ADHD hyperfocus refers to intense periods of concentration experienced by individuals with Attention-Deficit/Hyperactivity Disorder, often during tasks of particular interest. This phenomenon seems paradoxical given ADHD’s typical association with inattention.
Emotion dysregulation involves difficulties in managing emotional responses, including problems with recognition, understanding, and control of emotions.
Recent research suggests that ADHD might be better understood as a disorder of dysregulation rather than deficit. This perspective considers that individuals with ADHD struggle not only with maintaining attention but also with appropriately allocating it. Similarly, they often experience difficulties regulating emotional responses.
Viewing ADHD as a dysregulation disorder encompasses both attentional and emotional challenges, providing a more comprehensive understanding of the condition’s diverse symptoms and manifestations.
Ayers-Glassey, S., & MacIntyre, P. D. (2024). Investigating emotion dysregulation and the perseveration- and flow-like characteristics of ADHD hyperfocus in Canadian undergraduate students. Psychology of Consciousness: Theory, Research, and Practice, 11(2), 234–251. https://doi.org/10.1037/cns0000299
Key Points
- ADHD symptomatology and emotion dysregulation were found to be positively correlated, supporting the view of ADHD as a disorder of dysregulation rather than just attention deficit.
- Hyperfocus and perseveration measures were more similar to each other than to flow measures, suggesting hyperfocus may be more perseveration-like than flow-like.
- ADHD symptomatology predicted hyperfocus scores over and above emotion dysregulation tendencies in nonclinical participants.
- Clinical participants (self-reported ADHD with or without comorbidities) scored significantly higher on hyperfocus and perseveration measures compared to matched nonclinical participants.
- The study provides empirical support for hyperfocus as an ADHD-specific phenomenon, while also highlighting its similarities to perseveration.
- Results indicate a need for further refinement in the conceptualization and measurement of hyperfocus, perseveration, and flow.
- The research has limitations in terms of sample size, self-reported diagnoses, and focus on undergraduate students.
- Understanding hyperfocus and related phenomena is crucial for improving ADHD assessment, treatment, and support strategies.
Rationale
Attention-deficit hyperactivity disorder (ADHD) is typically characterized by inattention and hyperactivity/impulsivity.
However, paradoxical reports of hyperfocus – prolonged periods of intense concentration – in individuals with ADHD have led to suggestions that ADHD might be better described as a disorder of attention regulation rather than deficit (Hupfeld et al., 2019; Kooij et al., 2019).
Additionally, ADHD is strongly associated with difficulties in emotion regulation and comorbid emotion-based disorders like anxiety and depression (Adler et al., 2018; Brown, 2017).
Previous research on hyperfocus has yielded mixed results regarding its specificity to ADHD, possibly due to the novelty of self-report measures and their development based largely on anecdotal reports (Hupfeld et al., 2019; Ozel-Kizil et al., 2016).
Existing descriptions of hyperfocus often resemble perseveration, while some researchers have suggested similarities to the flow state (Ashinoff & Abu-Akel, 2019; Sedgwick et al., 2019). However, these phenomena have not been empirically investigated alongside each other.
Given the associations between ADHD, emotion dysregulation, and comorbidities, there is a need to extend understanding of hyperfocus to include its relationship with other mental health disorders and to approach these relationships from a transdiagnostic emotion dysregulation perspective.
This study aims to address these gaps by investigating hyperfocus along with perseveration and flow, while accounting for emotion dysregulation tendencies and ADHD symptomatology.
Method
Procedure
Participants completed a series of questionnaires measuring ADHD symptomatology, emotion dysregulation, hyperfocus, perseveration, and flow experiences.
Measures were randomly sorted into six different configurations to control for order bias, with demographic items always presented first.
Sample
The final sample consisted of 215 undergraduate participants: 29 self-reported ADHD (Clinical group) and 186 non-ADHD (Nonclinical group).
For some analyses, a matched comparison group of 26 Nonclinical participants was created based on age and gender to compare with 26 Clinical participants.
Measures
- Adult ADHD Self-Report Scale Screener (ASRS-S): A six-item scale measuring the frequency of ADHD symptoms in adults, used to screen for potential ADHD.
- Difficulty in Emotion Regulation Scale Short Form (DERS-SF): An 18-item scale assessing six dimensions of emotion dysregulation, including non-acceptance of emotional responses and difficulties with goal-directed behavior when distressed.
- Flow Experiences Scale (FES): A nine-item scale measuring general flow experiences, including aspects such as concentration, sense of control, and loss of self-consciousness during engaging activities.
- Novel Perseveration Questionnaire (PQ): A 15-item scale developed for this study to assess perseverative thinking and behavior, combining items from existing measures and new items to cover a range of perseveration characteristics.
- Hyperfocusing Scale (HFS): An 11-item scale measuring the tendency to become intensely focused on tasks, often to the exclusion of other stimuli or responsibilities.
- Adult Hyperfocus Questionnaire (AHFQ) – Dispositional Hyperfocus subscale: A 12-item scale assessing specific occurrences of hyperfocus, focusing on the intensity and duration of attention during engaging activities.
These measures collectively assessed ADHD symptoms, emotion regulation difficulties, flow experiences, perseverative tendencies, and hyperfocus experiences, allowing for a comprehensive examination of the relationships between these constructs.
Statistical measures
Pearson correlations, hierarchical regression analyses, Welch’s independent-sample t-tests, and exploratory factor analyses were conducted using IBM SPSS and JASP software.
Results
Hypothesis 1: ADHD symptomatology and emotion dysregulation would be positively correlated.
Result: Supported. ASRS-S and DERS-SF scores were positively correlated (r = .52, p < .001) in Nonclinical participants.
Hypothesis 2: Hyperfocus would correlate positively with both flow and perseveration measures.
Result: Partially supported. Hyperfocus and perseveration items loaded onto a similar factor, which was negatively correlated with flow (r = -.26).
Hypothesis 3a: ADHD symptomatology would predict hyperfocus scores over and above emotion dysregulation.
Result: Supported. ASRS-S scores predicted an additional 20.6% of variance in hyperfocus scores after accounting for DERS-SF scores in Nonclinical participants.
Hypothesis 3b: Hyperfocus and perseveration would be more prominent in the Clinical sample.
Result: Supported. Clinical participants scored significantly higher on hyperfocus (t(46) = 8.02, p < .001, d = 2.22) and perseveration (t(50) = 7.44, p < .001, d = 2.07) measures compared to matched Nonclinical participants.
Insight
This study provides novel insights into the relationship between hyperfocus, perseveration, and flow in the context of ADHD.
The findings suggest that hyperfocus, as currently measured, may be more similar to perseveration than to flow.
This challenges previous assumptions about the equivalence of hyperfocus and flow (Ashinoff & Abu-Akel, 2019) and supports the idea that perseveration might be a possible mechanism of hyperfocus (Hupfeld et al., 2019).
The study extends previous research by demonstrating that ADHD symptomatology predicts hyperfocus scores over and above emotion dysregulation tendencies.
This supports the clinical specificity of hyperfocus to ADHD while also acknowledging the role of emotion regulation difficulties in the experience.
The results highlight the need for further refinement in the conceptualization and measurement of hyperfocus.
Future research could focus on distinguishing between perseveration on positively and negatively valenced stimuli, which might help explain the differences observed between hyperfocus and perseveration scores despite their similarities.
The study also raises questions about the role of comorbidities in hyperfocus experiences, suggesting that future investigations should carefully consider the impact of comorbid conditions when studying ADHD-specific phenomena.
Strengths
This study had several methodological strengths, including:
- Novel comparison of hyperfocus, perseveration, and flow measures
- Inclusion of both clinical and nonclinical samples
- Consideration of emotion dysregulation as a transdiagnostic factor
- Use of matched comparison groups for clinical vs. nonclinical analyses
- Development and initial validation of a novel perseveration measure
Limitations
This study also had some methodological limitations, including:
- Reliance on self-reported diagnoses for group classification
- Relatively small sample size, particularly for the Clinical group
- Focus on undergraduate population limits generalizability
- Lack of specificity regarding “other” mental health disorders in the Clinical group
- Correlational nature of the findings precludes causal inferences
These limitations impact the generalizability of the results and highlight the need for replication with larger, more diverse samples and more rigorous diagnostic procedures.
Implications
The findings have significant implications for understanding and treating ADHD. The strong relationship between ADHD symptomatology and emotion dysregulation, even in nonclinical participants, supports the conceptualization of ADHD as a disorder of dysregulation rather than simply attention deficit.
This suggests that treatment approaches should address both attentional and emotional regulation difficulties.
The similarity between hyperfocus and perseveration measures indicates that clinicians should be cautious in interpreting hyperfocus-like experiences as purely positive or productive. Instead, these experiences might reflect difficulties in attentional control that could be targeted in interventions.
The study’s results also highlight the importance of considering comorbidities and transdiagnostic factors like emotion dysregulation when assessing and treating ADHD.
Clinicians should be aware that hyperfocus-like experiences might be influenced by both ADHD-specific symptoms and more general emotional difficulties.
For researchers, the study underscores the need for more precise and consistent measurement of phenomena like hyperfocus, perseveration, and flow.
Developing better tools to distinguish between these experiences could lead to more targeted interventions and a deeper understanding of attention regulation in both clinical and nonclinical populations.
References
Primary reference
Ayers-Glassey, S., & MacIntyre, P. D. (2024). Investigating emotion dysregulation and the perseveration- and flow-like characteristics of ADHD hyperfocus in Canadian undergraduate students. Psychology of Consciousness: Theory, Research, and Practice, 11(2), 234–251. https://doi.org/10.1037/cns0000299
Other references
Adler, L. A., Faraone, S. V., Sarocco, P., Atkins, N., & Khachatryan, A. (2019). Establishing US norms for the Adult ADHD Self‐Report Scale (ASRS‐v1. 1) and characterising symptom burden among adults with self‐reported ADHD. International journal of clinical practice, 73(1), e13260. https://doi.org/10.1111/ijcp.13260
Ashinoff, B. K., & Abu-Akel, A. (2021). Hyperfocus: The forgotten frontier of attention. Psychological research, 85(1), 1-19. https://doi.org/10.1007/s00426-019-01245-8
Brown, T. E. (2017). Outside the box: rethinking ADD/ADHD in children and adults: a practical guide. American Psychiatric Pub.
Hupfeld, K. E., Abagis, T. R., & Shah, P. (2019). Living “in the zone”: hyperfocus in adult ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11, 191-208. https://doi.org/10.1007/s12402-018-0272-y
Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balazs, J., Kasper, D. S., & Asherson, P. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European psychiatry, 56(1), 14-34.
Ozel-Kizil, E. T., Kokurcan, A., Aksoy, U. M., Kanat, B. B., Sakarya, D., Bastug, G., Colak, B., Altunoz, U., Kirici, S., Demirbas, H., & Oncu, B. (2016). Hyperfocusing as a dimension of adult attention deficit hyperactivity disorder. Research in Developmental Disabilities, 59, 351-358. https://doi.org/10.1016/j.ridd.2016.09.016
Sedgwick, J. A., Merwood, A., & Asherson, P. (2019). The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(3), 241-253. https://doi.org/10.1007/s12402-018-0277-6
Keep Learning
- How might the relationship between hyperfocus and perseveration inform our understanding of ADHD symptoms and their impact on daily functioning?
- What are the potential benefits and drawbacks of conceptualizing ADHD as a disorder of dysregulation rather than attention deficit?
- How could future research better differentiate between hyperfocus, perseveration, and flow experiences in both clinical and nonclinical populations?
- What are the implications of the study’s findings for developing more effective interventions for individuals with ADHD?
- How might the relationship between ADHD symptomatology and emotion dysregulation inform our understanding of comorbid conditions like anxiety and depression in ADHD?
