Comparing Interpersonal Problems and Attachment Styles in Adults With and Without Attention-Deficit/Hyperactivity Disorder

Attention–Deficit/hyperactivity Disorder (ADHD) is characterized by persistent and inappropriate developmental symptoms, such as inattention, hyperactivity, and impulsivity resulting in dysfunction. The symptoms of ADHD often lead to problems at school, the workplace, and social interactions and can be associated with interpersonal challenges. Interpersonal problems are unpredictable events; managing these problems can lead to various consequences. A set of interpersonal problems includes individuals' problems in assertiveness, politeness, obedience, intimacy, responsibility, and restraint. Attachment is a psychological factor that can be linked to the symptoms of ADHD. Attachment style indicates the individual's inner embodiment of the attachment relationship with his caregivers as a child. Attachment theory is not just about childhood; it concerns the evolutionary theory of life. Overall, given the high prevalence of ADHD in adults and the widespread negative consequences of this disorder, this study aimed to compare interpersonal problems and attachment styles in adults with and without ADHD.

The was a causal–comparative descriptive study. The study’s statistical population included individuals referring to Tabriz Counseling and Psychotherapy Center in 2020. The number of individuals in each subgroup in comparative causal research should not be less than 30; thus, the present study aimed to increase the validity and external validity of the findings by 50 individuals. Using the purposive sampling method, 50 patients with ADHD referred to Tabriz Counseling and Psychotherapy Center were selected. After a psychiatrist's definitive diagnosis of ADHD, the study participants were selected. Moreover, 50 healthy subjects were matched concerning gender, age, and education with the ADHD group. The inclusion criteria were psychiatrist's diagnosis of ADHD, the age range of 18–40 years, consent to participate in research, the lack of significant psychiatric disorders and neurological diseases (according to patient records and query), and no substance dependence. Both groups were assessed using the Adult Attachment SInventory (AAI) (Hazan & Shaver, 1987) and Inventory of Interpersonal Problems (IIP–60) (Herwitz et al., 1988). To analyze the obtained data, descriptive statistics, including mean, standard deviation, frequency, and percentage and inferential statistics, including Multivariate Analysis of Variance (MANOVA), were implemented at a significance level of 0.05 in SPSS.

The obtained data suggested that the mean scores of the components of interpersonal problems, including inhibitory problems (p=0.037), determination problems (p<0.001), Responsibility problems (p=0.013), and intimacy problems (p=0.037) in adults with ADHD significantly higher than healthy adults; however, in the problems related to obedience (p=0.393) and problems related to democratization (p=0.164) among adults with ADHD and healthy adults there was no significant difference. Furthermore, the mean score of safe attachment style in adults with ADHD was significantly lower than healthy adults (p=0.027). While the mean score of avoidant attachment in adults with ADHD was significantly higher than healthy adults (p=0.011), the mean score of bilateral attachment among adults with ADHD was significant. There was no significant difference between the adults with and without ADHD (p=0.664).

Adults with ADHD have more problems than normal adults in interpersonal relationships. Moreover, the attachment style in these subjects is of the avoidance attachment type, and they have less secure attachment than the healthy population.