Relationship difficulties: compounding effects of Adult Attention-Deficit/Hyperactivity Disorder (ADHD)
Main Article Content
Abstract
Once thought solely a childhood disorder, research on adult Attention-Deficit/Hyperactivity Disorder (ADHD) has become more prevalent since the condition’s recognition in the 1990s. However, information remains scarce about if and how it impacts functionality in relationships. Adults with Attention-Deficit/Hyperactivity Disorder can experience interpersonal relationship difficulties due to the disorder’s signature symptoms of hyperactivity, impulsivity, and inattentiveness, as well as due to their oft-observed dimension of emotional lability. Adults with Attention-Deficit/ Hyperactivity Disorder tend to have more trouble navigating romantic relationships and are more likely to be divorced than adults without Attention-Deficit/Hyperactivity Disorder. The purpose of this paper is to perform a systematic literature review of empirically-based studies of integrative couples therapy wherein at least one partner struggles with adult Attention-Deficit/Hyperactivity Disorder. Future research, gaps in the literature, and practice implications also are discussed, including hope for focus on the positive aspects of ADHD for individuals and partnerships.
Keywords:
adult; attention deficit hyperactivity disorder; ADHD; relationship; couples therapy
Article Details
How to Cite
HUYNH-HOHNBAUM, Anh-Luu; BENOWITZ, S. M..
Relationship difficulties: compounding effects of Adult Attention-Deficit/Hyperactivity Disorder (ADHD).
Medical Research Archives, [S.l.], v. 14, n. 2, feb. 2026.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/7244>. Date accessed: 02 mar. 2026.
doi: https://doi.org/10.18103/mra.v14i2.7244.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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Ben-Naim S, Marom I, Krashin M, Gifter B, Arad K. Life with a partner with ADHD: the moderating role of intimacy. J Child Fam Stud. 2017;26(5):1365-1373. doi:10.1007/s10826-016-0653-9
Bora E, Pantelis C. Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder. Psychol Med. 2016;46(4):699-716. doi:10.1017/S0033291715002573
Bruner MR, Kuryluk AD, Whitton SW. Attention-deficit/hyperactivity disorder symptom levels and romantic relationship quality in college students. J Am Coll Health. 2015;63(2):98-108. doi:10.1080/0 7448481.2014.975717
Buitelaar NJ, Posthumus JA, Bijlenga D, Buitelaar JK. The impact of ADHD treatment on intimate partner violence in a forensic psychiatry setting. J Atten Disord. 2019;23:1087054719879502. doi:10.1177/1 087054719879502
Canu WH, Tabor LS, Michael KD, Bazzini DG, Elmore AL. Young adult romantic couples’ conflict resolution and satisfaction varies with partner’s attention-deficit/hyperactivity disorder type. J Marital Fam Ther. 2014;40(4):509-524. doi:10.1111/jmft.12018
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Das D, Cherbuin N, Butterworth P, Anstey KJ, Easteal S. A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults. PLoS One. 2012;7(2):e31500. doi:10.1371/journal.pone.0 031500
Evren C. Alcohol- and cigarette-use-related behaviors across gender, dysfunctional COVID-19 anxiety, and the presence of probable ADHD during the pandemic: a cross-sectional study in a sample of Turkish young adults. Dusunen Adam J Psychiatry Neurol Sci. 2021. doi:10.14744/dajpns.2021.00161
Fayyad J, Sampson NA, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al Hamzawi A, et al. The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Published 2017.
Ghahramanzadeh M, Mashhadi A, Shamloo ZS, Kimiaee SA. Comparing emotional disturbances and quality of life in couples with attention-deficit and hyperactivity disorder and ordinary couples. J Fundam Ment Health. 2021;23(1):41-48.
González RA, Kallis C, Coid JW. Adult attention deficit hyperactivity disorder and violence in the population of England: does comorbidity matter? PLoS One. 2013;8(9):e75575. doi:10.1371/journal.p one.0075575
Hallowell EM, Hallowell S, Orlov M. Married to distraction: how to restore intimacy and strengthen your partnership in an age of interruption. Ballantine Books; 2011.
Hankin CS. ADHD and its impact on the family. Drug Benefit Trends. 2001;13(suppl C):15-16.
Hirvikoski T, Lindström T, Carlsson J, Waaler E, Jokinen J, Bölte S. Psychoeducational groups for adults with ADHD and their significant others (PEGASUS): a pragmatic multicenter randomized controlled trial. Eur Psychiatry. 2017;44:141-152. doi:10.1016/j.eurpsy.2017.04.005
Johnston C, Mash EJ, Miller N, Ninowski JE. Parenting in adults with attention-deficit/hyperactivity disorder (ADHD). Clin Psychol Rev. 2012;32(4):215-228. doi:10.1016/j.cpr.2012.01.007
Jiang Y, Johnston C. The relationship between ADHD symptoms and competence as reported by both self and others. J Atten Disord. 2012;16(5):418-426. doi:10.1177/1087054710392541
Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s128 88-017-1463-3
Kessler RC, Adler LA, Barkley R, Biederman J, Conners CK, Faraone SV, et al. Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the National Comorbidity Survey Replication. Biol Psychiatry. 2005;57(11):1442-1451. doi:10.1016/j.biopsych.20 05.04.001
Klein RG, Mannuzza S, Olazagasti MA, Roizen E, Hutchison JA, Lashua EC, et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry. 2012; 69(12):1295-1303. doi:10.1001/archgenpsychiatr y.2012.271
Libutzki B, Ludwig S, May M, Jacobsen R, Reif A, Hartman C. Direct medical costs of ADHD and its comorbid conditions on basis of a claims data analysis. Eur Psychiatry. 2019;58:38-44. doi:10.1016/j.eurps y.2019.01.019
Lui JH, Johnston C, Lee CM, Lee-Flynn SC. Parental ADHD symptoms and self-reports of positive parenting. J Consult Clin Psychol. 2013;81(6):988-998. doi:10.1037/a0033490
Markman HJ, Stanley SM, Blumberg SL, Jenkins NH, Whiteley C. 12 hours to a great marriage: a step-by-step guide for making love last. Jossey-Bass; 2004.
Marsh LE, Norvilitis JM, Ingersoll TS, Li B. ADHD symptomatology, fear of intimacy, and sexual anxiety and behavior among college students in China and the United States. J Atten Disord. 2015;19(3):211-221. doi:10.1177/1087054712453483
McGough JJ. Treatment controversies in adult ADHD. Am J Psychiatry. 2016;173(10):960-966. doi:10.1176/appi.ajp.2016.15091207
Michielsen M, Comijs HC, Aartsen MJ, Semeijn EJ, Beekman ATF, Deeg DJH, et al. The relationships between ADHD and social functioning and participation in older adults in a population-based study. J Atten Disord. 2015;19(5):368-379. doi:10.1177/1087054713515748
Moyá J, Stringaris AK, Asherson P, Sandberg S, Taylor E. The impact of persisting hyperactivity on social relationships. J Atten Disord. 2014;18(1):52-60. doi:10.1177/1087054712436876
National Academies of Sciences, Engineering, and Medicine. Adult attention-deficit/hyperactivity disorder: diagnosis, treatment, and implications for drug development: proceedings of a workshop. National Academies Press; 2024.
Pachado MP, Scherer JN, Guimarães LS, von Diemen L, Pechansky F, Kessler FH, et al. Markers for severity of problems in interpersonal relationships of crack cocaine users from a Brazilian multicenter study. Psychiatr Q. 2018;89(4):923-936. doi:10.100 7/s11126-018-9590-7
Pietromonaco PR, Overall NC. Applying relationship science to evaluate how the COVID-19 pandemic may impact couples’ relationships. Am Psychol. 2021;76(3):438-450. doi:10.1037/amp000 0714
Posner J, Polanczyk GV, Sonuga-Barke EJS. Attention-deficit hyperactivity disorder. Lancet. 2020;395(10222):450-462. doi:10.1016/S0140-673 6(19)33004-1
Robin A, Payson E. The impact of ADHD on marriage. ADHD Rep. 2002;10:9-13.
Romero-Martínez Á, Lila M, Moya-Albiol L. The importance of impulsivity and attention switching deficits in perpetrators convicted for intimate partner violence. Aggress Behav. 2019;45(2):129-138. doi:10.1002/ab.21802
Roy M, Ohlmeier MD, Osterhagen L, Prox-Vagedes V, Dillo W. Asperger syndrome: a frequent comorbidity in first diagnosed adult ADHD patients? Psychiatr Danub. 2013;25(2):133-141.
Sibley MH. Variable patterns of remission from ADHD in the multimodal treatment study of ADHD (MTA). J Am Acad Child Adolesc Psychiatry. 2021; 60(10). doi:10.1016/j.jaac.2021.07.203
Skirrow C, Asherson P. Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. J Affect Disord. 2013;147(1-3):80-86. doi:10.1016/j.jad.2012.10.011
Waxmonsky JG, Waschbusch DA, Babinski DE, Humphrey HH, Alfonso A, Crum KI, et al. Does pharmacological treatment of ADHD in adults enhance parenting performance? Results of a double-blind randomized trial. CNS Drugs.2014; 28(7):665-677. doi:10.1007/s40263-014-0165-3
Whisman MA, Baucom DH. Intimate relationships and psychopathology. Clin Child Fam Psychol Rev. 2012;15(1):4-13. doi:10.1007/s10567-011-0107-2
Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: what we know and what we can do to help. J Marital Fam Ther. 2021;47(3):664-681. doi:10.1111/jmft.12475
Wymbs BT, Dawson AE, Suhr JA, Bunford N, Gidycz CA. ADHD symptoms as risk factors for intimate partner violence perpetration and victimization. J Interpers Violence. 2017;32(5):659-681. doi:10.117 7/0886260515586371
Wymbs BT, Molina BSG. Integrative couples group treatment for emerging adults with ADHD symptoms. Cogn Behav Pract. 2015;22(2):161-171. doi:10.101 6/j.cbpra.2014.06.008
Xiao Y, Watson M. Guidance on conducting a systematic literature review. J Plan Educ Res. 2019; 39(1):93-112. doi:10.1177/0739456X17723971
Babinski DE, Waxmonsky JG, Waschbusch DA, Pelham WE. Behavioral observations of parents with ADHD during parent training. J Atten Disord. 2015; 22(13):1289-1296. doi:10.1177/1087054715580843
Ben-Naim S, Marom I, Krashin M, Gifter B, Arad K. Life with a partner with ADHD: the moderating role of intimacy. J Child Fam Stud. 2017;26(5):1365-1373. doi:10.1007/s10826-016-0653-9
Bora E, Pantelis C. Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder. Psychol Med. 2016;46(4):699-716. doi:10.1017/S0033291715002573
Bruner MR, Kuryluk AD, Whitton SW. Attention-deficit/hyperactivity disorder symptom levels and romantic relationship quality in college students. J Am Coll Health. 2015;63(2):98-108. doi:10.1080/0 7448481.2014.975717
Buitelaar NJ, Posthumus JA, Bijlenga D, Buitelaar JK. The impact of ADHD treatment on intimate partner violence in a forensic psychiatry setting. J Atten Disord. 2019;23:1087054719879502. doi:10.1177/1 087054719879502
Canu WH, Tabor LS, Michael KD, Bazzini DG, Elmore AL. Young adult romantic couples’ conflict resolution and satisfaction varies with partner’s attention-deficit/hyperactivity disorder type. J Marital Fam Ther. 2014;40(4):509-524. doi:10.1111/jmft.12018
Cortese S, Bellgrove MA, Brikell I, Franke B, Goodman DW, Hartman CA, et al. Attention-deficit/hyperactivity disorder (ADHD) in adults: evidence base, uncertainties and controversies. World Psychiatry. 2025;24(3):347-371. doi:10.1002/w ps.21374
Das D, Cherbuin N, Butterworth P, Anstey KJ, Easteal S. A population-based study of attention deficit/hyperactivity disorder symptoms and associated impairment in middle-aged adults. PLoS One. 2012;7(2):e31500. doi:10.1371/journal.pone.0 031500
Evren C. Alcohol- and cigarette-use-related behaviors across gender, dysfunctional COVID-19 anxiety, and the presence of probable ADHD during the pandemic: a cross-sectional study in a sample of Turkish young adults. Dusunen Adam J Psychiatry Neurol Sci. 2021. doi:10.14744/dajpns.2021.00161
Fayyad J, Sampson NA, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al Hamzawi A, et al. The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. Published 2017.
Ghahramanzadeh M, Mashhadi A, Shamloo ZS, Kimiaee SA. Comparing emotional disturbances and quality of life in couples with attention-deficit and hyperactivity disorder and ordinary couples. J Fundam Ment Health. 2021;23(1):41-48.
González RA, Kallis C, Coid JW. Adult attention deficit hyperactivity disorder and violence in the population of England: does comorbidity matter? PLoS One. 2013;8(9):e75575. doi:10.1371/journal.p one.0075575
Hallowell EM, Hallowell S, Orlov M. Married to distraction: how to restore intimacy and strengthen your partnership in an age of interruption. Ballantine Books; 2011.
Hankin CS. ADHD and its impact on the family. Drug Benefit Trends. 2001;13(suppl C):15-16.
Hirvikoski T, Lindström T, Carlsson J, Waaler E, Jokinen J, Bölte S. Psychoeducational groups for adults with ADHD and their significant others (PEGASUS): a pragmatic multicenter randomized controlled trial. Eur Psychiatry. 2017;44:141-152. doi:10.1016/j.eurpsy.2017.04.005
Johnston C, Mash EJ, Miller N, Ninowski JE. Parenting in adults with attention-deficit/hyperactivity disorder (ADHD). Clin Psychol Rev. 2012;32(4):215-228. doi:10.1016/j.cpr.2012.01.007
Jiang Y, Johnston C. The relationship between ADHD symptoms and competence as reported by both self and others. J Atten Disord. 2012;16(5):418-426. doi:10.1177/1087054710392541
Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17(1):302. doi:10.1186/s128 88-017-1463-3
Kessler RC, Adler LA, Barkley R, Biederman J, Conners CK, Faraone SV, et al. Patterns and predictors of attention-deficit/hyperactivity disorder persistence into adulthood: results from the National Comorbidity Survey Replication. Biol Psychiatry. 2005;57(11):1442-1451. doi:10.1016/j.biopsych.20 05.04.001
Klein RG, Mannuzza S, Olazagasti MA, Roizen E, Hutchison JA, Lashua EC, et al. Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. Arch Gen Psychiatry. 2012; 69(12):1295-1303. doi:10.1001/archgenpsychiatr y.2012.271
Libutzki B, Ludwig S, May M, Jacobsen R, Reif A, Hartman C. Direct medical costs of ADHD and its comorbid conditions on basis of a claims data analysis. Eur Psychiatry. 2019;58:38-44. doi:10.1016/j.eurps y.2019.01.019
Lui JH, Johnston C, Lee CM, Lee-Flynn SC. Parental ADHD symptoms and self-reports of positive parenting. J Consult Clin Psychol. 2013;81(6):988-998. doi:10.1037/a0033490
Markman HJ, Stanley SM, Blumberg SL, Jenkins NH, Whiteley C. 12 hours to a great marriage: a step-by-step guide for making love last. Jossey-Bass; 2004.
Marsh LE, Norvilitis JM, Ingersoll TS, Li B. ADHD symptomatology, fear of intimacy, and sexual anxiety and behavior among college students in China and the United States. J Atten Disord. 2015;19(3):211-221. doi:10.1177/1087054712453483
McGough JJ. Treatment controversies in adult ADHD. Am J Psychiatry. 2016;173(10):960-966. doi:10.1176/appi.ajp.2016.15091207
Michielsen M, Comijs HC, Aartsen MJ, Semeijn EJ, Beekman ATF, Deeg DJH, et al. The relationships between ADHD and social functioning and participation in older adults in a population-based study. J Atten Disord. 2015;19(5):368-379. doi:10.1177/1087054713515748
Moyá J, Stringaris AK, Asherson P, Sandberg S, Taylor E. The impact of persisting hyperactivity on social relationships. J Atten Disord. 2014;18(1):52-60. doi:10.1177/1087054712436876
National Academies of Sciences, Engineering, and Medicine. Adult attention-deficit/hyperactivity disorder: diagnosis, treatment, and implications for drug development: proceedings of a workshop. National Academies Press; 2024.
Pachado MP, Scherer JN, Guimarães LS, von Diemen L, Pechansky F, Kessler FH, et al. Markers for severity of problems in interpersonal relationships of crack cocaine users from a Brazilian multicenter study. Psychiatr Q. 2018;89(4):923-936. doi:10.100 7/s11126-018-9590-7
Pietromonaco PR, Overall NC. Applying relationship science to evaluate how the COVID-19 pandemic may impact couples’ relationships. Am Psychol. 2021;76(3):438-450. doi:10.1037/amp000 0714
Posner J, Polanczyk GV, Sonuga-Barke EJS. Attention-deficit hyperactivity disorder. Lancet. 2020;395(10222):450-462. doi:10.1016/S0140-673 6(19)33004-1
Robin A, Payson E. The impact of ADHD on marriage. ADHD Rep. 2002;10:9-13.
Romero-Martínez Á, Lila M, Moya-Albiol L. The importance of impulsivity and attention switching deficits in perpetrators convicted for intimate partner violence. Aggress Behav. 2019;45(2):129-138. doi:10.1002/ab.21802
Roy M, Ohlmeier MD, Osterhagen L, Prox-Vagedes V, Dillo W. Asperger syndrome: a frequent comorbidity in first diagnosed adult ADHD patients? Psychiatr Danub. 2013;25(2):133-141.
Sibley MH. Variable patterns of remission from ADHD in the multimodal treatment study of ADHD (MTA). J Am Acad Child Adolesc Psychiatry. 2021; 60(10). doi:10.1016/j.jaac.2021.07.203
Skirrow C, Asherson P. Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. J Affect Disord. 2013;147(1-3):80-86. doi:10.1016/j.jad.2012.10.011
Waxmonsky JG, Waschbusch DA, Babinski DE, Humphrey HH, Alfonso A, Crum KI, et al. Does pharmacological treatment of ADHD in adults enhance parenting performance? Results of a double-blind randomized trial. CNS Drugs.2014; 28(7):665-677. doi:10.1007/s40263-014-0165-3
Whisman MA, Baucom DH. Intimate relationships and psychopathology. Clin Child Fam Psychol Rev. 2012;15(1):4-13. doi:10.1007/s10567-011-0107-2
Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: what we know and what we can do to help. J Marital Fam Ther. 2021;47(3):664-681. doi:10.1111/jmft.12475
Wymbs BT, Dawson AE, Suhr JA, Bunford N, Gidycz CA. ADHD symptoms as risk factors for intimate partner violence perpetration and victimization. J Interpers Violence. 2017;32(5):659-681. doi:10.117 7/0886260515586371
Wymbs BT, Molina BSG. Integrative couples group treatment for emerging adults with ADHD symptoms. Cogn Behav Pract. 2015;22(2):161-171. doi:10.101 6/j.cbpra.2014.06.008
Xiao Y, Watson M. Guidance on conducting a systematic literature review. J Plan Educ Res. 2019; 39(1):93-112. doi:10.1177/0739456X17723971