Attention Magazine October 2021

What are sources of resilience for adolescents and young adults with ADHD during the pandemic? In this research update, the first study examined the experience of loneliness for college students with ADHD during COVID-19 and how their perceptions of social support and hope may make a difference in these experiences. The second study looked at how the mental health of adolescents with and without ADHD changed before the pandemic, during the pandemic lockdown, and after the lockdown. They found that prior emotion regulation was a source of resilience for these youth.

These studies highlight the need for support for youth and young adults with ADHD during COVID-19, with a focus on the roles of emotion regulation, social support, and hope.

Loneliness, ADHD, and distance learning
This study examined the experience of feeling lonely during distance learning for college students with ADHD. The experience of loneliness is associated with significant mental health risks, such as anxiety and depression, and distance learning from home during the pandemic is related to increased stress likely due to social isolation, the need for sustained attention and self-monitoring, and lack of structured daily routine.

The researchers examined whether students with ADHD had more difficulties with distance learning and more loneliness than students without ADHD, whether lack of perceived social support would explain how challenges with distance learning translate to loneliness, and whether hope (for example, belief in one’s ability to use strategies to achieve goals) explains the relationship between greater perceived social support and less loneliness. This research involved 648 college students (529 students without ADHD and 119 students with ADHD) in Israel who were learning online due to the pandemic.

Students participated in approximately six courses, and at the end of the semester, they completed study questionnaires. Results showed that students with ADHD had more challenges with learning online and more loneliness than students without ADHD. Social support explained the relationship between distance learning challenges and loneliness, and hope explained the relationship between social support and loneliness.

Overall, this study suggests that students with ADHD were more likely to experience challenges during online learning than students who do not have ADHD, and perceptions of hope and social support are potential sources for coping. Future studies should examine these questions using questionnaires from multiple sources and a methodology that extends across time.

Laslo-Roth R, Bareket-Bojmel L, & Margalit M. (2020). Loneliness experience during distance learning among college students with ADHD: The mediating role of perceived support and hope. European Journal of Special Needs Education. Advance online publication.

Emotion regulation abilities and mental health
This study examined changes in mental health across time for adolescents with and without ADHD prior to and during COVID-19. Two hundred and thirty-eight adolescents and their parents participated from two sites in the United States. They completed questionnaires over three time points: before COVID-19, Spring 2020 during a stay-at-home order, and Summer 2020 after the order had been lifted.

Results indicated that symptoms of anxiety, depression, concentration, and oppositionality were highest during the stay-at-home order in Spring 2020, compared to the first and third time points. Indeed, these symptoms generally declined to pre-COVID-19 levels in Summer 2020. Inattention symptoms were higher during COVID-19 compared to pre-COVID-19 and did not decline in the summer, suggesting a sustained effect for all adolescents. Compared to the adolescents without ADHD, the adolescents with ADHD had higher inattention, hyperactivity/impulsivity, and oppositional/defiance symptoms at all time points.

The findings also demonstrated that emotion regulation abilities are a protective factor, such that adolescents who had lower emotion regulation abilities pre-COVID-19 had worse mental health outcomes. Moreover, having ADHD and lower emotion regulation conveyed additional risk for inattention and hyperactivity/impulsivity symptoms.

Further, adolescents of families with lower income in this sample experienced increased inattention symptoms, and adolescents of higher income families experienced increased oppositional/defiance symptoms. This study was conducted with a largely middle class sample, and more research is necessary to understand these findings.

All in all, this study indicates that emotion regulation may be a potential area to target in interventions for COVID-19 impacts on adolescent mental health. However, future research needs to be conducted with additional time points to examine the adolescent experience beyond Summer 2020 and with a larger and more diverse sample.

Breaux R, Dvorsky MR, Marsh NP, Green CD, Cash AR, Shroff DM, Buchen N, Langberg JM, & Becker SP (2021). Prospective impact of COVID‐19 on mental health functioning in adolescents with and without ADHD: Protective role of emotion regulation abilities. Journal of Child Psychology and Psychiatry. Advance online publication.

Yuanyuan Jiang, PhD, is an assistant professor and registered psychologist at Saint Paul University and adjunct professor at the University of Alberta. Her research focuses on understanding how attention, behavior, and cognitions relate to each other to learn how to improve assessments and interventions for individuals with attentional difficulties.

Gwendolyn Adams-Sadiqi is studying toward a master’s degree in counselling and spirituality at Saint Paul University. Her research interests include the promotion of mental health and emotional wellness.