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1 Aug 2020

Sônego M et al. Braz J Psychiatry 2020; Epub ahead of print

A negative association between ADHD symptoms and work performance has been reported in the literature; however, most of this evidence has been derived from employees rather than self-employed persons (Küpper et al, 2012). Moreover, it is known that individuals with ADHD prefer to work independently (Painter et al, 2008), and that characteristics of ADHD could be positively related to an entrepreneurial profile (Verheul et al, 2015). However, despite some recent research studies, data on the association between ADHD symptoms and an entrepreneurial profile are still lacking. This study was performed to investigate the association between ADHD symptoms and entrepreneurial profiles, and the effects of entrepreneurial characteristics in individuals who screen positive for ADHD and self-identify as entrepreneurs.

A letter of invitation, including a link to a self-completed questionnaire, was sent by e-mail to 4341 people who registered for a career-development course for entrepreneurs. The invitation was sent three times, at weekly intervals, between the end of 2017 and the beginning of 2018. The participants filled out an instrument that collected sociodemographic data and then responded to specific instruments assessing participants’ ADHD symptoms (Adult ADHD Self-Report Scale v1.1), impairment due to symptoms (Barkley’s Current and Childhood Symptom Scales), entrepreneurial performance (the annual profits of the participants’ companies) and entrepreneurial characteristics (Individual Entrepreneurial Orientation [IEO] scale). Since the response rate was low (as for most Internet surveys), sociodemographic data from participants and non-responders were compared and a significant difference was found between the groups. The propensity score covariate adjustment was used to balance differences between the two non-equivalent groups and obtain a non-biased estimate.

Of the 4166 individuals who were invited to participate in three separate e-mails, 449 responded (response rate = 10.8%), 355 reported being entrepreneurs, and 259 (6%) completed the questionnaire fully and were included in the data analysis.

The association between ADHD and overall and dimensional IEO scores (after adjustment for propensity scores) was reported:

  • Those who screened positive for ADHD had higher risk-taking scores (odds ratio [OR] = 1.59; p = 0.016) and lower proactivity (OR = 0.55; p = 0.001) than those who screened negative.
  • Higher inattention scores were related to lower proactivity (p < 0.001), while higher hyperactive symptom scores (independent of ADHD diagnosis) were significantly associated with higher overall IEO scores (OR = 1.06; p = 0.033), indicating a more generalised entrepreneurial profile.
  • Across the entire sample, inattention symptoms were not associated with risk-taking scores (OR = 1.01; p = 0.733) or innovativeness (OR = 1.02; p = 0.333).
  • There was a marginally significant negative association between inattention and overall IEO score (OR = 0.95; p = 0.050).
  • Hyperactivity symptoms were also not associated with risk-taking (OR = 1.02; p = 0.267) or innovativeness (OR = 1.03; p = 0.189) and proactivity (OR = 1.00; p = 0.952).

The impact of entrepreneurial profile scores on the number of sites with impairment, total impairment scores and annual profits among participants with ADHD were also reported:

  • Higher risk-taking in individuals with ADHD was not significantly associated with profit (OR = 1.05; p = 0.359), impairment (OR = 0.98; p = 0.200) or total impairment (OR = 0.99; p = 0.167).
  • Proactivity scores were not significantly associated with profit (OR = 1.02; p = 0.651), impairment (OR = 0.99; p = 0.744) or total impairment (OR = 0.99; p = 0.327).
  • Innovativeness scores were not significantly associated with profit (OR = 1.02; p = 0.732), impairment (OR = 1.02; p = 0.195) or total impairment (OR = 1.01; p = 0.241).
  • Among ADHD-positive participants, entrepreneurial profile scores were not significantly associated with company profits or impairment.

The study had several limitations, including that it was an observational study and the data were collected by a self-report web-based survey, and therefore caution should be used when generalising the findings. Additionally, the response rate was low (which is usual with web-based surveys) and sociodemographic differences were found between responders and non-responders. As explained above, these differences were adjusted through covariate adjustment using the propensity score. Finally, a high percentage of participants met the criteria for ADHD. Previously reported studies on prevalence of ADHD in adults that used online self-report questionnaires also found a high prevalence of ADHD. Moreover, since the current survey explained that the topic under investigation was ADHD symptoms, it might have attracted the attention of individuals who self-identify with these symptoms (a frequent selection bias in this type of study).

The authors concluded that the study results indicate that individuals with ADHD, and those with a greater number of hyperactivity symptoms, have a greater entrepreneurial profile. ADHD-positive individuals had a higher risk-taking profile, and these characteristics did not negatively impact their lives. However, among entrepreneurs, inattention symptoms were negatively associated with proactivity.


Read more about exploring the association between ADHD and entrepreneurship here

Küpper T, Haavik J, Drexler H, et al. The negative impact of attention-deficit/hyperactivity disorder on occupational health in adults and adolescents. Int Arch Occup Environ Health 2012; 85: 837-847.

Painter CA, Prevatt F, Welles T. Career beliefs and job satisfaction in adults with symptoms of attention-deficit/hyperactivity disorder. J Employ Couns 2008; 45: 178-188.

Sônego M, Meller M, Massuti R, et al. Exploring the association between attention-deficit/hyperactivity disorder and entrepreneurship. Braz J Psychiatry 2020; Epub ahead of print.

Verheul I, Block J, Burmeister-Lamp K, et al. ADHD-like behavior and entrepreneurial intentions. Small Bus Econ 2015; 45: 85-101.

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