Abstract Amid rising adult ADHD diagnoses in recent decades, this article introduces a cultural ecosocial niche theory of adult ADHD, suggesting that symptoms emerge within specific cultural and social contexts rather than solely from neurobiological differences. Through in-depth interviews with seven Australian women recently diagnosed with adult ADHD, complemented by photo-voice methodology, we show how ADHD symptoms fluctuated markedly across different social interactions. The study found that participants actively construct and inhabit cultural ecosocial niches where their traits achieve a functional fit with their social and cultural environment. These niches ranged from adopting the macro-cultural framework of ‘neurodiversity’ to build affirming identities and communities, to finding micro-social occupational niches in fast-paced roles where their cognitive style became an advantage. Each niche was sustained by a reinforcing feedback loop, where the environment (such as a supportive social group or a demanding job) reinforced the very traits and beliefs that initially attracted them to that niche. This study challenges the notion that psychiatric symptoms are confined solely within a person or solely outside in the environment. Instead, it provides a concrete example of how symptoms and their meanings appear at the intersection of both. These findings illuminate the complex ways socio-cultural settings can both constrain and empower, while highlighting implications for how we conceptualise and address adult ADHD in an era of increasing diagnosis.
Ruse et al. (Mon,) studied this question.