IS IT POSSIBLE TO IDENTIFY SPECIFIC PERSONALITY PATTERNS IN PATIENTS CLINICALLY DIAGNOSED WITH ADULT ADHD? A PILOT STUDY
Authors: Logiudice *Maria , De Stefano Rosa , Messina Vincenzo , Fangano Giulia , Bruno Antonio , Cedro Clemente 
Published: February 2025

Abstract

Background
Attention-deficit/hyperactivity disorder (ADHD) is characterized by a wide range of symptoms that may include attention, hyperactivity, and impulsivity at varying degrees [1] ADHD is a common neurodevelopmental disease, with prevalence rates ranging from 5 to 10% in childhood and from 2 to 5% in adults. In several cases, it might only be diagnosed in adulthood and become part of more complex psychopathological pictures in terms of diagnosis and treatment. ADHD is often comorbid with other disorders as neurodevelopmental (e.g., autism spectrum disorders), externalizing (e.g., substance use and addiction), and internalizing disorders (e.g., depression and anxiety) [2].

Aims & Objectives
The aim of this pilot study is to investigate the presence of such recurrent patterns and possibly identify characteristic clusters.

Methods
47 patients with ADHD (diagnosed through the DIVA-2.0 test) from the Neurodivergence Outpatient Clinic for ADHD in Adults at the Psychiatry Unit of the University Hospital of Messina (Italy) were consecutively recruited and enrolled in the study. All patients underwent neuropsychological and psychodiagnostics assessments including the Personality Inventory (PID-5), which explores five main personality domains (Negative Affectivity, Detachment, Antagonism, Disinhibition and Psychoticism) and 25 related items [4].

Results
Examining results from PID at a domain level, three major personality domains (negative affectivity, detachment and disinhibition) were closely correlated with the presence of an ADHD disorder (&gt; 95th percentile). At a more detailed analysis level, ADHD-related traits (distractibility, irresponsibility, cognitive and perceptual dysregulation) resulted significantly related with specific personality facets (anxiety, depression, eccentricity, distrust) that were responsible for correlations at the domain level.

Discussion & Conclusion
Adolescence is a fundamental period in the neurobiological and psychological development; distress, trauma, and “lack of responses” can leave indelible marks on the personality development of these patients [3]. These preliminary data, consistent with the distinctive symptoms of ADHD patients, highlight the presence of overlapping dysfunctional personality traits.
From this perspective, misdiagnosis of ADHD in childhood and/or adolescence may have a role in promoting abnormal personality development as suggested by the correlations with specific dysfunctional personality profiles. Early diagnosis could change the patients' quality of life. What would have happened if these patients had been diagnosed with ADHD during childhood? Further studies on ADHD in adults should include personality assessments with the aim of investigating the missing link between undiagnosed ADHD in childhood and adolescence and personality dysfunctional traits and/or disorders, starting from the assumption that early diagnosis and timing treatment of ADHD may prevent the development of dysfunctional personality trajectories.

References
[1]Retz, W. et al. (2020b) 'Methylphenidate treatment of adult ADHD patients improves the degree of ADHD severity under routine conditions,' Journal of Neural Transmission, 127(10), pp. 1427–1434. https://doi.org/10.1007/s00702-020-02226-7.
[2]Kuja-Halkola, Ralf, et al. “Do Borderline Personality Disorder and Attention-Deficit/Hyperactivity Disorder Co-Aggregate in Families? A Population-Based Study of 2 Million Swedes.” Molecular Psychiatry, 15 Oct. 2018, https://doi.org/10.1038/s41380-018-0248-5.
[3]Benzi, Ilaria M. A., et al. “Assessment of Personality Functioning in Adolescence: Development of the Adolescent Personality Structure Questionnaire.” Assessment, 16 Jan. 2021, p. 107319112098815, https://doi.org/10.1177/1073191120988157.
[4]Fossati, Andrea, et al. “A Head-To-Head Comparison of the Personality Inventory ForDSM-5(PID-5) with the Personality Diagnostic Questionnaire-4 (PDQ-4) in Predicting the General Level of Personality Pathology among Community Dwelling Subjects.” Journal of Personality Disorders, vol. 30, no. 1, Feb. 2016, pp. 82–94, https://doi.org/10.1521/pedi_2015_29_184. Accessed 14 Dec. 2020.