Martin Oscarsson disputerar på en avhandling om psykisk ohälsa bland vuxna med ADHD

Oppontent: Professor J. Russell Ramsay, Perelman School of Medicine, University of Pennsylvania, USA.

Handledare: Professor Per Carlbring, Psykologiska institutionen, professor Fredrik U. Jönsson, Psykologiska institutionen, professor Alexander Rozental, Luleå tekniska universitet, och docent Ylva Ginsberg, Karolinska Institutet.

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Sammanfattning (på engelska)

Adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of adverse occupational outcomes and work-related mental ill-health. Yet, there is limited knowledge about how these difficulties are experienced by working adults with ADHD and few psychological interventions that target work-related mental health in this population. This thesis reports a four-year research project combining qualitative exploration with iterative development and controlled evaluation of a novel internet-delivered stress-management program based on cognitive-behavioral therapy (CBT).

Study I used semi-structured interviews with working adults with ADHD (n = 20) and qualitative content analysis to explore how participants understood the interplay between ADHD symptoms, workplace demands, and mental health. Participants described a working life characterized by sustained stress, persistent anxiety, impaired recovery, and repeated episodes of exhaustion, often compounded by emotional dysregulation and social hypersensitivity. They also reported limited access to healthcare support beyond pharmacological treatment of ADHD symptoms.

Study II translated these findings into Working with ADHD, a 12-module, internet-delivered cognitive-behavioral stress-management program with clinical support on demand. The intervention was tested in a single-arm open pilot trial (n = 36) with quality of life as the primary outcome. The program showed high adherence and large pre-to-post improvements across quality of life and multiple symptom measures. Participants’ feedback informed refinements to structure and content before large-scale evaluation.

Study III evaluated the revised program in a three-arm randomized controlled trial (n = 240) with a structurally matched mindfulness-based comparator and a waitlist control. Both active interventions outperformed the waitlist on quality of life and several symptom measures, with gains generally maintained at 12-week follow-up. No significant differences were observed between CBT and mindfulness at posttreatment; at 12-week follow-up, a single difference emerged for depressive symptoms, favoring mindfulness. Deterioration was rare, although most treated participants did not reach reliable improvement or recovery.

Overall, the findings deepen the understanding of work-related mental ill-health among adults with ADHD and support the feasibility and potential benefit of internet-delivered stress-management interventions in this population, while underscoring the need to optimize outcomes and clarify for whom, and under what conditions, digital support is most effective.