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ADHD, Integrated Treatment, Overweight, Participant Perspective, Sleeping Disorders



  1. Zwennes, Cinderella T. C. MANP/CA
  2. Loth, Christien A. PhD, MANP, MN


Background: People living with attention deficit hyperactivity disorder (ADHD) often have to cope with additional comorbid disorders. In daily practice, practitioners observe that ADHD not only causes a decline in participants' quality of life, but the presence of sleep and eating disorders also has an impact on daily functioning. The aims of this study are to give meaning to the experiences of participants who are living with ADHD and sleep deprivation and are overweight and to provide additional knowledge and data that will inform integrated treatment in the long term. The following research questions were formulated:


* How does living with ADHD-associated disorders such as sleep deprivation and being overweight affect daily routines and quality of life in participants with ADHD?


* Which essential themes from daily functioning, articulated by participants, should be addressed in an integrative treatment model?



Method: A qualitative design based on a Parse research method provided the best research framework to answer our questions. The method aims for data saturation, employing six steps in which data collection alternates with data analysis. This iterative process with double hermeneutics enlarges participants' perspectives on their experiences.


Results: Participants' daily life is continuously influenced by their experiences with (binge) eating, irregular sleeping patterns, and loss of emotional control. These complex phenomena are often caused by their ADHD, because of underdeveloped coping skills. An everyday struggle with life and difficulty making choices are the leading themes in participant narratives. Continuous feelings of failure, referred to in this report as everyday "failure moments," cause negative self-esteem and negative body image. According to participants, standardized care should include opportunities for participants to tell their life stories as well as an individualized analysis of how ADHD core symptoms affect daily decision making, taking into account sleeping and eating patterns.


Conclusion: The experience of failure moments, the struggle with making choices, and negative self-esteem and body image all develop in a different way for each participant. When professionals treat participants by solely focusing on the core symptoms using a one-dimensional cognitive behavioral approach, they may overlook underlying (biological) interactions.