Workplace and Social Support as Predictors of Job Satisfaction,Motivation,and Income in ADHD

Abstract

Background

Individuals with ADHD are at elevated risk for occupational impairment, yet little is known about the contextual factors that support workplace well-being in this population.

Objective

This study is among the first to examine the role of work climate, fair ADHD policies, high-quality supervision, and non-work social support in predicting key occupational outcomes.

Method

Participants were 100 adults with ADHD (51% male), ages 19–30 (M = 26.61, SD = 2.28), all employed full-time. They completed measures of ADHD symptoms, occupational contextual supports, and work outcomes (job satisfaction, work motivation, income).

Results

Controlling for medication status, sex, and age, hierarchical regression analyses indicated that perceptions of fair ADHD policies predicted all three outcomes. A positive work climate was associated with higher work motivation, although moderation analyses revealed that this benefit diminished as ADHD symptom severity increased. High-quality supervision was linked to greater work motivation, and non-work social support was associated with higher job satisfaction.

Conclusion

Overall, findings suggest that organizations fostering equitable treatment and opportunities for employees with ADHD may help mitigate occupational risks and promote better outcomes. Results further highlight the importance of contextual and systems-level supports in optimizing occupational functioning for adults with ADHD.

Keywords

attention-deficit/hyperactivity disorder work climate social support supervision job satisfaction

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent and chronic neurodevelopmental disorder, affecting an estimated 5–7% percent of adults globally (Thomas et al., 2015; Willcutt, 2012). Although ADHD is associated with substantial functional impairments across the lifespan (American Psychiatric Association [APA], 2022), most research has focused on children and adolescents (for review, see Sonuga-Barke et al., 2023). Consequently, relatively little is known about the factors that support successful occupational functioning in adults with ADHD (Gordon & Fabiano, 2019). This gap is critical to address, as individuals with ADHD face elevated risks of low job satisfaction, reduced career attainment, and diminished work motivation, which can collectively contribute to lifetime earnings approximately 75% lower than those of non-ADHD peers (Biederman et al., 2006; Gordon & Fabiano, 2019; Pelham et al., 2020). For evidence-based intervention development to occur, strength-based, theory driven research is needed to identify key mechanisms that promote positive occupational outcomes for individuals with ADHD. To that end, ecological systems theories propose that well-being emerges from the interaction between individual characteristics and contextual factors (Rosa & Tudge, 2013). Thus, examining occupational context-level factors, such as work climate and social support, may elucidate meaningful targets for intervention.

Positive work climates have been associated with higher levels of motivation at work, job satisfaction, and job performance (Berberoglu, 2018; Meeusen et al., 2011; Vanthournout et al., 2014; Zhenjing et al., 2022). Moreover, evidence from general samples indicates interventions aimed at improving work climate yield significant improvements in overall employee well-being (see meta-analytic review, Daniels et al., 2017). However, whether a positive work climate confers the same benefits for individuals with ADHD remains unknown. Indeed, individuals with ADHD often report significant impairment in the workplace, including challenges with distractibility, boredom, and difficulty managing long-term projects and attention to detail (Chan & Langberg, 2024; Cox, 2024; Fuermaier et al., 2021). Individuals with ADHD also report experiencing significant interpersonal difficulties at work, such as conflict with supervisors and feelings of isolation from coworkers (Brod et al., 2012; Fuermaier et al., 2021). Further, research suggests that ADHD symptom severity predicts interpersonal and task difficulties, with higher levels of ADHD symptoms associated with increased impairment (Chan & Langberg, 2024). Thus, individuals with ADHD, especially those with more severe symptoms, may have a negative experience in their workplace even if their non-ADHD colleagues report an overall positive work climate.

In this context, indices of work climate specific to ADHD may be better predictors of occupational outcomes, given the unique challenges individuals with ADHD experience at work. Under the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973, individuals in the United States with mental health conditions such as ADHD are protected against discrimination and harassment as well as have the right to reasonable accommodations to ensure job performance (Americans with Disabilities Act, 1990; Rehabilitation Act of 1973, 1973). Despite these laws, individuals with ADHD may still experience unfair treatment, such as fewer opportunities for promotion, due to the symptoms and impairments associated with their disorder. Workplaces that instill policies that promote equitable treatment and opportunity for individuals with ADHD may be protective. In fact, evidence suggests that when companies set policies that are fair and meet the unique challenges of their workforce (e.g., work-family benefits; Gutiérrez Vargas et al., 2023), these employees demonstrate better outcomes (Brooke & Tyler, 2011). However, how perceptions of organizational support can improve the job satisfaction, motivation, or performance of individuals with ADHD is yet to be studied.

Another promising protective factor against occupational problems among individuals with ADHD is high quality supervision. Supervision encompasses the style and strategies a supervisor employs in managing their employees (Vanthournout et al., 2014). For example, Kidd & Smewing (2001) found strong supervisors provide their employees with trust and authority to complete their job, which in turn promotes greater commitment from the employee. Further, employees report that high quality supervisors provide frequent feedback and goal setting, as well as delegate effectively and trust in the abilities of their supervisees (Kidd & Smewing, 2001). Evidence additionally indicates that a positive supervisor-supervisee relationship has significant impact on an employee's well-being (Hämmig, 2017), including perceived organizational support and, in turn, employee retention (Eisenberger et al., 2002). Nonetheless, individuals with ADHD often report conflictual relationships with their supervisors (Fuermaier et al., 2021), especially among employees with high levels of ADHD symptoms (Chan & Langberg, 2024). Thus, the benefits of a supportive supervisor may not be conferred to individuals with ADHD, whom are at high risk for strained supervisor-supervisee relationships (Chan & Langberg, 2024; Fuermaier et al., 2021).

Finally, given the strained work relationships individuals with ADHD often experience, they may benefit from social supports outside of work. Within a stress-buffering model of social support (Cohen & McKay, 2020), non-work social support from family and friends may help buffer against occupational challenges that an individual with ADHD may be experiencing. For example, increasing evidence indicates peer acceptance is protective for individuals within the school context (Chan et al., 2024; Dvorsky et al., 2018), but whether those benefits extend to the workplace remains unknown. Interestingly, there has been limited examination of how non-work social supports impact occupational outcomes (Beauregard et al., 2011). However, existing evidence indicates social support outside of work is more predictive of overall well-being (e.g., reduced burnout), as opposed to direct indices of work such as job performance (Baruch-Feldman et al., 2002). Similarly, non-work social supports may predict greater job satisfaction but not motivation or indices of performance (e.g., income) for individuals with ADHD.

Altogether, occupational impairments are prominent in ADHD (Chan & Langberg, 2024; Gordon & Fabiano, 2019). However, almost nothing is known about factors that may promote better work outcomes, including job satisfaction, motivation, and income, for individuals with ADHD. Applying an ecological systems framework (Bronfenbrenner, 1979; Rosa & Tudge, 2013), we evaluate context level factors that may protect against risk in the workplace among individuals with ADHD. Specifically, we examine (a) whether a positive work climate, fair ADHD policies, supportive supervision, and non-work social support predict higher levels of job satisfaction, motivation, and income for individuals with ADHD, and (b) whether ADHD symptom severity moderates those associations. Based on the above literature, we hypothesize that a positive work climate, fair ADHD policies, and high-quality supervision will be positively related with all three of our primary outcomes. We additionally hypothesize that non-work social support will be associated with higher levels of job satisfaction. Finally, we hypothesize that ADHD symptom severity will moderate all relations, in that higher ADHD symptoms will reduce the protective effects of our predictors to outcomes.

Methods

Participants

This study was approved by the Rutgers University Institutional Review Board. Participants were 100 adults with ADHD (51% male; M age = 26.61, SD = 2.28) recruited from Amazon Mechanical Turk (MTurk; http://www.mturk.com). Recruitment occurred in the spring and summer of 2024 and comprised of an online survey regarding occupational functioning for individuals ages 19–30. The sample was racially and ethnically diverse, with 45% identifying as White/Non-Hispanic, 35% as Black/African American, 18% as White/Hispanic, and 2% as Asian (Table 1). Educational attainment varied, with 1.9% completing high school, 5.6% reporting some college or an associate's degree, 72.2% holding a bachelor's degree, and 20.3% completing graduate training. Reported annual income ranged from $20,000 to $120,000, with the majority earning $60,000 or less. Nineteen participants (19%) reported current ADHD medication use.

Table 1.

Demographics.

Demographic Variable	M(SD) or %
Age	26.61 (2.28)
Male (%)	51%
Race/Ethnicity
White/Non-Hispanic	45%
Black/African American	35%
White/Hispanic	18%
Asian	2%
Educational Attainment
Completed High School	1.9%
Some College/Associate's Degree	5.6%
Bachelor's Degree	72.2%
Completed Graduate Training	20.3%
Income
$20,000 or less	3.77%
$40,000 or less	3.77%
$60,000 or less	71.7%
$80,000 or less	15.09%
$100,000 or less	3.77%
$120,000 or less	1.9%

After providing informed consent, participants completed a brief eligibility screening survey. Those who met eligibility criteria received $25 for completing the ADHD, work context, and occupational functioning surveys, which required approximately 50 min. Eligibility criteria included meeting full Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR; APA, 2022) diagnostic standards for either the inattentive or combined presentations of ADHD, which are the most common presentations in adulthood (Rivas-Vazquez et al., 2023 ). On the eligibility screener, participants were required to endorse at least five current and six childhood inattention symptoms on the Barkley Adult ADHD Rating Scale-IV (BAARS-IV; Barkley, 2011). Participants also needed to report working a minimum of 20 h per week. Adults with ADHD may encounter difficulties securing full-time (40-h) employment, thus including those working at least 20 h per week would allow for a more representative sample. Exclusion criteria were (a) a diagnosis of autism spectrum disorder, bipolar disorder, or schizophrenia and/or (b) current enrollment in higher education defined as completion of more than one college course. These criteria were selected to align with the study's focus on occupational functioning, as individuals simultaneously engaged in higher education and the workforce are likely to have distinct needs and access to additional free or low-cost resources.

Data Quality and Validity Procedures

The study adhered to the highest methodological recommendations for MTurk surveys to ensure data accuracy (Berinsky et al., 2012; Goodman et al., 2013; Paolacci et al., 2010; Peer et al., 2014). Specifically, participation was restricted to U.S.-based workers with a minimum 95% approval rating and at least 100 previously approved Human Intelligence Tasks (HITs; tasks/surveys on MTurk). To evaluate within-person validity of responses, demographic variables (e.g., ADHD diagnostic status, ethnicity) were assessed multiple times throughout the survey with slight modifications (Burnette et al., 2022). The study design also intentionally incorporated open-ended response items to identify nonsensical or irrelevant input (e.g., numerical values or symbols entered when asked about occupation; Burnette et al., 2022), and such participants were removed. During data collection, participants who attempted to complete the eligibility screener/HIT more than once were blocked from re-attempting the survey. Finally, after data collection, study completion time was reviewed for each participant and was required to fall within the expected range of 45 to 60 min.

Measures

ADHD Symptoms. The Barkley Adult ADHD Rating Scale-IV (BAARS-IV; Barkley, 2011) is a self-report instrument that evaluates for the 18 DSM symptoms of ADHD (APA, 2022). Participants rate each item using a 4-point Likert scale ranging from 1 (sometimes) to 4 (very often). The BAARS-IV scales demonstrate high levels of internal consistency (α = .77 to .91; Barkley, 2011).

Work Climate. The Work Climate Questionnaire (WCQ; Baard, 2002) is a 15-item scale assessing participants’ perceptions of support and autonomy in the workplace. Responses are rated on a 7-point Likert scale from “Not at all true” to “Very true”, with higher scores indicating better work climate. The WCQ was adapted from two comparable questionnaires focused on educational/medical work environments, both scales have high internal consistency (α = .92−.96).

Fair ADHD Policy. Perception of fair policies towards individuals with ADHD in the workplace were evaluated using an item modeled after a scale developed by Ambrose et al. (2009) on employee judgments of organizational justice. Specifically, participants were asked to rate from 0 = Never to 3 = Always: “At my work, job policies are fair towards individuals with ADD/ADHD.”

High Quality Supervision. The Self-Report Work History questionnaire which was developed as part of the Pittsburgh ADHD Longitudinal Study (PALS; Molina et al., 2017) to assess current and past work history (e.g., Kuriyan et al., 2013). Five items evaluating the frequency of High-Quality Supervision experiences was used in the present study. Items were rated on a Likert scale from “Never” = 1 to “More than 10 times” = 5, with higher scores indicating more positive supervision experiences. Items included: “Your supervisor assigned you extra responsibilities because you had been doing a good job” and “You were praised for your ability to work well with others.”

Social Support. The Interpersonal Support Evaluation List–12 (ISEL-12; Merz et al., 2014) is a brief, 12-item measure derived from the original 40-item ISEL. It assesses three dimensions of perceived social support: appraisal, belonging, and tangible support. Items are rated on a 4-point scale (0 = Definitely false to 3 = Definitely true), with higher scores reflecting greater perceived support. A total score was used in the present study.

Job Satisfaction. The Job Satisfaction Survey (JSS; Spector, 1994) is a 36-item self-report measure comprising nine subscales and a total score, designed to assess employees’ attitudes toward various aspects of their job. Items are rated on a 6-point Likert scale (1 = Disagree very much to 6 = Agree very much), with higher scores reflecting greater job satisfaction. The present study used the total score.

Work Motivation. The Multidimensional Work Motivation Scale (MWMS; Gagné et al., 2015) is a 19-item self-report measure assessing five types of work motivation based on self-determination theory: amotivation, external, introjected, identified regulation, and intrinsic motivation. Items are rated on a 7-point Likert scale ranging from Not at all to Completely/Entirely. The MWMS demonstrates good internal consistency (α = .70–.80). In the present study, the Intrinsic Motivation subscale was used, with higher scores reflecting greater intrinsic work motivation.

Income. Participants reported their approximate annual income using a categorical scale ranging from $20,000 or less to $150,000 or more, in $20,000 increments.

Analytical Approach

Hierarchical regression was used to examine whether a positive work climate, fair ADHD policies, high quality supervision, and non-work social support predict job satisfaction, work motivation, and income over and above ADHD symptom severity. A separate regression model was conducted for each outcome. In the final step of the regression, the interaction between the predictor and ADHD symptoms was included to test for moderation. Significant interactions were probed using the PROCESS macro for SPSS (Hayes, 2022). Simple slopes were calculated to examine the effect of the predictor on the outcome at values of the moderator 1 standard deviation above and below the mean. Sex, medication status, and age were included in all models as covariates.

Sensitivity analyses were also conducted using a Bonferroni correction to account for Type I error from multiple testing. This involved dividing the standard α by the number of tests conducted for each outcome (job satisfaction, work motivation, income; .05 / 4 = .01; Abdi, 2010). These corrections were not applied in the primary analyses, given that Bonferroni and similar adjustments have known methodological and statistical limitations (Nakagawa, 2004; Perneger, 1998). Instead, exact p-values and effect sizes are reported throughout to provide complete information for evaluating statistical effects.

Results

Preliminary Analyses

All independent/dependent variables were screened for univariate outliers defined as values exceeding 3 SD above/below sample mean. Three cases (0.28%) were identified as outliers and were corrected to the most extreme value with 3 SD of the mean. Missing data (3.83%) was low. Table 2 shows the bivariate correlations among the study's primary variables.

Table 2.

Means, Standard Deviations, and Intercorrelations Among Primary Study Variables.

	1	2	3	4	5	6	7	8	9	10	11
1. Age	–	.39**	−.13	−.001	.19	−.05	.03	−.07	−.06	.23*	−.08
2. Sex	.39**	–	.10	−.19	.13	−.09	−.007	−.06	−.02	.17	.10
3. Medication Status	−.13	.10	–	−.09	−.04	−.10	<.001	.12	.06	.03	.31*
4. ADHD Symptoms	−.001	−.19	−.09	–	−.15	−.03	.06	−.24*	−.44**	−.02	−.38**
5. Work Climate	.19	.13	−.04	−.15	–	.30**	.33**	.13	.12	.51**	.08
6. Fair ADHD Policies	−.05	−.09	−.10	−.03	.30**	–	.20*	.05	.25*	.36**	.39**
7. High Quality Supervision	.03	−.007	<.001	.06	.33**	.20*	–	.009	−.07	.30**	−.02
8. Social Support	−.07	−.06	.12	−.24*	.13	.05	.009	–	.61**	−.04	.14
9. Job Satisfaction	−.06	−.02	.06	−.44**	.12	.25*	−.07	.61**	–	.003	.15
10. Work Motivation	.23*	.17	.03	−.02	.51**	.36**	.30**	−.04	.003	–	−.07
11. Income	−.08	.10	.31*	−.38**	.08	.39**	−.02	.14	.15	−.07	–
M	26.61	–	–	15.55	74.21	2.91	11.47	31.01	129.58	15.37	3.17
SD	2.28	–	–	2.86	9.42	.61	4.20	3.76	14.79	2.68	.80

Note. * indicates p < .05; ** indicates p <=.01. Participants reported income on a categorical scale from $20,000 or less to $150,000.

or more, in increments of $20,000. Means and standard deviations are provided for all continuous variables.

Primary Regression Analyses

Job Satisfaction: In separate models (see Step 3; Table 3), results of our regression analyses revealed higher levels of fair ADHD workplace policies (β = .23, p = .01) and non-work social support (β = .54, p < .001) were associated with greater job satisfaction. These effects were found over and above ADHD symptom severity, medication status, age, and sex (Steps 1–2). An interaction effect (Step 4) was found for fair ADHD policy x ADHD (β = −.26, p = .005) and positive work climate x ADHD (β = −.21, p = .02). Probing the interaction revealed fair ADHD policies attenuated the association between low (β = 11.28, p < .001) and moderate (β = 5.36, p = .01) but not high (p = .92) ADHD symptoms to low job satisfaction (Figure 1a). In turn, a positive work climate predicted greater job satisfaction only at low ADHD symptom severity (β = .55, p = .02; see Figure 1b). No significant main or interaction effects were found for supportive supervision to job satisfaction (p > .59) (Table 4).

Figure 1.

ADHD symptom severity moderates the association between positive work climate and fair ADHD policies to job satisfaction. One SD below or above the mean were used to characterize low and high job satisfaction and low and high total ADHD symptoms. Both analyses controlled for sex, age, and medication status.

Table 3.

Buffering Effects of Work Climate, ADHD Work Policies, and Non-Work Social Support to Job Satisfaction.

	DV: Job Satisfaction						DV: Job Satisfaction
	Total R²	R²_inc	B	SE	β		Total R²	R²_inc	B	SE	β
Step 1:						Step 1:
Med			2.01	3.90	.05	Med			2.01	3.90	.05
Sex			−.20	3.29	−.01	Sex			−.20	3.29	−.01
Age			−.29	.73	−.05	Age			−.29	.73	−.05
Step 2:	.21	.17***				Step 2:	.21	.17***
ADHD			−2.40	.49	−.46***	ADHD			−2.38	.49	−.46***
Step 3:	.21	.17				Step 3:	.26	.22*
Work Climate (WC)			.12	.15	.07	Fair ADHD Policies			5.72	2.19	.23*
Step 4:	.26	.21*				Step 4:	.32	.28**
WC x ADHD			−.13	.06	−.21*	Policy x ADHD			−2.07	.72	−.26**
	DV: Job Satisfaction
Step 1:
Med			2.01	3.90	.05
Sex			−.20	3.29	−.01
Age			−.29	.73	−.05
Step 2:	.21	.17***
ADHD			−2.40	.49	−.46***
Step 3:	.47	.45***
Non-Work Social Support			2.12	.31	.54***
Step 4:	.49	.46
Non-Work Social Support x ADHD			−.15	.09	−.15

Note. Variables in prior steps are included in the model at the next step but are not presented in the table for space. R² change of .01 = small, .06 = medium, and .14 = large (Cohen et al., 2003). *p < .05, **p < .01, ***p < .001.

Table 4.

Buffering Effects of Work Climate, ADHD Policy, Positive Supervision to Work Motivation.

	DV: Work Motivation						DV: Work Motivation
	Total R²	R²_inc	B	SE	β		Total R²	R²_inc	B	SE	β
Step 1:						Step 1:
Med			.32	.69	.05	Med			.32	.69	.05
Sex			.45	.58	.09	Sex			.45	.58	.09
Age			.24	.13	.20	Age			.24	.13	.20
Step 2:	.06	.02				Step 2:	.06	.02
ADHD			.00	.10	.00	ADHD			.00	.10	.00
Step 3:	.29	.25***				Step 3:	.21	.17***
Work Climate (WC)			.14	.03	.50***	Fair ADHD Policies			1.74	.41	.40***
Step 4:	.33	.28*				Step 4:	.22	.17
WC x ADHD			.02	.01	.21*	Policies x ADHD			.07	.14	.05
	DV: Work Motivation
Step 1:
Med			.32	.69	.05
Sex			.45	.58	.09
Age			.24	.13	.20
Step 2:	.06	.02
ADHD			.00	.10	.00
Step 3:	.15	.10**
Positive Supervision (PS)			.19	.06	.30**
Step 4:	.16	.11
PS x ADHD			.03	.03	.11

Work Motivation: In separate models (see Step 3; Table 3), results of our regression analyses revealed higher levels of positive work climate (β = .50, p < .001), fair ADHD policies (β = .40, p < .001), and supportive supervision (β = .30, p = .003) were associated with greater work motivation. These effects were found over and above ADHD symptom severity, medication status, age, and sex (Steps 1–2). In addition, a significant interaction effect was found for a positive work climate x ADHD (β = .21, p = .02). Visual plot of the interaction revealed a positive work climate promoted higher work motivation for individuals with moderate (β = .13, p < .001) and high (β = .18, p < .001) but not low (p = .12) ADHD symptom severity (Figure 2). No significant main or interaction effects were found for social support to work motivation (p > .76).

Figure 2.

ADHD symptom severity moderates the association between positive work climate and work motivation. One SD below or above the mean were used to characterize low and high job satisfaction and low and high total ADHD symptoms. Analyses controlled for sex, age, and medication status.

Income: Results of our regression model revealed higher levels of fair ADHD policies were associated with higher incomes (β = .40, p = .003; see Step 3, Table 5). These effects were found over and above ADHD symptom severity, medication status, age, and sex (Steps 1–2). A significant interaction effect was found for high quality supervision x ADHD (β = .34, p = .03). ADHD symptoms were not a significant moderator of the interaction (ps > .11), though individuals with fewer ADHD symptoms and higher incomes were more likely to experience high quality supervision (p < .001). No significant main or interaction effect was found for social support or work climate to income (ps > .55).

Table 5.

Buffering Effects of ADHD Policy and Positive Supervision to Income.

	DV: Job Satisfaction						DV: Job Satisfaction
	Total R²	R²_inc	B	SE	β		Total R²	R²_inc	B	SE	β
Step 1:						Step 1:
Med			.66	.33	.30	Med			.66	.33	.30
Sex			.03	.27	.02	Sex			.03	.27	.02
Age			−.03	.06	−.07	Age			−.03	.06	−.07
Step 2:	.21	.15*				Step 2:	.21	.15*
ADHD			−.12	.05	−.36*	ADHD			−.12	.05	−.36*
Step 3:	.34	.27**				Step 3:	.21	.13
Fair ADHD Policies			.56	.18	.40**	Positive Supervision (PS)			.01	.03	.05
Step 4:	.35	.26				Step 4:	.29	.20*
Policies x ADHD			.06	.08	.11	PS x ADHD			.03	.01	.34*

Sensitivity Analyses

Sensitivity analyses were conducted using a Bonferroni correction to adjust for multiple comparisons across the six outcomes (.05 / 6 = .0083; Abdi, 2010). The pattern of results remained unchanged from those reported above with three exceptions. After correction, the following interaction effects became non-significant: positive work climate x ADHD to job satisfaction (β = −.21, p = .02); positive work climate x ADHD to work motivation (β = .21, p = .02); and high-quality supervision x ADHD to income (β = .34, p = .03).

Discussion

The present study is one of the first to examine the protective effects of work climate and social support to occupational functioning for individuals with ADHD. Among the four predictors examined (work climate, fair ADHD policy, high quality supervision, non-work social support), fair ADHD policy was the most consistent predictor of outcomes over and above ADHD symptom severity, medication status, and age. In addition, ADHD symptom severity moderated the association between fair ADHD policy to job satisfaction. Specifically, fair ADHD policies improved job satisfaction for individuals with low and moderate, but not high, levels of ADHD symptoms. Indeed, ADHD symptom severity is associated with significant risk for disciplinary action and lower task performance (Chan & Langberg, 2024; Fried et al., 2012), which may result in less satisfaction for this high-risk group of working adults with ADHD. Our findings further indicate that while the American Disabilities Act (ADA) prohibits discrimination against individuals with a disability (e.g., a clinical diagnosis; Field, Jette & Insititute of Medicine (US) Committee on Disability in America, 2007), employees with ADHD have heterogenous experiences of fairness in the workplace. Moreover, disparities in perceived fairness may substantially influence workplace well-being among individuals with ADHD. However, to our knowledge this is the first study to examine perceptions of fair ADHD policies and work, and findings are preliminary.

As a starting point for interpreting these findings, we can draw from the literature on ADHD, school psychology, and general workplace policy. For example, emerging evidence indicates that fair disciplinary practices at school protect against internalizing symptoms and emotion dysregulation, as well as promotes higher levels of academic motivation and close friendships for students with ADHD (Chan et al., 2025). Within the school psychology literature, evidence indicates authoritative disciplinary styles, which consistently balances discipline and relational support are perceived to be most fair and helpful for students (Gregory et al., 2010; Konold et al., 2018). Workplaces and supervisors may consider instilling disciplinary practices that are consistent across employees as well as provide individuals with ADHD opportunities to explain themselves and are not overly punitive. Moreover, workplaces may work to foster environments that are inclusive (e.g., respect difference) and ensure transparent processes for discipline, compensation, and promotion (Faruk, 2024). These recommendations have been associated with higher perceived institutional fairness (Cuffe et al., 2020; Ramey & Freelin, 2023). Specifically, fair ADHD policy was found to predict higher levels of work motivation, greater job satisfaction, and higher income. However, research is needed to determine what constitutes perceived fair ADHD policies and how it benefits working individuals with ADHD.

A positive work climate was the next most consistent predictor of work outcomes. Specifically, aligned with the occupational literature (e.g., Baruch-Feldman et al., 2002), our results revealed a positive work climate was associated with higher levels of job motivation. However, this effect was moderated by ADHD symptom severity, in which the benefits of a positive work climate to job satisfaction was experienced only by individuals with low ADHD symptom severity. Our findings are consistent with evidence indicating individuals with fewer ADHD symptoms experience better relationships and occupational outcomes than their colleagues with more severe ADHD (Chan & Langberg, 2024; Shifrin et al., 2010). As a result, individuals with lower levels of ADHD symptoms may feel more satisfied and require less institutional supports to experience motivation at work. Indeed, our findings further revealed that for individuals with high but not low levels of ADHD symptoms, a more positive work climate was associated with greater work motivation. Of note, these interaction effects were not robust to correction and need to be replicated. Nonetheless, we consider these findings informative, given the rigor of our study design (e.g., inclusion of relevant covariates) and the fact that most nonexperimental research is underpowered to detect statistical interactions (McClelland & Judd, 1993).

For example, it will be important to understand how best to provide a positive work climate for individuals with high levels of ADHD symptoms to promote greater job satisfaction and work motivation. Person-context fit may be essential for promoting a positive experience of work climate and job success for individuals. Some jobs require long periods of being seated and quiet (e.g., meetings, deskwork) as well as highly repetitive tasks (e.g., checking spreadsheets), which may be taxing and demotivating for an individual with high levels of hyperactivity and/or inattention symptoms. However, other jobs offer individuals with ADHD more opportunities to socialize, be active, and engage in novel tasks; all of which has qualitatively been associated with higher occupational well-being in ADHD (Hotte-Meunier et al., 2024; Oscarsson et al., 2022; Schrevel et al., 2016). Thus, research supporting identification of job contexts, tasks, and work arrangements that fit the unique symptom and neurobehavioral presentation of employees with ADHD, may lead to more positive experiences of work climate.

Results further revealed high quality supervision was associated with higher levels of work motivation over and above ADHD symptom severity, medication status, and age. While it has yet to be studied, researchers suggest individuals with ADHD may benefit from supervisors who provide feedback that is regular, concise, and structured (Adamou et al., 2013). Moreover, verbal information may be supplemented with clear, concise written instructions (Adamou et al., 2013). Such supervisory practices may prevent workplace challenges, such as frequent mistakes and uncompleted tasks, which are associated with ADHD inattention symptoms (Fuermaier et al.). Employees with ADHD may also benefit from supervisors who encourage and reinforce the use of organizational tools and strategies (e.g., planners, to-do lists), which are highly effective for individuals with ADHD and executive function difficulties (Anastopoulos et al., 2021). Interestingly, prior to correction our results also indicated individuals with fewer ADHD symptoms and higher incomes, were more likely to experience high quality supervision. Given our results are cross-sectional, we cannot determine causation. However, an individual with less severe ADHD and of good financial circumstance, may be better positioned to obtain positions with high quality supervisors. Nonetheless, it is critical to identify specific supervision strategies that support individuals with ADHD in the workplace regardless of symptom severity and socioeconomic background.

Finally, greater non-work social support was associated with higher levels of satisfaction at work. This finding is aligned with evidence from general samples in which non-work social supports are more predictive of overall well-being versus job performance (Baruch-Feldman et al., 2002). Stated differently, non-work social support may be effective for promoting mental health, but job performance and motivation likely needs to be fostered within the workplace. Importantly, non-work relationships are multi-faceted and comprised of many types of relationships such as with family, friends, and romantic partners. It will be important to identify the types, duration, and mechanisms (e.g., increasing self-efficacy) in which non-work social support benefits working adults with ADHD. This could contribute to the development of best practices for family and friends to offer support impacting job satisfaction.

Limitations and Future Directions

Few studies have examined occupational functioning in ADHD from a strength-based perspective, and the present study contributes by identifying specific context-level protective factors. The sample was moderate in size and included participants from diverse racial/ethnic backgrounds and income levels. However, the majority of participants held a bachelor's degree which might limit generalizability. Future research may benefit from including individuals with a wider range of educational backgrounds to better understand the impact across different job types. Further, the modest sample limited our ability to employ multivariate multiple regression, which would allow for a stronger evaluation of individual predictors while controlling for Type I error across multiple tests. Another strength of the study was the use of measures tailored to the workplace (e.g., work motivation, job satisfaction; Gagné et al., 2015; Spector, 1994). Nonetheless, several measures relied on self-report data, and in some cases single items (e.g., fair ADHD policy), underscoring the need for future research to incorporate more robust, multi-informant, and/or objective assessments of occupational functioning. The cross-sectional design also constrains conclusions about directionality and limits the ability to examine moderators and mediators; longitudinal research will be necessary to address these gaps. A further strength was our definition of full-time employment, operationalized as working at least 20 h per week and not being enrolled in more than one academic course. This decision reflects the reality that many adults with ADHD face challenges in securing traditional 40-h work weeks with benefits. Still, replication among individuals employed for 40 or more hours per week is warranted, as they may encounter distinct workplace demands compared to peers working fewer hours. In addition, we were unable to examine the role of industry, profession, or job position (e.g., managerial vs. non-managerial). However, different occupational types and roles may involve unique environmental supports and demands that interact in specific ways with ADHD symptom severity, representing an important direction for future research. Finally, because our sample consisted of working adults with ADHD in the United States, findings should be replicated across other cultural and occupational contexts, which may differ in expectations and workplace structures.

Conclusion

The present study is one of the first to establish how context level factors (work climate, fair ADHD policy, high quality supervision, non-work social support) impact occupational outcomes for individuals with ADHD. Fair ADHD policies was the most consistent predictor of outcomes (i.e., work motivation, job satisfaction, income) over and above ADHD symptom severity, medication status, and age. This finding indicates organizations that promote equitable treatment and opportunities for individuals with ADHD may protect against the significant occupational risks associated with the disorder. Further, a positive work climate was associated with higher work motivation, but that benefit diminished for individuals with high levels of ADHD symptoms. Stated differently, work climates and policies that may benefit employees with low levels of ADHD symptoms, may not be as helpful or sufficient for individuals with severe ADHD. Thus, research is needed to identify policies that equitably support adults with ADHD regardless of symptom severity. Finally, high quality supervision and non-work social supports were associated with greater work motivation and job satisfaction, respectively. Altogether, our findings indicate to optimize occupational outcomes for individuals with ADHD, there is a need to strengthen context level supports both within and outside of the workplace.

Footnotes

Acknowledgements

N/A

ORCID iD

Elizabeth SM Chan

Ethics Statement

Rutgers University, IRB #Pro2024000123

Informed Consent

All participants provided informed consent.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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