Chloé Voyer

Background: While psychosocial interventions for ADHD in children are well-established, there is a gap in addressing ADHD symptoms that persist into adulthood, particularly those impacting occupational functioning. Adults living with ADHD often face challenges in the workplace related to time management, regulating attention, task prioritization, and meeting deadlines. Methods: This study will evaluate the efficacy of a workplace intervention designed to improve the quality of work life in adults living with possible ADHD. A single-blind randomized controlled trial will compare an 8-week virtual psychosocial intervention to an active control group, with quality of work life as the primary outcome. Secondary outcomes will include self-reported measures related to work such as job satisfaction, psychological needs and well-being, self-esteem, self-efficacy, cognitive functioning, self-compassion, and quality of work relationships. Outcomes will be assessed at baseline, post-intervention, and at 3, 6, 9, and 12-month follow-up. In parallel, an optional awareness raising video will engage workplace stakeholders to improve ADHD literacy, reduce stigma, and offer neuroinclusive management strategies. Intention-to-treat analyses will use linear mixed-effects models. Discussion: A participatory research approach was used to co-design the intervention material with workplace managers, community representatives, service providers and adults with lived experience. The research team will disseminate findings in scientific journals, conferences, and by sharing bilingual intervention materials with service providers and adults living with ADHD. This study fills a gap in addressing ADHD in the workplace, with findings that will inform intervention practices and improve workplace inclusion. Trial registration: This study was registered at ClinicalTrials.gov (NCT06774378) on January 17, 2025.

Attention-deficit/hyperactivity disorder (ADHD) has a significant impact on psychosocial and occupational functioning. Sixty-five percent of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood, and an estimated 4% of the workforce has a diagnosis of ADHD. We performed a systematic literature review to understand the experience of ADHD in the workplace. Articles were included in the systematic literature review if they reported results on employment outcomes of adults with ADHD. Methodological quality assessment was evaluated using the Mixed Methods Appraisal Tool. Seventy-nine studies were included in this systematic literature review (N_ADHD = 68,275). Results were synthesized into four categories: challenges, strengths, adaptations, and sex differences. Eight themes were included: ADHD symptoms at work, workplace performance, job satisfaction, maladaptive work thoughts and behaviors, interpersonal relationships at work, personal strengths, embracing ADHD, person-environment fit, and accommodations and support. Workers with ADHD can adapt and thrive in employment with the right person-environment fit, and accommodations and support. Many challenges related to ADHD can be remodeled into assets in a workplace environment that promotes flexible working practices and openness to neurodiversity.

Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = .20, emotion dysfunction: r = .17, psychotic symptoms: r = .25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.