Is it ADHD or Autism? (Or Both)
Autism and ADHD Overlap
Taking on ADHD and Autism has felt like the most daunting diagram to create out of the #misdiagnosismonday series. I think this feels harder to tease out because I struggle to tease it out in my own mind! Writing it out into neat categories for an article is one thing—but experiencing it in my own brain is quite different.
Is my desk always a mess because of my executive functioning struggles associated with Autism or ADHD? Is the reason my email inbox says 1967 unread emails (most of them spam, but probably some important ones hidden in there) because of ADHD or Autism? Is my impulsivity, failure to close drawers, constant restlessness, tendency to interrupt people or the fact that I’m always looking for my keys, phone, and credit cards my Autism or ADHD?
Even with psychological training, when it comes to my lived experience, I struggle to tease out what is what. I believe this speaks to the complexity and messiness that is Autism-ADHD. It turns out that in my state of confusion, I am in good company. The research points to the fact this is incredibly convoluted and difficult to clinically distinguish between the two.
Overview of Autism and ADHD
There is a lot of overlap between ADHD and Autism. But where Autism is marked by difficulties with neurotypical social interaction and communication plus a tendency to self-regulate through repetition and routine (i.e. special interests, stimming, need for specific rituals). ADHD is marked by difficulty regulating attention and with hyperactivity/impulsivity.
Both occur at high rates in the general population with Autism considered the fastest-growing developmental condition with prevalence rates around 2.8% in children 3-17 (National Survey of Children’s Health). Where ADHD is estimated at 5-11% (Allely, 2014; Visser et al., 2014).
Contents:
Co-Occurring ADHD and Autism: Understanding the Genetics
The understanding of overlap of ADHD and Autism is relatively new. Until recently, if someone with traits of both conditions came in for an assessment, the clinician had to choose which diagnosis fit best. Until the DSM-5 came out in 2013, if a diagnosis of Autism or Asperger was made it took the place of a diagnosis of ADHD (Taurines et al., 2012.) Thankfully this was updated in the DSM-5-- both conditions can now be diagnosed in the same person. So, in the history of things, considering the ADHD/Autism overlap is relatively new!
Research has shown an overlap between ADHD and Autism Sokolova et al., 2017. An estimate of between 22-83% of Autistic children could now also be diagnosed with ADHD. On top of that approximately 30-65% of ADHDer children have significant autistic traits. Lastly, twin and family studies show a genetic overlap between ADHD and Autism of 50-72% (Sokolova et al., 2017).
While it is really common for the two to occur together. It is also common to see more ADHD traits within Autistics and more Autistic traits for the ADHDer. The person might not meet diagnostic criteria for both but still have more of the traits than a neurotypical person. I suspect that “pure ADHD” or “pure Autism” is the exception, not the norm.
Genetic Overlap
Out of the many hypotheses around this common co-occurrence. Leitner et al., 2014 hypothesize they share a common genetic cause.
Their theory is held up by twin studies, showing approximately a 50-72% overlap, which suggests a substantial genetic overlap. This theory suggests genetics is the reason that ADHD/Autism co-occurs within individuals and families at such high rates (Leitner et al., 2014; Rommelse et al., 2010).
The research also points to a strong neurobiological overlap, this means that there are similarities in the way ADHD and Autistic brains biologically function. Sokolova et al., 2017 suggests biological pathways in attentional control or inattention and task-switching may be a key factor in understanding the genetic similarities between the two.
ADHD and Autistic Trait Overlap
Both ADHD and Autism are classified as Neurodevelopmental conditions and impact how the brain processes sensory input and cognitive information. They also impact executive functioning, attention processes, and sensory processing. Here are some of the places that the traits overlap.
Executive Functioning Differences
Executive functioning challenges is a core feature of ADHD and is also common among Autistic people. These challenges may include difficulty organizing tasks, object permanence, memory, focus, decision-making, shifting attention, and regulating attention.
Social Differences
Both ADHDers and Autistic people struggle to fit in socially with neurotypical peers and systems, but often for different reasons. For ADHDers, this is related to challenges with regulating attention and impulsivity. For example, we might miss social cues due to inattention, such as not noticing when the other person is bored, or we may struggle to resist the impulse to finish their sentence.
For Autistic people, social difficulties often stem from differences in intuitively picking up on social cues, body language, understanding pretense, and challenges with task switching (since social communication involves considering multiple tasks at one time). For instance, we might find it hard to switch topics when the person we’re talking to does.
Both groups also have distinct ways of connecting, such as through discussions about specific objects or interests and skipping small talk. ADHDers and Autistic people tend to do better in conversations focused on topics of interest, where there is space for divergent processing—allowing for associative leaps and creative thinking.
Interoception Issues
Interoception, often referred to as the “8th sensory system,” is the ability to sense internal signals. This includes signals associated with elimination, hunger, thirst, and emotions. Interoceptive awareness is integral to self-care and emotional regulation because if we struggle to identify emotions or what our body needs, it is more difficult to address those needs until they become urgent.
A person with less sensitive interoceptive awareness will have difficulty registering and responding flexibly to their internal states and emotions. Research among ADHDers is mixed; some studies suggest varying levels of interoceptive sensitivity. However, overall, research indicates that both ADHDers and Autistic individuals often have less accurate interoceptive awareness compared to the general public.
To read more about interoception issues and neurodivergence, you can see my full article on it here.
Time Perception
Partially due to interoception differences, ADHDers and Autistic individuals often have an altered perception of time, sometimes referred to as “time blindness” or the more appropriate “time agnosia” (Carmelo et al., 2020).*
Sensory Differences
Sensory differences are very common in both ADHD and Autism and relate to how the brain processes sensory information. Each individual experiences sensory input differently. One person may be sensory sensitive, while another may seek out sensory input.
Sometimes, a person may vacillate between these two extremes or be sensory seeking in one area (like taste and smell) and sensory avoidant in another (like touch and visual). To learn more about the different sensory processing systems, you can check out this article on the eight primary sensory systems.
Hyperactivity/Receiving Comfort from Repetition (stimming)
Using stimming or repetitive movement to self-regulate is common among both Autistic people and ADHDers. Stimming involves repetitive motor movements and is used to regulate sensory input, while fidgeting is a way of releasing excessive energy. Although stimming is common in both groups, it is more prevalent among Autistic people. Additionally, ADHD fidgeting can often resemble the stimming seen in Autism.
Monotropism, Special Interests and Passions
Hyper-fixation and hyper-focus, particularly around our passions and special interests, are common among both ADHDers and Autistic people. Hyperfocus, as seen in the context of ADHD, can look a lot like hyper-fixation. ADHD passions can resemble Autistic special interests.
This tendency to become pulled into what I call "the vortex" is similar for both Autistic and ADHD people. While ADHDers have an interest-based nervous system, Autistic people have a monotropic brain, which can look similar but also has some distinct differences. Monotropism refers to the natural tendency to have a deep, singular focus on a limited range of interests at any given time, allowing for intense and immersive engagement. For ADHDers, an interest-based nervous system means our attention becomes more intense when working on an area of passion, interest, novelty, and urgency.
Emotional Regulation
Several factors contribute to the challenges ADHDers and Autistic individuals face in regulating and soothing intense emotions. These include differences in brain circuitry (such as more sensitive amygdalas), interoception differences, more rigid nervous systems, and sensory processing issues. All these elements make it more likely for both ADHDers and Autistic people to struggle with managing their emotional responses.
Nervous System Sensitivity
ADHDers and Autistic people both have distinct nervous systems that tend to be more sensitive and less flexible. This contributes to difficulties in regulating emotions, more easily flipping into stressed states, and a higher likelihood of developing certain medical conditions. As a result, we often have to be more thoughtful about our nervous system self-care. You can learn more by reading this article on the ADHD and Autistic nervous system: Neurodivergent Insights - Autistic and ADHD Nervous System.
Rejection Sensitive Dysphoria
Rejection Sensitive Dysphoria (RSD) refers to the tendency to experience extreme emotions surrounding perceived rejection, criticism, and possible failure. It is common among both ADHDers and Autistic people. While the term Rejection Sensitive Dysphoria is specific to ADHD literature, heightened sensitivity to rejection is common to both groups. This sensitivity likely arises from a complex interplay of factors, including experiencing negative feedback, social victimization, navigating neurotypical society, and having sensitive nervous systems.
Shared Psycho-Social Risks
In addition to sharing brain circuitry and traits, ADHDers and Autistic individuals also face shared psycho-social risks and similar experiences.
Addiction
Addiction is common among both ADHDers and Autistic people and may be related to a tendency to self-medicate, self-soothe overactive nervous systems, regulate sensory experiences, or as a result of co-occurring depression or anxiety.
For ADHDers, there is a strong link between ADHD and substance abuse, including alcoholism. Among adult alcoholics, ADHD is estimated to be 5-10 times more common than among neurotypicals. Among adults treated for alcohol and substance abuse, the rate of ADHD is 25% (WebMD). One study found that approximately 25% of adults and 30% of teens in treatment for alcohol disorder have ADHD, compared to 2-5% of adults in the general population (Smith et al., 2002)
While it was once thought that addiction was low among Autistic people, this appears not to be the case when looking at those without an intellectual disability. A recent study in Sweden found that Autistic individuals with average to high IQs were twice as likely to struggle with addiction to either alcohol or other drugs (Butwicka, 2017). Drugs are often used by Autistic people to cope with social stress and sensory sensitivities (Szalavitz). Additionally, Autistics have a higher prevalence of impulsivity-related addictions, including shopping, gambling, and internet gaming (Szalavitz).
Co-occurring Mental Health Conditions
ADHD and Autism rarely walk alone. Both ADHDers and Autistic individuals have a higher risk of mood conditions like depression, anxiety, bipolar, OCD and PTSD. According to Lever and Geurts, 79% of Autistics met the criteria for a psychiatric condition at least once in their life. Similarly, children with ADHD make up 50% of those receiving psychiatric treatment (Smith et al., 2002).
Mood Disorders
In adults, depression co-occurs with ADHD in 9-50% of cases (McIntosh et al., 2009). The number of adults with ADHD seeking outpatient psychiatric care is 8.5% for men and 21.6% for women, despite only comprising 4.4% of the adult population (Almeida et al., 2007). Bipolar disorder is also common among both Autistic and ADHD populations. While precise overlap is difficult to determine, you can read more about ADHD and Bipolar here and Autism and Bipolar here.
OCD
Both ADHDers and Autistic individuals have significantly higher rates of Obsessive-Compulsive Disorder (OCD). Research indicates similar neural circuitry differences are involved in all three conditions.
An estimate for the rate of OCD among ADHDers is around 30% and conversely about 25% of people with OCD are estimated to also be an ADHDer (Geller et al., 2002, Walitza et al., 2008).
There is also speculation that a larger proportion of people with OCD may also be Autistic. A population-based study in Denmark found familial links between OCD and Autism. They found that people diagnosed with Autism were 2x as likely to be diagnosed with OCD later in life. And people diagnosed with OCD were 4x more likely to be diagnosed with Autism later in life (Meier et al., 2015).
Self-Harm and Suicidality
Self-harm behavior and suicidality are alarmingly high among both ADHDers and Autistic people. The risk is likely amplified among those with other marginalized identities. Self-harm may be an attempt to regulate sensory load or manage difficult emotions.
For girls with ADHD, self-harm rates are particularly concerning. Girls often internalize many of their ADHD symptoms, which can lead to higher rates of self-harm. The risk of self-harm behavior is highest among those with ADHD combined type. Studies by Allely (2014) and Hinshaw et al. (2012) found that self-harm behavior occurred at a rate of 69% among adolescents with ADHD, compared to 32% among non-ADHD adolescents. Self-harm is also noted to be more common among Autistic girls and Autistic people who are genderqueer (Dudas et al., 2017).
Regarding ADHD and suicidal behaviors, previous research has shown a significant connection between the two for both men and women (Allely, 2014). Hurtig et al. (2012) found that adolescents with ADHD experience more suicidal ideation (57%) than non-ADHD adolescents (28%).
When it comes to Autistics rates were just as high, a longitudinal study found that they were three times more likely to attempt or die by suicide than neurotypicals. This was more elevated among women and those with co-occurring anxiety and depression (South et al.).
Eating Disorders
Both ADHDers and Autistics are more likely to struggle with eating disorders. For Autistics, anorexia appears to be more common than bulimia, while both conditions are approximately equal among ADHDers (Bleck et al., 2015). The rates of eating disorders in girls with ADHD are significantly higher than in the neurotypical population, with 4.2% of girls with ADHD affected compared to 2% of non-ADHD girls, making them 2.8 times more likely to have an eating disorder (Bleck et al., 2015).
While rates vary, researchers agree that approximately 23% of people diagnosed with anorexia nervosa are also Autistic. However, this is likely an underrepresentation due to the fact that Autism is often undiagnosed in women (Westwood and Tchanturia).
Many Autistic and ADHD individuals also experience Avoidant/Restrictive Food Intake Disorder (ARFID), which is commonly misdiagnosed as anorexia or other eating disorders.
Victimization
Both ADHDers and Autistic individuals experience high rates of peer victimization, with even higher rates among those with additional marginalized identities.
ADHD and Victimization
Humphrey et al. (2007) found a correlation between ADHD and peer victimization. Additionally, Wiener and Mak (2009) discovered that victimization rates are exceptionally high for girls with ADHD. ADHD traits, particularly hyperactivity-impulsivity, are also correlated with an increased risk of peer victimization (Papadopoulos et al., 2021).
Autism and Victimization
Research has shown that Autistic women and genderqueer individuals are more likely to be survivors of violent victimization. Risk factors include a tendency to be overly trusting and naive, missing when people are attempting to manipulate them, and a tendency to take things literally. One study indicated that Autistic adults were 7.3 times more likely to report having experienced sexual assault from a peer as a teen (Weiss and Fardella).
Shared Social Identities
Gender and Sexual Diversity
ADHDers and Autistic individuals often share diverse gender and sexual identities, experiencing higher rates of genderqueerness and non-heterosexual orientations compared to neurotypicals.
Gender Diversity
Autistics and ADHDers are more likely than neurotypicals to be genderqueer, and genderqueer people are more likely to be an ADHDer or Autistic than cisgender people. Trans people are 3-6 times more likely to be Autistic (Warrier et al., 2020). One study found that genderqueerness was was significantly more common among Autistics (7.59 times) and ADHDers (6.64 times) compared to the general population (Strang et al. 2014).
Sexual Diversity
Similar rates apply to sexual identity. Autistics are more likely to non-heterosexual than the general population (Sarris). The prevalence of LGB identities is 2 to 3 times higher among Autistics, with Autistic men being more likely to be heterosexual than Autistic women (Dewinter et al., 2017;George and Stokes, 2018). Another study found that ADHDers were more likely to identify as non-heterosexual than non-ADHDers (Barkley et al., 2008).
Neurominiority
Both groups have similar experiences as they navigate the world as neurominorities. This means that the systems they navigate, such as school, work, and healthcare, are not built with them in mind, and they often experience various barriers in accessing these systems. These experiences as neurominorities contribute to stress and can be compounded by other intersecting identities the person has.
Is It Autism or ADHD? How to Spot the Difference
Given the overlap and possibility that the person has both ADHD and Autistic traits, it can be difficult pick out which is which. Here are some considerations to take into account when diagnosing a suspected ADHD/Autistic client.
For a more in depth overview of this information, consider checking out our Autism vs. ADHD E-book.
Social Differences
To differentiate Criteria A of Autism (social difficulties), it’s essential to understand the nature of these difficulties, as the social challenges in both conditions can appear similar. Here are some things to consider:
Underlying Mechanisms:
ADHD: Difficulty socializing is often connected to impulsivity and inattention (Sokolova et al., 2017). ADHDers can read social cues when they are able to focus.
Autism: Social challenges are linked to difficulty interpreting allistic social cues. Autistic individuals often have inherent difficulty with this, relying more on their prefrontal cortex and analytical skills to navigate social interactions.
Key Questions to Ask:
Is the difficulty in socializing due to trouble focusing, or is the person relying on analytical skills to interpret social cues?
If you’re unsure, consider administering the Camouflaging Autistic Traits Questionnaire (CAT-Q) and be sure to ask about masking.
Social Motivation:
On average, ADHDers tend to have more social motivation than Autistic individuals.
Assess How the Person Navigates Disruptions to Routine
Many of the items in Criteria B for Autism can resemble ADHD traits, such as sensory sensitivities, special interests (which can look like hyper-fixation), and repetitive movements (which can look like hyperactivity). One key factor distinguishing Autism from ADHD is how the person adapts to change (Criteria B, item 2).
To understand this better, consider observing how an individual copes with unexpected alterations to their routine. It’s essential to differentiate between self-initiated changes (where the individual decides to modify their own routine) versus externally imposed changes (those that are unexpected or forced upon them).
For Autistic people, unanticipated alterations stemming from external sources often lead to intense emotional responses, including heightened irritability, anxiety, and stress. Therefore, gauging a person’s response to disruptions can provide valuable insight into their unique neurodivergent profile.
Repetitive Behaviors vs. Hyperactive
Repetitive behaviors can sometimes be mistaken for hyperactivity. Differentiating between the two requires an understanding of the underlying function and the individual's internal experience (Sokolova et al., 2017).
Understanding the Differences
Repetitive Behaviors (Autism):
Function: Often serve as a way to self-soothe, regulate sensory input, or cope with anxiety.
Examples: Hand flapping, rocking, swaying, pacing, spinning objects, or repeating phrases.
Internal Experience: These behaviors provide comfort and a sense of control, especially in overwhelming or unfamiliar situations. They are typically consistent and predictable.
Hyperactivity (ADHD):
Function: Often a manifestation of an overactive nervous system, an inability to stay still, or the need to release excess energy.
Examples: Fidgeting, tapping, running around, or interrupting conversations.
Internal Experience: These behaviors are driven by a need for stimulation and are usually more impulsive and less predictable.
Key Questions to Ask
Purpose of the Behavior:
Does the behavior seem to help the individual calm down and focus (more indicative of repetitive behaviors)?
Or does it seem to be a spontaneous, uncontrolled release of energy (more indicative of hyperactivity)?
Context of the Behavior:
Does the behavior occur in response to specific triggers, such as stress or sensory overload (repetitive behaviors)?
Or does it happen more consistently across various situations without clear triggers (hyperactivity)?
Duration and Consistency:
Are the behaviors more consistent and ritualistic, happening in a specific and repetitive manner (repetitive behaviors)?
Or are they more sporadic and variable, often changing in form and frequency (hyperactivity)?
Interview Tips
Ask Direct Questions: Inquire about the individual's experience and the reasons behind their behaviors. For example, "Do you find that doing this helps you feel calmer?" or "Do you do this because you feel like you have too much energy?"
By understanding the subjective experience and underlying motivation, you can better distinguish between repetitive behaviors and hyperactivity.
Rule out ADHD and Autism
When conducting assessments for either ADHD or Autism, it is essential to include routine screeners for both conditions. Surprisingly, Autism screeners are often overlooked in ADHD assessments, despite the substantial overlap between Autism and ADHD. In my assessments for ADHD, I always include:
Autism-Spectrum Quotient (AQ)
Ritvo Autism Asperger Diagnostic Scale (RAADS)
Camouflaging Autistic Traits Questionnaire (CAT-Q)
These tools help capture a comprehensive picture. Incorporating routine screeners for both conditions into your practice ensures a thorough evaluation, allowing you to effectively identify and address the presence of Autistic traits in individuals with ADHD.
Similarly, when conducting an Autism assessment, routinely including ADHD screeners like the Adult ADHD Self-Report Scale (ASRS-5) ensures that both conditions are being considered.
ADHD and Autism Screeners
Autism Screeners
To learn more about these screeners and to access them in one place, check out this roundup of autism screeners. Here are the ones I regularly include:
Autism Spectrum Quotient (AQ): A measure of the degree to which an adult with normal intelligence has the traits associated with the autism.
Aspie Quiz: A self-assessment tool designed to identify autistic traits.
Alexithymia Questionnaire: Although not technically an autism screener, this questionnaire assesses alexithymia, which is common among Autistics.
Ritvo Autism Asperger Diagnostic Scale-Revised (RAADS-R): A self-report questionnaire designed to identify adult Autistics who may "escape diagnosis" due to a subclinical level presentation.
Adult Repetitive Behaviors Questionnaire-2 (RBQ-2A): A self-administered questionnaire that measures restricted and repetitive behaviors in adults.
Camouflaging Autistic Traits Questionnaire (CAT-Q): A self-report measure of social camouflaging behaviors in adults. It may be used to identify Autistic individuals who do not currently meet diagnostic criteria due to their ability to mask their autistic traits.
ADHD Screeners
To learn more about these screeners and to access them in one place, check out this roundup of ADHD screeners. Here are ones I regularly include.
There are fewer online options for routine ADHD screeners. However, the ASRS or Wender Utah can provide a data point/sense of whether further evaluation is warranted.
Future Learning
If you’ve read this far, you’re likely either an adult exploring the possibility of Autism, ADHD, or both, or a clinician looking to expand your knowledge. If so, welcome to my digital ecosystem. Understanding Autism, ADHD, and non-stereotypical presentations, as well as neurodivergent wellness, is a special interest of mine. If you’re beginning your journey, it can be hard to know where to dive in. Here are some resources for future learning.
Stay in the Neurodivergent Loop
First, let me give a shameless plug for the Neurodivergent Insights Newsletter. Each Sunday, I send out fresh thoughts and a roundup of the newest resources. My most personal writing is for my newsletter, and since burning out on social media, I focus more on email connections. You also receive access to the newsletter vault (12+ PDFs) when you join.
Books
For Assessment
For clinicians working with ADHD/Autism you can check out my book recommendations for Neurodivergent Clinicians.
For Neurodivergent Adults
Autism Reads:
ADHD Focused
Podcasts
Divergent Conversations (I co-host this podcast with a fellow auDHD mental health therapist)
*Footnote: Interoception and ADHD have more mixed results: Kutscheidt et al. found impairment of interoception among ADHDers, Wiersema and Grodefroid, 2016 found interoception remained intact in the context of ADHD)
*The Blind community has requested that the ADHD community refrain from using the term “time blindness.” Some suggested alternatives include: time agnosia or time perception challenges
Citations
Almeida Montes, L. G., Hernández García, A. O., & Ricardo-Garcell, J. (2007). ADHD Prevalence Adult Outpatients With Nonpsychotic Psychiatric Illnesses. Journal of Attention Disorders, 11(2), 150–156. https://doi.org/10.1177/1087054707304428
Barkley, R. A., Murphy, K., & Fischer, M. (2008). ADHD in adults: What the science says. New York, NY: Guilford Press.
Biederman, J.; Ball, S.W.; Monuteaux, M.C.; Surman, C.B. MD; Johnson, J.L; Zeitlin, S (2007). Are Girls with ADHD at Risk for Eating Disorders? Results from a Controlled, Five-Year Prospective Study. Journal of Developmental & Behavioral Pediatrics. 28(4). https://doi.org/10.1097/DBP.0b013e3180327917
Bleck, J.R., DeBate, R.D. & Olivardia, R. The Comorbidity of ADHD and Eating Disorders in a Nationally Representative Sample. J Behav Health Serv Res 42, 437–451 (2015). https://doi.org/10.1007/s11414-014-9422-y
Butwicka, A., Långström, N., Larsson, H. et al. Increased Risk for Substance Use-Related Problems in Autism Spectrum Disorders: A Population-Based Cohort Study. J Autism Dev Disord 47, 80–89 (2017). https://doi.org/10.1007/s10803-016-2914-2
Dewinter, J., De Graaf, H., & Begeer, S. (2017). Sexual Orientation, Gender Identity, and Romantic Relationships in Adolescents and Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders, 47(9), 2927–2934. https://doi.org/10.1007/s10803-017-3199-9
Dudas, R. B., Lovejoy, C., Cassidy, S., Allison, C., Smith, P., & Baron-Cohen, S. (2017). The overlap between autistic spectrum conditions and borderline personality disorder. PloS one, 12(9), e0184447. https://doi.org/10.1371/journal.pone.0184447
Geller, D. A. et al (2002). Attention-deficit/hyperactivity disorder in children and adolescents with obsessive compulsive disorder: Fact or artifact?. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 52-58. DOI: https://pubmed.ncbi.nlm.nih.gov/11800207/
George, R., & Stokes, M. A. (2018). Gender identity and sexual orientation in autism spectrum disorder. Autism : the international journal of research and practice, 22(8), 970–982. https://doi.org/10.1177/1362361317714587
Hinshaw SP, Owens EB, Zalecki C, Huggins SP, Montenegro-Nevado AJ, Schrodek E, Swanson EN: Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. J Consult Clin Psychol. 2012, 80: 1041-1051.
Humphrey JL, Storch EA, Geffken GR. Peer victimization in children with attention-deficit hyperactivity disorder. J Child Health Care. 2007 Sep;11(3):248-60. doi: 10.1177/1367493507079571. PMID: 17709359.
Hurtig T, Taanila A, Moilanen I, Nordström T, Ebeling H: Suicidal and self-harm behaviour associated with adolescent attention deficit hyperactivity disorder-A study in the Northern Finland Birth Cohort 1986. Nord J Psychiat. 2012, 66: 320-328. 10.3109/08039488.2011.644806.
Kutscheidt, K., Dresler, T., Hudak, J. et al. Interoceptive awareness in patients with attention-deficit/hyperactivity disorder (ADHD). ADHD Atten Def Hyp Disord 11, 395–401 (2019). https://doi.org/10.1007/s12402-019-00299-3
Leitner Y. (2014). The co-occurrence of autism and attention deficit hyperactivity disorder in children - what do we know?. Frontiers in human neuroscience, 8, 268. https://doi.org/10.3389/fnhum.2014.00268
Lever, A. G., & Geurts, H. M. (2016). Psychiatric Co-occurring Symptoms and Disorders in Young, Middle-Aged, and Older Adults with Autism Spectrum Disorder. Journal of autism and developmental disorders, 46(6), 1916–1930. https://doi.org/10.1007/s10803-016-2722-8
McIntosh, D., Kutcher, S., Binder, C., Levitt, A., Fallu, A., & Rosenbluth, M. (2009). Adult ADHD and comorbid depression: A consensus-derived diagnostic algorithm for ADHD. Neuropsychiatric disease and treatment, 5, 137–150. https://doi.org/10.2147/ndt.s4720
Papadopoulos, A., Seguin, D., Correa, S. et al. Peer victimization and the association with hippocampal development and working memory in children with ADHD and typically-developing children. Sci Rep 11, 16411 (2021). https://doi.org/10.1038/s41598-021-95582-7
Rommelse, N. N., Franke, B., Geurts, H. M., Hartman, C. A., & Buitelaar, J. K. (2010). Shared heritability of attention-deficit/hyperactivity disorder and autism spectrum disorder. European child & adolescent psychiatry, 19(3), 281–295. https://doi.org/10.1007/s00787-010-0092-x
Sokolova, E. ., Sluiter-Oerlemans, A. ., Rommelse, N. N. ., Groot, P., Hartman, C. ., Glennon, J. ., Claassen, T., Heskes, T., & Buitelaar, J. . (2017). A Causal and Mediation Analysis of the Comorbidity Between Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Journal of Autism and Developmental Disorders, 47(6), 1595–1604. https://doi.org/10.1007/s10803-017-3083-7
South M, Costa AP, McMorris C. Death by Suicide Among People With Autism: Beyond Zebrafish. JAMA Netw Open. 2021;4(1):e2034018. doi:10.1001/jamanetworkopen.2020.34018
Springer Science+Business Media. "Wishing to be another gender: Links to ADHD, autism spectrum disorders." ScienceDaily. ScienceDaily, 12 March 2014. <www.sciencedaily.com/releases/2014/03/140312103102.htm>.
Smith, B. H., Molina, B., & Pelham, W. E., Jr. (2002). The Clinically Meaningful Link Between Alcohol Use and Attention Deficit Hyperactivity Disorder. Alcohol Research & Health, 26(2), 122–129.
Strang, J. F. et al. Increased gender variance in autism spectrum disorders and attention deficit hyperactivity disorder. Arch. Sex. Behav.43, 1525–1533 (2014). DOI: https://pubmed.ncbi.nlm.nih.gov/24619651/
Szalavitz, Maia (2017). Autism’s hidden habit. Spectrum Deep Dive. Retrieved at: https://www.spectrumnews.org/features/deep-dive/autisms-hidden-habit/
Taurines, R., Schwenck, C., Westerwald, E. et al. ADHD and autism: differential diagnosis or overlapping traits? A selective review. ADHD Atten Def Hyp Disord 4, 115–139 (2012). https://doi.org/10.1007/s12402-012-0086-2
Walitza S, Zellmann H, Irblich B, Lange KW, Tucha O, Hemminger U, et al. Children and adolescents with obsessive–compulsive disorder and comorbid attention-deficit/hyperactivity disorder: preliminary results of a prospective follow-up study. J Neural Transm (2008) 115(2):187–90. doi: 10.1007/s00702-007-0841-2
Watson, Stephanie. 2020 ADHD and Substance Abuse. Medically Reviewed by Smitha Bhandari, MD. WebMD. Retrieved from https://www.webmd.com/add-adhd/adhd-and-substance-abuse-is-there-a-link
Wiener, J. and Mak, M. (2009), Peer victimization in children with Attention-Deficit/Hyperactivity Disorder. Psychol. Schs., 46: 116-131. https://doi.org/10.1002/pits.20358
Wiersema JR, Godefroid E (2018) Interoceptive awareness in attention deficit hyperactivity disorder. PLoS ONE 13(10): e0205221. https://doi.org/10.1371/journal. pone.0205221
Westwood, H., Tchanturia, K. Autism Spectrum Disorder in Anorexia Nervosa: An Updated Literature Review. Curr Psychiatry Rep 19, 41 (2017). https://doi.org/10.1007/s11920-017-0791-9
Vicario, C. M., Nitsche, M. A., Salehinejad, M. A., Avanzino, L., & Martino, G. (2020). Time processing, interoception, and insula activation: a mini-review on clinical disorders. Frontiers in Psychology, 11, 1893.
DOI: https://doi.org/10.3389/fpsyg.2020.01893
Visser SN, Danielson ML, Bitsko RH, et al. Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003–2011. Journal of the American Academy of Child & Adolescent Psychiatry. 2014;53(1):34–46. e32.
Older Versions Of The Venn Diagram