The marital and family functioning of adults with ADHD and their spouses
Abstract
Little is known about the family relationships of adults with Attention-Deficit/Hyperactivity Disorder (ADHD). Thus, the marital adjustment and family functioning of 33 married adults with ADHD and their spouses was compared to 26 non-ADHD control participants and their spouses. Results revealed that married adults with ADHD reported poorer overall marital adjustment on the Dyadic Adjustment Scale (DAS; Spanier, 1989) and more family dysfunction on the Family Assessment Device (FAD; Eptein, Baldwin, & Bishop, 1983) than control adults. The spouses of adults with ADHD did not differ from control spouses in reports of overall marital adjustment and family dysfunction. A greater proportion of their marital adjustment scores, however, fell within the maladjusted range. The ADHD adults' perceptions of the health of their marriages and families were more negative than their spouses' perceptions. The way in which spouses of ADHD adults compensated for their partners' difficulties were explored through clinical interviews. The findings in this study underscore the need for assessments and treatments to address marital and family functioning of adults with ADHD.
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Strong, understanding, and accommodating social connections can significantly enhance the overall quality of life of individuals with ADHD.
“The presence of strong, understanding, and accommodating social connections can significantly enhance their overall quality of life (Babinski et al. 2019; Eakin et al. 2004; Fuller‐Thomson et al. 2022).”
From “I Felt Like a Burden”: An Exploration Into the Experience of Romantic Relationships for People With ADHD (2026) · cites this paper as Eakin et al. 2004
The subtheme, "Lost in Thought, Lost in Love," reflects some of the relational difficulties linked to attention regulation differences in ADHD, such as differences in active listening, partner understanding, and conflict resolution.
“The subtheme, “Lost in Thought, Lost in Love,” reflects some of the relational difficulties linked to attention regulation differences in ADHD, such as differences in active listening, partner understanding, and conflict resolution (Eakin et al. 2004; Öncü and Kişlak 2022).”
From “I Felt Like a Burden”: An Exploration Into the Experience of Romantic Relationships for People With ADHD (2026) · cites this paper as Eakin et al. 2004
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Lefler, E. K., Sacchetti, G. M., & Del Carlo, D. I. (2016) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-016-0190-9 · Cited by 68 · see citing works
“Adults with ADHD tend to report romantic relationship dissatisfaction (Canu and Carlson 2003; Eakin et al. 2004; Murphy and Barkley 1996) and have higher rates of divorce and more numerous marriages (Biederman et al.”
BackgroundAdult ADHD and romantic relationships: What we know and what we can do to help
Wymbs, B. T., Canu, W. H., Sacchetti, G. M., & Ranson, L. M. (2021) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12475 · Cited by 67 · see citing works
ADHD Symptoms as Risk Factors for Intimate Partner Violence Perpetration and Victimization
Wymbs, B. T., Dawson, A. E., Suhr, J., Bunford, N., & Gidycz, C. A. (2017) · Journal of Interpersonal Violence · doi:10.1177/0886260515586371 · Cited by 69 · see citing works
“In turn, men and women with ADHD, particularly those with elevated inattention and hyperactivity/impulsivity symptoms, report lower romantic relationship satisfaction and have greater difficulties resolving conflicts than those without ADHD (Canu, Tabor, Michael, Bazzini, & Elmore, 2014; Eakin et al., 2004).”
BackgroundBuss, A. T., & Spencer, J. P. (2017) · Developmental Science · doi:10.1111/desc.12602 · Cited by 66 · see citing works
“Previous research has shown a strong relationship between individual differences in EFs during early childhood and later academic achievement as well as quality of life outcomes into adulthood (Eakin et al., 2004; Moffitt et al., 2011), making EF a key target for early intervention efforts (Diamond & Lee, 2011; Heckma…”
BackgroundSchrevel, S. J. C., Dedding, C., van Aken, J. A., & Broerse, J. E. W. (2016) · Health Expectations · doi:10.1111/hex.12328 · Cited by 59 · see citing works
A Systematic Review of Global Publication Trends Regarding Long-Term Outcomes of ADHD
Hodgkins, P., Arnold, L. E., Shaw, M., Caci, H. M., Kahle, J. S., Woods, A. G., & Young, S. (2012) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2011.00084 · Cited by 60 · see citing works
ADHD Symptomology and Social Functioning in College Students
Sacchetti, G. M., & Lefler, E. K. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714557355 · Cited by 62 · see citing works
“…adults with ADHD tend to report more marital dissatisfaction and romantic relationship maladjustment than adults without ADHD (Canu & Carlson, 2003; Eakin et al., 2004; Murphy & Barkley, 1996), and they also have higher rates of divorce and more numerous marriages than adults without ADHD…”
BackgroundResultInfluentialPrevalence and Correlates of Self-Reported ADD/ADHD in a Large National Sample of Canadian Adults
Hesson, J., & Fowler, K. (2018) · Journal of Attention Disorders · doi:10.1177/1087054715573992 · Cited by 56 · see citing works
“In terms of social functioning, adults with ADHD experience higher levels of marital and family dysfunction (Eakin et al., 2004) and view themselves as less socially competent than others without ADHD (Friedman et al., 2003).”
BackgroundResultInfluentialStickley, A., Koyanagi, A., Ruchkin, V. V., & Kamio, Y. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.09.061 · Cited by 56 · see citing works
“, 2008), in the home (Eakin et al., 2004; Rösler et al., 2010) and in terms of health (Das et al.”
BackgroundCunningham, C. E. (2007) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsm021 · Cited by 56 · see citing works
Barkley, R. A. (2008) · Postgraduate Medicine · doi:10.3810/pgm.2008.09.1907 · Cited by 71 · see citing works
Promotion of Street-Dance Training on the Executive Function in Preschool Children
Shen, Y., Qing, Z., Huang, Y., Liu, G., & Fang, L. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.585598 · Cited by 60 · see citing works
Simpson, E., Dalal, S., & Semaan, B. (2023) · Proceedings of the ACM on Human-Computer Interaction · doi:10.1145/3579490 · Cited by 54 · see citing works
“Other psychology studies show how ADHD is disruptive for people’s interpersonal [11, 61], romantic, and family relationships [31, 42].”
BackgroundTest–Retest Reliability of Two Patient-Report Measures for Use in Adults With ADHD
Matza, L. S., Brunt, D. L. V., Cates, C. E., & Murray, L. T. (2010) · Journal of Attention Disorders · doi:10.1177/1087054710372488 · Cited by 54 · see citing works
“The items were generated on the basis of clinical expert input, patient reports, and published literature indicating that adult ADHD has an effect on multiple domains of HRQL, including work, daily activities, relationships, psychological well-being, and physical well-being (Biederman, Faraone et al., 2006; Brod, Perw…”
BackgroundMethodA Spanish version of the Family Assessment Device
Barroilhet, S. A., Prous, A. C., Cervera‐Enguix, S., Forjaz, M. J., & Guillén‐Grima, F. (2009) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-009-0022-8 · Cited by 52 · see citing works
“It has also been used to study samples of patients with eating disorders [15, 23, 81, 110], schizophrenia [27, 89], self-harm and suicidal behavior [44, 67, 96], addictions [71, 80], bipolar disorder [28, 102], OCD [25, 34], ADHD [ 29 ], and social phobia [61].”
Wymbs, B. T., Wymbs, F. A., & Dawson, A. E. (2014) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-014-9887-4 · Cited by 52 · see citing works
“2003; Zisser and Eyberg 2012) and romantic relationship discord (Eakin et al. 2004; Robin and Payson 2002) than is difficulties with behavioral regulation.”
BackgroundCanu, W. H., Tabor, L. S., Michael, K. D., Bazzini, D. G., & Elmore, A. L. (2013) · Journal of Marital and Family Therapy · doi:10.1111/jmft.12018 · Cited by 53 · see citing works
“, 2006) serious romantic relationships, as well as lower satisfaction within these relationships (Canu & Carlson, 2007; Eakin et al., 2004).”
BackgroundThe Impact of Persisting Hyperactivity on Social Relationships
Moyá, J., Stringaris, A. K., Asherson, P. J., Sandberg, S. T., & Taylor, E. A. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712436876 · Cited by 51 · see citing works
“It has been shown that clinic-referred adults with ADHD have poorer marital adjustment and family functioning (Eakin et al., 2004), as well as a higher incidence of separation and divorce, than normal controls (Biederman et al.”
BackgroundRingenbach, S. D. R., Holzapfel, S. D., Mulvey, G. M., Jimenez, A., Benson, A. M., & Richter, M. (2016) · Journal of Intellectual Disability Research · doi:10.1111/jir.12275 · Cited by 48 · see citing works
“…(Brown & Landgraf 2010; Davis et al. 2010), poor productivity, low employment rates (Bailey 2007), less dependable and more impulsive behaviour in relationships (Eakin et al. 2004) and socially problematic behaviours such as violence and emotional outbursts (Broidy et al. 2003; Denson et al. 2011).”
BackgroundThe Burden of ADHD in Older Adults: A Qualitative Study
Michielsen, M., de Kruif, A. J. T. C. M., Comijs, H. C., van Mierlo, S., Semeijn, E. J., Beekman, A. T. F., Deeg, D. J. H., & Kooij, J. J. S. (2015) · Journal of Attention Disorders · doi:10.1177/1087054715610001 · Cited by 50 · see citing works
“, 2008), relationships (Eakin et al., 2004), education (LeFever, Villers, Morrow, & Vaughn, 2002), and work (Halmøy, Fasmer, Gillberg, & Haavik, 2009).”
BackgroundThe Romantic Relationships of Adolescents With ADHD
Rokeach, A., & Wiener, J. (2014) · Journal of Attention Disorders · doi:10.1177/1087054714538660 · Cited by 47 · see citing works
“Eakin et al. (2004) suggests that in ADHD couples, partners often have conflicting views regarding their relationship.”
BackgroundIssues in the Diagnosis and Treatment of Adult ADHD by Primary Care Physicians
Adler, L. A., Shaw, D. M., Sitt, D. J., Maya, E., & Morrill, M. I. (2009) · Primary psychiatry · Cited by 46 · see citing works
The Pharmacology and Clinical Outcomes of Amphetamines to Treat ADHD
Hodgkins, P., Shaw, M., McCarthy, S., & Sallee, F. R. (2012) · CNS Drugs · doi:10.2165/11599630-000000000-00000 · Cited by 45 · see citing works
Anastopoulos, A. D., Sommer, J. L., & Schatz, N. K. (2009) · Current Attention Disorders Reports · doi:10.1007/s12618-009-0023-2 · Cited by 45 · see citing works
“More consistently reported is the finding that marital satisfaction seems to be lower among couples in which one member has ADHD [29], with greater dissatisfaction more often expressed by the spouse affected by ADHD [7••].”
BackgroundPredictors of Executive Functions in Preschoolers: Findings From the SPLASHY Study
Zysset, A., Kakebeeke, T., Messerli-Bürgy, N., Meyer, A., Stülb, K., Leeger-Aschmann, C., Schmutz, E. A., Arhab, A., Puder, J., Kriemler, S., et al. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.02060 · Cited by 43 · see citing works
Attention Deficit/Hyperactivity Disorder in Adults
Moss, S. B., Nair, R. J., Vallarino, A., & Wang, S. (2007) · Primary Care Clinics in Office Practice · doi:10.1016/j.pop.2007.05.005 · Cited by 43 · see citing works
Bjerrum, M. B., Pedersen, P. U., & Larsen, P. (2017) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003357 · Cited by 44 · see citing works
Groen, Y., den Heijer, A. E., Fuermaier, A. B. M., Althaus, M., & Tucha, O. M. (2017) · ADHD Attention Deficit and Hyperactivity Disorders · doi:10.1007/s12402-017-0236-7 · Cited by 43 · see citing works
“Studies on adults with ADHD reported friendship problems and poorer social interactions (Young et al. 2003; Kooij et al. 2010), loneliness (Philipsen et al. 2009) as well as poorer intimate relationships and marital adjustment (Eakin et al. 2004).”
BackgroundResultInfluentialWang, C. H., Mazursky-Horowitz, H., & Chronis-Tuscano, A. (2014) · Current Psychiatry Reports · doi:10.1007/s11920-014-0474-8 · Cited by 39 · see citing works
When does it end? Attention-deficit/hyperactivity disorder in the middle aged and older populations
Manor, I., Rozen, S., Zemishlani, Z., Weizman, A., & Zalsman, G. (2011) · Clinical Neuropharmacology · doi:10.1097/wnf.0b013e3182206dc1 · Cited by 45 · see citing works
“This seems to be a not uncommon phenomenon in younger adult populations, according to literature.(16) Six (55%) had other medical problems, which may be expected in this age group (hypertension, type 2 diabetes, and ischemic heart disease), although the percentage was relatively high.”
BackgroundMörstedt, B., Corbisiero, S., Bitto, H., & Stieglitz, R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0141342 · Cited by 38 · see citing works
“[34] found that spouses of people with ADHD reported fewer impairments to their married lives than their ADHD partners.”
BackgroundStickley, A., Koyanagi, A., Takahashi, H., Ruchkin, V. V., & Kamio, Y. (2017) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.01.007 · Cited by 39 · see citing works
“…to a number of functional impairments that impact on well-being and quality of life throughout adulthood in terms of family functioning, work and health (Barkley Murphy, & Fischer 2008; Das, Cherbuin, Butterworth, Anstey, & Easteal, 2012; Eakin et al., 2004; Murphy & Barkley, 1996; Nigg, 2013).”
BackgroundPrediction of Preschool Aggression from DRD4 Risk, Parental ADHD Symptoms, and Home Chaos
Farbiash, T., Berger, A., Atzaba-Poria, N., & Auerbach, J. G. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9791-3 · Cited by 37 · see citing works
Assessing Treatment Outcomes in Attention-Deficit/Hyperactivity Disorder
Epstein, J. N., & Weiss, M. D. (2012) · The Primary Care Companion For CNS Disorders · doi:10.4088/pcc.11r01336 · Cited by 37 · see citing works
Prefrontal mechanisms of comorbidity from a transdiagnostic and ontogenic perspective
MacDonald, A. N., Goines, K., Novacek, D. M., & Walker, E. F. (2016) · Development and Psychopathology · doi:10.1017/s0954579416000742 · Cited by 36 · see citing works
“EFs have been associated with a range of long-term outcomes related to academic performance (Borella, Carretti, Riboldi, & De Beni, 2010), job success (Bailey, 2007), criminal activity (Broidy et al., 2003), and relationships (Eakin et al., 2004).”
BackgroundInterparental aggression, attention skills, and early childhood behavior problems
Towe‐Goodman, N. R., Stifter, C. A., Coccia, M., Cox, M. J., & The Family Life Project Key Investigators (2011) · Development and Psychopathology · doi:10.1017/s0954579411000216 · Cited by 35 · see citing works
“Alternatively, genetic linkages may partially account for some of the associations, as parents with limited executive attention skills may be more likely to engage in intense interparental conflict (Eakin et al., 2004).”
BackgroundSexuality in Adults With ADHD: Results of an Online Survey
Hertz, P. G., Turner, D., Barra, S., Biedermann, L., Retz-Junginger, P., Schöttle, D., & Retz, W. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.868278 · Cited by 39 · see citing works
Adult attention deficit hyperactivity disorder: a comprehensive review
Williams, O. C. A., Prasad, S., McCrary, A., Jordan, E., Sachdeva, V., Deva, S., Kumar, H., Mehta, J., Neupane, P., & Gupta, A. (2023) · Annals of Medicine and Surgery · doi:10.1097/ms9.0000000000000631 · Cited by 42 · see citing works
“ADHD adults hold a negative impression of marriage leading to separation and divorces([21]).”
BackgroundMichielsen, M., Comijs, H. C., Semeijn, E. J., Beekman, A. T. F., Deeg, D. J. H., & Kooij, J. J. S. (2014) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2014.02.005 · Cited by 33 · see citing works
Nonmedication treatments for adult ADHD: Evaluating impact on daily functioning and well-being.
Ramsay, J. R. (2010) · American Psychological Association eBooks · doi:10.1037/12056-000 · Cited by 33 · see citing works
The Effects of ADHD in Adult Substance Abusers
Moura, H. F., Faller, S., Benzano, D., Szobot, C., von Diemen, L., Stolf, A. R., Souza-Formigoni, M. L., Cruz, M. S., Brasiliano, S., Pechansky, F., et al. (2013) · Journal of Addictive Diseases · doi:10.1080/10550887.2013.824359 · Cited by 33 · see citing works
Baez, A. C., Dajani, D. R., Voorhies, W., Parladé, M. V., Alessandri, M., Britton, J. C., Llabre, M. M., & Uddin, L. Q. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-019-04290-9 · Cited by 30 · see citing works
Lensing, M. B., Zeiner, P., Sandvik, L., & Opjordsmoen, S. (2013) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.12m07714 · Cited by 32 · see citing works
Simpson, A., Ruwaili, R. A., Jolley, R. P., Leonard, H. C., Geeraert, N., & Riggs, K. J. (2017) · Child Development · doi:10.1111/cdev.12949 · Cited by 31 · see citing works
Treatment of adults with attention-deficit/hyperactivity disorder
Hechtman, L. (2008) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s1747 · Cited by 31 · see citing works
Self-citationSelf-Reported ADHD and Adult Health in the United States
Landes, S. D., & London, A. S. (2018) · Journal of Attention Disorders · doi:10.1177/1087054718757648 · Cited by 31 · see citing works
“Compared with those who have never been diagnosed with ADHD, adults who have ever been diagnosed with ADHD are more likely to experience marital discord, separation, and divorce (Barkley et al., 2008; Biederman et al., 1993; Eakin et al., 2004) or to never have married (Lensing et al.”
BackgroundPérez, E. J. P., & García, C. P. (2007) · Adicciones · doi:10.20882/adicciones.298 · Cited by 30 · see citing works
The Relationship Between ADHD Symptoms and Competence as Reported by Both Self and Others
Jiang, Y., & Johnston, C. (2011) · Journal of Attention Disorders · doi:10.1177/1087054710392541 · Cited by 29 · see citing works
“These areas are domains in which ADHD-related impairments are well established (Eakin et al., 2004; Harpin, 2005; Murphy & Barkley, 1996).”
BackgroundSilverstein, M. J., Faraone, S. V., Alperin, S., Biederman, J., Spencer, T. J., & Adler, L. A. (2017) · Journal of Child and Adolescent Psychopharmacology · doi:10.1089/cap.2017.0082 · Cited by 28 · see citing works
“…adult ADHD have increased rates of psychiatric co-morbidities, underemployment and unemployment, substance abuse disorders, divorce and marital separation, and motor vehicle accidents (Mannuzza and Klein 1999; Barkley 2002; Eakin et al. 2004; Wilens and Dodson 2004; Biederman et al. 2006a, 2006b).”
Rösler, M., Ginsberg, Y., Arngrim, T., Adamou, M., Niemelä, A., Dejonkheere, J., van Oene, J., & Schäuble, B. (2011) · The World Journal of Biological Psychiatry · doi:10.3109/15622975.2011.571283 · Cited by 28 · see citing works
Marital and Coparenting Relationships
Williamson, D., & Johnston, C. (2016) · Journal of Attention Disorders · doi:10.1177/1087054712471717 · Cited by 22 · see citing works
“For example, the DAS scores were consistent with those from previous studies of adults with ADHD (Eakin et al., 2004), but predictably higher than what has been found in samples of adults with more severe psychological difficulties (Hunsley et al., 2001).”
BackgroundResultInfluentialEddy, L. D., Jones, H. A., Snipes, D. J., Karjane, N. W., & Svikis, D. S. (2017) · Journal of Attention Disorders · doi:10.1177/1087054716685839 · Cited by 27 · see citing works
Eklund, H., Cadman, T., Findon, J. L., Hayward, H., Howley, D., Beecham, J. K., Xenitidis, K., Murphy, D., Asherson, P. J., & Glaser, K. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1509-0 · Cited by 27 · see citing works
“For instance, adults with ADHD are more likely than the general population to: 1) be unemployed [4] and experience more frequent job losses [4]; 2) under achieve in education [5]; 3) experience greater instability in emotional relationships [6]; 4) display anti-social and offending behaviours [7] and 5) suffer from dr…”
BackgroundImpairments of interpersonal synchrony evident in attention deficit hyperactivity disorder (ADHD).
Problovski, H. Z. G., Lavi, D., Yozevitch, R., Sherman, M., Hagay, Y., & Dahan, A. (2020) · Acta Psychologica · doi:10.1016/j.actpsy.2020.103210 · Cited by 20 · see citing works
Arrondo, G., Osorio, A., Magallón, S., del Burgo, C. L., & Cortese, S. (2023) · Psychological Medicine · doi:10.1017/s0033291723001976 · Cited by 27 · see citing works
“Conversely, the romantic quality of their partners is also lower, with almost all individuals indicating that symptoms interfere in the relationship (Eakin et al., 2004; Wymbs et al., 2021).”
- Authors
- Eakin, L., Minde, K., Hechtman, L., Ochs, E., Krane, E., Bouffard, R., Greenfield, B., & Looper, K.
- Affiliations
- University of Virginia (US)
- McGill University (CA)
- University of Victoria (CA)
- Halifax, Canada
- Jewish General Hospital (CA)
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2004-08
- Volume
- 8
- Issue
- 1
- Pages
- 1-10
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- OpenAlex
- W2060747776
- Cited by
- 318
- References
- 42
- Citations by year
- 2026: 9 · 2025: 18 · 2024: 15 · 2023: 18 · 2022: 17 · 2021: 24 · 2020: 25 · 2019: 23 · 2018: 20 · 2017: 16 · 2016: 16 · 2015: 20 · 2014: 17 · 2013: 17 · 2012: 17
- FWCI
- 2.09
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Attention Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Social Psychology › Attachment and Relationship Dynamics
- Social Sciences › Demography › Family Dynamics and Relationships
- Keywords
- adult ADHD, marital adjustment, family functioning, spouses, family dysfunction, Dyadic Adjustment Scale, Family Assessment Device, spousal perceptions
- MeSH terms
- Adaptation, Psychological, Adult, Attention Deficit Disorder with Hyperactivity, Conflict, Psychological, Family Relations, Female, Humans, Male, Marital Therapy, Marriage, Middle Aged, Personal Satisfaction, Psychological Tests, Psychometrics, Reference Values, Spouses
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