"Lazy, Strange, Disorganized, and Diagnosed"? Mental Representations of ADHD in People With and Without a Diagnosis

Attention-Deficit/Hyperactivity Disorder (ADHD) has gained increasing visibility in public discourse on mental health, particularly in adulthood, while remaining associated with stigma, oversimplification, and misinformation. The present study aimed to identify mental representations of ADHD among Brazilian adults with and without a diagnosis.

This qualitative, exploratory, cross-sectional study included a non-probabilistic sample of 805 adults, comprising 463 participants with ADHD and 342 without a diagnosis. Data were collected online using the Free Word Association Technique, based on the inductive stimulus "ADHD." Analyses were conducted using IRaMuTeQ software, including word cloud analysis, Descending Hierarchical Classification, and specificity analyses, complemented by thematic content analysis.

Results were primarily organized into four classes: (a) Stigma and delegitimization of ADHD, characterized by pejorative labels and simplified understandings of the condition; (b) Distress and Insecurity, reflected in feelings of insecurity, frustration, and low self-esteem; (c) Technical-Diagnostic Perspective on ADHD, centered on symptoms such as inattention, deficits, and hyperactivity; and (d) Dysfunctional behaviors, related to difficulties with organization, procrastination, and overload. Overall, more similarities than differences were observed in how participants with and without ADHD represented the disorder.

These findings suggest that ADHD is socially constructed as an experience that extends beyond its clinical definition, shaped by symbolic, normative, and affective processes. Accordingly, there is a need for clinical and psychoeducational practices that integrate diagnostic knowledge with subjective experiences and the sociocultural conditions that influence distress and daily functioning in the Brazilian context.