Presenter Information

Jeffrey D Whitaker

Rick Zoucha

Duquesne University School of Nursing

Melissa Kalarchian

Duquesne University School of Nursing

Abstract

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical coding, constant comparative analysis, analytic memoing, and reflexive documentation. Results: The analysis yielded six focused codes, represented as living with unnamed difference, being misread by others, developing compensatory systems, accumulating functional strain, encountering ADHD as a possible self-explanation, and seeking clinical recognition. These codes were integrated into two provisional selective codes: “That could be me” and “Someone should have caught this.” Participants described self-recognition emerging through peers, family members, clinicians, books, podcasts, and online information. They also retrospectively identified missed opportunities across educational, family, occupational, cultural, and healthcare settings. Conclusion: The path to adult ADHD diagnosis appeared delayed, negotiated, and shaped by social and clinical contexts. Findings offer a preliminary foundation for a fuller process model and support developmentally informed assessment, attention to compensatory effort, and more accessible referral pathways for adults seeking ADHD evaluation. Further research should examine whether these processes hold across diverse populations and healthcare settings and contexts.

School

School of Nursing

Advisor

Melissa Kalarchian

Submission Type

Paper

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Uncovering the Path to Diagnosis Among Adults with Attention-Deficit/Hyperactivity Disorder: A Constructivist Grounded Theory Mini-Study

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood, yet many adults are first diagnosed only after years of functional strain, compensation, and alternative explanations for their difficulties. Purpose: This study explored how adults first diagnosed with ADHD in adulthood described navigating the process of obtaining a formal diagnosis. Methods: A constructivist grounded theory mini-study was conducted with seven adults, ages 27 to 43, who reported receiving their first formal ADHD diagnosis at age 18 or later. Participants completed semi-structured Zoom interviews focused on early experiences, symptom interpretation, help-seeking, and formal assessment. Data were analyzed using initial, focused, and theoretical coding, constant comparative analysis, analytic memoing, and reflexive documentation. Results: The analysis yielded six focused codes, represented as living with unnamed difference, being misread by others, developing compensatory systems, accumulating functional strain, encountering ADHD as a possible self-explanation, and seeking clinical recognition. These codes were integrated into two provisional selective codes: “That could be me” and “Someone should have caught this.” Participants described self-recognition emerging through peers, family members, clinicians, books, podcasts, and online information. They also retrospectively identified missed opportunities across educational, family, occupational, cultural, and healthcare settings. Conclusion: The path to adult ADHD diagnosis appeared delayed, negotiated, and shaped by social and clinical contexts. Findings offer a preliminary foundation for a fuller process model and support developmentally informed assessment, attention to compensatory effort, and more accessible referral pathways for adults seeking ADHD evaluation. Further research should examine whether these processes hold across diverse populations and healthcare settings and contexts.