Assessment & Research

Coping strategies among adults with ADHD: The mediational role of attachment relationship patterns.

Al-Yagon et al. (2020) · Research in developmental disabilities 2020
★ The Verdict

Attachment anxiety partly explains why adults with ADHD lean on avoidant coping—check attachment style before teaching coping skills.

✓ Read this if BCBAs working with adults with ADHD in clinic or day-program settings.
✗ Skip if Practitioners who serve only young children or non-ADHD populations.

01Research in Context

01

What this study did

Al-Yagon et al. (2020) asked adults with ADHD and adults without it to fill out three short surveys. One survey measured ADHD traits. One measured attachment style. One measured coping habits.

The team then used a mediation test to see if attachment anxiety carries part of the ADHD-coping link.

02

What they found

Adults with ADHD scored higher on attachment anxiety and used more avoidant coping than the control group.

Attachment anxiety explained part of the ADHD-coping gap. When anxiety was high, coping was worse.

03

How this fits with other research

Rodriguez-Seijas et al. (2020) found the same avoidant pattern, but in parents of ADHD kids. The two studies line up: ADHD in the family predicts avoidant coping across generations.

Muniandy et al. (2023) tested autistic adults and also saw that engagement coping protects well-being while disengagement hurts it. The pattern looks similar, suggesting the coping lesson crosses diagnoses.

De Laet et al. (2025) flipped the lens to caregivers. Positive coping lifted caregiver mood, especially when the young adult showed tough behaviors. Together the papers show coping matters on both sides of the care relationship.

04

Why it matters

If you coach adults with ADHD, add a quick attachment screen. High attachment anxiety signals they may default to avoidant coping. Build in simple engagement skills like problem-solving or seeking support. These small moves can loosen the anxiety-coping knot and lift day-to-day functioning.

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Add two attachment questions to your intake form and pick one engagement-coping skill to teach if scores are high.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
62
Population
adhd, neurotypical
Finding
positive
Magnitude
medium

03Original abstract

BACKGROUND: For adults with attention/hyperactivity disorder (ADHD), research is scarce on their coping with stress (despite studies demonstrating other self-regulation deficits) and their attachment patterns (despite rare research in younger persons with ADHD showing high vulnerability to insecure attachments). Attachment was linked with coping and self-regulation in general populations but not yet in ADHD. This study explored the possible mediational role of attachment patterns in explaining associations between adults' ADHD symptoms and dysregulated coping. METHODS: Participants comprised 62 adults (32 females, 30 males) ages 21-40 years (M = 27.60, SD = 4.80) in two groups: 31 adults with formally diagnosed ADHD and 31 demographically matched adults without ADHD. Instruments included computerized neuropsychological tests (sustained/executive attention) and self-reports (ADHD, coping, attachment). RESULTS: Disorder status was verified via ADHD-symptom self-reports and computerized testing. Preliminary analyses revealed significant intergroup differences on coping strategies and attachment. PROCESS analyses (Hayes, 2013) pinpointed attachment measures' mediating role (especially attachment anxiety) regarding ADHD's association with coping. CONCLUSIONS: Significantly more maladaptive attachment and coping outcomes emerged for adults with ADHD than controls. Attachment insecurity's role in mediating ADHD's association with coping was partially supported. Possible unique adaptive value of attachment relationships was discussed for coping with stressors in adulthood with ADHD.

Research in developmental disabilities, 2020 · doi:10.1016/j.ridd.2020.103657