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ADHD has been correlated with problematic internet use, which can result in distressing self-stigma. This study analyzed this relationship while stratifying for different types of problematic internet use and their unique effects.

A number of published studies have shown a link between problematic internet use and psychological stress. Youth with attention deficit hyperactivity disorder (ADHD) are at a higher risk of developing problematic internet use, psychological distress, and self-stigma. However, the precise relationship between problematic internet use, self-stigma, and distress in adolescents with ADHD is not well understood. This study, published in Research in Developmental Disabilities, seeks to understand whether self-stigma mediates relationships between different forms of problematic internet use. The study specifically addresses relationships between problematic gaming, problematic social media use, problematic smartphone use, and psychological distress, including depression, anxiety, and stress, in children with ADHD.

Self-Stigma and Problematic Internet Use Form a Feedback Loop of Distress

Individuals with ADHD may be especially vulnerable to developing a problematic relationship with internet use. They tend to exhibit core symptoms such as inattention, hyperactivity, and impulsivity. Both ADHD and problematic internet use tend to involve poor impulse control, which has been hypothesized as a core factor in the development of addictive behaviors, including problematic internet use.

Self-stigma in those with ADHD often manifests as the interpretation of negative interactions as being the result of their condition or issues. This self-stigma can exacerbate distress and result in further psychological suffering. This can result in a situation where people with ADHD exhibit self-stigma, which then changes their relationship to problematic internet use. Understanding this relationship is the aim of this study.

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Problematic Gaming: An Outlier Among ADHD Patients

This study relied on data from a total of 100 patients aged 7 to 20 years. All patients had a DSM-5 diagnosis of ADHD. Most participants (n=84) were male, and the mean age was 10.80 years. Participants spent an average of 1.56 hours gaming, 0.72 hours on social media, and 2.45 hours on smartphones per day. Self-stigma statistically predicted psychological distress in all models. Self-stigma was also found to mediate the association between problematic social media use, problematic smartphone use, and depression, anxiety, and stress. However, this mediation was not found with problematic gaming. 

The study findings suggest that individuals with ADHD tend to self-stigmatize some internet-related behaviors but not others. Gaming behaviors, even when problematic, did not seem to be stigmatized in the same way that social media use and smartphone use were, and thereby seem to not be part of this feedback loop of psychological distress. This can be a useful insight for clinicians dealing with this population group, as it can provide information about when and how to intervene in behaviors that increase distress in ADHD patients.


Lee, K. Y., Chen, C. Y., Chen, J. K., Liu, C. C., Chang, K. C., Fung, X. C. C., Chen, J. S., Kao, Y. C., Potenza, M. N., Pakpour, A. H., & Lin, C. Y. (2023). Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD. Research in Developmental Disabilities, 133, 104410. https://doi.org/10.1016/j.ridd.2022.104410