Seeking Connection, Autonomy, and Emotional Feedback: A Self-Determination Theory of Self-Regulation in Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) is one of the most prevalent and highly debated diagnosis for mental disorder in practice today. Two decades of research have substantially contributed to evolving conceptualizations and understanding of the condition. However, this evolution has not been extended to theoretical research. Current cognitive behavioral-based theories aim to identify the etiology of ADHD and experience challenges in accommodating the full spectrum of both neurobiological and behavioral research evidence. Characterizations historically associated with mental illness have generated public stigma, influencing low self-esteem, negative self-concept, and identity development in ADHD individuals. Neurodiversity research and activism recognize a diversity of nonnormative development and highlight the need for alternatives to deficit models of functioning. Recent research in psychology recommends developing approaches beyond symptom control and seeking to develop positive psychological factors and well-being. We propose that the perspective presented by self-determination theory (SDT) on human motivation, self-regulation, and self-determination offers a new understanding of ADHD research evidence and symptomology. According to this theory, humans have a natural tendency toward growth and self-actualization. We propose a framework grounded in SDT that provides an alternative understanding of ADHD neural processing, motivation and engagement, self-regulation, and a potential foundation for treatment approaches with self-determination and positive identity outcomes.