Edited by: Henry W. Chase, University of Pittsburgh, United States
Reviewed by: Rosa Angela Fabio, University of Messina, Italy; Yosuke Kita, Hitotsubashi University, Japan
This article was submitted to Psychopathology, a section of the journal Frontiers in Psychology
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Attention-deficit hyperactivity disorder (ADHD), which persists in 2.5–5% of adults (
To improve internalizing symptoms, it is necessary to approach the associated symptoms of ADHD as well as decreasing the cardinal symptoms (
Procrastination has two aspects: maladaptive and adaptive. Maladaptive procrastination is defined as “voluntarily delay in an intended course of action despite expecting to be worse off due to the delay” (
Procrastination, which can cause maladaptive problems, frequently appears in ADHD adults’ daily lives (
The presence of ADHD tendencies may explain the inconsistent research on the effects of procrastination on psychiatric symptoms. These inconsistent findings show that effects of procrastination differ depending on the presence of ADHD tendencies. For instance, the adaptive aspects of procrastination require executive functional skills such as time management and planning strategies (
Therefore, the current study aimed to investigate the moderating effect of ADHD symptoms on the association between procrastination and internalizing symptoms. Based on the literature regarding ADHD, procrastination, and internalizing symptoms, this study proposed the following three hypotheses: (a) People with ADHD exhibit more procrastination, (b) procrastination is positively correlated with depression and anxiety symptoms, and (c) ADHD symptoms strengthen this correlation.
All procedures of this study were approved by the institutional Ethics Review Committee on Research with Human Subjects of the first author’s affiliation (2018-282).
The online questionnaire survey was conducted among participants who had registered on an online survey company in Japan. It was executed during February and March 2019. Before completing the questionnaire, participants read an onscreen explanation about responding without compulsion as an ethical consideration. This study recruited 500 participants who were grouped according to their Adult ADHD Self-Report Scale-v1.1 (ASRS) score. The higher-level ADHD symptoms group (ADHD-H) were those who scored above the cutoff point of the ASRS Part A (
To ensure the quality of the online survey, data from 10 of the 500 participants were excluded because their answers showed patterns of straightlining for all scales. Straightlining is defined as giving the same answer for all items in each scale (
Attention-deficit hyperactivity disorder symptom status was assessed using the ASRS (
Self-reported difficulties related to procrastination were determined using the General Procrastination Scale (GPS;
The Patient Health Questionnaire (PHQ-9;
The Japanese version of the State–Trait Anxiety Inventory (
All statistical analyses were conducted using IBM SPSS Statistics 26.0 software (
An acceptable level of skewness was observed for all scales, indicating a normal distribution. The descriptive characteristics and
Sample characteristics and descriptive statistics for all analytic variables.
ADHD-H ( |
ADHD-L ( |
Cohen’s |
Kurtosis | Skewness | Cronbach’s |
|||||
---|---|---|---|---|---|---|---|---|---|---|
Mean | Mean | |||||||||
Age | 26.35 | 3.13 | 26.77 | 2.66 | −1.61 | 0.108 | 0.14 | −0.16 | −0.76 | |
ASRS Part A | 15.04 | 2.74 | 8.19 | 3.45 | 24.29 | 0.000 | 2.20 | 0.31 | −0.28 | 0.83 |
GPS | 42.27 | 7.97 | 35.49 | 8.40 | 9.17 | 0.000 | 0.83 | 0.21 | −0.13 | 0.84 |
PHQ | 9.40 | 7.01 | 6.52 | 6.55 | 4.69 | 0.000 | 0.42 | −0.12 | 0.81 | 0.92 |
STAI-T | 53.26 | 9.99 | 47.57 | 9.57 | 6.43 | 0.000 | 0.58 | 0.67 | 0.06 | 0.88 |
ASRS Part A, Adult ADHD Self-Report Scale-v1.1 Part A; GPS, General Procrastination Scale; PHQ, Patient Health Questionnaire-9; SD, standard deviation; STAI, State–Trait Anxiety Inventory-Form JYZ; ADHD-H, participants who scored above the ASRS Part A cutoff point; and ADHD-L, those who scored below the ASRS Part A cutoff point. Degrees of freedom=488.
Our analyses revealed significant differences between the two groups for all assessments (
Correlations among all variables.
2. | 3. | 4. | |
---|---|---|---|
1. ASRS Part A | 0.42 |
0.28 |
0.35 |
2. GPS | 0.28 |
0.39 |
|
3. PHQ-9 | 0.60 |
||
4. STAI-T |
Hierarchical multiple regression analyses using depressive and anxiety symptoms as outcome variables were conducted using all variables as predictors in the first step and adding the interaction of ADHD symptom status and procrastination as a predictor in the second step. These analyses allowed the examination of whether procrastination predicted internalizing symptom and if this relation is strengthened by ADHD symptom status as a moderator.
The results for depressive symptoms are presented in
Attention-deficit hyperactivity disorder symptom status, procrastination, and their interactions with PHQ.
95% CI | Adjusted |
AIC | BIC | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||||||
Step 1 | 0.090 | 0.083 | 11.997 | 0.000 | 1,860.215 | 1,881.187 | ||||||
Sex | 0.017 | 0.229 | 0.704 | −0.956 | 1.414 | |||||||
Age | 0.028 | 0.067 | 0.516 | −0.137 | 0.271 | |||||||
ADHD symptom status | −0.121 | −1.675 | 0.010 | −2.953 | −0.397 | |||||||
GPS | 0.232 | 0.182 | <0.001 | 0.109 | 0.254 | |||||||
Step 2 | 0.090 | 0.081 | 0.000 | 9.590 | 0.000 | 1,862.159 | 1,887.325 | |||||
Sex | 0.016 | 0.222 | 0.714 | −0.966 | 1.410 | |||||||
Age | 0.029 | 0.069 | 0.508 | −0.136 | 0.274 | |||||||
ADHD symptom status | −0.121 | −1.673 | 0.010 | −2.953 | −0.394 | |||||||
GPS | 0.233 | 0.182 | <0.001 | 0.109 | 0.255 | |||||||
ADHD symptom status × GPS | −0.010 | −0.017 | 0.813 | −0.162 | 0.128 |
Attention-deficit hyperactivity disorder symptom status, procrastination, and their interactions with STAI-T.
95% CI | Adjusted |
Δ |
AIC | BIC | ||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Lower | Upper | |||||||||||
Step 1 | 0.176 | 0.169 | 25.941 | 0.000 | 2,187.657 | 2,208.629 | ||||||
Sex | −0.021 | −0.418 | 0.620 | −2.073 | 1.237 | |||||||
Age | 0.041 | 0.144 | 0.321 | −0.141 | 0.429 | |||||||
ADHD symptom status | −0.152 | −3.085 | 0.001 | −4.871 | −1.300 | |||||||
GPS | 0.341 | 0.392 | <0.001 | 0.290 | 0.493 | |||||||
Step 2 | 0.176 | 0.168 | 0.000 | 20.713 | 0.000 | 2,189.647 | 2,214.813 | |||||
Sex | −0.020 | −0.413 | 0.625 | −2.073 | 1.246 | |||||||
Age | 0.041 | 0.143 | 0.326 | −0.143 | 0.429 | |||||||
ADHD symptom status | −0.152 | −3.086 | 0.001 | −4.874 | −1.299 | |||||||
GPS | 0.341 | 0.391 | <0.001 | 0.290 | 0.493 | |||||||
ADHD symptom status × GPS | 0.004 | 0.010 | 0.919 | −0.192 | 0.213 |
The present study aimed to examine the moderating effects of ADHD symptom status on the association between procrastination and internalizing symptoms. First, our analysis confirmed that adults with a higher ADHD symptom status showed more frequent procrastination than those with a lower ADHD symptom status. Participants in the ADHD-H group had higher scores for procrastination than those in the ADHD-L group, indicating a non-negligible effect size of Cohen’s
Third, contrary to our hypothesis, ADHD symptom status had no moderating effect – that is, the association between procrastination and internalizing symptoms did not depend on the severity of ADHD symptoms. Although clinical perspectives have indicated that adults with ADHD are more likely to experience maladaptive procrastination in their daily lives (
Although this study did not support the hypothesis, its findings can be regarded as a significant step in understanding the role of ADHD in the onset of the procrastination. The current result suggested that association between procrastination and internalizing symptoms was not moderated by ADHD symptomatology, inattention, hyperactivity, and impulsivity. However, among the ADHD core symptoms, inattentiveness was found to be positively associated with elevated neuroticism (
The present study has several limitations. First, all measurements were self-reported, meaning that the correlations observed here may be explained by the common method variance (
Second, this study was a cross-sectional survey. Therefore, the direction of causality between procrastination and internalizing symptoms is unclear. In the case of depression, symptoms of sluggish activity might cause procrastination (
Third, one of the six items of the ASRS Part A represents procrastination: “When you have a task that requires a lot of thought, how often do you avoid or delay getting started?” (
Finally, data for socioeconomic status, education level, intelligence quotient, or any other confounders were not collected. For instance, internalizing symptoms are known to be associated with the absence of partners (
This study revealed that people with higher ADHD symptom levels exhibited procrastination more frequently and showed more internalizing symptoms such as depression and anxiety. Focusing on procrastination would be helpful for those who suffer from ADHD and internalizing symptoms. However, there was no moderating effect of ADHD symptoms on the association between procrastination and internalizing symptoms. We should examine more precise and valid hypotheses and underlying mechanisms of procrastination in high and low ADHD symptom groups.
The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.
The studies involving human participants were reviewed and approved by the institutional Ethics Review Committee on Research with Human Subjects of the first author’s affiliation (2018-282). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
MO designed and conducted the survey, undertook the statistical analyses, and wrote the draft manuscript. TT, YN, and HK managed the survey and all other issues related to conducting the research. MO, TT, YN, and HK contributed to the critical revision and have approved the final version of the manuscript. All authors contributed to the article and approved the submitted version.
This study was supported by grants from the Ibuka fund and JSPS KAKENHI grant Number 202023103.
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
We would like to thank Editage (
Attention-deficit hyperactivity disorder
Adult ADHD Self-Report Scale
Higher-level ADHD symptoms group
Lower-level ADHD symptoms group
Akaike information criterion
Bayesian information criterion
General Procrastination Scale
Japanese version of the State–Trait Anxiety Inventory
Patient Health Questionnaire