Attention-deficit/hyperactivity disorder (ADHD) is often identified later in girls and women than in boys and men, as its characteristics may present differently or be consciously or unconsciously concealed. The use of ADHD camouflaging strategies, through which individuals reduce the visibility of their difficulties, has emerged in recent years as an important area of research. Nevertheless, compared with research on camouflaging among individuals with autism spectrum disorder, ADHD camouflaging remains relatively underexplored, particularly among young women.
The aim of the present study was to examine the use of ADHD camouflaging strategies among young women with ADHD during the transition to adulthood, and to empirically investigate the associations between camouflaging, ADHD symptom severity, feelings of exhaustion and mental effort, and mental health difficulties. In addition, the predictive value of ADHD camouflaging for self-reported stress severity was examined, as well as whether the use of camouflaging strategies differed according to the developmental period in which the ADHD diagnosis was received.
The study employed a quantitative correlational design. The sample comprised 63 young women with a formal ADHD diagnosis, aged between 18 and 29 years. Data were collected using an online questionnaire that included a measure of ADHD characteristics, a measure of ADHD camouflaging, a questionnaire assessing exhaustion and mental effort associated with the use of camouflaging strategies, and the Depression Anxiety Stress Scales (DASS-21) to assess mental health difficulties.
The results indicate that young women with ADHD score relatively highly on the ADHD symptom camouflaging scale. The most highly frequently endorsed strategies were related to concealing inattention, including creating the impression of being attentive, concealing lapses in attention, and hiding mind-wandering. Other highly frequently endorsed strategies included making an effort to organise responsibilities and monitoring speech in social situations. Greater use of camouflaging strategies was associated with higher self-reported ADHD symptom severity, greater exhaustion and mental effort following social and other everyday situations, and more pronounced mental health difficulties. Statistically significant positive associations were found between camouflaging and self-reported symptoms of depression, anxiety, and stress, with the strongest association observed for stress. Greater ADHD symptom severity was also associated with more extensive use of camouflaging strategies after controlling for age and the developmental period in which the diagnosis was received. Regression analyses showed that ADHD symptom camouflaging was associated with exhaustion and mental effort, even after accounting for ADHD symptom severity. Camouflaging also predicted self-reported stress severity after controlling for ADHD symptom severity. Because of the cross-sectional design of the study, these findings cannot be interpreted as evidence of causal relationships. The developmental period in which the ADHD diagnosis was received was not associated with the use of camouflaging strategies, exhaustion, or mental effort. A statistically significant difference was found in self-reported ADHD symptom severity: participants who received their diagnosis in adulthood reported higher ADHD symptom severity than those diagnosed during adolescence.
The findings contribute to a better understanding of ADHD camouflaging among young women and its associations with psychological burden. They highlight the importance of earlier identification of ADHD in girls and young women, as well as the development of support that may reduce the need for camouflaging and improve mental health outcomes.
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