Thriving at work with ADHD: antecedents and outcomes of proactive disclosure

• DOI: https://doi.org/10.1108/EDI-02-2022-0033
• Published date: 15 September 2022
• Date: 15 September 2022
• Pages: 228-247
• Subject Matter: HR & organizational behaviour,Employment law,Diversity,equality,inclusion
• Author: Cheryl K. McIntosh,Shelia A. Hyde,Myrtle P. Bell,Paul E. Yeatts

Thriving at work with ADHD:

antecedents and outcomes of

proactive disclosure

Cheryl K. McIntosh

Craig School of Business, Missouri Western State University,

Saint Joseph, Missouri, USA

Shelia A. Hyde

College of Business, Texas Woman’s University, Denton, Texas, USA

Myrtle P. Bell

Department of Management, University of Texas at Arlington,

Arlington, Texas, USA, and

Paul E. Yeatts

Texas Woman’s University, Denton, Texas, USA

Abstract

Purpose –The purpose of this study is to examine factors relating to the decision to proactively disclose a

diagnosis of attention deficit hyperactivity disorder (ADHD), a concealable stigmatized identity, before

experiencing performance issues at work. These factors include stigma consciousness, psychological safety,

and job demands. Proactive disclosure is also measured in relation to thriving.

Design/methodology/approach –Data were collected through the online research platform Prolific.

Variables of interest were measured using surveys of 166 working adults who have ADHD. Path analysis was

used to test the hypotheses.

Findings –The authors hypothesized that stigma consciousness is negatively related to proactive disclosure

of ADHD at work and that psychological safety and job demands are positively related to it. The authors

further hypothesized that proactive disclosure mediates the relationship between these variables and thriving

at work. The results partially support these hypotheses, indicating that stigma consciousness is negatively

related to proactive disclosure while psychological safety is positively related. Proactive disclosure fully

mediates the relationship between stigma consciousness and thriving and partially mediates the relationship

between psychological safety and thriving. Job demands relate to thriving but are not significantly related to

proactive disclosure.

Practical implications –Organizationscan help employees who haveconcealable disabilities toproactively

disclosethem and thrive by providinga psychologicallysafe environment where disabilitiesare not stigmatized.

Originality/value –This study diverges from previous studies by measuring positive contextual and

individual factors that help employees who have ADHD to thrive in the workplace. A proactive disclosure scale

is developed and validated.

Keywords ADHD, Proactive disclosure, Thriving, Stigma consciousness, Psychological safety, Concealable

disabilities

Paper type Research paper

Introduction

I once disclosed my ADHD to an employer at a previous job and it was used against me at every turn.

Every small mistake, every tardy arrival to work, every time I had to ask for something to be

repeated, I was confronted with ‘If you can’t control your ADHD, it’s going to affect your future with

[Company].’Occasionally, when I was working hard and really ‘in the zone,’my boss would make a

comment like ‘Looks like someone doubled-up on the Ritalin today!’My ADHD is unmedicated and

untreated. It was mortifying and absolutely affected the way I was viewed and treated by the

organization. Since leaving that company, I have never again disclosed my diagnosis of ADHD to

any employer or coworker. –Female middle manager participant, age 35.

EDI

42,2

228

The current issue and full text archive of this journal is available on Emerald Insight at:

https://www.emerald.com/insight/2040-7149.htm

Received 9 February 2022

Revised 14 August 2022

Accepted 25 August 2022

Equality, Diversity and Inclusion:

An International Journal

Vol. 42 No. 2, 2023

pp. 228-247

© Emerald Publishing Limited

2040-7149

DOI 10.1108/EDI-02-2022-0033

Beyond the visible accommodations, there’s also work to be done toward encouraging a culture of

acceptance and understanding around neurodiverse employees, who have faced a long history of

bias and misunderstanding, (qtd. in Poses, 2022).

According to Dr. Rob Austin of Ivey University, "‘...we are starting to think it’s worth doing the

hard work of fitting the puzzle pieces together and asking employees to bring their whole selves to

work. It’s often the parts of ourselves that we don’t share that are the most likely sources of new ways

of thinking and innovation,’" (qtd. in Mayne, 2019).

The need for scholarship about the experiences of employees with attention deficit

hyperactivity disorder (ADHD) is rising as its prevalence grows among adults. ADHD

[1] is characterized by ongoing inattention, hyperactivity and/or impulsivity that is present

across more than one social setting and is not associated with a mood or psychiatric disorder

(American Psychiatric Association, 2013). Over four percent of working-age adults (Kessler

et al., 2006) and more than eight percent of children and adolescents (Danielson et al., 2018)in

the United States have ADHD. Though these percentages may sound small, it means that

over eight million US employees have ADHD (Kessler et al., 2006;Organization for Economic

Co-operation and Development, 2021). That number is increasing (Chung et al., 2019) as this

disorder becomes more widely diagnosed and better understood. In spite of its prevalence and

potential for important individual and organizational outcomes, ADHD is rarely discussed in

the management diversity and inclusion literature (Doyle and McDowall, 2021).

A hallmark of ADHD is that it interferes with functioning at work, home, and/or school

(American Psychiatric Association, 2013). Without accommodations geared to their unique

needs, employees who have ADHD are more likely to miss deadlines, make mistakes on

routine tasks, forget important details, and struggle with social interactions (American

Psychiatric Association, 2013;Dipeolu, 2011;Nadeau, 1997;Painter et al., 2008;Patton, 2009;

Wyld, 1997). These negative behaviors are often characterized as personal flaws instead of

neurological differences (Patton, 2009). Without needed accommodations, employers may

focus on the potential negative outcomes of employing someone with a disability, including

the fact that their productivity could be less predictable than employees who do not have

disabilities (Moss et al., 2017). Previous research finds that employees who have ADHD have

higher unemployment, fewer career advancement opportunities, and lower pay on average

than employees without disabilities (Painter et al., 2008;Patton, 2009;Schwiebert et al., 1998;

Secnik et al., 2005;Wyld, 1997). The result for many employees who have ADHD is lower

career attainment.

These outcomes are losses for both employees and organizations, since having ADHD is

also associated with valuable characteristics. White and Shah (2006,2011) find that adults

who have ADHD have more real-world creative achievement than adults who do not have

ADHD, and they score higher on specific creativity preferences as a group, resulting in higher

levels of divergent thinking. Similar findings are discussed by Boot et al. (2017). They find

that people who have ADHD have more real-world creative achievements and enhanced

divergent thinking as well as more original reconstruction of complex problems.

Disclosing a diagnosis of ADHD could help to resolve work-related issues, enabling

organizations to benefit from the skills that employees who have ADHD have to offer.

Disclosing a concealable disability like ADHD, while potentially risky, is associated with

receiving accommodations and having higher levels of job satisfaction (Baumg€

artner et al.,

2015;Madaus et al., 2003;Redman and Snape, 2006;Schur et al., 2014;Snyder et al., 2010;Stone

and Colella, 1996) and lower levels of turnover intention (Gold et al., 2012). People who have

visible disabilities who discuss what they can and cannot do are perceived more positively at

work (Hudson, 2013;Lyons et al., 2018). We posit that this benefit extends to employees who

openly acknowledge and discuss their concealable disabilities. While most concealable

identity disclosure happens as a reaction to a history of performance concerns (Gerber and

Thriving at

work with

ADHD

229