Educational and Occupational Underattainment in Adults With Attention-Deficit/Hyperactivity Disorder: A Controlled Study

Joseph Biederman, MD; Carter R. Petty, MA; Ronna Fried, EdD; Roselinde Kaiser, BA; Chrystina R. Dolan, BA; Steven Schoenfeld, BA; Alysa E. Doyle, PhD; Larry J. Seidman, PhD; Stephen V. Faraone, PhD

J Clin Psychiatry 2008;69(8):1217-1222

Article Abstract

Objective: Attention-deficit/hyperactivity disorder (ADHD) has been consistently associated with intellectual, educational, and employment deficits. This study evaluated subjects to determine whether the educational and occupational deficits associated with ADHD are what would be expected given their intellectual abilities or lower than expected given their intellectual abilities.

Method: Participants derived from a case-control study of adults with (N = 224) and without (N = 146) DSM-IV ADHD. Subjects were comprehensively assessed with structured diagnostic interviews and neuropsychological assessments. Educational and occupational attainments were based on Hollingshead socioeconomic status scale. The expected educational and occupational levels of participants with ADHD were computed using ordered logistic regression models as a function of age, sex, and full scale IQ of controls. The study was conducted from 1998 to 2003.

Results: Based on their IQ, subjects with ADHD were predicted to have significantly more education than they actually attained. Additionally, based on their observed education, participants with ADHD were predicted to have significantly higher occupational levels than actually observed.

Conclusion: These findings indicate that ADHD is associated with significant educational and occupational underattainments relative to what would have been expected on the basis of intellectual potential.