Differences in COVID-19 Experiences Between U.S. Working Age Adults With and Without Attention-Deficit/Hyperactivity Disorder

Differences in COVID-19 infection and clinical outcomes between adults with and without ADHD are well documented. Less is known about disparities in their broader pandemic experiences or the extent to which substance use and socioeconomic resources contributed to these differences. Heightened isolation and psychological distress during the pandemic may have intensified ADHD-related stress and emotional instability, increasing reliance on coping strategies with health risks, such as substance use. Moreover, adults with ADHD often face structural disadvantages resulting in less robust socioeconomic resources to protect against pandemic stressors. Using data from the 2023 National Wellbeing Survey – a nationally representative sample of U.S. working-age adults aged 25–64 (N=5,725) – we examined ADHD-related differences in overall COVID-19 experiences and five specific domains: financial situation, physical health, mental health, relationships with family, and relationships with friends. We used regression and the Karlson–Holm–Breen method to assess the contribution of substance use and socioeconomic resources to these differences. Net of controls, adults with ADHD were significantly more likely to report adverse COVID-19-related experiences overall and across health and relationship domains. Adjusting for substance use and socioeconomic resources attenuated these differences, accounting for 9.5% to 23.8% of the differences between adults with versus without ADHD. These findings highlight the importance of recognizing how large-scale shocks like the COVID-19 pandemic can lead to adverse outcomes among people with ADHD. • Adults with ADHD reported worse COVID-19 experiences than adults without ADHD • Outcomes were worse overall and across health and social relationship domains • ADHD disadvantages partly accounted for by substance use and socioeconomic resources • Illicit drug and marijuana use account for the largest share of the indirect effects • ADHD disparities persisted after substance use and socioeconomic resource adjustments