Advancing understanding of athletes' experiences of ADHD in sport

The prevalence of attention deficit hyperactivity disorder (ADHD) in UK adults is approximately 3-4%, (1) with adult ADHD diagnosis rising in recent years. (2) Research suggests that ADHD could be more common in athletes than the general population. Furthermore, it is suggested suggests that ADHD symptoms may contribute to enhanced sport performance (e.g., the ability to "hyperfocus" in sport). (3)

Exercise is recommended for the management of ADHD symptoms by the National Institute for Health and Care Excellence (NICE). (4) There are cognitive, behavioural, and physical benefits of exercising for those with ADHD. (5) However, some ADHD symptoms may provide challenges for engaging in sport such as sensitivity to criticism and difficulty following instructions. (6)

Despite the co-benefits of exercise and ADHD, research and recommendations have overlooked, and are not clearly informed by, athletes with ADHD. (7) This lack of evidence and resources means that few guidelines exist on how to support individuals with ADHD in sport. Sport has a responsibility to meet the psychological needs of all athletes and provide them with a safe environment to train and compete in.

This mixed-methods project will systematically investigate ADHD in adult athletes and explore their experiences of sport and seeking help for their mental health and ADHD. To ensure that the research will hold relevance to those that it affects, public and patient involvement (PPI) will be embedded throughout with stakeholders already connected with in preparing this proposal. This will include the collaborators already involved in this PhD, who are representatives from the EIS (English Institute of Sport) and ECB (England Cricket Board). This PPI group will inform the specific research questions and the interview guide for the qualitative studies, and inform dissemination of the research findings.

The aims of this PhD are to:
1) Review the current academic literature on ADHD and athletes'
2) Understand the prevalence of ADHD and other mental health conditions in athletes'
3) Seek to understand ADHD athletes' experiences of sport
4) Understand stakeholders (e.g., coaches) understanding of ADHD
5) Develop recommendations on how to improve the sport for environment for those with ADHD
Given the lack of evidence and guidelines, this PhD will contribute to improving understanding, reducing stigma, and improving the sport environment for athletes with ADHD.

1.National Institute for Health and Care Excellence. NICE. 2022 [cited 2023 Jan 12]. Attention deficit hyperactivity disorder: How common is it? Available from: https://cks.nice.org.uk/topics/attention-deficit-hyperactivity-disorder/background-information/prevalence/
2.ADDitude. ADHD symptoms exposed: diagnoses spike during pandemic. ADDitude: Inside the ADHD mind [Internet]. 2022 Jul 25 [cited 2023 Jan 12]; Available from: https://www.additudemag.com/adhd-symptoms-diagnosed-treated-in-pandemic/
3.Ekman E, Hiltunen A, Gustafsson H. Do athletes have more of a cognitive profile with ADHD criteria than non-athletes? Sports Basel. 2021 May 11;9(5):61.
4.National Institute for Health and Care Excellence. NICE. NICE; 2019 [cited 2023 Jan 13]. Attention deficit hyperactivity disorder: diagnosis and management. Available from: https://www.nice.org.uk/guidance/ng87/chapter/Recommendations#managing-adhd
5.Ng QX, Ho CYX, Chan HW, Yong BZJ, Yeo WS. Managing childhood and adolescent attention-deficit/hyperactivity disorder (ADHD) with exercise: A systematic review. Complement Ther Med. 2017 Oct 1;34:123-8.
6.Goldrich C. PTS Coaching. 2019 [cited 2021 Oct 18]. Helping kids with ADHD thrive in sports. Available from: https://ptscoaching.com/2019/09/helping-kids-with-adhd-thrive-in-sports/
7.Moesch K, Kenttä G, Kleinert J, Quignon-Fleuret C, Cecil S, Bertollo M. FEPSAC position statement: Mental health disorders in elite athletes and models of service provision Psychol Sport Exerc 2018 Sep1 38:61-71