Have ADD or ADHD?

Sunday, October 23, 2016

Can You Be “Too Smart to Have ADHD?”



High intelligence does not protect you from the effects of ADHD, research shows (more about that below). Yet, it’s too often assumed—from childhood well into adulthood—that high IQ rules out ADHD entirely.
When my husband, a molecular biologist, and I started dating, I thought, “Wow, he’s the absent-minded professor.”  I asked my friend, a fellow journalist married to a biochemist, “Does he always miss the freeway exit?” “All the freakin’ time,” she deadpanned.  The implication was clear: Scientists live on another plane of existence; don’t expect them to be connected to the mundane realities of life. Just accept it.
It would be another two years before I connected the dots from his many puzzling behaviors to ADHD.  Turns out, my husband got through his doctoral program through sheer grit and willpower. Plus, he consumed tankards of coffee while wearing earphones in the library basement—and had no life outside the lab.
He got through it because he was smart and extremely motivated (he loves his work). But earning that PhD was still immensely harder for him than it was for his peers. It didn’t have to be that hard.
If you’re like me, you know several people with ADHD (diagnosed or not) who’ve been trying to finish their Ph.D. thesis for ages. Do them a favor, and forward to them this post. They might be glad to know that their challenges in procrastinating, prioritizing, and all the other executive functions have nothing to do with intelligence.
Psychologist Thomas E. Brown, a preeminent ADHD expert, has conducted several studies to learn more about high IQ individuals with ADHD. Here is an excerpt from his 2007 newsletter, as true today as it was then.  I’ve updated links  to abstracts of the now-published papers.

From Dr. Brown:

High IQ Children and Adults with ADHD

Often high IQ children and adults who suffer from ADHD are told by parents, educators and clinicians that they cannot have this disorder because they are so bright. Many seem to assume that being very bright protects individuals from having ADHD. Recent research at Harvard and at Yale has demonstrated that individuals with high IQ can and do suffer from ADHD.
In the J. of Child Psychology and Psychiatry (2007, 48: 7 pp. 687-694), Antshel and colleagues at Harvard reported on samples of children with IQ ≥ 120, 49 with ADHD diagnosis and 92 matched controls. They found that, in comparison to controls, those with ADHD:
  • Repeated grades more often
  • Needed more academic supports
  • Had more comorbid psychopathology
  • Were rated by their parents as having more functional impairments
ADHD was also shown to have elevated incidence rates in relatives of those with high IQ and ADHD.
When compared with a group of high IQ children without ADHD and to normal IQ children without ADHD, those with both high IQ and ADHD had a much higher incidence of ADHD among their relatives than did high IQ controls as well as normal IQ controls (23% vs 2.5% vs. 5.9%). These data suggest that the ADHD of those in the high IQ sample cannot be explained as a consequence of their having high IQ.

Brown Et Al Studies: High IQ Subjects with ADHD

My colleagues and I completed two somewhat similar studies at Yale.  In our study of 157 adults with ADHD and IQ ≥ 120, we found that 73% were significantly impaired on at least 5 of 8 measures of executive function (working memory index and processing speed index on the WAIS-IQ test, index score for short term memory of stories just heard; 5 cluster scores of Brown ADD Scale).
In our study of 117 children with high IQ and ADHD (ages 6 to 17 yrs) 62% showed significant impairment in at least 5 of 8 similar EF measures.
Meanwhile, taken together, these three studies offer substantial evidence to support the notion that ADHD does occur in very bright children and adults.
In some ways, these very bright individuals with ADHD may be at greater risk than many others because their ADD impairments often are not recognized by educators, parents or themselves until they have suffered years of frustration and underachievement in school.
Thomas E. Brown, PhD
How about you?  Did high IQ obscure ADHD for you personally or for a loved one?
—Gina Pera

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