ArticlePDF Available

The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment

Authors:

Abstract

Attention-deficit/hyperactivity (ADHD) symptoms have been associated with the decision to become self-employed. Although these symptoms are generally regarded as disadvantageous, there may also be a bright side. To our knowledge, however, there has been no systematic, epidemiological evidence to support this claim. This paper examines the association between ADHD symptoms and self-employment in a population-based sample from the STAGE cohort of the Swedish Twin Registry (N = 7208). For replication, we used a sample of Dutch students who participated in the Global University Entrepreneurial Spirit Students' Survey (N = 13,112). In the Swedish sample, we found a positive association with self-employment for both general ADHD symptoms [odds ratio (OR) 1.13; 95 % confidence intervals (CI) 1.04-1.23] and hyperactivity symptoms [OR 1.19; 95 % CI 1.08-1.32], whereas no association was found for attention-deficit symptoms [OR 0.99; 95 % CI 0.89-1.10]. The positive association between hyperactivity and self-employment was replicated in the Dutch student sample [OR 1.09; 95 % CI 1.03-1.15]. Our results show that certain aspects of ADHD, in particular hyperactivity, can have a bright side, as they are positively associated with self-employment.
BEHAVIOURAL EPIDEMIOLOGY
The association between attention-deficit/hyperactivity (ADHD)
symptoms and self-employment
Ingrid Verheul
1,5
Wim Rietdijk
2,3
Joern Block
4,5
Ingmar Franken
6
Henrik Larsson
8,9
Roy Thurik
2,3,5,7
Received: 24 February 2015 / Accepted: 4 May 2016 / Published online: 13 May 2016
ÓThe Author(s) 2016. This article is published with open access at Springerlink.com
Abstract Attention-deficit/hyperactivity (ADHD) symp-
toms have been associated with the decision to become
self-employed. Although these symptoms are generally
regarded as disadvantageous, there may also be a bright
side. To our knowledge, however, there has been no sys-
tematic, epidemiological evidence to support this claim.
This paper examines the association between ADHD
symptoms and self-employment in a population-based
sample from the STAGE cohort of the Swedish Twin
Registry (N =7208). For replication, we used a sample of
Dutch students who participated in the Global University
Entrepreneurial Spirit Students’ Survey (N =13,112). In
the Swedish sample, we found a positive association with
self-employment for both general ADHD symptoms [odds
ratio (OR) 1.13; 95 % confidence intervals (CI) 1.04–1.23]
and hyperactivity symptoms [OR 1.19; 95 % CI
1.08–1.32], whereas no association was found for atten-
tion-deficit symptoms [OR 0.99; 95 % CI 0.89–1.10]. The
positive association between hyperactivity and self-em-
ployment was replicated in the Dutch student sample [OR
1.09; 95 % CI 1.03–1.15]. Our results show that certain
aspects of ADHD, in particular hyperactivity, can have a
bright side, as they are positively associated with self-
employment.
Keywords Attention-deficit Hyperactivity Symptoms
ADHD Self-employment
Introduction
Prominent entrepreneurs have publicly credited their
attention-deficit hyperactivity (ADHD) symptoms as a
driver of their decision to become self-employed [13].
Examples include Ingvar Kamprad (founder of IKEA) and
Richard Branson (founder of the Virgin Group) [2,3]. The
Economist recently published a short article addressing the
suitability of self-employment for people who experience
ADHD symptoms [4].
ADHD is a neurodevelopmental disorder characterised
by attention-deficit and hyperactivity [57]. The onset of
ADHD is typically during childhood (before the age of 12),
and it is therefore often regarded as a childhood disorder.
Studies following children with a diagnosis of ADHD have
shown that ADHD symptoms are persistent over time, at
least into early adulthood [6,811], with 65 % of indi-
viduals still having a full ADHD diagnosis or partial
remission at the age of 25 [12]. Recent research has
&Ingrid Verheul
iverheul@rsm.nl
1
Rotterdam School of Management, Erasmus University
Rotterdam, P.O. Box 1738, 3000 DR Rotterdam,
The Netherlands
2
Erasmus School of Economics, Erasmus University
Rotterdam, Rotterdam, The Netherlands
3
Institute for Behavior and Biology (EURIBEB), Erasmus
University Rotterdam, Rotterdam, The Netherlands
4
Professur fu
¨r Unternehmensfu
¨hrung, Universita
¨t Trier, Trier,
Germany
5
Erasmus Research Institute of Management (ERIM), Erasmus
University Rotterdam, Rotterdam, The Netherlands
6
Institute of Psychology, Erasmus University Rotterdam,
Rotterdam, The Netherlands
7
Montpellier Business School, Montpellier, France
8
Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden
9
Karolinska Institutet Center of Neurodevelopmental
Disorders (KIND), Stockholm, Sweden
123
Eur J Epidemiol (2016) 31:793–801
DOI 10.1007/s10654-016-0159-1
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
devoted more attention to increasing our understanding of
the persistence of ADHD symptoms in (young) adults [13].
Furthermore, the most recent DSM criteria were adjusted to
enable a diagnosis across the lifespan and not only during
childhood [14].
Although prior research has mainly focused on the
negative consequences of ADHD for individual perfor-
mance in formal education and wage employment [1519],
recent studies have highlighted positive aspects of ADHD
symptoms, such as its association with resilience and well-
being [20], close friendship [21], and third-party inferences
about an individual’s generative qualities (being creative,
visionary, good at generating ideas) [22]. In the present
study, we focus on a potential positive aspect of ADHD:
self-employment as a career choice. Self-employment is
not just any career choice but is a manifestation of
entrepreneurship that is essential for employment creation,
innovation and the economic growth of modern societies
[23,24]. It can be used as an economic instrument in the
business cycle [25] and to lift people out of unemployment
[26].
In the popular press, it has been suggested that indi-
viduals with ADHD symptoms are able to break through
organisational inertia due to their ability to envision and
create new ‘realities’ and (successfully) start their own
ventures [24]. Allegedly, when individuals who experi-
ence ADHD symptoms succeed in developing mechanisms
to cope with their ‘weaknesses’, they would be able to
exploit their extraordinary talents and perform just as well
as or even better than their peers in business [2,27,28].
Academic research has found only circumstantial evidence
linking ADHD symptoms to self-employment when
examining the association with entrepreneurial intentions
[29], creativity [3032], risk-taking [33], and proactivity
[5]. To our knowledge, there is no systematic, epidemio-
logical evidence supporting a link between ADHD symp-
toms and self-employment.
The present study was designed to examine the associa-
tion between self-reported ADHD symptoms and self-em-
ployment in a population-based sample of 7208 individuals
from the STAGE cohort of the Swedish Twin Registry of the
Karolinska Institute. The findings were replicated in a
sample of 13,119 students participating in the Global
University Entrepreneurial Spirit Students’ Survey
(GUESSS) 2011 in the Netherlands. Given the discussions
in the (popular) literature and the circumstantial scholarly
evidence, we expected a positive association between
ADHD symptoms and the decision to become self-em-
ployed [14,29]. We should emphasise that the present
study does not focus on ADHD as a full-blown psychiatric
disorder. For the purpose of the present research, self-re-
ported psychiatric symptoms are defined along a continuum
[34] and not as a psychiatric classification.
Method
Swedish twin registry: STAGE cohort
as the discovery sample
We used the STAGE (Swedish Twin Studies on Adults:
Genes and Environment) cohort from the Karolinska
Institute in Stockholm, Sweden, as the discovery sample.
The STAGE cohort is part of the population-representative
Swedish Twin Registry (STR), which was established in
the 1950s to study the effects of smoking and drinking on
cancer and cardiovascular diseases [35]. At present, the
STR contains rich data about biological and clinical
markers together with the socio-economic background of
twins living in Sweden [35]. For a full account of the
design and execution of the STR project and details of the
ADHD data in the STAGE cohort, we refer to Lichtenstein
et al. [35] and Larsson et al. [10], respectively.
All twins born between 1959 and 1985 (a total of 42,582
twins) received an invitation letter with information about
the project in May and June 2005. The response rate was
59.6 % (N =25,364, 56 % female, age[mean] =41.56,
age[sd] =7.6). The entire questionnaire contained
approximately 1300 questions, of which the respondents
answered 800–900 questions on average [35]. Dropouts
could be explained by a general unwillingness to respond
to a lengthy survey [10]. Non-respondents were signifi-
cantly more often male, had at least one parent born outside
Sweden, and were more likely to have been diagnosed with
a psychiatric disorder and convicted of any type of crime
[10,36,37], which may indicate that the most severe cases
did not respond to the questionnaire. This limits generali-
sations to the more severe cases of the ADHD spectrum.
Informed consent was obtained from all individual partic-
ipants included in the study. This project was reviewed and
approved by the ethics committee of the Karolinska
Institute.
Self-employment measure
Participants answered two questions about their involve-
ment in self-employment: whether they were self-em-
ployed full-time (yes/no) and whether they were self-
employed part-time (yes/no). We constructed one measure
of self-employment (yes/no), which was coded 1 if the
participant was self-employed part-time or full-time and 0
if (s)he was not self-employed. In the STAGE cohort,
14,039 out of 25,364 participants (&55 %) provided their
self-employed status (yes/no). A total of 2096 participants
(&14 %) were self-employed, of whom 1270 (&9%)
were self-employed full-time and 826 (5 %) were self-
employed part-time. Three participants answered ‘yes’ to
both the part-time and full-time self-employment question
794 I. Verheul et al.
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
and were excluded from the analysis. Furthermore, we
randomly dropped one twin from each pair because their
similarity would violate the assumption of independent
observations, resulting in a final sample of 7208 partici-
pants (58 % female, age[mean] =43.9, age[sd] =6.7). Of
these respondents, a total of 897 (&12 %) were self-em-
ployed, of whom 515 (&7 %) were self-employed full-
time and 382 (&5 %) were self-employed part-time, which
was similar to the total sample distribution.
Attention-deficit/hyperactivity (ADHD) symptoms
measure
ADHD symptoms were assessed using the Adult ADHD
Self-Report Scale (ASRS-v1.1), which consists of 18 items
reflecting the DSM-IV-TR criteria [10]. Attention-deficit
symptoms and hyperactive symptoms were measured by 9
items each.
1
Answers for each item were given on a 3-point
Likert scale (0 =‘no’; 1 =‘yes, to some extent’; and
2=‘yes’). The 18 ASRS-v1.1 items were slightly modified
to allow for the assessment of ADHD symptoms in adults
[35]. As can be expected from a non-clinical population
sample, many participants reported having no or few ADHD
symptoms. The average percentage of respondents reporting
inattentive symptoms and hyperactive symptoms (with the
answer ‘yes’) was 3.6 and 4.6 %, respectively. Approxi-
mately one-third of the respondents reported no symptoms
[10]. This result closely resembles the prevalence rate of
adult ADHD reported in Kessler et al. [38].
The symptom scores were added to create a scale of
ADHD symptoms and two sub-scales of attention-deficit
and hyperactivity [10]. Values for the reliabilities of these
three scales in our sample were a=0.84, a=0.78, and
a=0.78, respectively. These reliabilities were similar to
those reported in Larsson et al. [10]. Because the three
scales were highly skewed (skewness: ADHD, 1.66;
attention-deficit, 1.77; hyperactivity, 1.72), the scales were
log-transformed (Log10[x ?1], where x is the initial
value) to normalise their distributions (skewness after log
transformation: ADHD, -0.16; attention-deficit, 0.27;
hyperactivity, 0.26). As indicated in Larsson et al. [10,
p. 199], the sum score of the 18 ADHD items used in this
study yielded results similar to those reported in other
studies using self- or parent-reported measures of ADHD.
Control variables
In the STAGE cohort, we included the following demo-
graphic variables: age, gender, and whether the participant
attended university (0 =no, 1 =yes) as an initial test to
control for additional effects.
GUESSS study: replication
We attempted to replicate the analysis linking ADHD
symptoms to self-employment in a student sample from the
Global University Entrepreneurial Spirit Students’ Survey
(GUESSS)
2
2011 in the Netherlands. GUESSS is an
international research consortium that studies the career
objectives of students in higher education. In the Nether-
lands, students at 14 universities and 24 polytechnics
received a link to the online survey through email. After
1 month, a reminder was sent. Two randomly drawn par-
ticipants received an iPad 2.0 to reward their participation.
To prevent self-selection of students with entrepreneurial
intentions, the topic of the survey was announced as future
career paths. The GUESSS Netherlands study was in line
with the Erasmus Research Institute of Management
review board’s standards and did not include clinical or
patient data [29].
The response rate for the GUESSS study was 7.6 % for
educational institutions that systematically recruited par-
ticipants [29], leading to an overall database of 13,119
students (56 % female, age [mean] =22.96, age
[sd] =0.49), of whom 374 were student entrepreneurs
(i.e., reported having their own business during their
studies). Comparing the GUESSS Netherlands sample with
the global GUESSS sample reported in Sieger et al. [39],
we found that our (Dutch) sample was representative in
terms of socio-demographic characteristics and the preva-
lence of student entrepreneurs. Specifically, in our sample,
56 % of the respondents were female compared to a global
average of 55.2 %, and the average age of 23 was within
the mid-range age of the international average, which is
between 20 and 27 years [39]. Furthermore, 2.9 % of the
students in our study had their own company, compared to
a global average of 2.5 % student entrepreneurs [39].
In the GUESSS study, self-employment was measured as
a dichotomous variable indicating whether students were
self-employed in their own founded firm during their studies.
ADHD symptoms were measured using the six-item Adult
ADHD Self-Report Scale v1.1 (ASRS v1.1) screener,
developed by Kessler et al. [38,40], which consists of the six
most predictive ADHD symptoms of the 18 DSM-IV-TR
criteria used in the STAGE study. This enabled us to repli-
cate the analysis in the STAGE cohort. Each item was
answered on a 5-point Likert scale (1 =never to 5 =al-
ways). Although the measures were different, the screener
and the full 18-item measure were found to be highly
1
Throughout the paper we refer to hyperactivity symptoms, although
the ASRS v1.1 measure is slightly broader given that it includes three
items related to impulsivity.
2
For more information about GUESSS, we refer to http://www.
guesssurvey.org.
The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment 795
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
correlated [38,40]. Average scores were computed for
ADHD symptoms (based on six items, a=0.59), attention-
deficit (based on four items, a=0.62), and hyperactivity
(based on two items, a=0.43). Although these scales had
low to moderate reliability, they were still close to the lower
bound of reported reliabilities for the ASRS screener ques-
tions in Kessler et al. [40] (see Verheul et al.) [29]. The three
scales were only moderately skewed: sample skewness for
the ADHD symptom scale, the attention-deficit scale, and
the hyperactivity scale amounted to 0.21, 0.35, and 0.06,
respectively, with a standard error of 0.02. These skewness
measures indicated that log-transformation of the variables
was not necessary. Given that the GUESSS study consisted
of only students from universities and polytechnics, we only
included age and gender as control variables in the model.
Statistical analysis
To examine the association between ADHD symptoms and
self-employment, we estimated binary logistic regressions.
First, in the STAGE cohort, we examined the association
between the sum score on the DSM-IV diagnostic criteria
items for all ADHD symptoms (18 items), attention-deficit
and hyperactivity symptoms (each 9 items), and self-em-
ployment (part-time/full-time). Second, we replicated this
analysis using data from the GUESSS study. Specifically, we
estimated the associations between the sum score on the
ASRS-6 v1.1 screener items for all ADHD symptoms (6
items), attention-deficit symptoms (4 items), hyperactivity
symptoms (2 items), and self-employment. We report the
effect sizes in terms of odds ratios (OR) and the associated
95 % confidence intervals (95 % CI). In the tables, we denote
statistical significance (pvalues at 5, 1, and 0.1 % levels,
respectively) using asterisks (*, **, and ***, respectively).
Results
STAGE cohort
In Table 1, we present the results of the binary logistic
regressions explaining self-employment (part-time/full-
time). We found a positive association with self-employ-
ment for both general ADHD symptoms (OR 1.13; 95 %
CI 1.04–1.23) and hyperactivity symptoms (OR 1.19; 95 %
CI 1.08–1.32) but not for attention-deficit symptoms (OR
0.99; 95 % CI 0.89–1.10).
GUESSS study: replication
We attempted to replicate the association between ADHD
symptoms and self-employment using the GUESSS 2011
data. The results of the binary logistic regressions are
presented in Table 2. We found no evidence of an asso-
ciation between general ADHD symptoms and self-em-
ployment (OR 1.00; 95 % CI 0.97–1.02). However, when
we separated attention-deficit and hyperactivity, we found
a negative association between self-employment and
attention-deficit symptoms (OR 0.95; 95 % CI 0.92–0.99)
and a positive association between self-employment and
hyperactivity symptoms (OR 1.09; 95 % CI 1.03–1.15).
To summarise, we found a positive association between
(general) ADHD symptoms and self-employment in the
STAGE cohort that could not be replicated (i.e.,
Table 1 STAGE cohort; Binary logistic regressions with self-em-
ployment (part-/full-time) as dependent variable and general ADHD
symptoms, and the two sub-scales attention-deficit symptoms and
hyperactivity symptoms as independent variables
(1) (2)
General ADHD symptoms 1.13**
(1.04–1.23)
Attention-deficit symptoms 0.99
(0.89–1.10)
Hyperactivity symptoms 1.19***
(1.08–1.32)
N 7208 7208
Log-likelihood -2599 -2597
df 4 5
Chi-square 209.2 222.7
Pseudo R-square 0.04 0.04
The coefficients are odds ratios (ORs) and 95 % confidence intervals
(CI) are in parentheses; *** p\0.001, ** p\0.01, * p\0.05
Both models control for age, gender, and university education
(0 =no and 1 =yes)
Table 2 GUESSS study; Binary logistic regressions with self-em-
ployment (part-/full-time) as dependent variable and general ADHD
symptoms, and the two sub-scales attention-deficit symptoms and
hyperactivity symptoms as independent variables
(1) (2)
General ADHD symptoms 0.99
(0.93–1.07)
Attention-deficit symptoms 0.89*
(0.79–1.00)
Hyperactivity symptoms 1.13*
(1.00–1.28)
N 13,119 13,119
Log-likelihood -3189 -3183
df 3 4
Chi-square 208.5 214.8
Pseudo R-square 0.07 0.07
The coefficients are odds ratios (ORs) and 95 % confidence intervals
(CI) are in parentheses; *** p\0.001, ** p\0.01, * p\0.05
Both models control for age, and gender
796 I. Verheul et al.
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
insignificant) in the GUESSS study. Furthermore, the
association between attention-deficit symptoms and self-
employment was significantly negative in the GUESSS
study and insignificant in the STAGE cohort. Finally, the
association between hyperactivity symptoms and self-em-
ployment was significantly positive in both the STAGE
cohort and the GUESSS study.
Sensitivity and additional analyses
We performed a series of sensitivity analyses using both
the STAGE and GUESSS data. First, we reran the logistic
regressions using the entire STAGE database, including
pairs of twins instead of randomly dropping one twin, and
clustered the standard error at the family level to account
for the joint characteristics of twins. In the larger sample of
approximately 11,000 respondents, the association between
ADHD symptoms and self-employment remained intact
(OR 1.23; 95 % CI 1.13–1.34). Furthermore, the results of
the sub-scales remained stable: attention-deficit was not
significantly associated with self-employment (OR 1.02;
95 % CI 0.94–1.11), and hyperactivity was positively
associated with self-employment (OR 1.19; 95 % CI
1.10–1.29).
3
Second, to compare the results of the GUESSS study
with those of the STAGE cohort, we examined the asso-
ciations between ADHD symptoms and self-employment
in the STAGE cohort using the 6 items from the ASRS-6
v1.1 screener instead of the 18 item ASRS-v1.1 score. In
line with the GUESSS findings, we found no evidence of a
significant association between general ADHD symptoms
and self-employment (OR 1.04; 95 % CI 1.00–1.09).
However, we did not find support for a significant (nega-
tive) association between self-employment and attention-
deficit symptoms (OR 0.97; 95 % CI 0.9–1.03). We did
find a positive association between hyperactivity symptoms
and self-employment (OR 1.04; 95 % CI 1.00–1.09), which
is in agreement with the analyses.
4
Third, we examined the association between ADHD
symptoms and self-employment using a stricter definition
of ADHD that was closer to an actual psychiatric diagnosis
[10]. In the STAGE data, we used the ‘‘strict criteria’
score: in the responses to the DSM-IV 18 items, 1 (‘‘yes’’)
was recoded to yes and 2 or 3 (‘‘yes, to some extent’’ or
‘no’’) were recoded to no. The outcomes supported those
of the initial analysis. The association between ADHD
symptoms and self-employment became stronger (OR:
1.35; 95 % CI 1.00–1.81), which was also true for hyper-
activity (OR: 1.54; 95 % CI 1.03–2.29). In the GUESSS
data, for each of the ASRS-6 v1.1 items, we examined
whether the score was beyond the threshold level
(‘yes =1’ and ‘no’ =‘0’) and constructed new scale
variables for ADHD symptoms, attention-deficit and
hyperactivity based on the sum of the dummy (0,1) scores
on six, four and two items, respectively. The findings
remained stable for ADHD symptoms (not significant, OR:
1.00; 95 % CI 0.93–1.07), attention-deficit (significant,
OR: 0.90; 95 % CI 0.82–0.98), and hyperactivity (signifi-
cant, OR: 1.27; 95 % CI 1.11–1.47).
Fourth, we re-estimated the logistic regressions includ-
ing additional control variables. Specifically, because
unemployment is an important push factor for self-em-
ployment [26] and because individuals who experience
ADHD symptoms have a higher chance of unemployment
[38,41], we added a control variable in the analyses with
the STAGE data that captured whether the individual had
mainly been unemployed or hardly worked in the 3 years
preceding the survey. The association between ADHD and
self-employment remained positive and significant (OR:
1.15; 95 % CI 1.06–1.25). This was also true for hyper-
activity (OR: 1.19; 95 % CI 1.07–1.32). Furthermore, we
controlled for personality characteristics of people with
ADHD symptoms. We included measures for extraversion
and neuroticism to account for the fact that ADHD
symptoms have been linked to (higher) neuroticism [42,
43] and extraversion [44]. These Big Five Factor traits have
also been linked with self-employment [45,46]. When
controlling for these two personality factors, both gen-
eral ADHD symptoms (OR: 1.17; 95 % CI 1.06–1.29) and
hyperactivity (OR: 1.14; 95 % CI 1.02–1.28) remained
significantly positive. In the analyses with the GUESSS
data, we were able to control for factors that are generally
associated with self-employment status, including self-
employed parents, study field and level. In particular,
parental role models have been linked with the decision to
become self-employed [47,48]. Accounting for the afore-
mentioned factors in the analyses, the results were stable,
and only attention-deficit and hyperactivity were signifi-
cantly associated with self-employment (attention-deficit,
OR: 0.96; 95 % CI 0.92–0.99; hyperactivity, OR: 1.07;
95 % CI 1.01–1.13).
Overall, the association between ADHD symptoms and
self-employment remained intact but became insignificant
when more controls were added. In the STAGE data, this
3
For the analyses including the ADHD symptom scale (plus
controls), the log pseudo likelihood was -2705, the pseudo R-square
was 0.06, and the Wald Chi-square was 319.4. Standard errors were
adjusted for 8434 clusters in pair ID (identifying twins). For the
analyses separating attention-deficit and hyperactivity, the log pseudo
likelihood amounted to -4118, the pseudo R-square was 0.04, and the
Wald Chi-square was 354.8. Standard errors were adjusted for 8771
clusters in pair ID.
4
In line with Kessler et al. [38,40], the reliability coefficients
(Cronbach’s alpha) for general ADHD symptoms, attention-deficit
symptoms and hyperactivity symptoms were 0.59, 0.58, and 0.50,
respectively, indicating that the scales were moderately reliable.
The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment 797
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
was the case when considering whether someone was
mainly wage employed in the past 3 years. This is not
surprising given the fact that approximately 60 % of the
respondents were currently wage employed and had mainly
been working in wage jobs in the past 3 years. In the
GUESSS data, the association between ADHD symptoms
and self-employment appeared sensitive to the inclusion of
career motives (e.g., challenge, realising a dream, income,
financial security, innovation, opportunity exploitation,
high position, flexibility, own boss, social mission), which
may be related to the importance of the person-occupation
fit for individuals with ADHD symptoms [29].
Finally, using the STAGE data, we tested for linkages
between ADHD symptoms and other occupations. The
findings showed no association with wage employment
(OR: 0.96; 95 % CI 0.90–1.03), suggesting that a regular
wage job may not be as suitable as self-employment for
people with high levels of ADHD symptoms. Together
with our finding that ADHD symptoms are positively
associated with unemployment (OR: 1.24; 95 % CI
1.12–1.37), we are unable to reject a potential push effect
by which people with ADHD symptoms become self-em-
ployed because of a lack of (suitable) alternative
occupations.
Discussion
The present study moved beyond the clinical view of
ADHD as a pathological disorder and used the symptoms
of ADHD across the entire measurement spectrum to
examine a potentially positive aspect: the association of
ADHD with the involvement in self-employment. Hence,
the aim of this study was not to diagnose individuals with
ADHD and then examine the viability of self-employment
as a career option. Instead, we investigated whether indi-
viduals who exhibit higher levels of ADHD symptoms–but
who do not necessarily screen positive for ADHD in a
clinical sense–are positively associated with self-employ-
ment. In line with previous research, special attention was
paid to whether this association involved general ADHD
symptoms or the separate attention-deficit and hyperactiv-
ity symptom dimensions [10,34,4951].
The present research is part of a series of investigations
on the relation between ADHD and entrepreneurship. In
Verheul et al. [29], the intention to become self-employed
was found to be associated with ADHD symptoms in a
survey of Dutch students. In Thurik et al. [52], the entre-
preneurial orientation, measured using innovativeness, risk
aversion and proactivity [53], was found to be associated
with ADHD symptoms in a survey of French business
owners. The present study investigates involvement in self-
employment. All three studies report a positive association,
although the hyperactivity part seems to dominate. Future
studies should also take into account entrepreneurial per-
formance, such as growth, profits, longevity, and
satisfaction.
Two independent samples were used for the present
analysis: Swedish adults (STAGE cohort) and Dutch stu-
dents (GUESSS study). In the Swedish sample, we found a
positive association of both general ADHD symptoms and
hyperactivity symptoms with self-employment, whereas
this association could not be found for attention-deficit
symptoms. The positive association between hyperactivity
symptoms and self-employment was replicated in the
Dutch sample. The effects remained intact in a series of
sensitivity analyses.
ADHD is typically characterised by high energy levels
that are expressed as severe and persistent attention-deficit
and hyperactivity and that are driven by behavioural ‘dis-
inhibition’ or a lack of restraint [22,41,54]. Less attention
is paid to ADHD symptoms for adult decision-making [55],
but it is generally recognised that high levels of attention-
deficit and hyperactivity have negative consequences in the
workplace. Individuals who demonstrate such behaviours
tend to show low job performance and a high chance of
becoming unemployed [5658]. However, the present
results show that ADHD symptoms, particularly hyperac-
tivity, are associated with aspects that may be beneficial for
the individual and society at large.
The present study has implications for further research.
Our results may be an initial step towards establishing a
link between ADHD symptoms and career choices, such as
self-employment, or other manifestations of entrepreneur-
ship. The outcomes of this study may help to ‘destigmatise’
ADHD as a disorder, particularly given the positive asso-
ciations with self-employment in view of its contribution to
socio-economic life. Given the high occurrence of mod-
erate psychiatric symptoms, it is plausible (from a Dar-
winian perspective) that psychiatric symptoms not only
confer risks but can also be beneficial for the individual.
For the field of psychopathology, it is important to study
the potential benefits of demonstrating a high level of
ADHD symptoms [21,32,59,60] across the lifespan [11,
14,27,61]. Such a focus on the value (rather than the cost)
of ADHD is at the heart of a recent stream of literature in
the field of psychiatry (i.e., Darwinian Psychiatry), which
argues that the persistence of such mental ‘disorders’
serves a purpose [27,6163]. According to this research
stream, psychiatric symptoms or genetic variations that are
mostly or currently disruptive for an individual’s work and
private life can–under some circumstances or in mild
forms–be beneficial for the ‘adaptation’ or survival of the
individual. Hence, (young) adults who experience mild to
severe ADHD symptoms may benefit rather than suffer
from them provided they find ways to cope with the
798 I. Verheul et al.
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
negative consequences in general and in relation to an
entrepreneurial context [22]. Benefits may be particularly
salient when individuals with ADHD symptoms find a
suitable work environment, such as self-employment,
where the ‘disorder’ is not harmful but instead can be
valuable and help them to function well in society [21,27,
61].
Although the present study only investigates one single
outcome, self-employment as a possibly positive aspect of
ADHD symptoms, it highlights some promising avenues
for future research. First, the current data do not enable us
to examine the association between ADHD symptoms and
the performance of self-employed individuals. The ques-
tion that arises is whether self-employed individuals who
score higher on ADHD symptoms also have better-per-
forming ventures [53]. Second, the decision to become
self-employed may not be the only association with ADHD
symptoms; underlying entrepreneurial behaviours such as
risk-taking and proactivity may share this association [52].
ADHD symptoms may also have ‘positive’ associations
with other socio-economic behaviours for occupational
choice, such as in management and consultancy positions
[24]. Third, to generalise the results of this study, it is
worthwhile to examine the association between ADHD
symptoms and self-employment in other, preferably non-
European, population-based cohorts. It is also important to
distinguish between individuals with a different occupa-
tional status in the control group, including wage
employment and unemployment. A first attempt is reported
in our section on sensitivity analyses. For future research, it
is important to distinguish between these (alternative)
occupations to effectively examine the association with
different control groups.
To conclude, our results indicate that the positive
association between ADHD symptoms and the decision to
become self-employed primarily hinges on the hyperac-
tivity symptoms of ADHD, whereas the overall association
between ADHD symptoms and self-employment is only
significant in one of our two samples. For future research, it
is important to understand how ADHD symptoms are
associated with more specific self-employment and
entrepreneurship behaviours, such as the level of risks
taken or performance in self-employment or as a business
owner. This research may enhance our understanding of the
positive effects of ADHD symptoms or even ‘destigmatise’
ADHD as a disorder that always deserves treatment.
Compliance with ethical standards
Conflicts of interest The authors have no conflicts of interest to
declare.
Ethical statement This study was conducted according to the
guidelines in the Declaration of Helsinki. The STAGE cohort study
was approved by the ethics committee of Karolinska Institutet,
Stockholm, Sweden, and all participants provided written informed
consent. The GUESSS study was in line with the Erasmus Research
Institute of Management (ERIM) review board’s standards and did
not include clinical or patient data.
Open Access This article is distributed under the terms of the
Creative Commons Attribution 4.0 International License (http://crea
tivecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided you give
appropriate credit to the original author(s) and the source, provide a
link to the Creative Commons license, and indicate if changes were
made.
References
1. Turner, R. Executive life: in learning hurdles, lessons for success.
New York Times (Business Day). November 23, 2003. p.10.
2. Archer, D. ADHD: the entrepreneur’s superpower. Forbes
Magazine (Leadership). May 14, 2014.
3. Archer, D. ADHD: the high price of a quick, quick fix. Forbes
Magazine (Leadership). January 6, 2014.
4. The Economist. In praise of misfits. Why business needs people
with Asperger’s syndrome, attention-deficit disorder and
dyslexia. Econ. (Business, Schumpeter). June 2, 2012.
5. Barkley RA. Behavioral inhibition, sustained attention, and
executive functions: constructing a unifying theory of ADHD.
Psychol Bull. 1997;121:65–94.
6. Cantwell DP. Attention deficit disorder: a review of the past 10
years. J Am Acad Child Adolesc Psychiatry. 1996;35:978–87.
7. Conners CK. Attention-deficit/hyperactivity disorder—historical
development and overview. J Atten Disord. 2000;3:173–91.
8. Biederman J, Petty CR, Monuteaux MC, Fried R, Byrne D, Mirto
T, et al. Adult psychiatric outcomes of girls with attention deficit
hyperactivity disorder: 11-year follow-up in a longitudinal case-
control study. Am J Psychiatry. 2010;167:409–17.
9. Biederman J, Petty CR, Evans M, Small J, Faraone SV. How
persistent is ADHD? A controlled 10-year follow-up study of
boys with ADHD. Psychiatry Res. 2010;177:299–304.
10. Larsson H, Asherson P, Chang Z, Ljung T, Friedrichs B, Larsson
J-O, et al. Genetic and environmental influences on adult atten-
tion deficit hyperactivity disorder symptoms: a large Swedish
population-based study of twins. Psychol Med. 2013;43:197–207.
11. Spencer TJ, Biederman J, Mick E. Attention-deficit/hyperactivity
disorder: diagnosis, lifespan, comorbidities, and neurobiology.
J Pediatr Psychol. 2007;32:631–42.
12. Faraone SV, Biederman J, Mick E. The age-dependent decline of
attention deficit hyperactivity disorder: A meta-analysis of fol-
low-up studies. Psychol. Med. 2006;36:159–65.
13. Wilens TE, Faraone SV, Biederman J. Attention-deficit/hyper-
activity disorder in adults. JAMA. 2004;292:619–23.
14. Kooij JJS, Buitelaar JK, van den Oord EJ, Furer JW, Rijnders
CAT, Hodiamont PPG. Internal and external validity of attention-
deficit hyperactivity disorder in a population-based sample of
adults. Psychol Med. 2005;35:817–27.
15. Kuriyan AB, Pelham WE, Molina BSG, Waschbusch DA, Gnagy
EM, Sibley MH, et al. Young adult educational and vocational
outcomes of children diagnosed with ADHD. J Abnorm Child
Psychol. 2013;41:27–41.
16. Raggi VL, Chronis AM. Interventions to address the academic
impairment of children and adolescents with ADHD. Clin Child
Fam Psychol Rev. 2006;9:85–111.
17. Loe IM, Feldman HM. Academic and educational outcomes of
children with ADHD. J Pediatr Psychol. 2007;32:643–54.
The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment 799
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
18. Kleinman NL, Durkin M, Melkonian A, Markosyan K. Incre-
mental employee health benefit costs, absence days, and turnover
among employees with ADHD and among employees with
children with ADHD. J Occup Environ Med. 2009;51:1247–55.
19. Biederman J, Faraone S. The effects of attention-deficit/hyper-
activity disorder on employment and household income. Med-
scape Gen Med. 2006;8:12.
20. Wilmshurst L, Peele M, Wilmshurst L. Resilience and well-being
in college students with and without a diagnosis of ADHD.
J Atten Disord. 2011;15:11–7.
21. Glass K, Flory K, Hankin BL. Symptoms of ADHD and close
friendships in adolescence. J Atten Disord. 2012;16:406–17.
22. Lerner DA. Behavioral disinhibition and nascent venturing: rel-
evance and initial effects on potential resource providers. J Bus
Ventur. 2016;31:234–52.
23. Audretsch DB, Thurik R. What’s new about the new economy?
Sources of growth in the managed and entrepreneurial econo-
mies. Ind Corporate Change. 2001;10:267–315.
24. Thurik AR, Stam E, Audretsch DB. The rise of the entrepre-
neurial economy and the future of dynamic capitalism. Techno-
vation. 2013;33:302–10.
25. Koellinger PD, Thurik AR. Entrepreneurship and the business
cycle. Rev Econ Stat. 2011;94:1143–56.
26. Thurik AR, Carree MA, van Stel A, Audretsch DB. Does self-
employment reduce unemployment? J Bus Ventur.
2008;23:673–86.
27. Shelley-Tremblay JF, Rose
´n LA. Attention deficit hyperactivity
disorder: an evolutionary perspective. J Genet Psychol.
1996;157:443–53.
28. Hartmann T. ADHD secrets of success: coaching yourself to
fulfillment in the business world. 1st ed. New York: SelectBooks;
2002.
29. Verheul I, Block JH, Burmeister-Lamp K, Thurik R, Tiemeier H,
Turturea R. ADHD-like behavior and entrepreneurial intentions.
Small Bus Econ. 2015;45:85–101.
30. Flach F. Disorders of the pathways involved in the creative
process. Creativity Res J. 1990;3:158–65.
31. Healey D, Rucklidge JJ. An investigation into the relationship
among ADHD symptomatology, creativity, and neuropsychologi-
cal functioning in children. Child Neuropsychol. 2006;12:421–38.
32. White HA, Shah P. Creative style and achievement in adults with
attention-deficit/hyperactivity disorder. Pers Individ Differences.
2011;50:673–7.
33. Ma
¨ntyla
¨T, Still J, Gullberg S, Del Missier F, Mantyla T, Del
Missier F. Decision making in adults with ADHD. J Atten Disord.
2012;16:164–73.
34. Hesse M. The ASRS-6 has two latent factors: attention deficit and
hyperactivity. J Atten Disord. 2012;17:203–7.
35. Lichtenstein P, Sullivan PF, Cnattingius S, Gatz M, Johansson S,
Carlstro
¨m E, et al. The Swedish Twin Registry in the third mil-
lennium: an update. Twin Res Hum Genet. 2006;9:875–82.
36. Friedrichs B, Wilmar L, Larsson H, Larsson J-O. Coexisting
psychiatric problems and stressful life events in adults with
symptoms of ADHD–a large Swedish population-based study of
twins. J Atten Disord. 2012;16:13–22.
37. Furberg H, Lichtenstein P, Pedersen NL, Thornton L, Bulik CM,
Lerman C, et al. The STAGE cohort: a prospective study of
tobacco use among Swedish twins. Nicotine Tob Res.
2008;10:1727–35.
38. Kessler R, Adler L, Ames M. The World Health Organization
Adult ADHD Self-Report Scale (ASRS): a short screening scale
for use in the general population. Psychol Med. 2005;35:245–56.
39. Sieger P, Fueglistaller U, Zellweger T. Entrepreneurial intentions
and activities of students across the world. GUESSS Proj: Int
Rep; 2011.
40. Kessler RC, Adler LA, Gruber MJ, Sarawate CA, Spencer T, Van
Brunt DL. Validity of the World Health Organization Adult
ADHD Self-Report Scale (ASRS) Screener in a representative
sample of health plan members. Int J Methods Psychiatr. Res.
2007;16:52–65.
41. Barkley RA, Fischer M, Smallish L, Fletcher K. Young adult
outcome of hyperactive children: Adaptive functioning in major
life activities. J Am Acad Child Adolesc Psychiatry.
2006;45:192–202.
42. Jacob CP, Romanos J, Dempfle A, Heine M, Windemuth-
Kieselbach C, Kruse A, et al. Co-morbidity of adult attention-
deficit/hyperactivity disorder with focus on personality traits and
related disorders in a tertiary referral center. Eur Arch Psychiatry
Clin Neurosci. 2007;257:309–17.
43. Gomez R, Corr PJ. ADHD and personality: a meta-analytic
review. Clin Psychol Rev. 2014;34:376–88.
44. Knouse LE, Traeger L, O’Cleirigh C, Safren SA. Adult attention
deficit hyperactivity disorder symptoms and five-factor model
traits in a clinical sample: a structural equation modeling
approach. J Nerv Ment Dis. 2013;201:848–54.
45. Zhao H, Seibert SE. The big five personality dimensions and
entrepreneurial status: a meta-analytical review. J Appl Psychol.
2006;91:259–71.
46. Brandstatter H. Personality aspects of entrepreneurship: a look at
five meta-analyses. Pers Individ Dif. 2011;51:222–30.
47. Dunn T, Holtz-Eakin D. Financial capital, human capital, and the
transition to self-employment: evidence from intergenerational
links. J Labor Econ. 2000;18:282–305.
48. Chlosta S, Patzelt H, Klein SB, Dormann C. Parental role models
and the decision to become self-employed: the moderating effect
of personality. Small Bus Econ. 2012;38:121–38.
49. Grizenko N, Paci M, Joober R. Is the inattentive subtype of
ADHD different from the combined/hyperactive subtype? J Atten
Disord. 2010;13:649–57.
50. Acosta M, Castellanos F, Bolton K. Latent class subtyping of
attention-deficit/hyperactivity disorder and comorbid conditions.
J Am Acad Child Adolesc Psychiatry. 2008;47:797–807.
51. Miller T, Nigg J, Faraone S. Axis I and II comorbidity in adults
with ADHD. J Abnorm Psychol. 2007;116:519.
52. Thurik R, Khedhaouria A, Torre
`s O, Verheul I. ADHD Symp-
toms and Entrepreneurial Orientation of Small Firm Owners.
Appl Psychol Int Rev. 2016. doi:10.1111/apps.12062.
53. Rauch A, Wiklund J, Lumpkin GTT, Frese M. Entrepreneurial
orientation and business performance: an assessment of past
research and suggestions for the future. Entrep Theory Pract.
2009;33:761–87.
54. Nigg JT. The ADHD response-inhibition deficit as measured by
the stop task: replication with DSM-IV combined type, extension,
and qualification. J Abnorm Child Psychol. 1999;27:393–402.
55. Young S. ADHD children grown up: an empirical review. Couns
Psychol Q. 2000;13:191–200.
56. Bozionelos N, Bozionelos G. Attention-deficit/hyperactivity dis-
order at work: does it impact job performance? Acad Manag
Perspect. 2013. doi:10.5465/amp.2013.0107.
57. Halmøy A, Fasmer OB, Gillberg C, Haavik J. Occupational
outcome in adult ADHD: impact of symptom profile, comorbid
psychiatric problems, and treatment: a cross-sectional study of
414 clinically diagnosed adult ADHD patients. J Atten Disord.
2009;13:175–87.
58. Halleland HB, Sorensen L, Posserud M-B, Haavik J, Lundervold
AJ. Occupational status is compromised in adults with ADHD
and psychometrically defined executive function deficits. J Atten
Disord. 2015. doi:10.1177/1087054714564622.
59. Panksepp J, Scott EL. Reflections on rough and tumble play,
social development, and attention-deficit hyperactivity disorders.
800 I. Verheul et al.
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
In: Gullotta TP, editor. Meyer AL. Phys. Act. Across Lifesp. New
York: Springer; 2012. p. 23–40.
60. White HA, Shah P. Uninhibited imaginations: creativity in adults
with attention-deficit/hyperactivity disorder. Pers Individ Dif.
2006;40:1121–31.
61. Williams J, Taylor E. The evolution of hyperactivity, impulsivity
and cognitive diversity. J R Soc Interface. 2006;3:399–413.
62. Bru
¨ne M, Belsky J, Fabrega H, Feierman JR, Gilbert P, Glantz K,
et al. The crisis of psychiatry - Insights and prospects from
evolutionary theory. World Psychiatry. 2012;11:55–7.
63. Troisi A, McGuire M. Darwinian psychiatry and the concept of
mental disorder. Neuro Endocrinol. Lett. 2002;23:31–8.
The association between attention-deficit/hyperactivity (ADHD) symptoms and self-employment 801
123
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
1.
2.
3.
4.
5.
6.
Terms and Conditions
Springer Nature journal content, brought to you courtesy of Springer Nature Customer Service Center GmbH (“Springer Nature”).
Springer Nature supports a reasonable amount of sharing of research papers by authors, subscribers and authorised users (“Users”), for small-
scale personal, non-commercial use provided that all copyright, trade and service marks and other proprietary notices are maintained. By
accessing, sharing, receiving or otherwise using the Springer Nature journal content you agree to these terms of use (“Terms”). For these
purposes, Springer Nature considers academic use (by researchers and students) to be non-commercial.
These Terms are supplementary and will apply in addition to any applicable website terms and conditions, a relevant site licence or a personal
subscription. These Terms will prevail over any conflict or ambiguity with regards to the relevant terms, a site licence or a personal subscription
(to the extent of the conflict or ambiguity only). For Creative Commons-licensed articles, the terms of the Creative Commons license used will
apply.
We collect and use personal data to provide access to the Springer Nature journal content. We may also use these personal data internally within
ResearchGate and Springer Nature and as agreed share it, in an anonymised way, for purposes of tracking, analysis and reporting. We will not
otherwise disclose your personal data outside the ResearchGate or the Springer Nature group of companies unless we have your permission as
detailed in the Privacy Policy.
While Users may use the Springer Nature journal content for small scale, personal non-commercial use, it is important to note that Users may
not:
use such content for the purpose of providing other users with access on a regular or large scale basis or as a means to circumvent access
control;
use such content where to do so would be considered a criminal or statutory offence in any jurisdiction, or gives rise to civil liability, or is
otherwise unlawful;
falsely or misleadingly imply or suggest endorsement, approval , sponsorship, or association unless explicitly agreed to by Springer Nature in
writing;
use bots or other automated methods to access the content or redirect messages
override any security feature or exclusionary protocol; or
share the content in order to create substitute for Springer Nature products or services or a systematic database of Springer Nature journal
content.
In line with the restriction against commercial use, Springer Nature does not permit the creation of a product or service that creates revenue,
royalties, rent or income from our content or its inclusion as part of a paid for service or for other commercial gain. Springer Nature journal
content cannot be used for inter-library loans and librarians may not upload Springer Nature journal content on a large scale into their, or any
other, institutional repository.
These terms of use are reviewed regularly and may be amended at any time. Springer Nature is not obligated to publish any information or
content on this website and may remove it or features or functionality at our sole discretion, at any time with or without notice. Springer Nature
may revoke this licence to you at any time and remove access to any copies of the Springer Nature journal content which have been saved.
To the fullest extent permitted by law, Springer Nature makes no warranties, representations or guarantees to Users, either express or implied
with respect to the Springer nature journal content and all parties disclaim and waive any implied warranties or warranties imposed by law,
including merchantability or fitness for any particular purpose.
Please note that these rights do not automatically extend to content, data or other material published by Springer Nature that may be licensed
from third parties.
If you would like to use or distribute our Springer Nature journal content to a wider audience or on a regular basis or in any other manner not
expressly permitted by these Terms, please contact Springer Nature at
onlineservice@springernature.com
... Since then, entrepreneurship researchers have begun to pay more and more attention to the relationship between attention deficit hyperactivity disorder (ADHD) and entrepreneurship. Moreover, rather than viewing ADHD as a deficit, this research stream has empirically shown associations between ADHD and several aspects of entrepreneurship, such as entrepreneurial orientation and entrepreneurial action (Patel et al., 2019;Verheul et al., 2016;Wiklund et al., 2017). ...
... Some research results have shown a positive relationship, while others have shown a negative relationship (Antshel, 2018;Lerner et al., 2018;Moore et al., 2019). Dimic and Orlov (2014) and Verheul et al. (2015) noted that several studies have explored the relationship between ADHD and entrepreneurial intention and orientation, whereas studies focusing on entrepreneurial action are scarce (Patel et al., 2019;Verheul et al., 2016;Wiklund et al., 2017). Verheul et al. (2015) also pointed out that entrepreneurial intention depends on ADHD behavior based on the person-environment fit theory (P-E). ...
... Thus, beyond the need to focus on the relationship between ADHD and entrepreneurship (Antshel, 2018;Wiklund at al., 2016), there remains a need to build on the research that explores the influence of ADHD on entrepreneurial action (Patel et al., 2019;Verheul et al., 2016;Wiklund et al., 2017) and the impact that entrepreneurial intention might have on this relationship. ...
Article
Full-text available
The fundamental objective of this research is to study the relationship between Attention-Deficit/Hyperactivity Disorder (ADHD) behavior and entrepreneurial behavior in Tunisian students. Based on the theory of person-environment adjustment (P-E), the theory of planned behavior (TPB) and the analysis of data collected from 267 Tunisian students using a self-administered online questionnaire, the results of the present study showed no relationship between ADHD behavior and entrepreneurial action. However, entrepreneurial intention plays a mediating role in this relationship. These results constitute a theoretical contribution to the entrepreneurial field. Similarly, the results of the current study lend further support to the person-environment “P-E” theory, which posits that the functionality of a component of ADHD behavior depends on its fit with the environment. In particular, the uncertain and autonomous entrepreneurial environment could be an attractive career choice for people who display hyperactive/impulsive behavior. As for the theory of planned behavior “TPB,” the results of this study also show that intention is a fundamental antecedent of entrepreneurial behavior. This research has practical implications. Its results can be used by stakeholders in the entrepreneurial ecosystem (teachers, incubators, career coaches,… etc.) to detect future entrepreneurs and absorb the unemployment of Tunisian university graduates.
... Such a hypothetical hardwired trait is pre-strategic venturing without intentionality, which has been concocted to make sense of a statistically significant link between a self-reported ADHD condition and entrepreneurial intentions found in data collected by the Netherlands chapter of the Global University Entrepreneurial Spirit Students Survey (GUESSS) (e.g., Verheul et al., 2015Verheul et al., , 2016Lerner et al., 2017Lerner et al., , 2018aLerner et al., , 2018bLerner et al., , 2019Wismans et al., 2020). Highly penetrant so-called monogenic phenotypes (i.e., a single gene whose strong influence is expressed in physical or behavioural traits notwithstanding epigenetic mechanisms) are, however, known for being rare (Chial, 2008). ...
... Against this backdrop, it is surprising to see how a link between a self-reported ADHD condition and entrepreneurial intentions in GUESSS has given rise to the idea of hardwired entrepreneurial intentions or 'pre-strategic venturing without intentionality' (Lerner et al., 2017, p.5;2018a, p.64). Thus, the entrepreneurship research in question claims to have confirmed that ADHDafflicted individuals are significantly more likely (Verheul et al., 2015) or almost twice as likely (Lerner et al., 2019) to espouse entrepreneurial intentions, as well as to be self-employed (Verheul et al., 2016). While the causal language in Verheul et al. (2016) is less salient, Verheul et al. (2015, pp.85, 89), in contrast, claim to 'predict' the aforementioned link and, perceiving a good fit between entrepreneurship and ADHD-like behaviour, assume that it is because of ADHD that subjects are likely to have entrepreneurial intentions. ...
... Thus, the entrepreneurship research in question claims to have confirmed that ADHDafflicted individuals are significantly more likely (Verheul et al., 2015) or almost twice as likely (Lerner et al., 2019) to espouse entrepreneurial intentions, as well as to be self-employed (Verheul et al., 2016). While the causal language in Verheul et al. (2016) is less salient, Verheul et al. (2015, pp.85, 89), in contrast, claim to 'predict' the aforementioned link and, perceiving a good fit between entrepreneurship and ADHD-like behaviour, assume that it is because of ADHD that subjects are likely to have entrepreneurial intentions. ...
Article
Full-text available
This paper disputes the thesis that a self-reported mental condition of apparent genetic origin makes its carriers entertain entrepreneurial intentions and assesses its implications for entrepreneurship-driven economic development. The findings are that the research in question mistakes true causative agents for superficial cause-hiding vectors, thus confusing a self-reported attention-deficit/hyperactivity disorder (ADHD) condition with the cause of entrepreneurial intentions. This is all the more so because ADHD was not properly accounted for, relying instead on the Global University Entrepreneurial Spirit Students Survey (GUESSS), self-administered without diagnostic evidence. Thus, entrepreneur-ship has been turned on its head, being misrepresented as a hardwired, innate human trait instead of a course of action that hinges on subjective preferences that can be influenced by the structure of rewards shaped by public policy. This misrepresentation may dwell in the so-called 'hardness bias', which underestimates the softer but crucial test of the quality of conjectures. The originality of this paper lies in the use of the harmful-dysfunction analysis, showing that the entrepreneurship research in question is based on a bogus notion of disorder.
... Person-environment fit had a critical role in job satisfaction, job maintenance and workplace adaptation for individuals with ADHD (Anhalt, 2015;Button, 2018;Goffer et al., 2022;Lasky, 2015;Lasky et al., 2016;Lyhne et al., 2021;Schreuer & Dorot, 2017). Workers with ADHD indicated that stimulating workplace environments with challenge, novelty, multitasking, fast-paced activities, physical labor, active learning, communal and quiet spaces, and personal autonomy were an especially good fit for ADHD (Abramowicz, 1998;Anhalt, 2015;Button, 2018;Glynn & Schaller, 2017;Goffer et al., 2022;Lasky, 2015;Lasky et al., 2016;Liebel et al., 2023;Lyhne et al., 2021;Schreuer & Dorot, 2017;Verheul et al., 2016). ...
... On this last point of personal autonomy, compared to traditional "9 to 5" employment, self-employment may be a better fit for some workers with ADHD as selfemployment allows the individual to establish their own work conditions, environment, and hours (Abramowicz, 1998;Högstedt et al., 2023;Kent, 2017;Mannuzza et al., 1993Mannuzza et al., , 1997Nagata et al., 2019;Schreuer & Dorot, 2017;Verheul et al., 2016). ...
Article
Attention-deficit/hyperactivity disorder (ADHD) has a significant impact on psychosocial and occupational functioning. Sixty-five percent of children with ADHD continue to meet full or partial diagnostic criteria for ADHD in adulthood, and an estimated 4% of the workforce has a diagnosis of ADHD. We performed a systematic literature review to understand the experience of ADHD in the workplace. Articles were included in the systematic literature review if they reported results on employment outcomes of adults with ADHD. Methodological quality assessment was evaluated using the Mixed Methods Appraisal Tool. Seventy-nine studies were included in this systematic literature review ( n ADHD = 68,275). Results were synthesized into four categories: challenges, strengths, adaptations, and sex differences. Eight themes were included: ADHD symptoms at work, workplace performance, job satisfaction, maladaptive work thoughts and behaviors, interpersonal relationships at work, personal strengths, embracing ADHD, person-environment fit, and accommodations and support. Workers with ADHD can adapt and thrive in employment with the right person-environment fit, and accommodations and support. Many challenges related to ADHD can be remodeled into assets in a workplace environment that promotes flexible working practices and openness to neurodiversity.
... Several studies validated a relationship between entrepreneurship and ADHD (e.g., Lerner et al., 2019;Verheul et al., 2016;Hunt et al., 2022). Notably, certain facets of ADHDhyperactivity-impulsivity, but not inattentionappear particularly germane to entrepreneurship. ...
... Freeman et al. (2018) Self-report study of entrepreneurs in a convenience sample 11% (of 242) entrepreneurs reported having bipolar spectrum disorder compared to a prevalence of 1% among (93) Verheul et al. (2015) 10,104 students Scores on the World Health Organization ADHD Self-Report Scale (ASRS) related to higher entrepreneurial career intentions. Verheul et al. (2016) Two samples: n = 7208 sampled from STAGE cohort of the Swedish Twin Registry; and n = 13,112 Dutch students of the GUESSS study Symptoms of hyperactivity-impulsivity, but not inattention were related to entrepreneurship. ADHD diagnosis increased odds of becoming an entrepreneur by 1.13. ...
Article
Full-text available
Highlights • Atypical dopamine physiology appears to be a biomarker of neurodiversity in entrepreneurs. • Dopaminergic personality traits include Openness, Extraversion and the Industriousness aspect of Conscientiousness. • Dopaminergic psychiatric conditions include bipolar spectrum syndromes, attention deficit hyperactivity disorder (ADHD), substance and behavioral addictions, and OCPD. • The dopaminergic perspective offers an integrative framework – connecting separate branches of research on personality and on psychiatric symptoms/conditions in entrepreneurship. • Future research opportunities include understanding the interplay between environmentally-triggered inhibition and expression of underlying genes, and entrepreneurship-related behavior. ABSTRACT Research conducted over the last three decades confirms that dopaminergic personality traits (Openness, Extraversion and the Industriousness aspect of Conscientiousness) are prominent among entrepreneurs. We highlight the continuum between dopaminergic traits, dimensions, temperaments, symptoms and psychiatric conditions (bipolar spectrum conditions, ADHD, substance and behavioral addictions, and OCPD) among entrepreneurs, and how behavioral manifestations of this continuum affect entrepreneurial action. Despite the pathological potential, the connection with some favorable outcomes of dopaminergic traits and psychiatric conditions suggests that atypical dopamine physiology may be one biomarker of the neurodiversity that distinguishes, empowers and endangers entrepreneurs. By showing the dopaminergic underpinnings of traits, dimensions, symptoms and conditions among entrepreneurs, we offer a unifying framework that contextualizes findings within the construct of dopaminergic differences – a framework that integrates otherwise isolated findings about the personality traits and psychiatric conditions of entrepreneurs. In other words, the neurodiversity biomarkers and bio-psycho-social characteristics found among entrepreneurs often reflect a polygenic endophenotype that features atypical dopamine physiology. Full opensource article: https://doi.org/10.1016/j.jbvi.2024.e00461
... White and Shah (2006) found that people with ADHD excel in creative pursuits and are able to problem-solve. People who have ADHD are suited to entrepreneurial careers in which impetuousness fuels risk-taking and autonomy are important (Verheul et al., 2016). The propensity to hyperfocus in one area of interest contributes to high levels of expertise (Baer, 2015). ...
Preprint
Full-text available
While childhood Attention-Deficit/ Hyperactivity Disorder (ADHD) has been extensively researched in recent years, studies concerning how adults with ADHD cope in their private lives or in the workplace are relatively few in number. The current study used a questionnaire survey to investigate the experiences of language teachers (N=48) with ADHD in the workplace. A content analysis of the textual responses to open-ended items showed that language teachers experience issues related to focus and self-control, task steps and process, task initiation and execution, memory, and emotional and physical responses. Three additional themes include: workplace relationships, coping mechanisms, and unique skills due to their ADHD. Findings indicate that the work life realities of teachers intersect with their work with students so much more research is needed to investigate how these unique relationships affect students’ learning.
... Whilst supported employment has advantages including enhanced employee well-being, research suggests competitive employment generally leads to the highest levels of job satisfaction, possibly because it enhances self-image and offers career development opportunities, especially when colleagues are supportive (Almalky 2020). Finally, in a study of self-employment amongst individuals with ADHD, the authors found hyperactivity was positively associated with this employment type (Verheul et al. 2016). ...
Article
Full-text available
OPEN ACCESS: https://onlinelibrary.wiley.com/doi/full/10.1002/hrm.22259 Growing recognition of neurodivergence amongst individuals poses challenges for career counselors and human resource practitioners when advising, guiding, and supporting the careers of this diverse group. Despite the potential for neurodivergent individuals to contribute to organizations, career guidance for these individuals is a relatively new area. We conducted a multidisciplinary project comprising a scoping review and stakeholder consultation to generate evidence‐based recommendations for identifying and supporting career paths that lead to positive employment outcomes for neurodivergent individuals. The scoping review included 78 articles on career guidance and associated employment issues (e.g., facilitators and barriers to employment) for neurodivergent individuals, while stakeholders, including neurodivergent individuals, counselors, and others, provided insights into their employment experiences. Our scoping review yielded nine themes: career guidance practice, predictors of employment, employment interventions, different forms of employment, work barriers and facilitators, strengths and challenges, person‐job fit, occupation and industry fit, and employment outcomes. The stakeholder consultations complemented the scholarly themes. Results were interpreted using the Stone and Colella theoretical model of factors influencing the treatment of people with disabilities. The model was extended across educational and work contexts, and to include the nature of occupations and industries. Building on this project and our overarching theoretical model, we map a future research agenda for the study of careers amongst neurodivergent individuals. Specifically, we highlight persistent methodological limitations of the literature before turning to theoretical implications across career stages. We conclude with practical implications for career counselors and human resource practitioners. Ultimately, our review calls for researchers and practitioners to help promote sustainable, high‐quality, and fulfilling careers for neurodivergent individuals.
Chapter
Full-text available
The concept of neurodiversity presents neurological differences, such as autism, ADHD, and dyslexia, as natural variations of human cognition rather than deficits. Adopting a strength-based approach to understanding neurodivergent individuals has significant implications for the field of entrepreneurship, as it highlights the unique skills and perspectives that neurodivergent entrepreneurs can bring to the table. Although there are no certain statistics regarding the prevalence of neurodiverse entrepreneurs, research and popular media alike suggest that entrepreneurship is an occupation that attracts the neurodivergent (e.g., Wiklund et al., 2017; Logan, 2009). Given the struggles that many neurodivergent individuals face in the regular labor market, such research can present an alternative, brighter, and more hopeful image of neurodiversity in the workplace. In this chapter, we discuss the relationship between neurodiversity and entrepreneurship by examining the literature on ADHD, autism, and dyslexia in relation to entrepreneurial activities. In addition, we explore the implications of this research for intervention programs and strategies aimed at supporting neurodivergent entrepreneurs.
Chapter
Persons with attention deficit hyper-activity disorder (ADHD) are more likely to be unemployed, underemployed, and live in poverty in comparison to their peers. A substantial body of literature examines the medical and occupational challenges experienced by persons with ADHD. Yet, an emerging area of research highlights how the relationship between ADHD and career success is multifaceted and dependent upon the interaction between individual and environment. Considering these advancements, it has become especially important to identify both the barriers and facilitators of career success encountered by persons with ADHD, so that individuals can make informed decisions and employers can become more ADHD-inclusive. In this chapter, we draw from research in the fields of management, psychology, sociology, industrial relations, rehabilitation sciences, medicine, disability studies, economics, and design to outline current understandings of career outcomes for persons with ADHD, relevant career success barriers and facilitators, and directions for future research.
Article
Full-text available
Avaible online: http://dx.doi.org/10.5465/amp.2013.0107
Article
Full-text available
Little is known about the relation between entrepreneurship and the extent of psychiatric symptoms. Validated psychiatric symptom scores are seldom used for non-clinical reasons. One prevalent symptom that deserves our interest is Attention Deficit and Hyperactivity Disorder (ADHD). ADHD is a developmental disorder characterized by inattentiveness and hyperactivity that has been linked to occupational choice and performance. Building on the person–environment fit literature, we hypothesize that individuals who exhibit behavior associated with ADHD are more likely to have entrepreneurial intentions. Using a sample of 10,104 students enrolled in higher education, we can confirm our prediction that students with a higher level of ADHD-like behavior are more likely to have entrepreneurial intentions. Additionally, we show that risk taking propensity is a mediator that partly explains this positive effect. Our study points to the importance of behavioral tendencies associated with developmental disorders, when making entrepreneurship decisions. Our study contributes to the literature on the determinants of entrepreneurship, which so far has largely neglected the effects of psychiatric symptoms on entrepreneurship.
Article
Full-text available
Objective: Problems related to executive function (EF) are frequently reported in adults with ADHD. However, only a subgroup of patients show deficits on common neuropsychological tests designed to measure EF. We investigated whether this subgroup also had higher levels of functional impairments, including unemployment, than the ADHD group without such deficits. Method: We defined executive function deficit (EFD) from selected tests from the Delis–Kaplan Executive Function System (D-KEFS) and assessed ADHD symptoms and psychiatric comorbidity with the use of questionnaires in 79 ADHD patients and 77 controls (IQ above 80 in both groups). Results: In the ADHD group, 24.3% had EFD. This subgroup showed significantly higher frequency of unemployment, more reading and writing problems, lower IQ scores, and more self-reported ADHD symptoms in childhood than the ADHD subgroup without EFD. Conclusion: These findings indicate that it may be possible to identify individuals at risk of functional impairments, and emphasizes the importance of effective treatment programs targeting EF.
Technical Report
Full-text available
The economic and social relevance of entrepreneurship in general and new ventures in particular is well-established across the world. Students, as they could be the entrepreneurs of tomorrow, have attracted considerable scholarly and public attention in the last decades. Despite strong research efforts in the past, many questions are still not sufficiently answered. Which individual, societal, family- and university-related factors enhance students' intention to found their own company? How do students' entrepreneurial intentions and activities compare across a multitude of nations? Are there globally applicable best practices? To generate unique insights and contributions that address these gaps, it is thus imperative to further investigate students' entrepreneurial intentions, activities and their antecedents on a global level. This is the overarching goal of the GUESSS research project (Global Universiy Entrepreneurial Spirit Students' Survey). At GUESSS, we not only focus on new venture creation, but we take a broader perspective to include different interesting variations of entrepreneurial intentions and activities. For instance, we are interested in students' intention to take over an existing company or to succeed in their parents' family firm. This report presents the results and insights of the 2011 edition of the GUESSS project on the global level. In Spring 2011, a large-scale quantitative survey was conducted in 26 different countries, addressing more than 1 Million students from 489 Universities, leading to a data set with more than 93'000 responses (N=93’265).
Chapter
The urge for physical play in mammals, including humans, is built into the nervous system (Panksepp, 2008). This has been rigorously demonstrated in laboratory animals (Ikemoto & Panksepp, 1992). Although the precise functions of physical play remain unspecified, it is likely essential for optimal childhood development, both body and mind, with many demonstrated benefits (Burgdorf, Kroes, Beinfeld, Panksepp, & Moskal, 2010; Panksepp, 1993, 2010). We propose that play forms the backbone of young children’s daily life through spontaneous social learning that enhances social interactions, promotes learning, and provides positive affect that may increase psychological resilience. In fact, we now know that play provides considerable benefits in young animals, where the necessary detailed behavioral work can be done (as summarized in Burgdorf et al., 2010; Burgdorf, Panksepp, & Moskal, 2011; Gordon, Burke, Akil, Watson, & Panksepp, 2003; Panksepp, Siviy, & Normansell, 1984; Pellis & Pellis, 2009; Vanderschuren, 2010).
Article
This study investigates the link between attention deficit hyperactivity disorder (ADHD) symptoms and entrepreneurial orientation (EO). EO is known to be a crucial factor for small firm survival and growth, conceptualised as a business characteristic but influenced by the personality of the small business owner and measured at her individual level. There is ample anecdotal evidence claiming that ADHD symptoms have helped entrepreneurs in their careers. Using a data set of French small firm owners, we are the first to go beyond the anecdotal level in linking ADHD symptoms and EO. Our study contributes to our understanding of entrepreneurship, particularly the determinants of EO, and to “destigmatising” ADHD, which is considered solely a clinical disorder that should be treated.
Article
The purpose of this paper is to document the fundamental shift that is taking place in OECD countries. This shift is from the managed economy to the entrepreneurial economy. While politicians and policymakers have made a plea for guidance in the era of entrepreneurship, scholars have been slow to respond. This paper attempts to make a first step identifying and articulating these differences. We do this by contrasting the most fundamental elements of the newly emerging entrepreneurial economy with those of the managed economy. We identify 14 trade-offs confronting these two polar worlds. The common thread throughout these trade-offs is the increased role of new and small enterprises in the entrepreneurial economy. A particular emphasis is placed on changes in economic policy demanded by the entrepreneurial economy vis-à-vis the managed economy.