Disorder (ADHD) are two relatively common conditions in the pediatric population, with multiple studies demonstrating a strong association between the two. Hypoxia and sleep fragmentation caused by OSA has been shown to exacerbate ADHD symptoms, while treatment for OSA, such as with continuous positive airway pressure or adenotonsillectomy, may improve ADHD symptoms. We aim to provide an updated systematic review and meta-analysis on the complex relationship between OSA and ADHD in children.</p><p><strong>Methods: </strong>PubMed, Embase, and SCOPUS were searched from inception to 1 December 2024 for longitudinal studies investigating the association between OSA and ADHD in children. Two independent authors selected relevant articles, extracted data, assessed bias using the Newcastle-Ottawa Scale and evaluated quality of evidence following the Grading of Recommendations, Assessment, Development and Evaluations framework. Random-effects meta-analysis was performed to synthesize pooled prevalence, while descriptive reviews were performed for all other outcomes.</p><p><strong>Results: </strong>This systematic review and meta-analysis of 11 studies and 903 children formally diagnosed with OSA or ADHD found that the pooled prevalence of OSA in children with ADHD was 44% (  95% CI [2%, 56%]). Descriptive analysis found that adenotonsillectomy for OSA consistently led to significant improvements in both OSA and ADHD symptoms, suggesting its potential in complementing existing pharmacological therapy in improving ADHD symptoms.</p><p><strong>Conclusion: </strong>OSA and ADHD are closely related comorbid conditions. Physicians should be cognizant of this association and consider concurrent evaluation for OSA in children with ADHD symptoms, which can effectively guide treatment strategies and potentially reduce the need for long-term pharmacological treatment.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"822-832"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Controlled by Female Hormones\": A Qualitative Interview Study of Swedish Women's Experiences of Gender-Specific Aspects of Life With ADHD.","authors":"Julia McTaggart, Lisa B Thorell, Charlotte Borg Skoglund, Niklas Envall, Helena Kopp Kallner","doi":"10.1177/10870547261427555","DOIUrl":"10.1177/10870547261427555","url":null,"abstract":"<p><strong>Objective: </strong>There is limited knowledge about how female specific factors such as fluctuating sex hormones influence symptom display and health-related conditions that are unique to, or more prevalent in females with ADHD. This study aims to investigate how women of reproductive age with ADHD experience their ADHD symptoms and well-being in relation to hormonal fluctuations, and secondly, how they perceive hormonal and reproductive counseling in healthcare.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 14 women with ADHD and analyzed using inductive thematic analysis.</p><p><strong>Results: </strong>Three main themes emerged from the analysis; (1) Controlled by female hormones, (2) Frustration with lack of knowledge/understanding, and (3) Living with ADHD and comorbidities. Many women have experienced challenges and fluctuations related to hormonal changes during their menstrual cycles and in different stages of life. Using hormones to stabilize mood and impulsivity and adjusting stimulant doses were suggested as potential solutions. Participants expressed frustration about the lack of knowledge, interest, and understanding from healthcare professionals regarding ADHD and how hormones influenced symptoms of ADHD and comorbidities in women.</p><p><strong>Conclusion: </strong>This qualitative study highlights the impact of cyclical hormonal fluctuations on daily functioning across the menstrual cycle. Specifically, participants reported cyclic patterns of high energy and productivity related to ovulation followed by low energy and difficulty managing tasks in the premenstrual week. This aligns with clinical experience, anecdotal evidence, and limited literature that suggest that women with ADHD may be particularly vulnerable to hormonal fluctuations. Our findings suggest that especially the premenstrual phase is a challenging time for women with ADHD. Our results emphasize the need for healthcare professionals to improve their understanding of the role sex hormones and the menstrual cycle play in female ADHD. The potential effect of adjusting ADHD medication dosage and introducing hormonal treatment for premenstrual dysphoric disorder (PMDD) in women with ADHD should be further explored.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"795-806"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Serum Netrin-1 Levels Among Children Diagnosed With ADHD.","authors":"Hümeyra Hilal Öztürk, Selen Sezen, Elçin Çağlar, Serenay Elgün Ülkar, Sadettin Burak Açıkel","doi":"10.1177/10870547251408127","DOIUrl":"10.1177/10870547251408127","url":null,"abstract":"<p><strong>Objective: </strong>ADHD is a common neurodevelopmental disorder of childhood characterized by altered projections of dopaminergic neurons and connectivity issues in various brain regions. In our study, we aim to investigate the potential effects of axon guidance molecules, Netrin-1 and Semaphorins 3A, 4D, and 7A, on these connectivity problems by examining the levels of these molecules in the peripheral blood of children with ADHD compared to healthy controls.</p><p><strong>Methods: </strong>A total of 43 children with ADHD and 40 healthy controls 6 to 12 years of age were included in the study. The K-SADS-PL was administered to exclude any additional psychopathologies (excluding ODD in the ADHD group). The Revised Child Anxiety and Depression Scale was provided to the children, while parents completed the revised Conners' Parent Rating Scale (CPRS-R), the Social Responsiveness Scale (SRS), and the Behavior Rating Inventory for Executive Functioning (BRIEF). Additionally, teachers of the ADHD group were given the Conners' Teacher Rating Scale. Furthermore, the WISC-4 was administered to assess the IQ profile of 35 children in the ADHD group.</p><p><strong>Results: </strong>Netrin-1 was found to be statistically higher in the ADHD group. When the R-CADS scores were recalculated taking the covariate into account, the significant increase in the ADHD group remained. There was no statistically significant difference between the two groups for semaphorin 3A, 4D, and 7A. The positive correlation of Netrin-1 with the hyperactivity subscores on the CPRS-R and the Global Executive Score on the BRIEF scale is noteworthy.</p><p><strong>Conclusion: </strong>Netrin-1 may play a role in the etiopathogenesis of ADHD. Further studies are needed to clarify the relationship between Netrin-1 and ADHD.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"765-772"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visceral Adipose Tissue Accumulation in Children With Obesity and Co-occurring ADHD: A Case-Control Analysis of Body Fat Distribution Patterns.","authors":"Muhan Li, Shijie Li, Yan Hu, Chenlu Yang, Aimin Liang","doi":"10.1177/10870547251397010","DOIUrl":"10.1177/10870547251397010","url":null,"abstract":"<p><strong>Objective: </strong>ADHD and obesity frequently co-occur in children, yet differences in visceral adipose tissue (VAT) distribution between co-occurring ADHD + Obesity and obesity alone are incompletely characterized. This study compared depot-specific adiposity between these groups.</p><p><strong>Methods: </strong>This cross-sectional analysis (December 2022-2024, Beijing Children's Hospital) included 306 children (6-12 years) stratified into: ADHD + Obesity (<i>n</i> = 65), obesity-only (<i>n</i> = 77), and Control (<i>n</i> = 164). Body composition was assessed using bioelectrical impedance. Group comparisons for depot-specific adiposity and metabolic markers were performed using multivariable linear regression, adjusting for age, sex, and BMI <i>z</i>-score.</p><p><strong>Results: </strong>The ADHD + Obesity group exhibited significantly greater visceral adiposity than the Obesity-only group, as reflected by a 16.84 cm² larger visceral fat area (VFA) and a 1.03 kg/m² higher fat mass index (FMI). The ADHD + Obesity group also showed a more adverse metabolic profile, including elevated liver enzymes and fasting glucose.</p><p><strong>Conclusion: </strong>Excess visceral adiposity represents a distinct phenotypic feature of ADHD + Obesity. These findings support the need for integrated clinical management addressing both neurobehavioral and metabolic domains and inform future mechanistic investigations.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"747-756"},"PeriodicalIF":2.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Tight Junction Protein Alterations in ADHD: The Role of Claudin-5, β-Catenin and Paxillin.","authors":"Necati Uzun, Ayhan Bilgiç, Hurşit Ferahkaya, Mehmet Berat Taş, İbrahim Kılınç, Ahmet Osman Kılıç","doi":"10.1177/10870547251400398","DOIUrl":"10.1177/10870547251400398","url":null,"abstract":"<p><strong>Objective: </strong>Blood-brain barrier permeability (BBB) has been suggested to be involved in the etiopathogenesis of ADHD. Claudin-5, β-catenin and paxillin are important molecules with different roles in this barrier. Alterations in these molecules may disrupt the neurodevelopmental process by affecting various critical processes in the developing brain. Therefore, this study aimed to evaluate whether the peripheral levels of these molecules differ in children and adolescents with ADHD.</p><p><strong>Method: </strong>A total of 90 patients with ADHD aged between 8 and 18 years and 60 healthy controls were included in this study. The severity of ADHD symptoms was determined with the Atilla Turgay Scale. Child Anxiety-Depression Scale-Revised was completed to evaluate additional psychiatric problems of the patients. Serum levels of biochemical parameters were measured using enzyme-linked immunosorbent assay kits.</p><p><strong>Results: </strong>Serum claudin-5 levels were significantly lower and β-catenin levels were significantly higher in the ADHD group compared to the control group. However, there was no significant difference in paxillin serum levels between the groups.</p><p><strong>Conclusion: </strong>This study suggests that claudin-5 and beta-catenin may play a role in the pathogenesis of ADHD. These proteins may affect the brain by causing a dysregulation in BBB permeability or through other mechanisms.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"757-764"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention Deficit Hyperactivity Disorder (ADHD) in Military Contexts with regard to Psychosocial and Occupational Outcomes: A Scoping Review.","authors":"Lorna Bateman, Jessica Bramham, Mary Keating, Fionnbar Lenihan","doi":"10.1177/10870547261439441","DOIUrl":"https://doi.org/10.1177/10870547261439441","url":null,"abstract":"<p><strong>Introduction: </strong>ADHD is typically characterised by inattention, impulsivity, and hyperactivity, often persisting into adulthood and influencing occupational performance, social interactions, and mental well-being. This scoping review and narrative synthesis aims to address a critical knowledge gap by systematically mapping the existing research on ADHD in military contexts with regard to psychosocial and occupational outcomes. As such, the aims of this study were (a) to aggregate findings regarding ADHD and psychosocial and occupational outcomes of military personnel and (b) to critically review and provide an account of the methodological quality of these studies.</p><p><strong>Methods: </strong>A systematic search across four electronic databases (PubMed, PsycINFO, Embase and CINAHL) detected and retrieved 1,956 studies. After removal of duplicates, 1,263 titles and abstracts were screened. Following this, 106 articles progressed to full text review, and a total of 51 studies were included in the current scoping review and narrative synthesis.</p><p><strong>Results: </strong>The review indicated that ADHD is strongly associated with comorbid conditions such as post-traumatic stress disorder (PTSD), depression, and substance use disorders, though the extent to which these outcomes are attributable to ADHD versus broader environmental factors remains debated. Occupational functioning outcomes are similarly complex, with some studies reporting challenges in training, career progression, and retention, while others highlight the adaptability and strengths of personnel with ADHD when adequately supported.</p><p><strong>Conclusions: </strong>While ADHD presents both occupational and psychosocial challenges for military personnel, existing research primarily focuses on impairment rather than adaptation or strengths. Future studies should adopt a more holistic approach, incorporating neuroaffirmative principles, environmental factors, and individual variability with a view to informing current practices.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261439441"},"PeriodicalIF":2.2,"publicationDate":"2026-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148101365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in the Association Between Attention-Deficit Hyperactivity Disorder and Physical Diseases in Childhood and Adolescence Using Nationwide Birth Cohorts.","authors":"Martin Dalgaard Villumsen, Niels Bilenberg, Hans-Christoph Steinhausen","doi":"10.1177/10870547261448260","DOIUrl":"10.1177/10870547261448260","url":null,"abstract":"<p><strong>Objective: </strong>To examine the effect of attention-deficit hyperactivity disorder (ADHD) on sex differences in the hazard risk of a physical disease (PD) in childhood and adolescence, per ICD-10 criteria.</p><p><strong>Method: </strong>The Danish population born from 1984 to 1995, comprising over 800,000 individuals, was studied for the 13 different ICD-10 PD categories with ADHD as a time-dependent exposure in time-to-event settings. Time from birth to first episode PD, emigration, death, or 31st December 2017, whichever occurred first, was analyzed by use of piecewise Cox models.</p><p><strong>Results: </strong>Individuals with an ADHD diagnosis had higher or similar hazard risk than undiagnosed individuals throughout follow-up. Across all PD categories, baring malignant neoplasms, ADHD-diagnosed individuals had a higher hazard risk from teen age. In the general population, females had higher hazard risk of most PDs from teen age or early adolescence, while males had higher hazard risk in early childhood. Dispersed modification occurred in the hazard difference between sex post-ADHD diagnosis. For eye and adnexa diseases in childhood, males had about a 15% added hazard that of females in the general population, while females had twice the hazard of males among those diagnosed with ADHD. In the general population of young adulthood, females faced a hazard risk of endocrine, nutritional, and metabolic diseases nine times higher than that of males, with an ADHD diagnosis reducing this ratio by half.</p><p><strong>Conclusion: </strong>The time-dependent ADHD diagnosis alters sex differences in the vulnerability to certain PD categories at various ages, while ADHD considerably increases vulnerability to all PDs except malignant neoplasms.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261448260"},"PeriodicalIF":2.2,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Study of Functional Outcome in Stimulant Treatment of ADHD in Adults.","authors":"Margaret D Weiss, Jeffrey H Newcorn, Pratap Chokka, Marc Cataldo, Sailaja Bhaskar, Graeme A E Donnelly","doi":"10.1177/10870547261440452","DOIUrl":"https://doi.org/10.1177/10870547261440452","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this analysis was to describe the effects of methylphenidate-mediated symptom improvement on functional impairments in adults with ADHD.</p><p><strong>Methods: </strong>This is an exploratory study of self-reported functional impairment on the Weiss Functional Impairment Rating Scale (WFIRS-S) in 351 ADHD adults treated in a forced dose, double blind (DB), randomized, parallel clinical trial of a 16-hr methylphenidate stimulant (PRC-063) for 4 weeks followed by open-label (OL; N = 147) for 6 months.</p><p><strong>Results: </strong>During the 4-week DB period, there was a statistically significant response to medication versus placebo in the WFIRS-S domain of \"work.\" Forty percent of DB subjects, assigned a random dose of medication, showed functional improvement as defined by the Minimal Clinical Important Differences (MCID) of the WFIRS. At the end of DB, one third of subjects had scores below symptomatic and functional impairment thresholds and two thirds by the end of OL. Although the OL period was uncontrolled, when all subjects had been dose optimized with sufficient time for functional impairment to manifest, all WFIRS functional domains showed clinically-relevant improvements from baseline to end of the 6-month OL (<i>p</i> < .0001). There was a fair-to-moderate correlation between change in symptoms and change in function, but ADHD symptoms were about twice as sensitive to change. The strongest predictor of improvement in function was greater improvement in ADHD symptoms. Younger age predicted greater functional impairment.</p><p><strong>Conclusion: </strong>This study of the relationship between change in symptoms and functional outcome illustrates that improvement in symptoms may be associated with an almost cotemporaneous improvement in function, that increases over time. Identification of subjects who are symptom responders with residual functional impairment suggests the need for additional intervention to target residual functional difficulty. Further research needs to replicate this methodology using an individually dose optimized design to demonstrate full potential for change and to confirm the domains of functioning in adults with ADHD that are most responsive to stimulant treatment.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/study/NCT02139124.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261440452"},"PeriodicalIF":2.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Effect of ADHD on Occupational Outcomes in the U.S. Marine Corps.","authors":"Nathan Carnes, Jennifer McAnany, Zeina Khodr, Adam Biggs, James Bonkowski, Wisam Barkho","doi":"10.1177/10870547261446718","DOIUrl":"https://doi.org/10.1177/10870547261446718","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit/hyperactivity disorder (ADHD) can potentially disqualify individuals for military service. However, some past research suggests the performance of individuals with ADHD in military service may be comparable to individuals without ADHD. The objective of the present research is to evaluate the effect of ADHD on occupational outcomes in the first enlistment term. We hypothesized that ADHD would be associated with weak or small performance decrements.</p><p><strong>Method: </strong>Study 1 (<i>N</i> = 51,845) linked Recruit Assessment Program (RAP) survey data collected from U.S. Marine recruits between 2013 and 2018 with up to 4-years of active duty career records from the Defense Manpower Data Center. The RAP survey is a cross-sectional, baseline survey of mental, physical, and behavioral health-including self-reported ADHD diagnosis. Study 2 (<i>N</i> = 161,507) utilized the Career History Archival Medical and Personnel System (CHAMPS) to obtain a study population of all active duty U.S. Marine Corps enlistees who accessed between 2013 and 2018 with follow-up through 2023. ADHD cases were identified by diagnoses and prescriptions captured in CHAMPS medical data. Estimated propensity scores and military characteristics were adjusted for to mitigate confounding.</p><p><strong>Results: </strong>Across both studies, Marines with ADHD (2.0%-3.2%) performed at a comparable level to Marines without ADHD. The differences in occupational outcomes (e.g., promotions, demotions, deployments, and attrition) generally fell within ±3% and failed to reach statistical significance despite high statistical power. Subgroup analyses in Study 2 suggested those with treated ADHD performed significantly better than those with untreated ADHD.</p><p><strong>Conclusion: </strong>Complementing past work using medical waivers, the present research suggests those with a prior or current ADHD diagnosis are just as likely to perform successfully in the U.S. Marine Corps as those without ADHD.</p>","PeriodicalId":15237,"journal":{"name":"Journal of Attention Disorders","volume":" ","pages":"10870547261446718"},"PeriodicalIF":2.2,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}