Self-Compassion in University Students With ADHD: A Qualitative Exploration

Abstract

This study explored the lived experience of university students with attention-deficit hyperactivity disorder (ADHD) and identified factors that help or hinder their capacity for self-compassion in higher education. Fourteen university students with ADHD aged 18–25 participated in individual semi-structured interviews exploring experiences of self-compassion in academic contexts. Transcripts were analysed using reflexive thematic analysis and four themes identified: three barriers and one facilitator. The barriers included students internalising a chronic sense of being “not good enough,” feeling pressure to work harder to compensate for ADHD-related difficulties, and finding self-compassion cognitively difficult to practice. The facilitator was understanding and acceptance of ADHD, from others and themselves, which enabled more self-compassionate responses to setbacks. University students with ADHD face distinct challenges to self-compassion rooted in internalised stigma and executive function differences. Universities should provide ADHD informed psychoeducation and peer support to promote self-acceptance and well-being in emerging adults with ADHD.

Keywords

ADHD qualitative methods self-compassion college mental health

Introduction

The start of every academic year heralds the arrival of a new cohort of university students, each bringing their dreams and aspirations for the future. Estimates predict that between 2–8% will have attention deficit hyperactivity disorder (ADHD; DuPaul et al., 2009), a neurodevelopmental disorder characterised by poor self-regulation of attention and impulsivity (American Psychiatric Association, 2013). Research finds that university students with ADHD do not differ in intelligence from their peers without ADHD, however, perform more poorly on executive function measures (e.g., impulsivity, sustained attention; Weyandt & DuPaul, 2008). Consequently, students with ADHD are more likely to struggle with attention, planning, and organisation, and exert more effort to obtain similar levels of cognitive performance relative to their non-ADHD peers (Weyandt & DuPaul, 2008; Woltering et al., 2013). Longitudinal studies demonstrate that the challenges conferred by ADHD lead to poor academic outcomes such as lower grade point averages and higher dropout rates (DuPaul et al., 2021; Henning et al., 2021). Students with ADHD therefore experience a more challenging journey towards graduation.

Higher education is typically undertaken during emerging adulthood (18–25 years of age), an important developmental period when identity is continuing to form in an atmosphere of greater freedom and independence (Arnett, 2000). This life-stage is characterised by reduced external support and increased demands for self-regulation (e.g., less monitoring and supervision from parents and teachers). Successful adaptation to these new stresses and adult responsibilities contributes to the development of an individual’s sense of self-worth and belief in their own abilities and potential for success. For individuals with ADHD, emerging adulthood can be a particularly stressful time, as it imposes increased functional demands on the self-regulatory processes that are impaired in ADHD. Moreover, those entering higher education may experience cognitive demands that are greater than emerging adults with ADHD who have chosen pursuits more adapted to their symptoms. This combination of challenges confronting students with ADHD has been referred to as a “perfect storm”, illustrating the disadvantage they experience at the intersection of their disorder, their developmental stage, and the academic environment (Anastopoulos & King, 2015; Fleming & McMahon, 2012).

In conjunction with academic difficulties, students with ADHD experience depression, anxiety, and suicidal behaviour at substantially higher levels than their peers (Anastopoulos et al., 2018; DuPaul et al., 2021; Eddy et al., 2020). A cognitive-behavioural therapy (CBT) model of ADHD proposes past underachievement and failures lead to the development of negative cognitions and symptoms of depression and anxiety. These, in turn, make it harder to function efficiently, creating a feedback loop (Safren et al., 2004). This theory finds support in longitudinal research suggesting that negative self-concept is an important precursor to depressive symptoms in emerging adults with ADHD, which, furthermore, impairs future academic performance (Eddy et al., 2018; Henning et al., 2021). Similarly, qualitative research by Kwon et al. (2018), exploring the difficulties faced by 12 university students with ADHD symptoms, found the repetition of negative experiences and unsuccessful efforts to overcome symptoms leads students to distrust themselves and their ability to achieve their goals. Students reported frequently feeling disappointed in themselves and ruminating over past failures. Additionally, individuals with ADHD often encounter negative social feedback and poor treatment from others in response to their symptoms that increases the burden of distress, and may contribute to individuals with ADHD treating themselves similarly (Beaton et al., 2020, 2022). In sum, the compounding effects of academic struggles, negative cognitive patterns, and social challenges contribute to a significant burden of distressing emotions for students with ADHD.

Managing the emotional impact of living with ADHD can be challenging as the cognitive processes underlying the self-regulatory difficulties of ADHD are also implicated in the regulation of emotions (Barkley, 2010). ADHD is associated with more frequent use of maladaptive emotion regulation strategies such as self-blame, catastrophising, and rumination (Mayer et al., 2022). Several studies have observed that emotion regulation difficulties play a key role in the development of internalising conditions such as depression and anxiety in the general population, as well as among individuals with ADHD (Faraone et al., 2019; Naragon-Gainey et al., 2017). Whilst interventions aimed at university students with ADHD primarily focus on academic functioning, the need for a broader scope that includes emotional functioning has been highlighted (Vasko et al., 2020).

One skill that might be particularly well-suited to this role is self-compassion. Self-compassion is a style of relating to oneself during times of personal suffering that has its roots in Eastern philosophical thought, particularly Buddhism (Neff, 2003a). It consists of three key components: self-kindness, common humanity, and mindfulness. In research, it is typically measured using the Self-Compassion Scale (SCS; Neff, 2003b), which includes subscales representing compassionate self-responding (self-kindness, common humanity, mindfulness) and uncompassionate self-responding (self-judgement, isolation, overidentification). Self-compassion interventions aim to move individuals towards more compassionate ways of relating to themselves (Finlay-Jones, 2023). Meta-analyses consistently associate higher self-compassion with lower levels of distress, depression, and anxiety (Ferrari et al., 2019; MacBeth & Gumley, 2012), along with increased psychological well-being (Zessin et al., 2015). Among university students, self-compassion shows positive associations with various outcomes relevant to ADHD, including reduced negative affect in response to everyday challenges and failures (Leary et al., 2007), improved mood stability, and decreased negative affect following academic goal setbacks (Hope et al., 2014). Furthermore, it is linked to improved self-efficacy (Liao et al., 2021) and a greater inclination toward adaptive coping mechanisms over avoidance-oriented strategies such as procrastination (Neff et al., 2005; Sirois, 2014). Collectively, these findings underscore the potential efficacy of self-compassion as an adaptive strategy for emotion regulation among students with ADHD.

Recently, several quantitative studies have established that ADHD (both having a diagnosis and scoring high on ADHD trait measures) is associated with low self-compassion in samples of community adults (Beaton et al., 2020) and students in higher education (Farmer et al., 2022; Willoughby & Evans, 2019). Farmer et al.’s (2022) examination of the SCS subscales in a sample of university students found that there was a greater tendency for uncompassionate self-responding (self-judgement, feeling isolated from others by difficulties, and overidentification with negative emotions) among students higher in ADHD traits. However, the capacity for compassionate self-responding (self-kindness, common humanity, and mindfulness) did not vary according to ADHD symptomatology. This study also demonstrated that uncompassionate self-responding mediated the relationship between ADHD symptoms and mental health, and that increased emotion regulation difficulties was one probable mechanism by which this occurs. Overall, it is evident that self-compassion is a promising skill for promoting the mental health and adaptive emotion regulation of students with ADHD. However, up to now, little attention has been paid to how self-compassion is experienced in this population. Existing research is quantitative, looking at the amount of self-compassion that is experienced rather than how it is experienced.

To date, no studies have qualitatively explored how students with ADHD make sense of self-compassion in their daily lives, or what specific barriers and supports shape their ability to practice it. Research that explores the lived experiences of students with ADHD is crucial for understanding their unique perspectives and the contextual factors that contribute to the results observed in quantitative research. This knowledge is important to guide the development of targeted interventions that address ADHD-specific barriers to self-compassion and, it is hoped, enable students to maintain mental health and a positive self-concept as they pursue their academic goals. Accordingly, this study asks: How do university students with ADHD experience self-compassion, and what facilitates or hinders its practice? The study is conceptually grounded in Neff’s (2003a) model of self-compassion, which provides a theoretical framework for exploring these questions. It applies a constructivist approach and reflexive thematic analysis to enrich our understanding of how self-compassion is experienced by students with ADHD.

Methods

Study Design

This study used a qualitative design, using semi-structured individual interviews to gather data from participants. A community reference group of five university students with ADHD was created and consulted about the development of the study, the interview questions, and interpretation of results. Ethical approval for this study was granted by the University of Western Australia’s Human Ethics office (2021/ET000159).

Participants

A purposeful sampling method was used to recruit students aged 18–25 years old who were enrolled at an Australian university and had formally registered a clinical diagnosis of ADHD with their institution. There were no exclusion criteria. The study was advertised via disability support centres at two universities, which emailed flyers outlining the study and contact details to students with a registered diagnosis of ADHD. The advertisement invited students with ADHD to take part in a study exploring their experiences of self-compassion in daily life. Interested students followed a link to an online Qualtrics survey, where they completed eligibility questions, read the participant information and consent form, and indicated their preference for an in-person or online interview. Eligible students were then contacted by the first author to arrange an interview time. All participants received a $25 eGift Card as an honorarium for their participation.

Data Collection

One interviewer (GMF) conducted all data collection using semi-structured interviews that lasted for approximately 1 hour each and were audio recorded. Half of the participants chose online and half chose in-person interviews. Audio-recording was conducted via Zoom for online interviews and Audacity software for in-person interviews. Students were interviewed individually over a two-week period in November 2021, directly after the conclusion of Semester 2 exams. Audio recordings were transcribed verbatim by the first author, who completed all transcription manually without the use of automated software.

At the beginning of each interview, the researcher reminded participants of the study purpose, voluntary nature of participation, their right to withdraw at any time without consequence, and the option to decline to answer specific questions. Participants were also asked if they had any questions before recording began. The semi-structured interview schedule was developed iteratively by the research team, including a researcher with expertise in self-compassion. The development process was further informed by consultation with the community reference group, who provided feedback on the wording, content, and scope of questions to ensure they were clear and relevant. The schedule was designed to elicit rich narrative data while minimising cognitive burden, with an emphasis on open-ended questioning and the use of prompts to encourage elaboration where needed. It comprised three broad sections: (1) contextual questions about participants’ ADHD diagnosis and course of study; (2) exploration of challenges experienced as university students with ADHD and how participants related to themselves in those moments; and (3) discussion of self-compassion, including participants’ own definitions, followed by reflections on Neff’s (2003a) three domains (self-kindness vs. self-criticism, common humanity vs. isolation, and mindfulness vs. over-identification). Participants were first asked what the term self-compassion meant to them, after which a brief definition consistent with Neff’s model was provided. The interviewer then explained each domain and invited participants to reflect on their experiences in each area, including situations or influences that made it harder or easier for them to be compassionate with themselves. Example questions included.

• “Can you give me some examples of the challenges that you face as a uni student with ADHD?”

• “How do you tend to treat yourself at those times?”

• “What does the term self-compassion mean to you?”

• “When you are having a hard time, where do you land on a scale between self-kindness and self-criticism?”

The schedule contained ten core open-ended questions, supplemented by follow-up questions to explore in more detail where needed. The sample size of 14 participants provided rich and experientially diverse data that met the analytic requirements for reflexive thematic analysis (Braun & Clarke, 2022), and was considered sufficient to capture depth and diversity of experiential accounts.

Data Analytic Approach

This study adopted a constructivist approach, which assumes that knowledge and meaning are co-constructed through participants’ experiences and the interpretive lens of the researcher. Reflexive thematic analysis (Braun & Clarke, 2022) was selected as the most appropriate analytic method because it enabled us to explore participants’ meaning-making in depth while remaining attentive to the study’s conceptual focus on self-compassion. This approach focuses on identifying patterns of shared meaning within and across participants’ accounts to generate themes, enabling both descriptive and interpretative insights. Our analysis was guided by the view that themes do not simply emerge from the data but are actively produced through the researcher’s interpretive engagement in a reflective and iterative process. In practice, this involved a combination of inductive and deductive approaches: coding was primarily data-driven, allowing themes to arise from participants’ own accounts, with interpretation guided by Neff’s (2003a) self-compassion framework.

Reflexive thematic analysis was guided by Braun and Clarke’s (2022) six phase process. In phase one, the first author became familiar with the data by immersion (including transcription and multiple active re-readings of the transcripts). Ideas and insights were noted during this process. In the second phase, relevant segments of data were coded inductively. Coding was primarily semantic, though attention was also paid to underlying assumptions and meanings. Codes were generated flexibly, from short segments to longer extracts to preserve context, with analytic notes kept throughout to support reflection and later discussion. Coding was managed in NVivo 20. In the third phase, transcripts were searched again to ensure all relevant extracts were coded. Codes were then collated to preliminary themes that meaningfully addressed the research question. In the fourth phase, these topic-based themes were critically reviewed and reorganised into richer, interpretive themes that told coherent “stories” about participants’ experiences and captured deeper shared meanings and patterns (e.g., moving from topic-level themes such as “academia challenges self-worth” to broader interpretive themes such as “not good enough”). In the fifth phase themes were refined and named. In the final phase, the strength of supportive evidence in the interview data was reviewed, and data extracts that best illustrated the essence and interpretations in each theme were agreed upon between the co-authors. The data extracts provided have been edited for unnecessary detail following recommendations by Braun and Clarke (2022) and are denoted by pseudonyms allocated by the researcher (based on naming trends for the age group).

To enhance rigour and trustworthiness, we drew on multiple strategies aligned with the criteria of credibility, transferability, dependability, and confirmability. The first author (GMF), a female PhD student with lived experience of studying with ADHD and a background in psychology, engaged in reflexive journaling throughout the research process to examine assumptions and reflect on how her positioning informed data collection and analysis. Regular analytic meetings with the co-authors provided opportunities to critically review coding decisions, theme development, and interpretations. This collaborative process enhanced credibility by ensuring themes were critically examined from multiple viewpoints. The co-authors are all female academics or researchers with training in psychology, with expertise including development (DMB), self-compassion (AFJ), and ADHD (JLO). The final author (JLO) is also a clinical psychologist and has previous experience working with children who have an ADHD diagnosis and their families. Additional strategies to support rigour included consultation with the student reference group, maintenance of an audit trail in NVivo 20, reflexive practice, and provision of rich, descriptive data extracts.

Results

In total, 14 participants were interviewed. Their demographic information is provided in Table 1. Participants were enrolled in a variety of disciplines. The time since being diagnosed and taking part in the interview was 10 years for one participant, and between 2 months and 3 years (mean 12.5 months) for the other thirteen.

Table 1.

Participant Demographic Information

Participant characteristic	Range (M ± SD) or % (n)
Age, range (M ± SD)	18—25 (22 ± 2.1)
Sex, % (n)
Female	57% (n = 8)
Male	43% (n = 6)
Course level, % (n)
Undergraduate	71% (n = 10)
Postgraduate	29% (n = 4)
Years of university education	1—6 (3 ± 1.6)

In general, participants blamed themselves for their ADHD-related difficulties and noted that their ADHD made practicing self-compassion challenging. Four themes, each with two sub-themes, were found to best describe the data (see Table 2). As each are described, many quotes are used from participants to ground the interpretation and results description firmly in the participants’ lived experience.

Table 2.

Overview of Themes and Subthemes

Themes	Subthemes
Not good enough	Falling short of the ideal self
Not good enough	Academia challenges self-worth
Must try harder	Stigmatising attitudes toward ADHD
Must try harder	Shouldering blame
It’s hard to be self-compassionate	Default thinking and hyperfocus
It’s hard to be self-compassionate	Self-compassion is unfamiliar
Understanding and acceptance aid self-compassion	Knowing and accepting the ADHD self
Understanding and acceptance aid self-compassion	Acceptance from others

Theme 1. Not Good Enough

This theme captures how participants frequently fell short of their own expectations and did not feel deserving of self-compassion. Two subthemes are described in which participants felt ‘not good enough’ with respect to their ideals in general, and academia more specifically.

Falling Short of the Ideal Self

The difference between “what you think you should be able to do and what you are actually doing and able to do” (Erin) was central to much of the self-judgement participants described. Although this discrepancy was due to ADHD, Kara’s reaction was typical of many, “I just get annoyed at myself and frustrated… I feel pretty angry and disappointed in myself…there’s just not much you can do.” Sometimes the inner voice was self-critical, for example “you are so useless, you are so stupid, why can’t you just do it?” (Nia), but often it was characterised by self-doubt, for example “I’m not good enough, I’m not smart enough to do this” and “feelings of not being competent” (Alexa). Aaron recognised that self-compassion was particularly relevant when: “I’m not doing as well as I feel like I should be” but explained that although “those practises are there, there is a lot of frustration as well ‘cause it’s kind of like no, I should be able to do this.” The sense of not deserving self-compassion was shared by many participants, with one describing their internal battle:

I can hear both sides of my brain, I can hear the little voice behind me going you deserve kindness, but a lot of my brain will just be like, you’re such a failure, why did you do that? You know better, honestly, I expected better from you. (Nia)

In addition to falling short of their own expectations, participants noticed their shortcomings in comparison to others. The feeling of being different and “worse than other people” (Kara) often began at school. Feelings of shame drove self-criticism and were a barrier to self-compassion. Clarissa described self-criticism as having “always been a part of me because I was weird” and Soraya explained “I feel always like I’m the only one flawed, […] everyone else is doing great, everyone else is perfect, and I’m just a shit person, pardon my French, because of that belief any kind words are not really going to penetrate.”

Academia Challenges Self-Worth

Many participants placed a high value on academic achievement and their self-worth was closely connected to their academic performance. These attitudes developed early in life and were emphasised among those who disclosed a history of giftedness or learning disorders. Erin described high achievement as having always been “a big part of my identity,” while Bianca felt a “really high personal drive to do well” and believed that “if I don’t do well, I’m a failure.” The negative impact of ADHD on academic endeavours often led to harsh self-judgment and fostered perfectionistic tendencies. Several participants noted how perfectionism hindered their ability to initiate and complete tasks. Alana outlined her difficulty submitting essays on time, despite the grading penalties for lateness, saying, “if I thought that it didn’t sound totally right, I was like, well it’s worth literally nothing.” Kara described the challenge of receiving feedback “because you overthink everything” and always think “there’s some way you could have improved, it’s like you’re always criticising yourself.” Perfectionistic attitudes did not necessarily extend to other areas of life.

Regular academic assessment promoted continuous self-evaluation and provided tangible benchmarks for shortcomings and social comparison. Some participants recounted becoming “upset” and “breaking down” over disappointing grades. Soraya described university as a “culture of comparison,” where “there’s absolutely no way you’re not going to compare when you’re literally being rated.” ADHD-related difficulties in meeting and managing multiple assignment deadlines induced significant self-criticism and anxiety. Participants often felt they couldn’t afford the time for breaks or were consumed by guilt and anxiety if they did. Aaron described “constantly pushing and criticising” himself, noting that he could be more self-compassionate when he had a reduced workload with fewer deadlines. Soraya wished for evenly spaced deadlines so that she could “take a breather and not feel so emotionally exhausted.” Alexa summarised these difficulties, stating, “the expectations of what it is to be an academic are sometimes not aligned with symptoms of ADHD, and therefore I feel a sort of…shame.” While reasonable adjustments like extensions are an option available to students that some participants used comfortably, others were reluctant and felt ashamed for needing them.

Theme 2. Must try Harder

This theme describes how stigma and misunderstandings about ADHD meant that symptoms were often conflated with character flaws that could be overcome by trying harder. Two subthemes are described in which societal misunderstanding about ADHD predominate, and trying harder is seen as the responsible course of action, not self-compassion.

Stigmatising Attitudes Toward ADHD

Although many participants believed that a more self-compassionate approach could be beneficial, they were worried that being more understanding about their ADHD might diverge from societal expectations, and that it could be met with misunderstanding or disapproval from others. Several cited the widespread lack of understanding about ADHD as a “learning disorder and a disability” (Alana) as a barrier. Alexa felt “it would be easier to be compassionate towards myself if I had more understanding from other people of what it is to have the condition.” Soraya explained that “All other people see are character flaws of, she can’t manage her time, she can’t make due dates, she procrastinates, she struggles with workload. These are all flaws that in this world don’t deserve compassion,” concluding “there’s absolutely no point showing myself compassion. Rather, I should try to conform” and “say I’ll try harder next time.” Participants described how attempting to bridge the understanding gap by explaining their condition to others could be burdensome and risked a poor reception.

Societal lack of understanding about ADHD had significant implications for how participants perceived themselves and related to their own ADHD. Many participants had difficulty recognising their ADHD symptoms and distinguishing them from character flaws. Soraya observed, “I can’t recognise ADHD almost ever; I just think I’m flawed as a person all the time.” Similarly, Clarissa described thinking that “laziness” was “just part of my personality, as opposed to it being ADHD” adding “it’s always been a part of me, so I haven’t really differentiated it.” Some participants struggled to accept the legitimacy of ADHD and the impact it had on their lives, downplaying their diagnosis. Kara believed that everyone experienced similar symptoms, making her hesitant to attribute her struggles to ADHD. This difficulty in recognising and accepting ADHD acted as a barrier to self-compassion, as illustrated by Ryan:

I mean, I get why I’m harsher with myself because of ADHD … I keep thinking I’m letting myself off, what if it’s an excuse? I don’t know if it’s a thing because, you know, maybe I’m just lazy?

Shouldering Blame

Participants strived to be conscientious and responsible but blamed themselves when their symptoms prevailed, belying a perception that symptoms could be fully controlled with enough effort. Alana traced this back to her school days, when others “saw evidence of what I was capable of and the level I was currently performing at and it’s like, no, you’re not trying your best.” Max recalled being “yelled at” for being “lazy or not trying hard enough” and asked “Do you not think this is important? Do you not want to be here?” Many participants had received moral judgement for their symptoms, and some were aware of having internalised it “because there was no other explanation at the time” (Alana).

Most participants associated being hard on themselves with motivating self-improvement, but not self-compassion. Consequently, participants struggled to extend the compassion they showed others to themselves. Nico explained “I’m always a lot harder on myself” describing self-compassion as “inefficient.” There was an assumption that self-compassion involved avoiding responsibility or excusing low standards. Participants were unanimous in their belief that “ADHD is not an excuse.” Some participants reported that having a diagnosis increased their sense of responsibility for symptom management. Nico explained “OK, maybe you have ADHD, try not to put yourself in those situations anymore, but if you do land up in those situations your ADHD is not an excuse. Because you knew better.” Concerns about using ADHD as an excuse meant that its utility as an explanation was sometimes overlooked, perpetuating self-blame for symptoms.

Theme 3. It’s Hard to be Self-Compassionate

This theme captures the cognitive challenges that students with ADHD experience in implementing self-compassion. Two subthemes are highlighted: habitual thinking patterns and hyperfocus as powerful forces, and self-compassion as an unfamiliar concept that is effortful to understand and practice.

Default Thinking and Hyperfocus

Some participants described how lifelong habits, contrary to a self-compassionate stance, persisted despite recognising that they did more harm than good. Deeply ingrained self-criticism posed a significant challenge to implementing a new approach to self-relating. Students familiar with the concept of self-compassion often expressed their efforts with phrases like “I’ve been told to,” (Aaron) “I know I should,” (Nico) and “I’ve been trying” (Soraya, Nia), noting it was harder to be self-compassionate when they were tired, hungry, rundown, or had lots of assignments due. Daniel explained, “I think most of my problems, in terms of mental, boil down to my sleeping patterns, they’re absolutely horrendous.” Alexa found self-compassion most challenging during ovulation, observing that it coincided with “the three days of the month where it’s like my symptoms are the absolute worst.”. All-or-nothing thinking was common among participants, and translated into hyperbolic self-talk that impeded self-soothing:

When everything is on top of me I’m like, no! No one has ever failed as badly as you! And then I’ll compare myself to the worst people, I’ll be like, I don’t know, Hitler did some pretty bad things, and be like nope! I did worse. (Nia)

Overall, participants viewed self-compassion as a fundamentally “different mindset” that was inconsistent with their existing thinking patterns, highlighting the effort required to override them.

Additionally, attention regulation difficulties, especially hyperfocus, acted as a barrier to self-compassion by predisposing students to over-identification rather than mindfulness. While hyperfocus could boost productivity, it was difficult to interrupt, and many participants felt powerless to intervene once it took hold. Daniel related, “If I try and divert from what I’m focusing on, it always goes back,” and Aaron described being “unable to let go” when he was in a state of academic striving. Erin explained that, specifically, “it’s really hard to let go of something you can’t do,” to allow “the more compassionate voice to come in.” In addition to tasks and goals, hyperfocus was applied to negative experiences and aspects of oneself. Rumination on perceived flaws and mistakes allowed feelings of shame to escalate to unmanageable proportions and frequently culminated in periods of self-isolation, leading to shame about that too. Bianca recalled a situation in which, “I was so consumed with guilt and embarrassment and all other things that… I just couldn’t leave my bed for a good …I think 5 hours and I remember just thinking, other people would be able to get over this.” Clarissa described a time when “I was s’posed to be going to uni but I stayed in my room for almost three weeks straight,” explaining how, “ that brings you into another hole, a different hole altogether because you’re self-loathing because you actually abandoned everyone and everything, so you’re just self-loathing because you’re self-loathing, basically.” Thus, difficulty regulating attention and emotions could combine to create intense states of uncompassionate self-responding that were similarly difficult to interrupt, with several participants describing being “quite aware” as they took hold, but unable to intervene.

Self-Compassion is Unfamiliar

Most participants were not familiar with the definition of self-compassion, and it was often confused with self-pity, self-indulgence, or “just being nice to yourself” (Max), contributing to the belief it might be “a waste of time” (Nico). Several participants found the idea of self-compassion “foreign” (Max). Clarissa noted that she didn’t know “any friends with ADHD that have actually implemented self-compassion.” Erin explained, “I haven’t really had compassion modelled for me,” and felt it would be useful to have examples of “kind things to say to yourself,” because when “you’re so used to self-criticism, you don’t really know what self-kindness actually sounds like.” Alexa grappled aloud with self-expression that balanced her determination and high standards with her desire to be more self-compassionate, concluding, “your expectations were high and you’re still doing well even if you didn’t achieve them.” Nia described self-compassion as requiring a deliberate process of going back to “re-talk” to herself after recognising her initial self-critical response. Together, these reflections portray self-compassion as an unfamiliar concept, requiring effort to understand and put into practice. Overcoming the barriers described in this theme was summed up by Nico as “like trying to climb Mount Everest.”

Theme 4. Understanding and Acceptance Aid Self-Compassion

This theme captures how ADHD knowledge and acceptance facilitate self-compassion. Two subthemes are described including being understanding and accepting towards oneself and feeling understood and accepted by others.

Knowing and Accepting the ADHD-Self

Many participants reported being more understanding towards themselves following their diagnosis. The diagnosis validated their struggles and offered an alternative to previously accepted character-based explanations. Nico felt “relieved that it wasn’t just me being a bad student or a bad person.” Learning about ADHD enabled participants to adjust their self-expectations and access strategies that were more effective than self-blame. Leo described a transition from “continually beating myself up” to “knowing specifically what my condition can do and how to treat it.” Nia went from asking herself “Why are you so lazy?” to “Is this who you are, or is this maybe a symptom of something?” explaining:

It doesn’t mean I don’t have any power over it. It just means I can go, it’s not who you are, it’s not an inherent part of you and who you want to be, it’s just that you have difficulty with these things. So, let’s think of something to counteract it.

Clarissa explained that although the level of frustration she experienced due to ADHD hadn’t changed, “I’m not really being as hard on myself as I used to be,” adding “post diagnosis I’ve been much better social-wise, health-wise, and everything like that.” Doing “a tonne of research” helped Alana to increasingly differentiate between symptoms and character flaws. Similarly, Alexa described “slowly but surely” transitioning from self-blame to recognising that “these are just my ADHD symptoms” which “makes it a lot easier to not be so hard on myself,” adding that being more self-compassionate could “stop a bad day turning into a bad week.” For some participants, medication reduced self-criticism by closing the gap between their actions and intentions. Some were “shocked” (Daniel) at how their ability to “get work done” (Aaron) contrasted with the “hours and hours and hours trying to get started” (Alana).

Acceptance From Others

Most participants familiar with self-compassion first learned about it from their psychologists, highlighting professional support as a key source of learning. However, this encouragement alone was rarely enough to surmount barriers. For instance, Soraya encountered strong resistance until recently, when a recruitment experience with an understanding and supportive workplace led her to “the closest I’ve come to not feeling shameful about my ADHD.” As she transitioned from academia to the professional world, she reflected, “I think I may be able to show compassion to myself more, ‘cause this transition to the world, it seems like a different perspective on things.” This experience suggests that environmental factors and societal responses to ADHD can be a powerful force in shaping the way people with ADHD perceive and respond to themselves.

Many participants described experiencing social anxiety and/or the need to mask their ADHD at university. Alexa explained, “it can feel quite isolating because I feel like I can’t just be my ADHD-self in this environment.” Despite this, most participants felt socially well connected in their lives and several highlighted the important role of like-minded friends. Participants appreciated being around others with ADHD because they “understand the struggles” (Alana) and “you don’t have to explain yourself” (Clarissa). Participants recruited via a university facilitated support program described a “strong connection” (Bianca) and “zero judgment” (Nico) within the group. They benefited from exchanges of understanding and support between members that modelled compassion in the context of ADHD and facilitated self-compassion. Online ADHD communities were a valued source of learning and the only connection some participants had to others with ADHD. Alana experienced them as “uplifting” and discovered “things that I thought for my entire life were unique personality traits are just symptoms of ADHD” and “a bunch of people talking about what really worked for them.” Participants invariably felt “less alone” after visiting online communities. Learning about how ADHD affected others normalised difficulties and differences, alleviated feelings of isolation, and provided insights into participants’ own behaviour.

Discussion

This study explored how university students with an ADHD diagnosis relate to themselves in response to their ADHD-related challenges and identified the barriers and facilitators to practicing self-compassion. While some examples of self-compassion were described, participants mostly described relating to themselves in a self-critical, or uncompassionate manner, in line with quantitative research in this area. Themes centred around three barriers (not good enough, must try harder, and it’s hard to be self-compassionate) and one facilitator (understanding and acceptance), and together these provide insight into the reasons students with ADHD struggle to be self-compassionate in times of difficulty. The following discussion is situated within Neff’s (2003a) self-compassion framework, which comprises three core components: self-kindness vs. self-judgement, mindfulness vs. over-identification, and common humanity vs. isolation.

The inherent mismatch between the core symptoms of ADHD and the demands of academia meant that participants experienced substantial frustration and disappointment in their pursuit of higher education, along with a chronic sense of being ‘not good enough’. The gap between participants’ self-expectations and their actual performance was at the heart of most self-criticism. In the self-compassion literature this phenomenon has been referred to as the ‘disappointment gap’ (Gilbert, 2009) and described as the difference between the ideal and actual self, which in the context of this study may be alternatively framed as the ADHD-self. Although such a gap can be expected insofar as ADHD makes it difficult to match intentions with actions (Barkley, 1997), participants were unanimous in blaming themselves and typically did not believe they deserved much self-compassion for their difficulties. There was a sense that only the ideal-self deserved self-compassion and positive regard, or that compassion was only permissible when one’s performance was perfect; there seemed to be an underlying message that to deserve self-compassion you must change who you are or overcome ADHD. This represents a lack of understanding that compassion is a response to suffering, and is most relevant when one is struggling or has failed in some way.

Societal misconceptions and negative attitudes concerning both self-compassion and ADHD strongly influenced the way students perceived and approached their ADHD-related challenges. Misunderstandings about ADHD growing up meant that symptoms were often conflated with character flaws, such as laziness and complacency. This study, like others, found that many participants had internalised these views and come to see themselves as being of fundamentally poor character—a bad person, rather than a good person with ADHD (Attoe & Climie, 2023; Young et al., 2008). Due to the neurodevelopmental nature of ADHD, negative core beliefs often developed early in life, and remained influential into adulthood. Ongoing difficulty distinguishing symptoms from character flaws perpetuated negative self-beliefs, and obstructed insights required for effective self-support, an important component of self-compassion.

The stigma surrounding ADHD highlights the difficulty of living with a condition characterised by self-regulatory deficits that others may experience from time to time and overcome with reasonable effort. People with ADHD are assumed to have the same level of control over their behaviour, when in fact the very nature of self-regulation difficulties is that they are hard to overcome through effort alone. The lack of awareness and understanding regarding self-regulatory capacity is a significant issue for individuals living with ADHD, contributing to stereotypes and the stigma that ADHD isn’t a real disorder (e.g. Ginapp et al., 2022; Young et al., 2008). The findings of this study demonstrate how these attitudes can be internalised, furthering self-blame and discouraging self-compassion. Therefore, the results support recommendations to move beyond focusing solely on attention and hyperactivity symptoms towards a more contemporary view of ADHD as a neurodevelopmental problem of poor self-regulation (Ayers-Glassey & MacIntyre, 2021; Ramsay & Rostain, 2016).

Gaps between participants’ expectations of themselves and their actual performance were the impetus for self-criticism which was focused on motivating self-improvement. Participants felt strongly that they were responsible for their own behaviour, and self-compassion was at odds with their sense of accountability. Many of the barriers to self-compassion identified in this study are common fears that have been well documented in the self-compassion literature. These barriers include conflating self-compassion with negative attributes such as low motivation, self-indulgence, low conscientiousness, or poor performance (Kirby et al., 2019; Ortiz et al., 2023). Additionally, beliefs that practicing self-compassion contradicts the expectations of one’s family or culture have been well-established (Bayir & Lomas, 2016; Campion & Glover, 2017). What makes these fears especially salient is that they align with existing stereotypes and stigmas that individuals with ADHD already contend with, such as being lazy and complacent. Even though self-compassion is a relatively internal process, some participants were concerned about what others would think and worried that approaching their ADHD-related difficulties compassionately was yet another way of being out of step with societal expectations.

Cognitive processes such as the inhibition of prepotent and habitual self-critical responses, attention dysregulation, and cognitive flexibility were described as barriers to self-compassion. Participants had largely internalised the belief that criticism and self-blame are the appropriate response to ADHD-related difficulties and reacted instinctively. Fear of standing out for the wrong reasons starts at a young age for individuals with ADHD (Grønneberg et al., 2023). The strong instinct for self-criticism has also been identified as a barrier to self-compassion among autistic adults (Cai et al., 2023), suggesting it is a common factor in neurodivergent individuals’ struggle to be self-compassionate. To overcome this, it is recommended that self-compassion programs focus on supporting individuals to generate and express compassion for the critical self and acknowledge self-criticism and the struggle to enact self-compassion as a form of suffering.

Hyperfocus was described as a barrier to self-compassion because it is both difficult to break and diminishes awareness of non-task relevant stimuli, leaving little room for compassionate thoughts or actions. Basic self-care tasks, such as eating and resting, were often neglected during periods of hyperfocus. Although ignoring personal needs might be perceived as self-uncompassionate, it is important to note that the motivation was not self-punishment. The enhanced task performance associated with hyperfocus also contributed to the disappointment gap, as it does not occur on demand but still influences overall performance expectations.

Emotion dysregulation was also impacted by hyperfocus-like attention on negative emotions and experiences. ADHD-related hyperfocus shares similarities with perseveration (Ayers-Glassey & MacIntyre, 2021), a quality that was especially apparent in participants’ experiences of becoming overwhelmed by negative emotions. While participants reported being generally aware of and able to identify their emotions, they faced difficulties disengaging from intense emotional states and could find themselves caught in a downward spiral of rumination that rendered them unable to function for periods ranging from hours to weeks. Notably, this experience was characterised by the negative dimensions of self-compassion— self-criticism, isolation, and over-identification. Self-compassion has strong negative correlations with rumination (Ewert et al., 2021) and interventions are shown to reduce rumination in both clinical and student populations (Frostadottir & Dorjee, 2019; Smeets et al., 2014), suggesting that cultivating a self-compassionate attitude may be particularly beneficial to university students with ADHD. However, given that self-compassion requires engagement with one’s suffering, the tendency to perseverate should be accounted for in interventions aimed at individuals with ADHD. Hyperfocus is an emerging area of research in the ADHD literature and few recommendations currently exist for managing it. Overall, it is recommended that self-compassion programs support students to become mindful of their individual hyperfocus tendencies and recognise the ways in which it can be both a strength, and a form of suffering.

This study, like other research, found that poor academic performance was not characteristic of university students with ADHD (Godfrey-Harris & Shaw, 2023; Morley & Tyrrell, 2023). Participants recognised that academic success hinged on their ability to compensate for their symptoms and most applied great determination to doing so. Overworking, trouble relaxing, and burnout have been observed in other studies exploring the work habits individuals with ADHD adopt to compensate for their symptoms (Michielsen et al., 2018; Nadeau, 2005). Furthermore, self-criticism may be seen as particularly important among university students, as they are receiving constant feedback on their academic performance through examinations and other coursework. The participants in this study were motivated to do well and saw self-criticism as a way to achieve this. These patterns, characteristic of perfectionism, were common among the participants in this study, along with a marked tendency to self-judge in all or nothing terms and use hyperbolic self-talk that ran counter to the nuanced thinking required for self-compassion. Accordingly, a relevant focus of self-compassion interventions for this population may be to support students to understand how to motivate themselves from a compassionate perspective.

Perfectionistic concerns were commonly expressed among the sample group, consistent with evidence that ADHD symptoms are positively associated with maladaptive perfectionism (Bodalski et al., 2023). Strohmeimer et al. (2016) found perfectionism was the most frequently endorsed category of cognitive distortion among adults with ADHD, proposing that “ADHD-related perfectionism is better conceptualised as problems with procrastination and avoidance of tasks due to a history of frustration, poor results not commensurate with efforts, and resulting emotional discomfort associated with various tasks.” This characterisation aligns well with experiences participants related in the current study. Interventions tailored to support university students with ADHD should note the high level of perfectionism that can be anticipated and the follow recommendations for dealing with this barrier, such as the need for psychoeducation about self-compassion to be augmented by additional strategies to help people translate knowledge into self-compassionate responses (Biskas et al., 2023), and guidance on modifying dichotomous self-statements to reflect standards more accepting of imperfection (Strohmeier et al., 2016).

Understanding and acceptance was described as the primary facilitator of self-compassion in the current study, and invariably stemmed from receiving a diagnosis of ADHD. Other research has also linked diagnosis with enhanced self-acceptance and capacity for self-compassion (Ginapp et al., 2022; Godfrey-Harris & Shaw, 2023; Morley & Tyrrell, 2023; Young et al., 2008). In the current study, psychoeducation and acceptance of the diagnosis emerged as important factors influencing the extent to which these positive effects occurred. While participants acknowledged their diagnosis, there was an underlying sense of disbelief among many indicating that, as found by Young et al. (2008), acceptance is a process that takes time and involves several stages.

A central challenge to knowing and accepting the ADHD-self was recognising and challenging internalised beliefs and negative self-perceptions derived from stigma and stereotypes. Contact with others with ADHD emerged as an important source of psychoeducation that increased self-awareness and self-acceptance. This is consistent with other research among university students with ADHD that highlights the importance of contact with other individuals with ADHD both for reducing self-stigma and as a source of validation and encouragement (Chew et al., 2009; Ginapp et al., 2023; Godfrey-Harris & Shaw, 2023). Some participants expressed disappointment in the lack of formal support addressing this need.

Common humanity is an aspect of self-compassion defined by feeling connected to others and acknowledging shared challenges (Neff, 2003a). While participants experienced these feelings towards their peers, they also experienced intense shame regarding their ADHD and routinely concealed it to avoid judgement. Several studies have noted the tendency for individuals to mask their ADHD around others, and find it easier to be themselves with other neurodivergent people (Dangmann et al., 2024; Ginapp et al., 2022, 2023). Although self-compassion is an individual process, it is often facilitated by interactions with others, and modelling is one method through which this can be accomplished (Finlay-Jones, 2023). Overall, these findings suggest that a peer-led intervention could be most effective in this population to mitigate the propensity for shame and enable openness about mistakes and experiences of failure, which are important targets of self-compassion.

Limitations and Conclusion

While this study provides valuable insight into the self-compassion experiences of university students with ADHD, limitations should be considered. The sample may not fully represent the wider student population. Firstly, the fact that participants reported being highly motivated suggests the possibility of self-selecting bias. Students who volunteered may differ in motivation and capacity from those who did not volunteer. Secondly, participants recruited from disability services may exhibit a higher level of self-acceptance and support, potentially deviating from the experiences of students who do not register with such services. Additionally, individuals with formally diagnosed ADHD may not fully represent the full spectrum of students affected, which includes undiagnosed cases, including those with less severe symptoms or limited access to support.

Other limitations to consider when interpreting the results include the presence of comorbid conditions among some participants, adding a layer of complexity that may have impacted the results. Additionally, the age-specific focus on university students aged 18–25 (emerging adults) suggests avenues for future research, including exploring self-compassion experiences of individuals with ADHD in other developmental stages and beyond the academic context. Unique barriers and facilitators to self-compassion may also exist in different groups of emerging adults, emphasising the need for a broader exploration of this phenomenon. Future research might also evaluate the clinical utility of self-compassion interventions for mitigating the emotional distress experienced by university students with ADHD.

In summary, university students with ADHD experience a challenging journey towards graduation and can be especially hard on themselves when they encounter setbacks, compounding the emotional challenges of navigating academic life with ADHD. This study explored students’ lived experience to provide insight into the reasons they struggle to practice self-compassion. Identified barriers included a chronic sense of being ‘not good enough’, societal misconceptions concerning ADHD, and incongruous cognitive tendencies. Understanding and acceptance of the ADHD-self emerged as a key facilitator of self-compassion. These findings not only provide insights to guide the development of tailored interventions for students with ADHD but also highlight a challenge that may be common during this developmental stage: reconciling the gap between one’s ideal and actual self. Disappointments and setbacks are a natural part of adapting to new responsibilities and increased independence. Promoting self-compassion skills may help emerging adults maintain psychological well-being and a positive self-concept as they navigate the emotional demands of this transition.

Footnotes

Acknowledgments

We would like to express gratitude to the students who participated in this study.

ORCID iD

Glenda M. Farmer

Ethical Considerations

Approval was obtained from the Human Ethics Committee of the University of Western Australia (2021/ET000159). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

Consent to Participate

Informed consent was obtained from all individual participants included in the study.

Author Contributions

All authors contributed to the study conception and design. Material preparation and data analysis were performed by Glenda Farmer, with assistance from all authors. The first draft of the manuscript was written by Glenda Farmer, and all authors revised previous versions of the manuscript. All authors read and approved the final manuscript.

Funding

No funding was received to assist with the preparation of this manuscript.

Declaration of Conflicting Interests

The authors declare that they have no conflict of interest

Transparency and Openness Statement

The raw data contained in this manuscript are not openly available as participants of this study were not asked to consent for their data to be shared publicly. The list of questions and coding manual are available upon request to the corresponding author. No aspects of the study were pre-registered.

Author Biographies

Glenda Farmer is a Ph.D. candidate in the School of Psychological Science at the University of Western Australia. Her research focuses on the role of self-compassion in the mental health of university students with ADHD, with an emphasis on developing effective support strategies.

Donna Bayliss is an Associate Professor in the School of Psychological Science at the University of Western Australia. Her research focuses on the development of attention regulation and working memory and how this relates to educational achievement and developmental disorders. She also conducts research on early childhood adversity and the impact of this on development.

Associate Professor Amy Finlay-Jones is a Registered Psychologist and Head of the Early Neurodevelopment and Mental Health team at the Kids Research Institute Australia. Her interests are infant, child, and adolescent mental health and development, with a specific focus on children experiencing adversity. Her research and practice also focus on methods drawn from contemplative science, particularly self-compassion.

Jeneva Ohan is a Professor and Director of the Clinical Psychology Programs in the School of Psychological Science at the University of Western Australia. She also is an Honorary Research Fellow at the Kids Research Institute of Australia. She is a clinical psychologist in Australia and conducts research into factors that affect and support child and parent mental health and psychological wellbeing.

References

American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing. https://doi.org/10.1176/appi.books.9780890425596

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 and Adolescent Psychology, 47(2), 236–247. https://doi.org/10.1080/15374416.2015.1105137

Anastopoulos

A. D.

King

K. A.

(2015). A cognitive-behavior therapy and mentoring program for college students with ADHD. Cognitive and Behavioral Practice, 22(2), 141–151. https://doi.org/10.1016/j.cbpra.2014.01.002

Arnett

J. J.

(2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469

Attoe

D. E.

Climie

E. A.

(2023). Miss. Diagnosis: A systematic review of ADHD in adult women. Journal of Attention Disorders, 27(7), 645–657. https://doi.org/10.1177/10870547231161533

Ayers-Glassey

MacIntyre

P. D.

(2021). Investigating emotion dysregulation and the perseveration- and flow-like characteristics of ADHD hyperfocus in Canadian undergraduate students. Psychology of Consciousness: Theory, Research, and Practice, 11(2), 234–251. https://doi.org/10.1037/cns0000299

Barkley

R. A.

(1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94. https://doi.org/10.1037/0033-2909.121.1.65

Barkley

R. A.

(2010). Why emotional impulsiveness should be a central feature of ADHD. The ADHD Report, 18(4), 1–5. https://doi.org/10.1521/adhd.2010.18.4.1

Bayir

Lomas

(2016). Difficulties generating self-compassion: An interpretative phenomenological analysis. The Journal of Happiness & Well-Being, 4(1), 15–33.

10.

Beaton

D. M.

Sirois

Milne

(2020). Self-compassion and perceived criticism in adults with attention deficit hyperactivity disorder (ADHD). Mindfulness, 11(11), 2506–2518. https://doi.org/10.1007/s12671-020-01464-w

11.

Beaton

D. M.

Sirois

Milne

(2022). Experiences of criticism in adults with ADHD: A qualitative study. PLoS One, 17(2), Article e0263366. https://doi.org/10.1371/journal.pone.0263366

12.

Biskas

Sirois

F. M.

Webb

T. L.

(2023). Does psychoeducation help people to respond to goal lapses with self-compassion? Journal of Psychoeducational Assessment, 41(8), 839–851. https://doi.org/10.1177/07342829231189010

13.

Bodalski

E. A.

Abu-Ramadan

T. M.

Hough

C. E.

Lefler

E. K.

Meinzer

M. C.

Antshel

K. M.

(2023). Low standards yet disappointed: ADHD symptoms and experiential avoidance in college students. Journal of Contextual Behavioral Science, 28, 180–184. https://doi.org/10.1016/j.jcbs.2023.04.002

14.

Braun

Clarke

(2022). Thematic analysis: A practical guide. Sage Publications Ltd.

15.

Cai

R. Y.

Gibbs

Love

Robinson

Fung

Brown

(2023). “Self-compassion changed my life”: The self-compassion experiences of autistic and non-autistic adults and its relationship with mental health and psychological wellbeing. Journal of Autism and Developmental Disorders, 53(3), 1066–1081. https://doi.org/10.1007/s10803-022-05668-y

16.

Campion

Glover

(2017). A qualitative exploration of responses to self-compassion in a non-clinical sample. Health and Social Care in the Community, 25(3), 1100–1108. https://doi.org/10.1111/hsc.12408

17.

Chew

B. L.

Jensen

S. A.

Rosén

L. A.

(2009). College students’ attitudes toward their ADHD peers. Journal of Attention Disorders, 13(3), 271–276. https://doi.org/10.1177/1087054709333347

18.

Dangmann

C. R.

Skogli

G. K. W.

Holthe

M. E. G.

Steffenak

A. K. M.

Andersen

P. N.

(2024). Life gets better: Important resilience factors when growing up with ADHD. Journal of Attention Disorders, 28(8), 10870547241246645. https://doi.org/10.1177/10870547241246645

19.

DuPaul

G. J.

Gormley

M. J.

Anastopoulos

A. D.

Weyandt

L. L.

Labban

Sass

A. J.

Busch

C. Z.

Franklin

M. K.

Postler

K. B.

(2021). Academic trajectories of college students with and without ADHD: Predictors of four-year outcomes. Journal of Clinical Child and Adolescent Psychology, 50(6), 1–16. https://doi.org/10.1080%2F15374416.2020.1867990

20.

DuPaul

G. J.

Weyandt

L. L.

O’Dell

S. M.

Varejao

(2009). College students with ADHD: Current status and future directions. Journal of Attention Disorders, 13(3), 234–250. https://doi.org/10.1177/1087054709340650

21.

Eddy

L. D.

Dvorsky

M. R.

Molitor

S. J.

Bourchtein

Smith

Oddo

L. E.

Eadeh

H.-M.

Langberg

J. M.

(2018). Longitudinal evaluation of the cognitive-behavioral model of ADHD in a sample of college students with ADHD. Journal of Attention Disorders, 22(4), 323–333. https://doi.org/10.1177/1087054715616184

22.

Eddy

L. D.

Eadeh

H.-M.

Breaux

Langberg

J. M.

(2020). Prevalence and predictors of suicidal ideation, plan, and attempts, in first-year college students with ADHD. Journal of American College Health, 68(3), 313–319. https://doi.org/10.1080/07448481.2018.1549555

23.

Ewert

Vater

Schröder-Abé

(2021). Self-compassion and coping: A meta-analysis. Mindfulness, 12(5), 1063–1077. https://doi.org/10.1007/s12671-020-01563-8

24.

Faraone

S. V.

Rostain

A. L.

Blader

Busch

Childress

A. C.

Connor

D. F.

Newcorn

J. H.

(2019). Practitioner review: Emotional dysregulation in attention-deficit/hyperactivity disorder - Implications for clinical recognition and intervention. Journal of Child Psychology and Psychiatry, 60(2), 133–150. https://doi.org/10.1111/jcpp.12899

25.

Farmer

G. M.

Ohan

J. L.

Finlay-Jones

A. L.

Bayliss

D. M.

(2022). Well-being and distress in university students with ADHD traits: The mediating roles of self-compassion and emotion regulation difficulties. Mindfulness, 14(2), 448–459. https://doi.org/10.1007/s12671-022-02051-x

26.

Ferrari

Hunt

Harrysunker

Abbott

M. J.

Beath

A. P.

Einstein

D. A.

(2019). Self-compassion interventions and psychosocial outcomes: A meta-analysis of RCTs. Mindfulness, 10(8), 1455–1473. https://doi.org/10.1007/s12671-019-01134-6

27.

Finlay-Jones

(2023). A house with many doors – Toward a more nuanced self-compassion intervention science. In Finlay-Jones

Bluth

Neff

(Eds.), Handbook of self-compassion (pp. 433–454). Springer International Publishing. https://doi.org/10.1007/978-3-031-22348-8_24

28.

Fleming

A. P.

McMahon

R. J.

(2012). Developmental context and treatment principles for ADHD among college students. Clinical Child and Family Psychology Review, 15(4), 303–329. https://doi.org/10.1007/s10567-012-0121-z

29.

Frostadottir

A. D.

Dorjee

(2019). Effects of mindfulness based cognitive therapy (MBCT) and compassion focused therapy (CFT) on symptom change, mindfulness, self-compassion, and rumination in clients with depression, anxiety, and stress. Frontiers in Psychology, 10, 1099. https://doi.org/10.3389/fpsyg.2019.01099

30.

Gilbert

(2009). The compassionate mind: A new approach to life’s challenges. Constable.

31.

Ginapp

C. M.

Greenberg

N. R.

Macdonald-Gagnon

Angarita

G. A.

Bold

K. W.

Potenza

M. N.

(2023). The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study. SSM - Qualitative Research in Health, 3, Article 100223. https://doi.org/10.1016/j.ssmqr.2023.100223

32.

Ginapp

C. M.

Macdonald-Gagnon

Angarita

G. A.

Bold

K. W.

Potenza

M. N.

(2022). The lived experiences of adults with attention-deficit/hyperactivity disorder: A rapid review of qualitative evidence. Frontiers in Psychiatry, 13, 949321. https://doi.org/10.3389/fpsyt.2022.949321

33.

Godfrey-Harris

Shaw

S. C. K.

(2023). The experiences of medical students with ADHD: A phenomenological study. PLoS One, 18(8), Article e0290513. https://doi.org/10.1371/journal.pone.0290513

34.

Grønneberg

S. V.

Engebretsen

Torp Løkkeberg

(2023). When ADHD knocks on the door – Discourse theory as a frame to explore subject positions and mental wellbeing before diagnosis. International Journal of Qualitative Studies on Health and Well-Being, 18(1), Article 2209964. https://doi.org/10.1080/17482631.2023.2209964

35.

Henning

Summerfeldt

L. J.

Parker

J. D. A.

(2021). ADHD and academic success in university students: The important role of impaired attention. Journal of Attention Disorders, 26(6), 10870547211036758–10870547211036901. https://doi.org/10.1177/10870547211036758

36.

Hope

Koestner

Milyavskaya

(2014). The role of self-compassion in goal pursuit and well-being among university freshmen. Self and Identity, 13(5), 579–593. https://doi.org/10.1080/15298868.2014.889032

37.

Kirby

J. N.

Day

Sagar

(2019). The ‘Flow’ of compassion: A meta-analysis of the fears of compassion scales and psychological functioning. Clinical Psychology Review, 70, 26–39. https://doi.org/10.1016/j.cpr.2019.03.001

38.

Kwon

S. J.

Kim

Kwak

(2018). Difficulties faced by university students with self-reported symptoms of attention-deficit hyperactivity disorder: A qualitative study. Child and Adolescent Psychiatry and Mental Health, 12(1), 12–22. https://doi.org/10.1186/s13034-018-0218-3

39.

Leary

M. R.

Tate

E. B.

Adams

C. E.

Batts Allen

Hancock

(2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904. https://doi.org/10.1037/0022-3514.92.5.887

40.

Liao

K. Y.-H.

Stead

G. B.

Liao

C.-Y.

(2021). A meta-analysis of the relation between self-compassion and self-efficacy. Mindfulness, 12(8), 1878–1891. https://doi.org/10.1007/s12671-021-01626-4

41.

MacBeth

Gumley

(2012). Exploring compassion: A meta-analysis of the association between self-compassion and psychopathology. Clinical Psychology Review, 32(6), 545–552. https://doi.org/10.1016/j.cpr.2012.06.003

42.

Mayer

J. S.

Brandt

G. A.

Medda

Basten

Grimm

Reif

Freitag

C. M.

(2022). Depressive symptoms in youth with ADHD: The role of impairments in cognitive emotion regulation. European Archives of Psychiatry and Clinical Neuroscience, 272(5), 793–806. https://doi.org/10.1007/s00406-022-01382-z

43.

Michielsen

De Kruif

C. M.

Comijs

H. C.

Van Mierlo

Semeijn

E. J.

Beekman

A. T. F.

Deeg

D. J. H.

Kooij

J. J. S.

(2018). The burden of ADHD in older adults: A qualitative study. Journal of Attention Disorders, 22(6), 591–600. https://doi.org/10.1177/1087054715610001

44.

Morley

Tyrrell

(2023). Exploring female students’ experiences of ADHD and its impact on social, academic, and psychological functioning. Journal of Attention Disorders, 27(10), 1129–1155. https://doi.org/10.1177/10870547231168432

45.

Nadeau

K. G.

(2005). Career choices and workplace challenges for individuals with ADHD. Journal of Clinical Psychology, 61(5), 549–563. https://doi.org/10.1002/jclp.20119

46.

Naragon-Gainey

McMahon

T. P.

Chacko

T. P.

(2017). The structure of common emotion regulation strategies: A meta-analytic examination. Psychological Bulletin, 143(4), 384–427. https://doi.org/10.1037/bul0000093

47.

Neff

(2003a). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2(2), 85–101. https://doi.org/10.1080/15298860309032

48.

Neff

(2003b). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250. https://doi.org/10.1080/15298860309027

49.

Neff

K. D.

Hsieh

Y. P.

Dejitterat

(2005). Self-compassion, achievement goals, and coping with academic failure. Self and Identity, 4(3), 263–287. https://doi.org/10.1080/13576500444000317

50.

Ortiz

Goold

Zhang

J. W.

(2023). Self-compassion, personal improvement, and motivation. In Finlay-Jones

Bluth

Neff

(Eds.), Handbook of self-compassion (pp. 201–211). Springer International Publishing. https://doi.org/10.1007/978-3-031-22348-8_12

51.

Ramsay

J. R.

Rostain

A. L.

(2016). Adult attention-deficit/hyperactivity disorder as an implementation problem: Clinical significance, underlying mechanisms, and psychosocial treatment. Practice Innovations, 1(1), 36–52. https://doi.org/10.1037/pri0000016

52.

Safren

S. A.

Sprich

Chulvick

Otto

M. W.

(2004). Psychosocial treatments for adults with attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America, 27(2), 349–360. https://doi.org/10.1016/S0193-953X(03)00089-3

53.

Sirois

F. M.

(2014). Procrastination and stress: Exploring the role of self-compassion. Self and Identity, 13(2), 128–145. https://doi.org/10.1080/15298868.2013.763404

54.

Smeets

Neff

Alberts

Peters

(2014). Meeting suffering with kindness: Effects of a brief self-compassion intervention for female college students. Journal of Clinical Psychology, 70(9), 794–807. https://doi.org/10.1002/jclp.22076

55.

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

56.

Vasko

J. M.

Oddo

L. E.

Meinzer

M. C.

Garner

Chronis-Tuscano

(2020). Psychosocial interventions for college students with ADHD: Current status and future directions. The ADHD Report, 28(4), 5–12. https://doi.org/10.1521/adhd.2020.28.4.5

57.

Weyandt

L. L.

DuPaul

G. J.

(2008). ADHD in college students: Developmental findings. Developmental Disabilities Research Reviews, 14(4), 311–319. https://doi.org/10.1002/ddrr.38

58.

Willoughby

Evans

M. A.

(2019). Self-processes of acceptance, compassion, and regulation of learning in university students with learning disabilities and/or ADHD. Learning Disabilities Research & Practice, 34(4), 175–184. https://doi.org/10.1111/ldrp.12209

59.

Woltering

Liu

Rokeach

Tannock

(2013). Neurophysiological differences in inhibitory control between adults with ADHD and their peers. Neuropsychologia, 51(10), 1888–1895. https://doi.org/10.1016/j.neuropsychologia.2013.06.023

60.

Young

Bramham

Gray

Rose

(2008). The experience of receiving a diagnosis and treatment of ADHD in adulthood: A qualitative study of clinically referred patients using interpretative phenomenological analysis. Journal of Attention Disorders, 11(4), 493–503. https://doi.org/10.1177/1087054707305172

61.

Zessin

Dickhäuser

Garbade

(2015). The relationship between self-compassion and well-being: A meta-analysis. Applied Psychology: Health and Well-Being, 7(3), 340–364. https://doi.org/10.1111/aphw.12051