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Abstract

ADHD has a high comorbidity with affective and anxiety disorders. While core ADHD symptoms may contribute to negative psychological outcomes, characteristic experiences of individuals with ADHD should also be considered. This study investigated the relationships between ADHD symptoms, hyperfocus, procrastination, and adverse psychological outcomes, with maladaptive daydreaming (MD) examined as a potential mediating factor. A sample of 512 adults with formal or self-reported ADHD diagnoses completed online questionnaires assessing ADHD symptoms, hyperfocus, procrastination, MD, depression, anxiety, and stress. Results indicated that MD significantly mediated the associations between ADHD symptoms and negative outcomes. When ADHD symptoms and hyperfocus were included in the model, procrastination no longer showed a direct association with anxiety and stress, whereas hyperfocus demonstrated no direct link with depression. The proposed model explained 15% of MD variance, 22% of depression variance, and 18% of the variance in both anxiety and stress. These findings highlight the pivotal role of MD in shaping the connections between ADHD-related behaviors and adverse psychological outcomes.

Keywords

ADHD procrastination maladaptive daydreaming hyperfocus

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References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787

Anastopoulos

A. D.

DuPaul

G. J.

Weyandt

L. L.

Morrissey-Kane

Sommer

J. L.

Rhoads

L. H.

Murphy

K. R.

Gormley

M. J.

Gudmundsdottir

B. G.

(2018). Rates and patterns of comorbidity among first-year college students with ADHD. Journal of Clinical Child & Adolescent Psychology, 47(2), 236–247. https://doi.org/10.1080/15374416.2015.1105137

Zhang

Miyake

Osborne

Shah

Jonides

(2023). A d factor? Understanding trait distractibility and its relationships with ADHD symptomatology and hyperfocus. PloS One, 18(10), e0292215. https://doi.org/10.1371/journal.pone.0292215

Ayers-Glassey

Smilek

(2024). The relations between hyperfocus and similar attentional states, adult ADHD symptoms, and affective dysfunction. Current Psychology, 43(12), 11254–11266. https://doi.org/10.1007/s12144-023-05235-3

Barkley

R. A.

Koplowitz

Anderson

McMURRAY

M. B.

(1997). Sense of time in children with ADHD: Effects of duration, distraction, and stimulant medication. Journal of the International Neuropsychological Society, 3(4), 359–369. https://doi.org/10.1017/S1355617797003597

Barra

Grub

Roesler

Retz-Junginger

Philipp

Retz

(2021). The role of stress coping strategies for life impairments in ADHD. Journal of Neural Transmission, 128(7), 981–992. https://doi.org/10.1007/s00702-021-02311-5

Bentler

P. M.

(1990). Comparative fit indexes in structural models. Psychological Bulletin, 107(2), 238–246. https://doi.org/10.1037/0033-2909.107.2.238

Bentler

P. M.

Bonett

D. G.

(1980). Significance tests and goodness of fit in the analysis of covariance structures. Psychological Bulletin, 88(3), 588–606. https://doi.org/10.1037/0033-2909.88.3.588

Blunt

A. K.

Pychyl

T. A.

(2000). Task aversiveness and procrastination: A multi-dimensional approach to task aversiveness across stages of personal projects. Personality and Individual Differences, 28(1), 153–167. https://doi.org/10.1016/S0191-8869(99)00091-4

10.

Bodalski

E. A.

Flory

Canu

W. H.

Willcutt

E. G.

Hartung

C. M.

(2023). ADHD Symptoms and procrastination in college students: The roles of emotion dysregulation and self-esteem. Journal of Psychopathology and Behavioral Assessment, 45(1), 48–57. https://doi.org/10.1007/s10862-022-09996-2

11.

Bolden

Fillauer

J. P.

(2020). “Tomorrow is the busiest day of the week”: Executive functions mediate the relation between procrastination and attention problems. Journal of American College Health, 68(8), 854–863. https://doi.org/10.1080/07448481.2019.1626399

12.

Brevik

E. J.

Lundervold

A. J.

Haavik

Posserud

M. B.

(2020). Validity and accuracy of the adult attention-deficit/hyperactivity disorder (ADHD) self-report scale (ASRS) and the Wender Utah rating scale (WURS) symptom checklists in discriminating between adults with and without ADHD. Brain and Behavior, 10(6), e01605. https://doi.org/10.1002/brb3.1605

13.

Cheung

(2024). semhelpinghands: Helper functions for structural equation modeling. R package version 0.1.12. https://sfcheung.github.io/semhelpinghands/

14.

Colodro-Conde

Couvy-Duchesne

Zhu

Coventry

W. L.

Byrne

E. M.

Gordon

Wright

M. J.

Montgomery

G. W.

Madden

P. A. F.

Ripke

Eaves

L. J.

Heath

A. C.

Wray

N. R.

Medland

S. E.

Martin

N. G.

(2018). A direct test of the diathesis–stress model for depression. Molecular Psychiatry, 23(7), 1590–1596. https://doi.org/10.1038/mp.2017.130

15.

Dwyer

Williams

Z. J.

Lawson

W. B.

Rivera

S. M.

(2024). A trans-diagnostic investigation of attention, hyper-focus, and monotropism in autism, attention dysregulation hyperactivity development, and the general population. Neurodiversity, 2, 27546330241237883. https://doi.org/10.1177/27546330241237883

16.

Fayyad

Sampson

N. A.

Hwang

Adamowski

Aguilar-Gaxiola

Al-Hamzawi

Andrade

L. H. S. G.

Borges

de Girolamo

Florescu

Gureje

Haro

J. M.

Karam

E. G.

Lee

Navarro-Mateu

O’Neill

Pennell

B.-E.

Piazza

Kessler

R. C.

(2017). The descriptive epidemiology of DSM-IV adult ADHD in the World Health Organization World Mental Health Surveys. ADHD Attention Deficit and Hyperactivity Disorders, 9(1), 47–65. https://doi.org/10.1007/s12402-016-0208-3

17.

Ferrari

J. R.

Sanders

S. R.

(2006). Procrastination rates among adults with and without AD/HD: A pilot study. Journal of Consulting and Clinical Psychology, 3(1), 2–9. https://www.researchgate.net/publication/276354426_Procrastination_Rates_Among_Adults_With_and_Without_ADHD_A_Pilot_StudyRevelle

18.

Flett

A. L.

Haghbin

Pychyl

T. A.

(2016). Procrastination and depression from a cognitive perspective: An exploration of the associations among procrastinatory automatic thoughts, rumination, and mindfulness. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 34(3), 169–186. https://doi.org/10.1007/s10942-016-0235-1

19.

Flett

G. L.

Sawatzky

D. L.

Hewitt

P. L.

(1995). Dimensions of perfectionism and goal commitment: A further comparison of two perfectionism measures. Journal of Psychopathology and Behavioral Assessment, 17(2), 111–124. https://doi.org/10.1007/BF02229013

20.

Flett

G. L.

Stainton

Hewitt

P. L.

Sherry

S. B.

Lay

(2012). Procrastination automatic thoughts as a personality construct: An analysis of the procrastinatory cognitions inventory. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 30(4), 223–236. https://doi.org/10.1007/s10942-012-0150-z

21.

Giguère

Sirois

F. M.

Vaswani

(2016). Delaying things and feeling bad about it? A norm-based approach to procrastination. In Procrastination, health, and well-being (pp. 189–212). Academic Press. https://doi.org/10.1016/B978-0-12-802862-9.00009-8

22.

Goodman

D. W.

(2007). The consequences of attention-deficit/hyperactivity disorder in adults. Journal of Psychiatric Practice, 13(5), 318. https://psycnet.apa.org/doi/10.1097/01.pra.0000290670.87236.18

23.

Groen

Priegnitz

Fuermaier

A. B.

Tucha

Aschenbrenner

Weisbrod

Pimenta

M. G.

(2020). Testing the relation between ADHD and hyperfocus experiences. Research in Developmental Disabilities, 107, 103789. https://doi.org/10.1016/j.ridd.2020.103789

24.

Hair

Black

Babin

Anderson

Tatham

(2006). Multivariate data analysis (6th ed.). Pearson Prentice Hall.

25.

Harpin

Mazzone

Raynaud

J. P.

Kahle

Hodgkins

(2016) Long-Term outcomes of ADHD. Journal of Attention Disorders, 20(4), 295–305. https://doi.org/10.1177/1087054713486516

26.

Harrington

(2005). It’s too difficult! Frustration intolerance beliefs and procrastination. Personality and Individual Differences, 39(5), 873–883. https://doi.org/10.1016/j.paid.2004.12.018

27.

Herscu

Somer

Federman

Soffer-Dudek

(2023). Mindfulness meditation and self-monitoring reduced maladaptive daydreaming symptoms: A randomized controlled trial of a brief self-guided web-based program. Journal of Consulting and Clinical Psychology, 91(5), 285–300. https://doi.org/10.1037/ccp0000790

28.

L.-t.

Bentler

P. M.

(1998). Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods, 3(4), 424–453. https://doi.org/10.1037/1082-989X.3.4.424

29.

Hupfeld

K. E.

Abagis

T. R.

Shah

(2019). Living “in the zone”: Hyperfocus in adult ADHD. ADHD Attention Deficit and Hyperactivity Disorders, 11(2), 191–208. https://doi.org/10.1007/s12402-018-0272-y

30.

Hupfeld

K. E.

Osborne

J. B.

Tran

Q. T.

Hyatt

H. W.

Abagis

T. R.

Shah

(2024). Validation of the dispositional adult hyperfocus questionnaire (AHQ-D). Scientific Reports, 14(1), 1–15. https://doi.org/10.1038/s41598-024-70028-y

31.

Jackson

Farrugia

(1997). Diagnosis and treatment of adults with attention deficit hyperactivity disorder. Journal of Counseling & Development, 75(4), 312–319. https://doi.org/10.1002/j.1556-6676.1997.tb02346.x

32.

Karaağaç

Korkmaz

ŞA

(2025). The relationship between maladaptive daydreaming and academic procrastination, depression, anxiety and stress levels in medical students. Anatolian Current Medical Journal, 7(3), 320–325. https://doi.org/10.38053/acmj.1659391

33.

Kaufmann

F. A.

Kalbfleisch

M. L.

Castellanos

F. X.

(2000). Attention deficit disorders and gifted students: What do we really know? National Research Center on the Gifted and Talented, University of Connecticut.

34.

Kessler

R. C.

Adler

Ames

Demler

Faraone

Hiripi

E. V. A.

Howes

M. J.

Jin

Secnik

Spencer

Ustun

T. B.

Walters

E. E.

(2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS): A short screening scale for use in the general population. Psychological Medicine, 35(2), 245–256. https://doi.org/10.1017/s0033291704002892

35.

Kline

R. B.

(2005). Principles and practice of structural equation modeling (2nd ed.). The Guilford Press.

36.

Lewczuk

Marcowski

Wizła

Gola

Nagy

Koós

Kraus

S. W.

Demetrovics

Potenza

M. N.

Ballester-Arnal

Batthyány

Bergeron

Billieux

Briken

Burkauskas

Cárdenas-López

Carvalho

Castro-Calvo

Chen

Bőthe

(2024). Cross-cultural adult ADHD assessment in 42 countries using the adult ADHD self-report scale screener. Journal of Attention Disorders, 28(4), 512–530. https://doi.org/10.1177/10870547231215518

37.

Lewis

L. F.

(2017). A mixed methods study of barriers to formal diagnosis of autism spectrum disorder in adults. Journal of Autism and Developmental Disorders, 47(8), 2410–2424. https://doi.org/10.1007/s10803-017-3168-3

38.

Lovibond

P. F.

Lovibond

S. H.

(1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U

39.

Makara-Studzińska

Tyburski

Załuski

Adamczyk

Mesterhazy

(2022). Confirmatory factor analysis of three versions of the depression anxiety stress scale (DASS-42, DASS-21, and DASS-12) in Polish adults. Frontiers in Psychiatry, 12, 770532. https://doi.org/10.3389/fpsyt.2021.770532

40.

Meinzer

M. C.

Pettit

J. W.

Leventhal

A. M.

Hill

R. M.

(2012). Explaining the covariance between attention-deficit hyperactivity disorder symptoms and depressive symptoms: The role of hedonic responsivity. Journal of Clinical Psychology, 68(10), 1111–1121. https://doi.org/10.1002/jclp.21884

41.

Meinzer

M. C.

Pettit

J. W.

Waxmonsky

J. G.

Gnagy

Molina

B. S.

Pelham

W. E.

(2016). Does childhood attention-deficit/hyperactivity disorder (ADHD) predict levels of depressive symptoms during emerging adulthood? Journal of Abnormal Child Psychology, 44(4), 787–797. https://doi.org/10.1007/s10802-015-0065-0

42.

Morsink

Sonuga-Barke

Mies

Glorie

Lemiere

Van der Oord

Danckaerts

(2017). What motivates individuals with ADHD? A qualitative analysis from the adolescent’s point of view. European Child & Adolescent Psychiatry, 26(8), 923–932. https://doi.org/10.1007/s00787-017-0961-7

43.

Nejati

Yazdani

(2020). Time perception in children with attention deficit–hyperactivity disorder (ADHD): Does task matter? A meta-analysis study. Child Neuropsychology, 26(7), 900–916. https://doi.org/10.1080/09297049.2020.1712347

44.

Netzer Turgeman

Pollak

(2023). Using the temporal motivation theory to explain the relation between ADHD and procrastination. Australian Psychologist, 58(6), 448–456. https://doi.org/10.1080/00050067.2023.2218540

45.

Niermann

H. C.

Scheres

(2014). The relation between procrastination and symptoms of attention-deficit hyperactivity disorder (ADHD) in undergraduate students. International Journal of Methods in Psychiatric Research, 23(4), 411–421. https://doi.org/10.1002/mpr.1440

46.

Nowacki

Pyszkowska

(2024a). The everchanging maladaptive daydreaming–a thematic analysis of lived experiences of Reddit users. Current Psychology, 43(35), 28488–28499. https://doi.org/10.1007/s12144-024-06506-3

47.

Nowacki

Pyszkowska

(2024b). It is all about discomfort avoidance: Maladaptive daydreaming, frustration intolerance, and coping strategies–a network analysis. Current Psychology, 43(34), 27447–27455. https://doi.org/10.1007/s12144-024-06382-x

48.

Oguchi

Takahashi

Nitta

Kumano

(2021). The moderating effect of attention-deficit hyperactivity disorder symptoms on the relationship between procrastination and internalizing symptoms in the general adult population. Frontiers in Psychology, 12, 708579. https://doi.org/10.3389/fpsyg.2021.708579

49.

Öster

Ramklint

Meyer

Isaksson

(2020). How do adolescents with ADHD perceive and experience stress? An interview study. Nordic Journal of Psychiatry, 74(2), 123–130. https://doi.org/10.1080/08039488.2019.1677771

50.

Pietkiewicz

I. J.

Hełka

A. M.

Barłóg

Tomalski

(2023). Validity and reliability of the Polish Maladaptive Daydreaming Scale (PMDS-16) and its short form (PMDS-5). Clinical Psychology & Psychotherapy, 30(4), 882–897. https://doi.org/10.1002/cpp.2844

51.

Pietkiewicz

I. J.

Nęcki

Bańbura

Tomalski

(2018). Maladaptive daydreaming as a new form of behavioral addiction. Journal of Behavioral Addictions, 7(3), 838–843. https://doi.org/10.1556/2006.7.2018.95

52.

Pychyl

T. A.

Sirois

F. M.

(2016). Procrastination, emotion regulation, and well-being. In Procrastination, health, and well-being (pp. 163–188). Academic Press. https://doi.org/10.1016/B978-0-12-802862-9.00008-6

53.

Pyszkowska

Nowacki

Celban

(2025). The daydream spectrum: The role of emotional dysregulation, internalized stigma and self-esteem in maladaptive daydreaming among adults with ADHD, ASD, and double diagnosis. Journal of Attention Disorders, 29(1), 53–69. https://doi.org/10.1177/10870547241290901

54.

Revelle

(2025). psych: Procedures for psychological, psychometric, and personality research. R package version 2.5.6. Evanston, IL: Northwestern University. https://CRAN.R-project.org/package=psych

55.

Rosseel

(2012). Lavaan: An R package for structural equation modeling. Journal of Statistical Software, 48(1), 1–36. https://doi.org/10.18637/jss.v048.i02

56.

Rozental

Bennett

Forsström

Ebert

D. D.

Shafran

Andersson

Carlbring

(2018). Targeting procrastination using psychological treatments: A systematic review and meta-analysis. Frontiers in Psychology, 9, 1588. https://doi.org/10.3389/fpsyg.2018.01588

57.

Rychik

Fassett-Carman

Snyder

H. R.

(2021). Dependent stress mediates the relation between ADHD symptoms and depression. Journal of Attention Disorders, 25(12), 1676–1686. https://doi.org/10.1177/1087054720925900

58.

Scholz

Werle

Philipsen

Schulze

Collonges

Gensichen

(2023). Effects and feasibility of psychological interventions to reduce inattention symptoms in adults with ADHD: A systematic review. Journal of Mental Health, 32(1), 307–320. https://doi.org/10.1080/09638237.2020.1818189

59.

Seymour

K. E.

Chronis-Tuscano

Iwamoto

D. K.

Kurdziel

MacPherson

(2014). Emotion regulation mediates the association between ADHD and depressive symptoms in a community sample of youth. Journal of Abnormal Child Psychology, 42(4), 611–621. https://doi.org/10.1007/s10802-013-9799-8

60.

Seymour

K. E.

Miller

(2017). ADHD and depression: The role of poor frustration tolerance. Current Developmental Disorders Reports, 4(1), 14–18. https://doi.org/10.1007/s40474-017-0105-2

61.

Shafran

Cooper

Fairburn

C. G.

(2002). Clinical perfectionism: A cognitive–behavioural analysis. Behaviour Research and Therapy, 40(7), 773–791. https://doi.org/10.1016/s0005-7967(01)00059-6

62.

Shrout

P. E.

Bolger

(2002). Mediation in experimental and nonexperimental studies: New procedures and recommendations. Psychological Methods, 7(4), 422–445. https://doi.org/10.1037/1082-989X.7.4.422

63.

Sirois

Pychyl

(2013). Procrastination and the priority of short-term mood regulation: Consequences for future self. Social and Personality Psychology Compass, 7(2), 115–127. https://doi.org/10.1111/spc3.12011

64.

Sirois

F. M.

(2023). Procrastination and stress: A conceptual review of why context matters. International Journal of Environmental Research and Public Health, 20(6), 5031. https://doi.org/10.3390/ijerph20065031

65.

Sirois

F. M.

Kitner

(2015). Less adaptive or more maladaptive? A meta–analytic investigation of procrastination and coping. European Journal of Personality, 29(4), 433–444. https://doi.org/10.1002/per.1985

66.

Sirois

F. M.

Melia-Gordon

M. L.

Pychyl

T. A.

(2003). “I'll look after my health, later”: An investigation of procrastination and health. Personality and Individual Differences, 35(5), 1167–1184. https://doi.org/10.1016/S0191-8869(02)00326-4

67.

Soffer-Dudek

Somer

(2018). Trapped in a daydream: Daily elevations in maladaptive daydreaming are associated with daily psychopathological symptoms. Frontiers in Psychiatry, 9, 194. https://doi.org/10.3389/fpsyt.2018.00194

68.

Somer

Lehrfeld

Bigelsen

Jopp

D. S.

(2016a). Development and validation of the Maladaptive Daydreaming Scale (MDS). Consciousness and Cognition, 39, 77–91. https://doi.org/10.1016/j.concog.2015.12.001

69.

Somer

Soffer-Dudek

Ross

C. A.

(2017). The comorbidity of daydreaming disorder (maladaptive daydreaming). Journal of Nervous and Mental Disease, 205(7), 525–530. https://doi.org/10.1097/NMD.0000000000000685

70.

Somer

Jopp

D. S.

(2016b). Childhood antecedents and maintaining factors in maladaptive daydreaming. Journal of Nervous & Mental Disease, 204(6), 471–478. https://doi.org/10.1097/NMD.0000000000000507

71.

Somer

(2002). Maladaptive daydreaming: A qualitative inquiry. Journal of Contemporary Psychotherapy, 32(2–3), 197–212. https://doi.org/10.1023/A:1020597026919

72.

Steel

(2010). Arousal, avoidant and decisional procrastinators: Do they exist? Personality and Individual Differences, 48(8), 926–934. https://doi.org/10.1016/j.paid.2010.02.025

73.

Strohmeier

C. W.

Rosenfield

DiTomasso

R. A.

Ramsay

J. R.

(2016). Assessment of the relationship between self-reported cognitive distortions and adult ADHD, anxiety, depression, and hopelessness. Psychiatry Research, 238, 153–158. https://doi.org/10.1016/j.psychres.2016.02.034

74.

Svartdal

Pfuhl

Nordby

Foschi

Klingsieck

K. B.

Rozental

Carlbring

Lindblom-Ylänne

Rębkowska

(2016). On the measurement of procrastination: Comparing two scales in six European countries. Frontiers in Psychology, 7, 203489. https://doi.org/10.3389/fpsyg.2016.01307

75.

Szaniawska

(2023). Adult ADHD Self-Report Scale(ASRS-v1.1). https://files.clickweb.home.pl/b6/b3/b6b30342-8062-4462-8924-16ec79c03e74.pdf

76.

Theodor-Katz

Somer

Hesseg

R. M.

Soffer-Dudek

(2022). Could immersive daydreaming underlie a deficit in attention? The prevalence and characteristics of maladaptive daydreaming in individuals with attention-deficit/hyperactivity disorder. Journal of Clinical Psychology, 78(11), 2309–2328. https://doi.org/10.1002/jclp.23355

77.

Tong

Shi

Zhang

Yuan

Xia

Jiang

Xiong

(2016). Mediating effect of anxiety and depression on the relationship between attention-deficit/hyperactivity disorder symptoms and smoking/drinking. Scientific Reports, 6(1), 1–8. https://doi.org/10.1038/srep21609

78.

Townes

Liu

Panesar

Devoe

Lee

S. Y.

Taylor

Arnold

P. D.

Crosbie

Schachar

(2023). Do ASD and ADHD have distinct executive function deficits? A systematic review and meta-analysis of direct comparison studies. Journal of Attention Disorders, 27(14), 1571–1582. https://doi.org/10.1177/10870547231190494

79.

Turgeman

R. N.

Pollak

(2025). Adult ADHD-related poor quality of life: Investigating the role of procrastination. Scandinavian Journal of Psychology, 66(5), 729–737. https://doi.org/10.1111/sjop.13117

ADHD,Hyperfocus,and Procrastination: The Mediating Role of Maladaptive Daydreaming in Adverse Psychological Outcomes

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