Attention Deficit Hyperactivity Disorder in Military Contexts

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition often characterised by inattention, hyperactivity, and impulsivity. While extensively studied in civilian populations, its presence and impact within military settings remain underexplored, despite evidence suggesting a higher prevalence among military personnel. The structured, high-pressure nature of military life presents unique challenges and opportunities for individuals with ADHD. Aim: This thesis addresses a critical gap in understanding ADHD within military contexts by mapping existing research and exploring the lived experiences of military personnel with ADHD. It integrates findings from a scoping review and a qualitative study to inform evidence-based clinical practice, policy development, and future research. Study 1: A scoping review and narrative synthesis examined the impact of ADHD on psychosocial and occupational outcomes among military personnel. From 1,956 studies, 51 met the inclusion criteria. Findings highlighted significant comorbidity with PTSD, depression, and substance use, alongside mixed occupational impacts. Some individuals experienced challenges in training and retention, while others reported adaptability and strength when adequately supported. The existing literature largely adopts a deficit-based perspective, underscoring the need for more holistic, neuroaffirmative approaches. Study 2: A qualitative study explored the lived experiences of eight male members of the Irish Defence Forces, all diagnosed with ADHD in adulthood. Employing a critical realist framework and thematic analysis, seven themes emerged: (1) complex diagnostic journeys involving late recognition and emotional impact, (2) occupational functioning shaped by both rigidity and routine, (3) the emotional toll of masking ADHD traits, (4) stigma and inconsistent institutional support, (5) psychological strain including anxiety and burnout, (6) mixed social experiences of camaraderie and isolation, and (7) recognition of ADHD-related strengths such as problem-solving, hyperfocus, and adaptability. Participants advocated for greater awareness, more inclusive practices, and a shift from diagnosis-driven fitness assessments to those based on functional ability. Conclusion: ADHD presents both challenges and strengths within military environments. This thesis calls for systemic change through increased awareness, leadership training, inclusive policy development, and tailored support strategies, such as cognitive-behavioural interventions and task management tools. Future research should prioritise longitudinal, cross-cultural, and interdisciplinary studies to enhance understanding and improve support for neurodivergent personnel.