Personality Disorders And ADHD: Is There A Relationship?

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent among the child population; and, in many cases, it persists into adulthood. The relationship between this disorder and other psychological disorders such as anxiety, depression or substance use has been found. However, there is also an important association between personality disorders and ADHD that is less well known.

Obtaining a proper diagnosis is essential to be able to apply a quality psychological intervention. However, when there is comorbidity (coexistence between several disorders), this task is difficult. Both ADHD and personality disorders are chronic conditions and some of their symptoms often overlap. Thus, when evaluating and treating a person, it is important to consider how they are related.

The relationship between personality disorders and ADHD

Several studies have found significant associations between ADHD and personality disorders ; however, the prevalence is highly variable depending on which ones are consulted. Personality disorders are usually grouped into three distinct categories or clusters:

• A: paranoid, schizoid, and schizotypal.
• B: borderline, antisocial, histrionic and narcissistic.
• C: dependent, obsessive compulsive and avoidant.

Thus, ADHD is related to disorders in the three previous categories, the associations it maintains with clusters B and C being especially important. Furthermore, this comorbidity seems to be mediated by the patient’s gender. Thus, women are more frequently associated with borderline, histrionic, and dependent disorders. Meanwhile, in men there are greater associations with antisocial and narcissistic disorders.

Variations based on the ADHD subtype

Furthermore, the subtypes of ADHD also seem to play a relevant role. And it is that not all of them seem to be related to the same extent with the different personality disorders. Thus, the main conclusions are the following:

• The inattentive subtype is more often associated with avoidant personality disorder.
• For its part, the hyperactive-impulsive subtype is more associated with narcissistic and antisocial disorders.
• The combined subtype is the one that shows the highest and most intense comorbidity with the different personality disorders.

Borderline and antisocial personality disorders and ADHD

Among the many personality disorders that can occur alongside ADHD, borderline and antisocial disorders are the ones that generate the greatest personal and social impact. For this reason, it is necessary to know how they are related.

On the one hand, borderline personality disorder overlaps many of its symptoms with ADHD. Both disorders can present impulsiveness, irritability, and low tolerance for stress and frustration. This significantly complicates a proper diagnosis of both pathologies, especially in women.

In boys, ADHD is often more accurately diagnosed than in girls during infancy. And it is that its symptoms are more striking and disruptive. In the case of women, as they reach adulthood, this apparent absence of childhood symptoms can leave ADHD unrecognized.

On the other hand, it has been found that children with ADHD have an increased risk of developing antisocial personality disorder, especially if they present early behavior problems. Thus, certain characteristics of ADHD such as impulsivity, aggressiveness and emotional numbness can lead to the development of an antisocial disorder.

However, this relationship seems to be mediated by some environmental / educational aspects. That is, those children with ADHD who have suffered parental neglect more frequently develop the second disorder.

Why is the association between personality disorders and ADHD relevant?

Although there is an overlap of symptoms between several disorders, it is important to properly diagnose each of them separately. Only in this way can the causes of both be understood and an appropriate intervention carried out. If the relationship between personality disorders and ADHD is not known, some of them may go unidentified.

On the other hand, being aware of this association between pathologies allows us to carry out an early intervention in order to prevent the appearance of the second disorder. For example, acting on the symptoms of ADHD that increase the risk of presentation of other disorders.

In short, both the evaluation and the diagnosis and treatment must be rigorous and exhaustive. Only in this way will it be possible to cover all the problems that the person presents.