adhd wandering thoughts

• ADHD in Real Life
• ADDA Library

ADHD Intrusive Thoughts: How to Spot and Manage Them

• Posted by ADDA Editorial Team
• Categories ADHD in Real Life
• Date February 14, 2024
• Comments 0 comment

Do you sometimes have thoughts that make you feel distressed or uneasy?

These are called intrusive thoughts – unwanted, strange, and persistent ideas or images that appear in your mind – and you’re not alone in having them.

Research has found that people with attention deficit hyperactivity disorder (ADHD) tend to have more intrusive thoughts than those without the disorder. [1]  This can be explained by the unique wiring of the ADHD brain , which makes it harder for the person to control their attention and thinking.

If you have ADHD, this might be something you struggle with. It might even cause you to question who you are.

However, it’s important to remember that your thoughts don’t define or represent you – what matters is what you choose to do with them.

Understandably, they can still be disruptive and cause you to lose focus or become anxious. But with the right mindset and techniques, you can learn how to manage and overcome intrusive thoughts.

Signs of ADHD Intrusive Thoughts

Many adults with ADHD experience intrusive thoughts without knowing what they are.

By understanding what these thoughts can look like, you can label them for what they are – simply thoughts.

Here are some traits of intrusive thoughts:

• Unwanted and inappropriate. These thoughts can be disturbing. For example, they may be explicit or violent, such as imagining yourself causing harm to someone else.
• Worrying or distressing. Many people find that their intrusive thoughts are troubling or anxiety-inducing. For example, they may have negative self-thoughts. Alternatively, they could worry about doing something embarrassing in front of others.
• Out of character. You might feel disturbed because they deviate largely from your personality. They’re unusual and don’t follow your usual thinking patterns.
• Fast-paced or racing. These thoughts are usually fast-paced, as the ADHD brain can jump quickly from one idea to another.
• Repetitive and obsessive. They can be repetitive and keep coming back. The more you try to get rid of them, the worse they become.
• Unexpected and sudden. They may appear out of the blue, coming and going unpredictably.

If you experience these types of thoughts, it can be a relief to know that many other people do, too.

Having a supportive community around you can also provide comfort and relief. Through ADDA+ , you’ll gain access to a community of adult ADHDers who understand what you’re going through.

How Does ADHD Cause Intrusive Thoughts?

Intrusive thoughts in ADHD might come from a glitch in what’s called executive function [2] —a key player in how we remember, focus, plan, and keep our impulses in check.

Think of it as the brain’s command center that ADHD can sometimes disrupt, making those unwelcome thoughts more likely to pop up.

Because of this, ADHDers may find it challenging to focus and direct their attention. They might also have trouble inhibiting unwanted thoughts and behaviors. [1]  As a result, they can experience streams of intrusive thoughts that are hard to control.

Aside from this, ADHD is also linked to problems with the default mode network (DMN) of the brain. [3] This part of the brain clicks on when you daydream.

Due to this, ADHD can be associated with excessive mind wandering and mental restlessness. [4] As a result, you may often overthink and have streams of thoughts that are distracting and difficult to control.

Understanding the link between intrusive thoughts and the ADHD brain can help you show more compassion to yourself.

Essentially, these thoughts are involuntary and appear frequently because of how the ADHD brain is wired. You’re not to blame for having them.

4 Tips to Manage Intrusive and Obsessive Thoughts in ADHD

While it’s difficult to eliminate these thoughts entirely, by handling them well, you can minimize their impact on your focus, productivity, and mental health.

Here are some ways to manage intrusive thoughts:

1. Acknowledge the Thought

Trying to push these thoughts away can make them worse. Instead, try to accept them.

Acknowledge them with a non-judgemental mindset so you don’t invest emotions into them. Label them as intrusive, then let them float by. They’re likely to return, but that’s okay.

Ultimately, intrusive thoughts are involuntary and out of our control. You’re not a bad person for having them. But you’re probably irritated by them because they’re out of character and so unlike you.

2. Externalize the Thought

You might be afraid to open up about this issue. But confiding in someone you trust can help you externalize the thought, so it no longer holds as much power in your mind.

Find someone to confide in who’s non-judgemental and knows your character. They’ll provide relief and help comfort you by reminding you of who you truly are.

Another way to externalize your thoughts is journaling. By writing your thoughts down, you’re able to reduce them down to a manageable size, cutting down their perceived vastness.

This also provides you with the added benefit of being able to revisit your thoughts in the future, to see how the way you think has changed over time.

3. Keep Yourself Occupied

While you should acknowledge the thought, it’s important not to overthink or ruminate on it.

Find something that takes your focus out of your mind. When your brain finds something else to engage with, it will be much easier for the thought to float by instead of sticking around.

Certain activities can also help you to relax and destress. For example, taking a walk in nature, exercising, or spending time with your friends and family.

4. Carry Out Mindfulness Exercises

Research suggests that mindfulness exercises can help reduce how much your mind wanders. [5] This means you can be attentive and focus better on the present moment, and you are less likely to get distracted by unrelated thoughts.

Additionally, one study discovered that mindfulness training can help a person reduce intrusive thoughts [6]  This skill teaches you to observe your thoughts without judging or attaching any emotions to them.

You can practice mindfulness at any time and anywhere. If you’d like, you can enhance this skill in your spare time by doing mindfulness exercises.

Simply find a quiet place where you won’t be bothered. Focus on how your body feels. Concentrate on your breathing, counting to four each time you breathe in and each time you breathe out. If your mind wanders, gently bring it back to focus on your body and breathing.

Don’t Be Afraid to Seek Professional Help and Therapy

Navigating ADHD and intrusive thoughts is a journey you don’t have to embark on by yourself.

Though it may seem challenging, reaching out for treatment and support can significantly enhance your ability to manage those thoughts, turning the journey into one of empowerment and growth.

Certain ADHD therapies can also help. One example is cognitive behavioral therapy (CBT), a form of talking therapy. It helps you replace unhelpful thinking patterns with healthier ones.

[1] Abramovitch, A., & Schweiger, A. (2009). Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder. Psychiatry Research , 168(3), 230–233. https://doi.org/10.1016/j.psychres.2008.06.004

[2] Roselló, B., Berenguer, C., Baixauli, I., Mira, Á., Martinez-Raga, J., & Miranda, A. (2020). Empirical examination of executive functioning, ADHD associated behaviors, and functional impairments in adults with persistent ADHD, remittent ADHD, and without ADHD. BMC psychiatry , 20(1), 134. https://doi.org/10.1186/s12888-020-02542-y

[3] Saad, J. F., Griffiths, K. R., Kohn, M. R., Braund, T. A., Clarke, S., Williams, L. M., & Korgaonkar, M. S. (2022). Intrinsic Functional Connectivity in the Default Mode Network Differentiates the Combined and Inattentive Attention Deficit Hyperactivity Disorder Types. Frontiers in human neuroscience , 16, 859538. https://doi.org/10.3389/fnhum.2022.859538

[4] Kandeğer, A., Süheyla Ünal, & Metin Ergün. (2023). Mentation processes such as excessive mind wandering, rumination, and mindfulness mediate the relationship between ADHD symptoms and anxiety and depression in adults with ADHD. European Psychiatry , 66(S1), S113–S114. https://doi.org/10.1192/j.eurpsy.2023.309

[5] Kandeğer, A., Odabaş Ünal, Ş., Ergün, M. T., & Yavuz Ataşlar, E. (2023). Excessive mind wandering, rumination, and mindfulness mediate the relationship between ADHD symptoms and anxiety and depression in adults with ADHD. Clinical psychology & psychotherapy , 10.1002/cpp.2940. Advance online publication. https://doi.org/10.1002/cpp.2940

[6] Ashton, S. M., Sambeth, A., & Quaedflieg, C. W. E. M. (2023). A mindful approach to controlling intrusive thoughts. Scientific reports , 13(1), 10966. https://doi.org/10.1038/s41598-023-37447-9

Previous post

ADHD Emotional Dysregulation: Managing Intense Emotions

Adhd and binge eating: how to build a healthy relationship with food, you may also like.

How I stopped fixing what wasn’t broken. The Story Behind My Story

ADHD and Weight Gain: Tips for Weight Management & Healthy Living

Leave a reply cancel reply.

Your email address will not be published. Required fields are marked *

Celebrating 25 Years

• Join ADDitude
•  | 

• What Is ADHD?
• The ADHD Brain
• ADHD Symptoms
• ADHD in Children
• ADHD in Adults
• ADHD in Women
• Find ADHD Specialists
• New! Symptom Checker
• ADHD Symptom Tests
• All Symptom Tests
• More in Mental Health
• Medication Reviews
• ADHD Medications
• Natural Remedies
• ADHD Therapies
• Managing Treatment
• Treating Your Child
• Behavior & Discipline
• School & Learning
• Teens with ADHD
• Positive Parenting
• Schedules & Routines
• Organizing Your Child
• Health & Nutrition
• More on ADHD Parenting
• Do I Have ADD?
• Getting Things Done
• Relationships
• Time & Productivity
• Organization
• Health & Nutrition
• More for ADHD Adults
• Free Webinars
• Free Downloads
• ADHD Videos
• ADHD Directory
• eBooks + More
• Newsletters
• Guest Blogs
• News & Research
• For Clinicians
• For Educators
• Manage My Subscription
• Get Back Issues
• Digital Magazine
• Gift Subscription
• Renew My Subscription

“9 Calming Strategies for a Racing, Restless Mind.”

“although it can be exhausting to live in my head, i now feel so much more in control after learning and implementing techniques that help calm my racing mind. here’s the formula i’m constantly tweaking, ensuring that the daily dance with my thoughts is a mostly positive one.”.

Prior to my diagnosis, I assumed that my inner chatter, curiosity, questioning, hypervigilance, and overthinking were pretty normal. I wondered why no one else seemed so completely drained by the end of the day, but I did not yet appreciate the extent to which people with ADHD dwell inside their particularly busy heads. Yes, I am always taking in other people’s thoughts and opinions, but the real exhaustion came from contending with my own, disruptive inner chatter.

The ‘H’ in ADHD, I learned, doesn’t just refer to physical hyperactivity (although sitting for long periods isn’t easy for me). It is also very much connected to ‘ internal restlessness ’ and a fired-up nervous system – in itself connected to emotional burnout. When my diagnosing psychiatrist explained this to me, it was like the heavens opened, and I could hear the angelic echo of ‘hallelujah.’ Finally, I understood the cause of my frequent mental exhaustion, and why I often prefer to listen, rather than talk.

Don’t get me wrong – having a busy brain that runs at x 1.5 speed can also be a huge asset. I’m the queen of ideas, from brainstorming to problem solving to matchmaking (I have a mental Rolodex of single friends and have orchestrated four successful relationships to date).

But an ever-running mind has caused some major headaches over the years. With four children (one already diagnosed with ADHD), overthinking and catastrophizing doesn’t help much. Years of working in public relations had me convinced that one oversight on my part could mean the end of an entire business. True insight into how my mind works could have spared me years of anxiety and worry.

Before I was diagnosed with ADHD, I thought I was just a neurotic killjoy, sapping the fun out of most situations with my anxiety-ridden ‘what if’ and catastrophe-setting scenarios. Now I recognize that overthinking and ruminating are common to the ADHD experience.

[ On Rumination: How to Stop Obsessive Thoughts ]

Although it can be exhausting to live in my head, I now feel so much more in control after learning and implementing techniques that help calm my racing mind.

So here is my formula that I’m constantly tweaking, ensuring that the daily dance with my thoughts is mostly a positive one.

How to Relax Your ADHD Mind

1. take action — any action..

If we know that we have the tendency to live in our heads, then sometimes taking the smallest step forward can be enough to quiet our thoughts, worries, and anxieties.

Staying in the rumination zone leads to procrastination, perfectionism, guilt, imposter syndrome or believing we’re unable to do anything. But taking any action often leads us out of this zone. Action, in many ways, is the antidote to a busy mind. When our focus is away from our automated thoughts, we can pour more focus, love, patience and creativity into the things that matter. The more we access this, the less space we have to overthink negative thoughts.

[ Read: 6 Ways to a Worry-Free Mind ]

2. Try to be more intentional with your thoughts.

Guard your headspace, and pay attention to where you’re focusing your mental energy; set clear boundaries for emotional wellbeing. When we’re not intentionally choosing the right thoughts, the negativity can quickly become our reality and we begin attracting relatable scenarios to match what we’re energetically absorbing. Try this EFT tapping video to help you overcome your anxious thinking and ruminating.

3. Dismiss the thoughts that do not serve you.

Just because it’s in your head doesn’t mean you have to believe it. Make a conscious effort every day to return your brain to a neutral thought and avoid getting sucked in by the negative. Take five minutes in the morning, before you check your phone, to do some meditating , breathing, or tapping to ground yourself and decrease reactivity. No matter what, don’t allow a negative narrative to pull you off path and limit your success – whatever that may look like.

4. Notice your triggers.

Create mental boundaries to protect yourself from certain thoughts or beliefs that aren’t serving your highest good. The TV shows or channels we watch, the podcasts we choose, the people with whom we engage, and the books we read can all inform our self-beliefs – sometimes in the negative. These combine to play a feedback loop to our brains, potentially making our ruminations even scarier.

Take notice of the activities and people that align with your values and contribute to inner peace. Magnetize yourself to only the stuff that creates positive energy, action and change. If the other stuff fills you with dread, unpack it and decide if it’s there to serve you or shame you.

5. Commit to what makes you feel best.

What makes you feel good? What would improve your day? Whether it’s a yoga class, singing, baking, exercising, dancing, or chatting with a friend, try incorporating one element of joy into your day to keep your mind in a more positive state.

If you’re unable to commit to a feel-good activity, think deep about where the push/pull is coming from, and what areas of your life can be adjusted.

6. Resisting isn’t always the answer.

Embrace and accept the way your brain works. Trying to put a full stop to your thoughts will never work; that resistance often contributes to our internal battles and anxiety. In understanding our brains more, we empower ourselves to make conscious and aligned thought choices every day.

Try EFT tapping , which helps the brain step out of fight or flight mode and instead activates the parasympathetic nervous system, which is associated with calm and stress reduction. Taking an opportunity to pause and consciously breathe can also do wonders to quiet the mind, as can meditation – being conscious of our thoughts with no judgement.

7. Relax the body.

Try this powerful technique of noticeably softening your body by recognizing where you’re holding tension. This grounding exercise allows the body and mind to simultaneously relax and become more present. You can do this reset as many times as you need (I do it up to 20 times a day) to help recalibrate and regulate your emotions.

Physically shaking it off is another way to jolt your system “out of it.” In all, any form of physical movement you enjoy is great for disengaging the brain from overthinking.

8. Attend to your restlessness.

Could your inner restlessness be trying to tell you something? Do your thoughts and worries follow a pattern? Consider gently inviting them in for a change. Learning to sit with your thoughts and reconnect with your intuition can be especially valuable with ADHD in the picture. Our hypersensitivity and emotional dysregulation can sometimes lead us off course and plague us with self-doubt, which is why it’s important to train the skill of recognizing when something feels right or wrong.

9. A sense of humor helps.

Being able to laugh at ourselves can be a powerful tool toward self-compassion and kindness. A sense of humor removes the heaviness of a situation while offering commonality and interconnectedness. Develop your sense of humor and lightness by embracing your truth, learning to open up with vulnerability, and speaking with honesty.

How to Relax Your Mind: Next Steps

• Read: How to Feel Carefree When You Have ADHD
• Read: “Why Do I Assume the Worst-Case Scenario?” How to Stop the ADHD Mind from Worrying
• Download: Make Mindfulness Work for You

SUPPORT ADDITUDE Thank you for reading ADDitude. To support our mission of providing ADHD education and support, please consider subscribing . Your readership and support help make our content and outreach possible. Thank you.

Guest Blogs: Read These Next

ADHD at the Center: A Whole-Life, Whole-Person Condition

6 Types of Anxiety

“What It Feels Like Living with Undiagnosed ADHD”

ADDitude’s 10 Most Popular Webinars of 2017

Adhd newsletter, for women only, finally, i feel like i'm not crazy, or lazy, or defective. i feel understood..

It appears JavaScript is disabled in your browser. Please enable JavaScript and refresh the page in order to complete this form.

ADHD May Stop Thoughts in Their Tracks

• Metacognition
• Mindfulness
• Psychological Science

People with ADHD are known to have trouble staying on task, their attention drifting elsewhere.  Research published in  Psychological Science ,  however,   suggests that their minds may not be wandering at all, but instead going…blank.

A wandering mind maintains a continuous train of thought, such as a daydream, that is simply unrelated to the task at hand. While any child can become distracted in this way, the study found that the minds of children with untreated ADHD were more likely to simply go blank, leaving them with no reportable mental content. The findings also showed that these children experienced similar levels of environmental distraction as their peers.

While these findings conflict with previous studies that have documented increased mind-wandering among individuals with ADHD, the authors of the new study note that participants in previous studies typically did not have the option to report instances of mind blanking. This has led the authors to suggest that ADHD may in fact lead to mind blanking at the expense of on-task focus and self-generated thoughts.

Study co-author Charlotte Van den Driessche, Paris Sciences et Lettres Research University, said that this research is, to her knowledge, the first to use experience sampling rather than external behavioral cues to study the mental state of young ADHD patients. Van den Driessche cautioned that while these findings do not yet have direct implications for the treatment or diagnosis of ADHD, they could lead to better outcomes for children with the disorder.

“What I would say, as a child psychiatrist, is that our empirical demonstration of the stream of thought of children with ADHD enriches our understanding of the disorder beyond its well-known behavioral and cognitive components. And a better understanding of a disorder always improves empathy in the caregivers and therefore the global support of the patient,” she said.

The study consisted of 80 children ages 6 to 12 years old – 20 were untreated for ADHD, 20 were treated with methylphenidate for ADHD, 20 were diagnosed with other psychiatric conditions, and 20 showed neurotypical development. Van den Driessche and colleagues recruited the children through École Normale Supérieure University and the pediatric psychiatry unit of Hôpital Robert-Debré in France. Participants completed a series of intentionally unengaging tasks that were randomly interrupted by eight thought probes prompting them to orally describe their thoughts, select a drawing that represented their mental state, and categorize their thoughts into one of five options: on-task focus, mind wandering, distraction, task-related interference, and mind blanking.

Children treated with methylphenidate reported the same level of mind blanking as did those without ADHD. but only their rate of mind wandering felllevels. This doesn’t mean that methylphenidate is unnecessary or ineffective for these patients, said Van den Driessche – rather, it suggests that mind wandering and on-task focus stem from common mechanisms that share executive resources.

“A deficit in executive functions entails shorter episodes of thoughts resulting in a chaotic flow of consciousness that is either more difficult to report verbally, or that contains empty, non-reportable ‘gaps,” she explained. “Our interpretation of the paradoxical finding that, in the context of our dull task, methylphenidate increases mind wandering is that methylphenidate fosters sustained train of thoughts whatever their origin.”

A second study of nonclinical adults, 15 out of 40 of whom were assigned to the ADHD group based on self-reported symptoms, found a similar decrease in mind-wandering and on-task focus in favor of mind-blanking, suggesting that the pattern extends across age groups.

A recent study on temporal expectation deficits also found that while neurotypical adults generally pause their eye movements in anticipation of a pattern, adults with ADHD don’t show this kind of pause. The finding supports the current understanding of ADHD as impairing attention and anticipation processes, but the researchers also found that individual level of focus was a better predictor of the temporal expectation pause than whether or not someone was diagnosed with ADHD was.

Together, these studies illuminate the range of neuropsychological function among people with ADHD.

Further study is still needed on whether mind-blanking in children and adults with ADHD is a result of an executive function deficit leading to a truly blank state or a metacognition deficit that leads to the perception of blankness after a thought has occurred, according to the study authors. The cognitive consequences of mind blanking verses mind wandering also warrants additional research, Van de Driessche added.

Dankner, Yarden, et al. “Corrigendum: Prestimulus Inhibition of Saccades in Adults With and Without Attention-Deficit/Hyperactivity Disorder as an Index of Temporal Expectations.”  Psychological Science , vol. 28, no. 9, 18 May 2017, pp. 1369–1370., doi:10.1177/0956797617725051. 

Driessche, C. V., Bastian, M., Peyre, H., Stordeur, C., Acquaviva, É, Bahadori, S., . . . Sackur, J. (2017). Attentional Lapses in Attention-Deficit/Hyperactivity Disorder: Blank Rather Than Wandering Thoughts.  Psychological Science . doi: 10.1177/0956797617708234

Kane, M. J., Gross, G. M., Chun, C. A., Smeekens, B. A., Meier, M. E., Silvia, P. J., & Kwapil, T. R. (2017). For Whom the Mind Wanders, and When, Varies Across Laboratory and Daily-Life Settings.  Psychological Science,   28 (9), 1271-1289. doi: 10.1177/0956797617706086

Yes! I am very excited to read about this study since I am suffering from ADHD as well and I have been experiencing this “blank state” symptom for some time now. It has had a serious impact on my life but I felt like I was the only one with this symptom. Excited for future research!

I have never been diagnosed with ADHD but I have a learning disability — dyslexia. On occasion my mind goes blank when I have to perform cognitive task such as speaking a foreign language or doing math problems. I have always associated this with anxiety. My son who has been diagnosed with ADHD and dyslexia also talks about his mind going blank. Were there any measurements of anxiety taken across the different groups?

OMG thanks for this article, I have been searching for literally decades to find anyone anywhere mentioning this symptom. I had been mocked throughout my life by “smart” people when I actually scored better than they did, all because I “didn’t seem smart”.

Even in my middle age, I have years ahead of me of therapy from the sense of mistrust and alienation and hopelessness/helplessness I feel with others and the anger that has built inside me as a reslt of my youthful naivete.

Thank you for this wonderful summary! Distinguishing between mind wandering and mind blanking is so interesting and I think extremely important too. It would be absolutely fascinating to see if “mind blanks” are something which has to do with certain types of internal or external stimulus or whether there are ways to work around these blanks. As someone with ADHD myself, I have experienced these blanks my whole life and continue to today even though I have been treated with medication since being diagnosed last year. I often refer to the blanks affectionately as “brain farts”. Personally, I’ve noticed them happening while I have to juggle different forms of memory at the same time. A salient example is engaging in procedural and working memory simultaneously i.e. walking from room to room while holding conversation, finding my purse to pay for things while speaking with a cashier, raising my hand to ask or answer a question in class. It feels almost as if my brain has short-circuited mid-process. The above mentioned situations where mind blanking has happened may be for an entirely different reason, of course! It’s simply a pattern I’ve noticed in my own behaviour and cognition, and very much musing conjecture about a possible theory. I’ll have to research and see if there’s information about other possible factors, and am keen to see what other aspects may contribute to these confounding “brain farts”. Thanks again for synthesising these studies into a neat article!

“Stopping thoughts in their tracks” is a perfect description for what I do. I was originally diagnosed with OCD, but besides a few specific things I would obsess about, I couldn’t explain why I always felt stressed out, tense, and unable to focus. I could feel my therapist’s frustration when I would tell him I had a horrible week and he asked me what I’d been thinking about and I’d say “I’m not sure”. I knew it sounded dumb, but that was the truth. After a few long years of trying practically every SSRI medication and getting no results, I slowly came to the realization myself that the core of my problems seemed to be more rooted in an attention problem. So I got diagnosed with ADHD by another psychologist and they put me on Adderall, which doesn’t completely solve the problem, but it definitely helps quite a bit.

So anyway, that’s some backstory. But what I’ve come to realize about myself is that underneath all of the fog and tension are a lot of restless thoughts and emotions that come in overwhelming bursts. If I let them, they would hit me with such force that my brain would be flooded to the point where I probably couldn’t tell you my own name in that instant. However, instead of feeling the full force of these thoughts and emotions and feeling overwhelmed, I instantly suppress them (or “stop them in their tracks”) so that I can feel more in control of myself, I suppose. And this is so automatic that I do it without even realizing it. I’m pretty sure I’ve done it my whole life and just became aware of it recently. So anyway, the problem with suppressing the thoughts and overwhelming emotions is that it causes them to keep coming back and I get stuck in a constant state of resisting all of this while trying to go about focused on my day. But since this is all happening without me being aware of it, I constantly feel stressed out but I don’t even know why or what I’m thinking about. It all just becomes a fog in my mind and I become like a deer in the headlights. So many times during the day, I stop and realize that my brain is not moving forward. I am all tense and it’s like my mind has put the brakes on the free flowing of thoughts. So I’m just left feeling blank. This is a bit random, but I remember having so much trouble writing papers in school because I could never think of what to write; and I absolutely hated when teachers would tell me “just write the first thing that comes to your head and don’t worry about whether it’s perfect or not”, and I would think “yeah, but there’s nothing in my head!”. Anyway, I’ve written too much, but I was excited to see this article and feel I can relate to it. I hope some of what I said can also resonate with someone else.

APS regularly opens certain online articles for discussion on our website. Effective February 2021, you must be a logged-in APS member to post comments. By posting a comment, you agree to our Community Guidelines and the display of your profile information, including your name and affiliation. Any opinions, findings, conclusions, or recommendations present in article comments are those of the writers and do not necessarily reflect the views of APS or the article’s author. For more information, please see our Community Guidelines .

Please login with your APS account to comment.

Communicating Psychological Science: Neurodiversity in the Workplace

Özge Gürcanlı Fischer-Baum explores how greater awareness of neurodiversity has influenced great (but not enough) change in research, advocacy, and cultural expectations.

One of Us: Combating Stigma Against People with Intellectual and Developmental Disabilities

Conversations about the health disparities facing people with intellectual and developmental disabilities and disorders, and how to combat them, are long overdue.

Individuals With Intellectual and Developmental Disabilities Were Excluded From COVID-19 Vaccine Priority Guidelines

It is critical that the entire I/DD population gains access to priority vaccines, writes developmental psychologist Emily Hotez.

Privacy Overview

How to Tame Your Wandering Mind

Learn to take steps to deal with distraction..

Posted April 24, 2022 | Reviewed by Jessica Schrader

• Understanding Attention
• Find counselling to help with ADHD
• We can tame our mind-wandering.
• Three tips can help you use mind-wandering to your advantage.
• These include making time to mind-wander and controlling your response to it.

Researchers believe that when a task isn’t sufficiently rewarding, our brains search for something more interesting to think about.

You have a big deadline looming, and it’s time to hunker down. But every time you start working, you find that, for some reason, your mind drifts off before you can get any real work done. What gives? What is this cruel trick our brains play on us, and what do we do about it?

Thankfully, by understanding why our mind wanders and taking steps to deal with distraction, we can stay on track. But first, let’s understand the root of the problem.

Why do our minds wander?

Unintentional mind-wandering occurs when our thoughts are not tied to the task at hand. Researchers believe our minds wander when the thing we’re supposed to be doing is not sufficiently rewarding, so our brains look for something more interesting to think about.

We’ve all experienced it from time to time, but it’s important to note that some people struggle with chronic mind-wandering : Though studies estimate ADHD afflicts less than 3% of the global adult population, it can be a serious problem and may require medical intervention.

For the vast majority of people, mind-wandering is something we can tame on our own—that is, if we know what to do about it. In fact, according to Professor Ethan Kross, director of the Emotion & Self Control Laboratory at the University of Michigan and author of Chatter: The Voice in Our Head, Why It Matters, and How to Harness It , mind-wandering is perfectly normal.

“We spend between a third to a half of our waking hours not focused on the present,” he told me in an email. “Some neuroscience research refers to our tendency to mind-wander as our ‘default state.’”

So why do we do it?

“Mind-wandering serves several valuable functions. It helps us simulate and plan for the future and learn from our past, and it facilitates creative problem-solving,” Kross explained. “Mind-wandering often gets a bad rep, but it’s a psychological process that evolved to provide us with a competitive advantage. Imagine not being able to plan for the future or learn from your past mistakes.”

Is mind-wandering bad for you?

“Like any psychological tool, however, mind-wandering can be harmful if used in the wrong context (i.e., when you’re trying to focus on a task) or inappropriately (i.e., when you worry or ruminate too much),” according to Kross. In other words, mind-wandering is a problem when it becomes a distraction. A distraction is any action that pulls you away from what you planned to do.

If, for instance, you intended to work on a big project, such as writing a blog post or finishing a proposal, but instead find yourself doing something else, you’re distracted.

The good news is that we can use mind-wandering to our advantage if we follow a few simple steps:

1. Make time to mind-wander

Mind-wandering isn’t always a distraction. If we plan for it, we can turn mind-wandering into traction. Unlike a distraction , which by definition is a bad thing, a diversion is simply a refocusing of attention and isn’t always harmful.

There’s nothing wrong with deciding to refocus your attention for a while. In fact, we often enjoy all kinds of diversions and pay for the privilege.

A movie or a good book, for instance, diverts our attention away from real life for a while so we can get into the story and escape reality for a bit.

Similarly, if you make time to allow your mind to drift and explore whatever it likes, that’s a healthy diversion, not a distraction.

The first step to mastering mind-wandering is to plan time for it. Use a schedule maker and block off time in your day to let your thoughts flow freely. You’ll likely find that a few minutes spent in contemplation can help you work through unresolved issues and lead to breakthroughs. Scheduling mind-wandering also lets you relax because you know you have time to think about whatever is on your mind instead of believing you need to act on every passing thought.

It’s helpful to know that time to think is on your calendar so you don’t have to interrupt your mind-wandering process or risk getting distracted later.

2. Catch the action

One of the difficulties surrounding mind-wandering is that by the time you notice you’re doing it, you’ve already done it. It’s an unconscious process so you can’t prevent it from happening.

The good news is that while you can’t stop your mind from wandering, you can control what you do when it happens.

Many people never learn that they are not their thoughts. They believe the voice in their head is somehow a special part of them, like their soul speaking out their inner desires and true self. When random thoughts cross their mind, they think those thoughts must be speaking some important truth.

Not true. That voice in your head is not your soul talking, nor do you have to believe everything you think.

When we assign undue importance to the chatter in our heads, we risk listening to half-baked ideas, feeling shame for intrusive thoughts, or acting impulsively against our best interests.

A much healthier way to view mind-wandering is as brain static. Just as the random radio frequencies you tune through don’t reveal the inner desires of your car’s soul, the thoughts you have while mind-wandering don’t mean much—unless, that is, you act upon them.

Though it can throw us off track, mind-wandering generally only lasts a few seconds, maybe minutes. However, when we let mind-wandering turn into other distractions, such as social-media scrolling, television-channel surfing, or news-headline checking, that’s when we risk wasting hours rather than mere minutes.

If you do find yourself mentally drifting off in the middle of a task, the important thing is to not allow that to become an unintended action, and therefore a distraction.

An intrusive thought is not your fault. It can’t be controlled. What matters is how you respond to it—hence the word respon-sibility.

Do you let the thought go and stay on task? Or do you allow yourself to escape what you’re doing by letting it lead you toward an action you’ll later regret?

3. Note and refocus

Can we keep the helpful aspects of mind-wandering while doing away with the bad? For the most part, yes, we can.

According to Kross, “Mind-wandering can easily shift into dysfunctional worry and rumination. When that happens, the options are to refocus on the present or to implement tools that help people mind-wander more effectively.”

One of the best ways to harness the power of mind-wandering while doing an important task is to quickly note the thought you don’t want to lose on a piece of paper. It’s a simple tactic anyone can use but few bother to do. Note that I didn’t recommend an app or sending yourself an email. Tech tools are full of external triggers that can tempt us to just check “one quick thing,” and before we know it, we’re distracted.

Rather, a pen and Post-it note or a notepad are the ideal tools to get ideas out of your head without the temptations that may lead you away from what you planned to do.

Then, you can collect your thoughts and check back on them later during the time you’ve planned in your day to chew on your ideas. If you give your thoughts a little time, you’ll often find that those super important ideas aren’t so important after all.

If you had acted on them at the moment, they would have wasted your time. But by writing them down and revisiting them when you’ve planned to do so, they have time to marinate and may become less relevant.

However, once in a while, an idea you collected will turn out to be a gem. With the time you planned to chew on the thought, you may discover that mind-wandering spurred you to a great insight you can explore later.

By following the three steps above, you’ll be able to master mind-wandering rather than letting it become your master.

Nir Eyal, who has lectured at Stanford's Graduate School of Business and the Hasso Plattner Institute of Design, is the author of Indistractable: How to Control Your Attention and Choose Your Life.

• Find a Therapist
• Find a Treatment Center
• Find a Psychiatrist
• Find a Support Group
• Find Online Therapy
• International
• New Zealand
• South Africa
• Switzerland
• Asperger's
• Bipolar Disorder
• Chronic Pain
• Eating Disorders
• Passive Aggression
• Personality
• Goal Setting
• Positive Psychology
• Stopping Smoking
• Low Sexual Desire
• Relationships
• Child Development
• Therapy Center NEW
• Diagnosis Dictionary
• Types of Therapy

Understanding what emotional intelligence looks like and the steps needed to improve it could light a path to a more emotionally adept world.

• Coronavirus Disease 2019
• Affective Forecasting
• Neuroscience

Advertisement

Mind-Wandering and Childhood ADHD: Experimental Manipulations across Laboratory and Naturalistic Settings

• Published: 05 March 2022
• Volume 50 , pages 1139–1149, ( 2022 )

Cite this article

• Brittany M. Merrill   ORCID: orcid.org/0000-0003-3844-8399 1 , 2 ,
• Joseph S. Raiker   ORCID: orcid.org/0000-0001-5364-3825 1 , 2 ,
• Aaron T. Mattfeld   ORCID: orcid.org/0000-0003-4024-8249 1 , 2 ,
• Fiona L. Macphee 1 , 2 ,
• Marcela C. Ramos   ORCID: orcid.org/0000-0002-6379-4552 1 , 2 ,
• Xin Zhao   ORCID: orcid.org/0000-0001-8455-9757 1 , 2 ,
• Amy R. Altszuler 1 , 2 ,
• Jonathan W. Schooler 3 ,
• Stefany Coxe   ORCID: orcid.org/0000-0002-2203-0775 1 , 2 ,
• Elizabeth M. Gnagy 1 ,
• Andrew R. Greiner 1 ,
• Erika K. Coles 1 , 2 &
• William E. Pelham Jr.   ORCID: orcid.org/0000-0002-3195-4478 1 , 2  

1310 Accesses

2 Citations

16 Altmetric

Explore all metrics

The conceptual overlap between mind-wandering and attention-deficit/hyperactivity disorder (ADHD)-related impairments is considerable, yet little experimental research examining this overlap among children is available. The current study aims to experimentally manipulate mind-wandering among children with and without ADHD and examine effects on task performance. Participants were 59 children with ADHD and 55 age-matched controls. Participants completed a novel mind-wandering sustained attention to response task (SART) that included non-self-referential and self-referential stimuli to experimentally increase self-referential mind-wandering, reflected by increases in reaction time variability (RTV) following self-referential stimuli. The ADHD group participated in a classroom study with analogue conditions aimed at encouraging self-referential future-oriented thinking (free play/movie before and after class work) compared to a control condition (newscast) and a cross-over methylphenidate trial. The significant interaction between ADHD status and self-referential stimuli on SART performance indicated that self-referential stimuli led to greater RTV among children with ADHD (within-subject d  = 1.29) but not among controls. Methylphenidate significantly reduced RTV among youth with ADHD across self-referential ( d  = 1.07) and non-self-referential conditions ( d  = 0.72). In the ADHD classroom study, the significant interaction between mind-wandering condition and methylphenidate indicated that methylphenidate led to higher work completion ( d s > 5.00), and the free-play mind-wandering condition had more consistent detrimental effects on productivity ( d s ≥ 1.25) than the movie mind-wandering condition. This study is the first to manipulate mind-wandering and assess effects among children with ADHD using a behavioral task. Results provide evidence that children with ADHD are uniquely susceptible to mind-wandering interference.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Similar content being viewed by others

An overview on neurobiology and therapeutics of attention-deficit/hyperactivity disorder

The positive aspects of attention deficit hyperactivity disorder: a qualitative investigation of successful adults with ADHD

Understanding and Supporting Attention Deficit Hyperactivity Disorder (ADHD) in the Primary School Classroom: Perspectives of Children with ADHD and their Teachers

Data availability.

Data are available upon reasonable request of the corresponding author.

Code Availability

Data were analyzed in SAS 9.4 using PROC GLIMMIX.

Three children in the ADHD group completed an incorrect version of the MW SART in error and one child did not submit SR photos required for the task. Of the 59 participants with ADHD, 55 completed the MW SART, and therefore 55 children without ADHD were recruited for the control group.

Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA School-Age Forms & Profiles . University of Vermont, Research Center for Children, Youth, & Families.

Google Scholar  

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

Book   Google Scholar  

Andrews-Hanna, J. R., Reidler, J. S., Sepulcre, J., Poulin, R., & Buckner, R. L. (2010). Functional-anatomic fractionation of the brain’s default network. Neuron, 65 (4), 550–562.

Article   PubMed   PubMed Central   Google Scholar  

Barkley, R. A., Murphy, K. R., & Fischer, M. (2010). ADHD in Adults: What the Science Says . Guilford Press.

Becker, S.P. & Barkley, R.A. (2021). Field of daydreams? Integrating mind-wandering in the study of sluggish cognitive tempo and ADHD. Journal of Child Psychology and Psychiatry Advances .

Becker, S. P., Fredrick, J. W., Foster, J. A., Yeaman, K. M., Epstein, J. N., Froehlich, T. E., & Mitchell, J. T. (2021). “My mom calls it Annaland”: A Qualitative Study of Phenomenology, Daily Life Impacts, and Treatment Considerations of Sluggish Cognitive Tempo. Journal of Attention Disorders .

Buckner, R. L., Andrews-Hanna, J. R., & Schacter, D. L. (2008). The brain’s default network: Anatomy, function, and relevance to disease. Annals of the New York Academy of Sciences, 1124 (1), 1–38.

Article   PubMed   Google Scholar  

Centers for Disease Control and Prevention. (2011). Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among children. United States, 2003 and 2007. Morbidity and Mortality Weekly Report, 59 , 1439–1443.

Cheyne, J. A., Solman, G. J. F., Carriere, J. S. A., & Smilek, D. (2009). Anatomy of an error: A bidirectional state model of task engagement/disengagement and attention-related errors. Cognition, 111 (1), 98–113.

Article   Google Scholar  

Christoff, K., Gordon, A. M., Smallwood, J., Smith, R., & Schooler, J. W. (2009). Experience sampling during fMRI reveals default network and executive system contributions to mind-wandering. Proceedings of the National Academy of Sciences of the United States of America, 106 (21), 8719–8724.

Cortese, S., Kelly, C., Chabernaud, C., Proal, E., Di Martino, A., Milham, M. P., & Castellanos, F. X. (2012). Toward systems neuroscience of ADHD: A meta-analysis of 55 fMRI studies. The American Journal of Psychiatry, 169 (10), 1038–1055.

Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, S. J. (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among US children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47 (2), 199–212.

Epstein, J. N., Langberg, J. M., Rosen, P. J., Graham, A., Narad, M. E., Antonini, T. N., & Simon, J. O. (2011). Evidence for higher reaction time variability for children with ADHD on a range of cognitive tasks including reward and event rate manipulations. Neuropsychology, 25 (4), 427–441.

Fabiano, G. A., Pelham, W. E., Gnagy, E. M., Burrows-Maclean, L., Coles, E. K., Chacko, A., & Robb, J. A. (2007). The single and combined effects of multiple intensities of behavior modification and methylphenidate for children with attention deficit hyperactivity disorder in a classroom setting. School Psychology Review, 36 (2), 195–216.

Fabiano, G. A., Schatz, N. K., Aloe, A. M., Pelham Jr, W. E., Smyth, A. C., Zhao, X., ... & Coxe, S. (2021). Comprehensive meta-analysis of attention-deficit/hyperactivity disorder: psychosocial treatments investigated within between-group studies. Review of Educational Research, 91(5), 718-760.

Fox, M. D., Snyder, A. Z., Vincent, J. L., Corbetta, M., Van Essen, D. C., & Raichle, M. E. (2005). The human brain is intrinsically organized into dynamic, anticorrelated functional networks. Proceedings of the National Academy of Sciences of the United States of America, 102 (27), 9673–9678.

Franklin, M. S., Mrazek, M. D., Anderson, C. L., Johnston, C., Smallwood, J., Kingstone, A., & Schooler, J. W. (2014). Tracking distraction: The relationship between mind-wandering, meta-awareness, and ADHD symptomatology. Journal of Attention Disorders, 21 (6), 475–486.

Franklin, M. S., Smallwood, J., & Schooler, J. W. (2011). Catching the mind in flight: Using behavioral indices to detect mindless reading in real time. Psychonomic Bulletin & Review, 18 (5), 992–997.

Fredrick, J. W., & Becker, S. P. (2021). Sluggish cognitive tempo symptoms, but not ADHD or internalizing symptoms, are uniquely related to self-reported mind-wandering in adolescents with ADHD. Journal of Attention Disorders, 25 (11), 1605–1611.

Hoza, B., Gerdes, A. C., Hinshaw, S. P., Arnold, L. E., Pelham, W. E., Molina, B. S. G., & Wigal, T. (2004). Self-perceptions of competence in children with ADHD and comparison children. Journal of Consulting and Clinical Psychology, 72 (3), 382–391.

Huang-Pollock, C. L., Nigg, J. T., & Carr, T. H. (2005). Deficient attention is hard to find: Applying the perceptual load model of selective attention to attention deficit hyperactivity disorder subtypes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 46 (11), 1211–1218.

Koch, E. D., Moukhtarian, T. R., Skirrow, C., Bozhilova, N., Asherson, P., & Ebner-Priemer, U. W. (2021). Using e-diaries to investigate ADHD–State-of-the-art and the promising feature of just-in-time-adaptive interventions. Neuroscience & Biobehavioral Reviews, 127 , 884–898.

Kofler, M. J., Alderson, R. M., Raiker, J. S., Bolden, J., Sarver, D. E., & Rapport, M. D. (2014). Working memory and intraindividual variability as neurocognitive indicators in ADHD: Examining competing model predictions. Neuropsychology, 28 (3), 459–471.

Kofler, M. J., Rapport, M. D., Sarver, D. E., Raiker, J. S., Orban, S. A., Friedman, L. M., & Kolomeyer, E. G. (2013). Reaction time variability in ADHD: A meta-analytic review of 319 studies. Clinical Psychology Review, 33 (6), 795–811.

Massetti, G.M., Pelham, W.E., Chacko, A., Walker, K.S., Arnold, F., Coles, E.K., & Burrows-MacLean, L. (2003, November). Situational variability of ADHD, ODD, and CD: Psychometric properties of the DBD interview and rating scale. Poster presented at the Association for Advancement of Behavior Therapy Conference , Boston.

Morris, S.B. & DeShon, R.P. (2002) Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods,  7(1), 105-125. https://doi.org/10.1037/1082-989X.7.1.105

Mowlem, F. D., Skirrow, C., Reid, P., Maltezos, S., Nijjar, S. K., Merwood, A., & Asherson, P. (2016). Validation of the mind excessively wandering scale and the relationship of mind-wandering to impairment in adult ADHD. Journal of Attention Disorders, 23 (6), 624–634.

Mrazek, M. D., Smallwood, J., & Schooler, J. W. (2012). Mindfulness and mind-wandering: Finding convergence through opposing constructs. Emotion, 12 (3), 442–448.

Nigg, J.T., & Barkley, R. (2014). Attention-Deficit/Hyperactivity Disorder. In E.J. Mash & R. Barkley (Eds.), Child Psychopathology (3 rd ed.). New York, NY: Guilford Press.

Owens, J. S., Goldfine, M. E., Evangelista, N. M., Hoza, B., & Kaiser, N. M. (2007). A critical review of self-perceptions and the positive illusory bias in children with ADHD. Clinical Child and Family Psychology Review, 10 (4), 335–351.

Pelham, W. E., Carlson, C., Sams, S. E., Vallano, G., Dixon, M. J., & Hoza, B. (1993). Separate and combined effects of methylphenidate and behavior modification on boys with attention deficit-hyperactivity disorder in the classroom. Journal of Consulting and Clinical Psychology, 61 (3), 506–515.

Pelham, W. E., Fabiano, G. A., & Massetti, G. M. (2005). Evidence-based assessment of attention-deficit/hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34 (3), 449–476.

Pelham, W. E., Gnagy, E. M., Burrows-Maclean, L., Williams, A., Fabiano, G. A., Morrisey, S. M., & Lock, T. M. (2001). Once-a-day Concerta methylphenidate versus three-times-daily methylphenidate in laboratory and natural settings. Pediatrics, 107 (6), e105–e105.

Pelham, W. E., Waschbusch, D. A., Hoza, B., Gnagy, E. M., Greiner, A. R., Sams, S. E., & Carter, R. L. (2011). Music and video as distractors for boys with ADHD in the classroom: Comparison with controls, individual differences, and medication effects. Journal of Abnormal Child Psychology, 39 (8), 1085–1098.

Pliszka, S. R. (2007). Pharmacologic treatment of attention-deficit/hyperactivity disorder: Efficacy, safety and mechanisms of action. Neuropsychology Review, 17 , 61–72.

Querne, L., Fall, S., Le Moing, A. G., Bourel-Ponchel, E., Delignières, A., Simonnot, A., & Berquin, P. (2014). Effects of methylphenidate on default-mode network/task-positive network synchronization in children with ADHD. Journal of Attention Disorders, 21 (14), 1208–1220.

Robb, J. A., Sibley, M. H., Pelham, W. E., Foster, E. M., Molina, B. S. G., Gnagy, E. M., & Kuriyan, A. B. (2011). The estimated annual cost of ADHD to the US education system. School Mental Health, 3 (3), 169–177.

Rapport, M. D., Chung, K. M., Shore, G., & Isaacs, P. (2001). A conceptual model of child psychopathology: Implications for understanding attention deficit hyperactivity disorder and treatment efficacy. Journal of Clinical Child Psychology, 30 (1), 48–58. https://doi.org/10.1207/S15374424JCCP3001_6

Sonuga-Barke, E. J. (2002). Psychological heterogeneity in AD/HD-a dual pathway model of behaviour and cognition. Behavioural Brain Research, 130 , 29–36. https://doi.org/10.1016/S0166-4328(01)00432-6

Seli, P., Carriere, J. S. A., Thomson, D. R., Cheyne, J. A., Martens, K. A. E., & Smilek, D. (2014). Restless mind, restless body. Journal of Experimental Psychology: Learning, Memory, and Cognition, 40 (3), 660–668.

PubMed   Google Scholar  

Seli, P., Cheyne, J. A., & Smilek, D. (2013). Wandering minds and wavering rhythms: Linking mind-wandering and behavioral variability. Journal of Experimental Psychology: Human Perception and Performance, 39 (1), 1.

Seli, P., Risko, E. F., Smilek, D., & Schacter, D. L. (2016). Mind-wandering with and without intention. Trends in Cognitive Sciences, 20 (8), 605–617.

Seli, P., Smallwood, J., Cheyne, J. A., & Smilek, D. (2015). On the relation of mind-wandering and ADHD symptomatology. Psychonomic Bulletin & Review, 22 (3), 629–636.

Sexton, C. C., Gelhorn, H. L., Bell, J. A., & Classi, P. M. (2012). The co-occurrence of reading disorder and ADHD: Epidemiology, treatment, psychosocial impact, and economic burden. Journal of Learning Disabilities, 45 (6), 538–564.

Shulman, G. L., Fiez, J. A., Corbetta, M., Buckner, R. L., Miezin, F. M., Raichle, M. E., & Petersen, S. E. (1997). Common blood flow changes across visual tasks: Ii. decreases in cerebral cortex. Journal of Cognitive Neuroscience, 9 (5), 648–663.

Smallwood, J., Beach, E., Schooler, J. W., & Handy, T. C. (2008). Going AWOL in the brain: Mind-wandering reduces cortical analysis of external events. Journal of Cognitive Neuroscience, 20 (3), 458–469.

Smallwood, J., & Schooler, J. W. (2006). The restless mind. Psychological Bulletin, 132 (6), 946–958.

Smallwood, J., Fishman, D. J., & Schooler, J. W. (2007). Counting the cost of an absent mind: Mind-wandering as an underrecognized influence on educational performance. Psychonomic Bulletin & Review, 14 (2), 230–236.

Tamm, L., Narad, M. E., Antonini, T. N., O’Brien, K. M., Hawk, L. W., & Epstein, J. N. (2012). Reaction time variability in ADHD: A review. Neurotherapeutics, 9 (3), 500–508.

Van den Driessche, C., Bastian, M., Peyre, H., Stordeur, C., Acquaviva, É., Bahadori, S., & Sackur, J. (2017). Attentional lapses in attention-deficit/hyperactivity disorder: Blank rather than wandering thoughts. Psychological Science, 28 (10), 1375–1386.

Visser, S. N., Danielson, M. L., Bitsko, R. H., Holbrook, J. R., Kogan, M. D., Ghandour, R. M., & Blumberg, S. J. (2014). Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003–2011. Journal of the American Academy of Child & Adolescent Psychiatry, 53 (1), 34–46.

Wang, S., Zhang, D., Fang, B., Liu, X., Yan, G., Sui, G., & Wang, S. (2021). A study on resting EEG effective connectivity difference before and after neurofeedback for children with ADHD. Neuroscience, 457 , 103–113.

Wechsler, D. (2009). Wechsler Individual Achievement Test (3rd ed.). Pearson.

Wechsler, D. (2011). Wechsler Abbreviated Scale of Intelligence (2nd ed.). Pearson.

Weissman, D. H., Roberts, K. C., Visscher, K. M., & Woldorff, M. G. (2006). The neural bases of momentary lapses in attention. Nature Neuroscience, 9 (7), 971–978.

Download references

This work was supported by the National Institute of Mental Health (R01 MH099030) and the Center for Children and Families and University Graduate School at Florida International University.

Author information

Authors and affiliations.

Center for Children and Families, Florida International University, Miami, FL, USA

Brittany M. Merrill, Joseph S. Raiker, Aaron T. Mattfeld, Fiona L. Macphee, Marcela C. Ramos, Xin Zhao, Amy R. Altszuler, Stefany Coxe, Elizabeth M. Gnagy, Andrew R. Greiner, Erika K. Coles & William E. Pelham Jr.

Department of Psychology, Florida International University, Miami, FL, USA

Brittany M. Merrill, Joseph S. Raiker, Aaron T. Mattfeld, Fiona L. Macphee, Marcela C. Ramos, Xin Zhao, Amy R. Altszuler, Stefany Coxe, Erika K. Coles & William E. Pelham Jr.

Department of Psychology, University of California, Santa Barbara, CA, USA

Jonathan W. Schooler

You can also search for this author in PubMed   Google Scholar

Corresponding author

Correspondence to Brittany M. Merrill .

Ethics declarations

Ethics approval.

All procedures were approved by the Florida International University Institutional Review Board (IRB-16–0217-CR03).

Consent to Participate

Written informed consent was obtained from the parents and written informed assent was obtained from child participants.

Conflicts of Interest

The authors have declared that they have no competing or potential conflicts of interest.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 16 KB)

Rights and permissions.

Reprints and permissions

About this article

Merrill, B.M., Raiker, J.S., Mattfeld, A.T. et al. Mind-Wandering and Childhood ADHD: Experimental Manipulations across Laboratory and Naturalistic Settings. Res Child Adolesc Psychopathol 50 , 1139–1149 (2022). https://doi.org/10.1007/s10802-022-00912-6

Download citation

Accepted : 24 February 2022

Published : 05 March 2022

Issue Date : September 2022

DOI : https://doi.org/10.1007/s10802-022-00912-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

• Attention-deficit/hyperactivity disorder
• Mind-wandering
• Psychostimulants
• Find a journal
• Publish with us
• Track your research

• Counselling and Psychotherapy
• View all types of therapy
• Online therapy
• Face to face therapy
• Our therapists
• Psychiatric services
• Neurodevelopmental services
• Psychiatric assessments
• How do we deliver psychiatry?
• View all conditions
• Consultancy
• Corporate analytics
• Clinical services
• Adult mental health
• Children and young people
• Need urgent help?
• Private Medical Insurance
• Healthcare professionals
• Group income protection
• Occupational mental healthcare
• Personal injury providers
• Employee assistance programmes
• Aesthetic Surgeons
• News & blogs
• Our companies
• What drives us
• Clinical excellence
• Clinical network

Adult ADHD: Overthinking and Intrusive Thoughts

Do you ever find yourself unable to focus on a task because your mind is flooded with unwanted thoughts? Do you spend hours analysing a situation, going over every detail repeatedly? These experiences could be symptoms of adult ADHD.

According to a study published in the British Journal of Psychiatry , it is estimated that around 2.8% of adults in the UK have Attention Deficit Hyperactivity Disorder (ADHD) , but only about 10% of those with ADHD have been diagnosed and go on to receive the appropriate treatment. This means that most adults with ADHD in the UK remain undiagnosed and untreated.  

The increased media attention on intrusive thoughts has helped to raise public awareness and reduce the stigma surrounding mental health issues but has also led to many people self-diagnosing.  Self-diagnosing mental health conditions based on information found on the internet can be problematic, as it may contain inaccurate or subjective information.

Social media provides a wealth of information about mental health conditions, including symptoms, treatment options, and personal stories of those who have experienced them. However, it can also lead to potential misinterpretation of symptoms.

Take, for example, ADHD. While most people associate ADHD with hyperactivity and impulsivity, it can also manifest in more subtle ways, such as through intrusive thoughts and overthinking.

Intrusive thoughts are unwanted and repetitive thoughts that can be distressing or disturbing. They can take many forms, such as worries, doubts, or even violent or taboo images. 

These symptoms are often associated with mental health conditions such as anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and depression. 

For individuals with ADHD, these thoughts can be particularly persistent and disruptive if left untreated or misdiagnosed.

Why are intrusive thoughts particularly persistent and disruptive in people with ADHD?

Intrusive thoughts can be persistent and disruptive in people with ADHD due to the underlying neurobiological differences in the brain. Individuals with ADHD often experience difficulty regulating their attention, leading to a constant stream of thoughts that are difficult to control.

Research suggests that individuals with ADHD may have an imbalance of neurotransmitters, such as dopamine and norepinephrine. These imbalances can affect cognitive processes such as attention, impulsivity, and working memory.

In addition, individuals with ADHD may have a hyperactive default mode network (DMN), a brain network responsible for mind-wandering and self-referential thought. The hyperactivity in the DMN can lead to a constant stream of thoughts that are difficult to control.

Furthermore, individuals with ADHD often have co-occurring mental health conditions, such as anxiety or depression, which can contribute to the experience of intrusive thoughts. For example, anxiety can lead to obsessive worrying and ruminating. 

What are examples of intrusive thoughts in individuals with ADHD?

Three examples of intrusive thoughts related to ADHD:

• Racing thoughts : People with ADHD may experience a constant flow of thoughts, making it difficult to focus on any one thing. This can lead to racing thoughts that are hard to control and can interfere with daily life.
• Obsessive worrying : ADHD can cause individuals to become fixated on specific worries, going over them repeatedly in their minds. This can lead to anxiety and stress, making it difficult to complete tasks or make decisions.
• Negative self-talk : ADHD can cause individuals to be overly critical of themselves, leading to negative self-talk. This can damage self-esteem and cause individuals to avoid new challenges or opportunities.

What do intrusive thoughts mean?

Intrusive thoughts do not necessarily indicate that someone is at risk of acting on them. Many people experience intrusive thoughts at some point, which can be managed through therapy, medication, or other coping strategies. 

However, less often do people consider that their unwanted thoughts might be associated with a neurodiverse condition. Because of this, some individuals who haven’t yet received a diagnosis delay assessment as they have come to terms with their symptoms relating to a mental health condition rather than considering it could be neurodevelopmental.  

Traumatic experiences or elevated levels of stress can also contribute to the development of intrusive thoughts.

What to do if you experience persistent intrusive thoughts?

If you experience any of these symptoms, it may be worth seeking more information on how to get diagnosed with ADHD as an adult. Typically,  a psychiatric assessment will involve a comprehensive evaluation of symptoms, medical development, and psychological testing. A formal diagnosis can help individuals understand the underlying causes of their thoughts and other symptoms affecting their day-to-day lives and lead to an appropriate treatment plan.

Treatment for ADHD may include medication, therapy, or a combination of both. Cognitive Behavioural Therapy is recommended to help individuals develop coping strategies for managing symptoms. With the proper treatment, individuals with ADHD can lead successful and fulfilling lives.

Why is it essential to get a clinical ADHD diagnosis?

Many people with ADHD go undiagnosed for years, leading to unnecessary stress and personal and professional difficulties. Seeking a private assessment through Onebright as soon as possible can provide relief and improve the overall quality of life. A private ADHD assessment is the first step in helping to unravel negative thinking patterns and start dealing with complex emotions. 

Where can you get a private ADHD assessment in the UK?

Onebright offers virtual ADHD assessments in the UK with a licensed clinician qualified to give a formal diagnosis.  Please reach out for support if you think you are experiencing symptoms of ADHD and would like to explore treatment pathways.

Enquire about our ADHD assessment

The science of ADHD and creativity: Thought patterns & medication effects

Thinking outside the box? We have ADHD. We forgot the box was even there.

I have ADHD. And because of that, I'm constantly reminded of my own limitations. Do you know how many times I've walked into a room and immediately forgotten why I got up in the first place? Or how often I space out during conversations? Or how mad I get at myself when I get distracted while reading a book, and read the same sentence over and over? And read the same sentence over and over? And read the same sentence over…

It's a constant reminder that my brain works differently.

And, sure, being different isn't necessarily a bad thing, but let's be honest, ADHD makes life so much harder. So, when the script is flipped and a positive aspect of ADHD is presented to us, we tend to cling to it for dear life.

Often called “ ADHD superpowers ,” there are strengths specific to ADHD, which typically include things like hyperfocus, high energy, and having a quick-witted sense of humor. But, without a doubt, the most common trait cited as a "perk" to having ADHD? Creativity .

But is there actually any truth to this? Are people with ADHD more likely to be creative?

Here’s what the science says.

Too long; didn’t read

• Creativity involves both cognitive flexibility (divergent thinking) and cognitive persistence (convergent thinking.)
• ADHDers tend to display more creative skills while working on tasks that require divergent thinking.
• Some ADHD traits - including distractibility, hyperfocus, curiosity, and mind-wandering - are associated with heightened creativity.
• The t hree different presentations of ADHD may show varying levels and distinct types of creativity.

What’s the definition of creativity?

Creativity is an easy concept to recognize, but it’s harder to define.

In general, creativity can be described as the ability to use your imagination to come up with new ideas, solutions, or products that are original, unique, and meaningful.

The result of creativity might take the form of a tangible object, like an invention or a work of art. It can also be something intangible , such as a theory or an explanation for something.

Mental processes involved in creative thinking

There are two main types of thinking:

• Convergent thinking is when you try to find the best solution to a problem.
• Divergent thinking is used when you come up with lots of different ideas.

These types of thinking involve two important cognitive elements: persistence and flexibility . 1

Convergent thinking: Problem-solving and mental stamina

Convergent thinking is characterized by “ cognitive persistence ,” which allows you to stay focused on a single task or goal. When given a problem to solve, convergent thinkers narrow down the possibilities and apply logical and systematic reasoning to identify the best solution.

Divergent thinking: Idea generation and mental flexibility

Divergent thinking involves plasticity or “ cognitive flexibility ,” which is the ability to think “outside the box” and explore many different ideas — sometimes all at once! People who are divergent thinkers (aka innovative thinkers) often break away from conventional or linear thinking patterns. 2

While both convergent and divergent thinking are used in the creative process, divergent thinking is more closely linked to creativity, especially during the initial phase of idea generation .

How do people with ADHD think?

Although there’s no definitive causal relation between ADHD and creativity, it’s the most readily cited “ADHD superpower” for a reason.

Studies have found that ADHDers tend to generate more original ideas than neurotypicals, suggesting that ADHD brains are less restricted by existing knowledge during creative tasks. 3 In other words, they’re more likely to be capable of something called “ conceptual expansion .”

ADHD and divergent thinking

Research suggests that children and adults with ADHD are more likely to have divergent thinking patterns , which means they can quickly connect seemingly unrelated concepts and generate a wide variety of creative ideas and solutions. 3,4

🤔 Just a thought... This might explain why so many people with ADHD bounce from one topic to another during conversations or why it’s hard for us to focus on a task from start to finish without getting distracted.

However, it’s important to remember that not all people with ADHD are divergent thinkers. Some ADHDers don’t consider themselves creative at all!

ADHD and convergent thinking

Convergent thinking requires a more focused and structured approach to finding a single solution, which can be a bit more challenging for ADHDers.

Here’s how ADHD may interfere with the ability to think “inside the box”:

• Inattention: Most adults and kids with ADHD struggle with attention regulation. Because of this, they may be unable to filter out irrelevant information and distractions , making it difficult to focus on the task from beginning to end.
• Unorganized thoughts: Many people with ADHD experience unorganized thoughts. When someone has disorganized thinking, their thought process lacks structure, which can lead to confusion, random associations, and trouble sequencing ideas to reach a solution.
• Hyperactivity: ADHD hyperactivity often presents as restlessness and difficulty sitting still. This relentless urge to move can make it harder to engage in focused tasks. However, mental hyperactivity can also negatively affect the ability to follow a linear thought process.
• Motivation deficit: ADHDers tend to struggle with executive dysfunction , which can affect motivation levels and make it difficult to focus on tasks that aren’t stimulating or exciting. A lack of motivation can make it even more challenging to adopt the structured approach needed for convergent thinking.✨ In dire need of motivation? Check out our favorite motivation hacks for ADHD .

Are people with ADHD more creative?

It’s no secret that ADHD brains are wired differently , which could explain the creative connection.

In fact, certain symptoms and behaviors related to ADHD might enhance creative thinking.

ADHD symptoms and traits that boost creativity

Mind-wandering.

Research shows that those with ADHD tend to spontaneously engage in more wandering thoughts, which can help draw connections and generate new ideas. This “mind-wandering” may also allow for a different perspective on problems and potential solutions.

Mind-wandering and divergent thinking are associated with a brain network called the “default mode network” (DMN) . 5 The DMN is most active when the brain is awake and at rest, i.e. not sleeping.

When neurotypical brains are focusing on a task, the DMN is deactivated , and task-positive networks (TPNs) are activated .

However, ADHD brains have shown different activation patterns: While TPNs are activated during cognitive tasks, the DMN is not entirely inactive, which may explain common inattentive symptoms. 6 This incomplete deactivation of the default mode network has been linked to higher individual creativity . 7

Some scientists even suggest that this link between ADHD and creativity is reason to reconsider “ADHD as a particular ‘mode of thought’ rather than simply a ‘disorder.’” 8

Hyperactivity

One 2021 study found that hyperactivity, especially in those with combined type ADHD (ADHD-C) , was linked to higher originality scores on divergent thinking tasks. In a questionnaire assessing creative abilities in different domains, participants with ADHD-C also rated their creativity higher than other groups, particularly in the Performance domain (e.g., music, theater, dance.)

Researchers hypothesized that hyperactivity may be a trait that helps people with ADHD-C feel more comfortable when they're performing. 9

Risk-taking behavior

ADHDers often have a higher tendency to take risks. This trait might be problematic in some contexts, but when it comes to creativity, it can be a helpful quality. Their willingness to take risks means that they aren’t afraid to go off the beaten track and explore uncharted territory , increasing the potential for innovative ideas.

People with ADHD tend to be highly curious and love going down rabbit holes to learn about their newest interests or hobbies. Small wonder, since curiosity and dopamine are linked: When we find something new that piques our interest, dopamine is released . This natural curiosity is what drives people to explore the unknown.

Several research papers have linked certain types of curiosity with creativity and the ability to think up unique solutions. 10,11

ADHD hyperfocus

Contrary to the popular belief that people with ADHD are always distractible, they can also experience hyperfocus - an intense concentration on a specific task or activity. This ability to deeply immerse themselves in what they find interesting can lead to profound insights and creative outcomes.

ADHD presentation and creativity

ADHD isn’t a one-size-fits-all diagnosis. In fact, there are three presentations of ADHD , and that may have an impact on creativity.

In one study, researchers found that adults with combined-type ADHD were more creative than adults with predominantly inattentive ADHD . 9 However, it’s important to remember that time-restricted studies may not reflect reality, particularly for people with inattentive-type ADHD:

The authors stressed that mind-wandering, a trait associated with ADHD-I, may enhance divergent thinking . But, since this trait requires time spent away from the task, the study design (which didn't allow for breaks) could have disadvantaged inattentive ADHDers.

Can ADHD medication make you less creative?

Several research studies have explored how ADHD medications — particularly stimulants like Adderall, Ritalin, Vyvanse, and Concerta — affect creativity.

‼️ Heads up! It’s important to note that the following studies only investigated the effects of methylphenidate , which is more commonly known under brand names like Ritalin or Concerta.

How does stimulant medication affect creativity in ADHD children? (2016 research)

In 2016, Gracia González-Carpio Hernández and Juan Pedro Serrano Selva published a study that raised concerns about using stimulant medications to treat ADHD (methylphenidate, aka Ritalin and Concerta) and the potential impact on creativity. 12

Study results showed that ADHDers had similar - or even better - creativity test scores when they were not taking stimulant medication compared to when they were medicated . When medicated, they had fewer creative responses with less originality. This could be because stimulants can put someone in a “zombie-like” state of focus, which may limit their use of creative inspiration from their surroundings.

In their conclusion, the authors noted that, when evaluating creativity in kids with ADHD, it’s important to consider whether they’re medicated since ADHD meds could hide their true creative potential .

How do stimulants affect creative abilities in ADHD adults? (2020 research)

Four years later, Matthijs Baas et al. conducted a similar study on ADHD adults. 13 Researchers gave participants a 20 mg dose of methylphenidate and observed its effect on creativity.

Surprisingly, they found that methylphenidate might not directly affect creativity in ADHD adults. However, participants also didn’t note an increase in alertness, which is what the drug is supposed to do. This could indicate that the dose wasn’t high enough.

Still, the researchers concluded that while there might have been methodological factors that made it hard to see Ritalin’s true effects on creativity, it’s quite possible that methylphenidate doesn’t affect creative performance in ADHD adults at all .

Lastly, the study suggests that more research with larger groups and more sensitive tasks is needed to understand better how these drugs affect creativity.

Final thoughts

The relationship between ADHD and creativity is fascinating and complex. Research suggests that ADHDers often excel at divergent thinking , coming up with original ideas due to their wandering thoughts, risk-taking tendencies, and moments of hyperfocus. However, creativity levels can also vary among the three ADHD presentations.

Regarding ADHD medication, studies indicate that stimulants like Ritalin may influence creativity, potentially hiding it, particularly in children with ADHD. However, other research suggests that adults may not experience the same effects and can maintain their full creative ability while on medication.

Although more research is needed to fully grasp the connection between ADHD and creativity, one thing is clear: Having ADHD offers a unique perspective that can nurture creativity. Embracing our differences can unlock the potential for innovation and imagination, highlighting the remarkable possibilities that lie within our very own neurodivergent brains.

1 NeuroImage | Metacontrol of human creativity: The neurocognitive mechanisms of convergent and divergent thinking (2020) 2 Current Opinion in Behavioral Sciences | Creativity and the Big Two model of personality: plasticity and stability (2019) 3 Journal of Creative Behavior | Thinking “Outside the Box”: Unconstrained Creative Generation in Adults with Attention Deficit Hyperactivity Disorder (2018) 4 Creativity Research Journal | Scope of Semantic Activation and Innovative Thinking in College Students with ADHD (2016) 5 Neuropsychologia | Creativity and the default network: A functional connectivity analysis of the creative brain at rest (2014) 6 Brain and Behavior | Brain functional connectivity abnormalities in attention-deficit hyperactivity disorder (2016) 7 NeuroImage | Failing to deactivate: The association between brain activity during a working memory task and creativity (2011) 8 Brain Behav . | Gender differences in parieto-frontal brain functional connectivity correlates of creativity (2019) 9 Journal of Attention Disorders | Creativity in the Predominantly Inattentive and Combined Presentations of ADHD in Adults (2022) 10 Journal of Creative Behavio r | A Meta-Analysis of the Relationship between Curiosity and Creativity (2019) 11 Personality and Individual Differences | Outside the box: Epistemic curiosity as a predictor of creative problem solving and creative performance (2017) 12 Psicothema | Medication and creativity in Attention Deficit Hyperactivity Disorder (2016) 13 NeuroImage | Methylphenidate does not affect convergent and divergent creative processes in healthy adults (2020)

Your voice matters!

Katie is a freelance writer, mother, and creative soul with ADHD. Her background in Psychology is...

Related articles

Nighttime productivity: 6 reasons why you work better at night

Adderall's focus formula: The science of stimulants and ADHD

Looking for support?

Inflow can help you thrive with ADHD and reach your full potential. Start your journey now by taking our quiz.

Related articles:

The bittersweet truth about ADHD and sugar

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Sage Choice

Validation of the Mind Excessively Wandering Scale and the Relationship of Mind Wandering to Impairment in Adult ADHD

Florence d. mowlem.

1 Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK

Caroline Skirrow

Stefanos maltezos, simrit k. nijjar, andrew merwood.

2 Department of Psychology, University of Bath, UK

Edward Barker

Ruth cooper, jonna kuntsi, philip asherson, associated data.

Supplemental material, Mindwandering_and_ADHD_SupplementaryMaterial_JAD for Validation of the Mind Excessively Wandering Scale and the Relationship of Mind Wandering to Impairment in Adult ADHD by Florence D. Mowlem, Caroline Skirrow, Peter Reid, Stefanos Maltezos, Simrit K. Nijjar, Andrew Merwood, Edward Barker, Ruth Cooper, Jonna Kuntsi and Philip Asherson in Journal of Attention Disorders

Objective: This study investigates excessive mind wandering (MW) in adult ADHD using a new scale: the Mind Excessively Wandering Scale (MEWS). Method: Data from two studies of adult ADHD was used in assessing the psychometric properties of the MEWS. Case-control differences in MW, the association with ADHD symptoms, and the contribution to functional impairment were investigated. Results: The MEWS functioned well as a brief measure of excessive MW in adult ADHD, showing good internal consistency (α > .9), and high sensitivity (.9) and specificity (.9) for the ADHD diagnosis, comparable with that of existing ADHD symptom rating scales. Elevated levels of MW were found in adults with ADHD, which contributed to impairment independently of core ADHD symptom dimensions. Conclusion: Findings suggest excessive MW is a common co-occurring feature of adult ADHD that has specific implications for the functional impairments experienced. The MEWS has potential utility as a screening tool in clinical practice to assist diagnostic assessment.

Introduction

The diagnosis of ADHD is based mainly on descriptions of behaviors that reflect inattention, hyperactivity, and impulsivity. Yet older children, adolescents, and adults frequently report phenomenological descriptions of internal subjective experiences that may underlie the behavioral changes seen in ADHD. Characteristic descriptions of the mental state in ADHD include reports of ceaseless mental activity, thoughts that are constantly on the go, or a mind constantly full of thoughts. Thoughts are experienced as uncontrolled, with multiple occurring at the same time. Another common description is of short-lived thoughts that flit from one thing to another, jumping between different ideas ( Asherson, 2005 ; Downey, Stelson, Pomerleau, & Giordani, 1997 ; Weyandt et al., 2003 ). Here, we propose that such excessive mind wandering (MW) may reflect a core difficulty in ADHD that underlies some of the experienced impairments.

MW is conceptualized as periods in time when attention and the contents of thoughts shift away from external sources and/or ongoing tasks to unrelated internal thoughts or feelings ( Smallwood & Schooler, 2015 ). It is a universal human experience; individuals in the general population are estimated to spend between 24% and 50% of their waking hours engaging in self-generated thoughts unrelated to their external environment ( Kane et al., 2007 ; Killingsworth & Gilbert, 2010 ; Smallwood & Schooler, 2015 ; Song & Wang, 2012 ). Two main types of MW have been identified; first, self-generated internal thoughts that occur intentionally/deliberately, such as planning the menu for a party while driving to work. Second, unintentional/spontaneous MW when the mind drifts off, for example, during a lecture or conversation. Despite its ubiquitous nature, individuals differ in the frequency and intentionality of their MW.

Excessive spontaneous MW has been associated with functional impairment and implicated in psychopathologies such as ADHD ( Franklin et al., 2017 ). Mental restlessness, a descriptive term encompassing excessive MW, has been reported as more common in ADHD than non-ADHD individuals ( Downey et al., 1997 ; Weyandt et al., 2003 ). Previous work suggests that ADHD is associated with spontaneous MW, rather than deliberate MW, and detrimental episodes of MW ( Franklin et al., 2017 ; Seli, Smallwood, Cheyne, & Smilek, 2015 ; Shaw & Giambra, 1993 ). Detrimental MW has been defined as instances when task-unrelated thoughts (TUTs) interfere with task performance. In contrast, strategic MW occurs at times when TUTs are less likely to interfere with performance (whether intentional or not) or when the benefits outweigh the costs, and can be an economic use of neuronal resources ( Franklin et al., 2017 ; Smallwood & Schooler, 2015 ).

Using an experience sampling technique to measure on- and off-task thoughts during an attention task, Shaw and Giambra (1993) found the frequency of spontaneous (but not deliberate) TUTs was increased in college students with a childhood history of ADHD compared with controls. Furthermore, a sub-clinical group with high levels of ADHD symptoms demonstrated more TUTs compared with those with low ADHD scores. This finding was subsequently replicated using a rating scale measure of deliberate and spontaneous MW in both clinical and non-clinical ADHD samples ( Seli et al., 2015 ). In addition, regression analyses revealed spontaneous MW to be independently related to ADHD symptomatology, whereas deliberate MW was unrelated, further suggesting that spontaneous MW is a feature of ADHD.

ADHD symptomatology has also been shown to positively correlate with both the frequency of MW and the lack of awareness of engaging in MW ( Franklin et al., 2017 ). A sub-clinical group with high ADHD symptom scores had disruptive MW episodes even when they were detrimental and interfered with function in daily life. In this study, lacking awareness of MW was shown to mediate between ADHD symptoms and impairment, suggesting that increasing awareness of MW in ADHD might lead to functional improvements.

Collectively, these findings suggest that adults with ADHD are highly susceptible to excessive spontaneous MW and may have a core difficulty controlling spontaneous thoughts unrelated to the current context. Excessive MW could therefore underlie many of the symptoms and impairments that characterize the disorder. To explore the role that MW may play in the pathogenesis of ADHD, as well as its potential role in diagnosis, our research group developed the Mind Excessively Wandering Scale (MEWS; see Figure 1 ). The MEWS is a 15-item self-report measure designed to reflect MW in ADHD, derived from patient reports of subjective experiences of their thought processes. The scale captures the main characteristics of the mental state described by adults with ADHD: thoughts on the go all the time, thoughts that jump or flit from one topic to another, and multiple lines of thoughts at the same time ( Asherson, 2005 ). The MEWS therefore reflects the form as opposed to the content of the experienced thought processes in ADHD. Uniquely, the MEWS assesses a mental phenomenon as opposed to the behavioral symptoms conventionally assessed with ADHD rating scales.

Items from the Mind Excessively Wandering Scale (MEWS).

Note. Items are scored on a 4-point Likert-type scale (0 = not at all or rarely , 1 = some of the time , 2 = most of the time , 3 = nearly all of the time or constantly ). The MEWS scale is copyrighted and available without charge from the corresponding author, and we welcome use of this scale in research.

a Items we recommend excluding from the scale in future research, based on analysis conducted here.

The aim of the present study was to validate the MEWS as an instrument to assess MW in adult ADHD using two study samples. In Study 1, we conducted a preliminary evaluation of the psychometric properties of the MEWS in a small sample of adult males with ADHD selected for the absence of comorbid psychiatric conditions. In Study 2, we cross-validated the MEWS in a larger independent sample including males and females, less highly selected against comorbidity. We further investigated the relationship of MEWS scores to other measures of ADHD symptomatology, and investigated the relationship between MW and functional impairment.

Study 1 Sample

Participants were a small subset of adults from the MIRIAD (Mood Instability Research in ADHD) project, a longitudinal case-control study of emotional lability (EL) and neuropsychological functioning in adult men with ADHD with no co-occurring comorbidities ( Skirrow & Asherson, 2013 ). Forty-one adults with ADHD and 47 controls aged between 18 and 65 years (ADHD: M = 28.54 years, SD = 9.52 years; control: M = 29.00 years, SD = 10.46 years) participated in the MIRIAD project. There were no significant differences between groups for age or IQ (see Table 1 ). ADHD participants were recruited from the waiting list of the National Adult ADHD Clinic at the South London and Maudsley Hospital (SLaM) and were medication free at the time of the research assessment. Further detail on the recruitment process is provided elsewhere ( Skirrow & Asherson, 2013 ).

Case-Control Differences for Age, Sex, IQ, MEWS, INN, HI, EL, and IMP.

Note. See Online Supplementary Table 1 for Time 2 and Time 3. MEWS = Mind Excessively Wandering Scale; INN = inattention; HI = hyperactivity/impulsivity; EL = emotional lability; IMP = impairment.

As the MEWS was developed after the MIRIAD project began, only a subset of the ADHD cases and controls provided MEWS data. At study entry (baseline), 25 cases and 24 controls completed the MEWS. Follow-up assessments completed approximately 9 months after baseline provided data on 18 cases and 18 controls at both time points. In addition, six cases and 18 controls provided MEWS data at follow-up assessment alone. Of the 18 ADHD cases with data at both time points, 16 were treated with methylphenidate and one with atomoxetine at follow-up, initiated by local services and not following a specific protocol. Ethical approval for this study was obtained from the Joint Research Ethics Committee of the Institute of Psychiatry and SLaM.

Study 2 Sample

Participants were from the OCEAN (Oils and Cognitive Effects in Adult ADHD Neurodevelopment) project, a study investigating the relationship of omega-3 dietary supplementation (not analyzed in this study) to cognitive and electrophysiological measures in adults with ADHD. Participants were aged between 18 and 65 years. The sample consisted of 81 adults with ADHD (37 female, 44 male; M age = 33.52 years, SD = 10.26 years) and 30 healthy controls (14 female, 16 male; M age = 29.51 years, SD = 8.8 years). Groups did not significantly differ on age, sex, or IQ (see Table 1 ). ADHD participants were recruited through SLaM Adult ADHD Service, advertisements on ADHD support websites, and previous study databases. See online supplementary material for further information on recruitment.

At baseline (Time 1), 79 cases and 29 controls provided MEWS data. Two separate follow-up assessments of the ADHD cases took place, 3 months (Time 2) and 6 months (Time 3) after baseline. At Time 2 and Time 3, 79 and 55 ADHD cases provided MEWS data, respectively. Ethical approval for the study was granted by the National Research Ethics Service (NRES) Committee London.

ADHD symptoms

ADHD symptoms were assessed using the self-rated Barkley Adult ADHD Rating Scale (BRS; Barkley, 1998 ) in Study 1, and the Conners’ Adult ADHD Rating Scales (CAARS; Conners, Erhardt, & Sparrow, 1999 ) in Study 2. Both scales cover the same list of 18 DSM-IV/DSM-5 items for inattention and hyperactivity ( Diagnostic and Statistical Manual of Mental Disorders (4th ed. and 5th ed.; American Psychiatric Association [APA], 1994 and 2013 ).

Emotional dysregulation

Emotional Lability (EL) was measured using the Affective Lability Scale–Short Form (ALS-SF; Oliver & Simons, 2004 ), which measures rapid changes in emotional states.

Functional impairment across major life domains (family, work, school, life-skills, self-concept, social, and risk) was measured using the Weiss Functional Impairment Rating Scale–Self-Report (WFIRS-S; Sadek, 2014 ).

Mind wandering

MW was measured using the newly created MEWS (see Figure 1 ). This publication is the first report of this scale. The MEWS is a 15-item self-report measure reflecting MW in ADHD. Items were based on patient descriptions of MW in ADHD as previously described by Asherson (2005) . P.A., C.S., and P.R. drew up the list of questions based heavily on their combined experience of patient’s reports of MW, and questions were refined during several consensus meetings. The final item checklist was agreed by all three authors and implemented initially in the MIRIAD study before further testing in the OCEAN study (reported here). The MEWS scale is copyrighted and available without charge from the corresponding author.

Statistical Analyses

Mean values for each rating scale and subscale were used as summary measures. The raw data and square-root transformations were used in analysis, and parametric and non-parametric tests were used as appropriate.

Principal components analysis (PCA) with varimax rotation was conducted to examine the factor structure of the MEWS. Cronbach’s alpha was used as a measure of reliability to assess internal consistency and Pearson’s correlation coefficient was used to analyze test–retest reliability of the scale. Construct validity was assessed with independent t tests and Mann–Whitney U tests to investigate case-control differences. Receiver operating characteristic (ROC) analysis was used to examine diagnostic accuracy and the optimal cut-off point of the measure.

Convergent validity of the MEWS in relation to ADHD symptom scales was assessed using polyserial correlations to provide unbiased estimates of cross-variable correlations in case-control samples ( Olsson, 1979 ). For these analyses, we fixed the z value threshold for affection status corresponding to 3.4% prevalence of ADHD in adults ( Fayyad et al., 2007 ). In Study 1, polyserial correlations were also conducted on change scores (Time 1-Time 2). For change scores in Study 2, we used partial correlations to control for potential influences of the study intervention (placebo or essential fatty acid). Hierarchical multiple regression was used to investigate whether MEWS scores were independent predictors of impairment; inattention and hyperactivity/impulsivity were entered in the first step and MW in the second.

Psychometric evaluation

The scree plot and eigenvalues indicated a unidimensional structure to the MEWS with one factor accounting for 69.16% of the variance (eigenvalue = 10.37; see online supplementary material). Factor loadings were greater than .7, with the exception of Item 14 (.51). Table 2 shows Cronbach’s alpha coefficients for the full 15-item MEWS in comparison with the other rating scales. At baseline, internal consistency was high for all scales for both cases and controls (α > .78). Examination of item total correlations showed each item to correlate well with the full 15-item scale (correlations > .75, with the exception of Items 6 [.66], 10 [.70], and 14 [.47]), suggesting items are measuring the same underlying construct. Inter-item correlations ranged from .27 to .88, with an average inter-item correlation of .66, reflecting the internal consistency of the scale items.

Reliability Coefficients (α) for the MEWS as Compared With the INN, HI, EL, and IMP Rating Scales.

Note. MEWS = Mind Excessively Wandering Scale; INN = inattention; HI = hyperactivity/impulsivity; EL = emotional lability; IMP = impairment.

There was a mean interval of 9.7 months ( SD = 3.3 months) for cases and 9.5 months ( SD = 4.0 months) for controls between baseline and follow-up. Test–retest reliability was significant for the whole sample ( r = .84, 95% confidence interval [CI] = [.74, .92], p < .001), and for both cases ( r = .63, 95% CI = [.06, .88], p = .005) and controls ( r = .82, 95% CI = [.40, .93], p < .001).

Construct validity

Case-control comparisons at baseline revealed significantly elevated ratings of MW in individuals with ADHD, t (47) = −7.83, p < .0001, comparable with that found for the other rating scales of ADHD symptom domains: inattention, t (73.07) = −14.58, p < .0001; hyperactivity/impulsivity, t (85) = −11.40, p < .0001; emotional lability, U = 168.5, z = −6.53, p < .0001 ( Table 1 ). Participants with ADHD also demonstrated significantly greater overall impairment on the WFIRS-S, t (86) = −13.08, p < .0001, as well as for each domain of impairment, t range = −5.78-11.40, p < .0001, for impairment in family life, work, school, life-skills, self-concept, social problems, and risk taking. Similar results were found at follow-up (see online supplementary material).

ROC analysis was used to examine the capacity of the scale to discriminate between cases and controls. Area under the curve (AUC) was .92 (95% CI = [.85, 1.00], p < .0001) which, being close to 1, indicates excellent discriminant capacity of the MEWS. This was comparable with the AUC value of existing rating scales of ADHD symptom domains (inattention: AUC = .99, 95% CI = [.97, 1.00]; hyperactivity/impulsivity: AUC = .95, 95% CI = [.91, .99]; emotional lability: AUC = .91, 95% CI = [.84, .97]). A score of 15 or above provides the optimal balance of sensitivity (.88) and specificity (.88), suggesting a cut-off for disorder threshold (see online supplementary material).

Convergent validity

Polyserial correlations in the combined case-control data set showed strong positive correlations between MW and the other rating scales of ADHD and impairment: inattention ( r = .81, 95% CI = [.72, .87]), hyperactivity/impulsivity ( r = .77, 95% CI = [.66, .84]), emotional lability ( r = .81, 95% CI = [.72, .88]), and impairment ( r = .82, 95% CI = [.71, .89]), as well as ADHD affection status ( r = .70, 95% CI = [.57, .79]). The strongest correlation was between MW and impairment ( Table 3 ). In addition, moderate to large positive correlations were seen between MW and ADHD symptom dimensions and impairment in both cases and controls analyzed separately (see online supplementary material), indicating severity of symptoms and impairment in both cases and controls.

Polyserial Correlations (95% Confidence Intervals), Corrected for Selection (Affection Threshold = 3.4%), Between the MEWS, INN, HI, EL, and IMP Rating Scales, and AFF.

Note. MEWS = Mind Excessively Wandering Scale; INN = inattention; HI = hyperactivity/impulsivity; EL = emotional lability; IMP = impairment; AFF = affection status.

For the sub-sample with both baseline and follow-up data, the correlation of baseline to follow-up change scores for MW with change scores for the rating scale measures of ADHD symptoms and impairments revealed temporal covariance between the measures: positive correlations were found between change in MW and change in inattention ( r = .72, 95% CI = [.54, .83]), hyperactivity/impulsivity ( r = .55, 95% CI = [.33, .70]), emotional lability ( r = .70, 95% CI = [.44, .84]), and impairment ( r = .51, 95% CI = [.23, .72]; see Table 4 ). In the 16 cases treated with methylphenidate at follow-up, there was a significant reduction in MEWS scores, t (15) = 2.28, p = .04, between the baseline medication-free period ( M = 23.38, SD = 10.93) and follow-up ( M = 17.25, SD = 10.58).

Correlations (95% Confidence Intervals) Between Change Scores for the MEWS, INN, HI, EL, and IMP Rating Scales.

Note . Polyserial correlations corrected for selection (affection threshold = 3.4%) were used in Study 1, and partial correlations to correct for study intervention in Study 2 (with significance levels). MEWS = Mind Excessively Wandering Scale; INN = inattention; HI = hyperactivity/impulsivity; EL = emotional lability; IMP = impairment.

Data from 49 participants were used in regression analyses with the WFIRS-S total impairment score. Inattention and hyperactivity/impulsivity accounted for 82.4% of the variability in functional impairment ( R 2 = .824). The addition of MW as a predictor led to a significant increase in predictive power of the model ( R 2 Δ = .024), with the variability accounted for by the model increasing to 84.9%, F Δ(1, 45) = 7.17, p = .01. This indicates that MW is having a small but significant effect beyond that accounted for by inattention and hyperactivity/impulsivity. Inattention carried the most importance in the model (β = .45), followed by MW (β = .31) and hyperactivity/impulsivity (β = .21). Only inattention and MW significantly contributed to the model ( p = .001 and .01, respectively).

Within the ADHD group, MW had an independent effect on impairment in the domains of self-concept, R 2 Δ = .145, F Δ(1, 21) = 6.57, p < .02, and social problems, R 2 Δ = .137, F Δ(1, 21) = 4.50, p < .05. For the social problems domain, MW carried more importance in the model (β = .44) than inattention (β = −.42), but not hyperactivity/impulsivity (β = .50). Only MW and hyperactivity/impulsivity significantly contributed to the model ( p = .05 and .03, respectively). Interpretation of work and life-skills dimensions was not possible due to heteroskedasticity in the data.

The scree plot and eigenvalues suggested a one-factor solution with an eigenvalue of 9.44, accounting for 62.92% of the variance (see online supplementary material). All items loaded highly onto this factor (>.76, with the exception of Items 6 [.60], 10 [.68], and 14 [.40]). Internal consistency was high for all scales for both cases and controls (α > .78; see Table 2 ). Examination of item total correlations showed each item to correlate well with the full 15-item scale (correlations > .72, with the exception of Items 6 [.56], 10 [.63], and 14 [.37]). Inter-item correlations ranged from .24 to .82, with an average inter-item correlation of .59, reflecting the internal consistency of the scale items.

The mean interval between Time 1 and Time 3 was 6.4 months ( SD = 0.58 months), and MEWS scores showed satisfactory retest reliability across this time period ( r = .63, 95% CI = [.42, .80], p < .0001).

Case-control comparisons revealed significantly elevated ratings of MW in individuals with ADHD ( U = 87.00, z = −7.34, p < .0001). This difference was comparable with that found for the other rating scales of ADHD symptom domains (inattention: U = 20.00, z = −7.94, p < .0001; hyperactivity/impulsivity: U = 64.50, z = −7.65, p < .0001; emotional lability: U = 140.50, z = −7.12, p < .0001; see Table 1 ). ADHD cases also demonstrated significantly greater overall impairment on the WFIRS-S ( U = 53.50, z = −7.70, p < .0001), as well as for each domain of impairment ( z range = −4.87 to −7.57, p < .0001 for impairment in family life, work, school, self-concept, social problems, life-skills, and risk taking; see online supplementary material).

ROC curve analysis indicated that the MEWS successfully discriminated between cases and controls (AUC = .96, 95% CI = [.93, .99], p < .0001). This was comparable with the AUC value of existing rating scales of ADHD symptom domains (inattention: AUC = .99, 95% CI = [.98, 1.00]; hyperactivity/impulsivity: AUC = .97, 95% CI = [.95, 1.00]; emotional lability: AUC = .94, 95% CI= [.90, .98]). A score of 15 on the MEWS provides the optimal balance of sensitivity (.90) and specificity (.90; see online supplementary material).

Using polyserial correlations in the combined case-control data set, we found a positive correlation between MW and the other rating scales of ADHD and impairment: inattention ( r = .77, 95% CI = [.69, .83]), hyperactivity/impulsivity ( r = .69, 95% CI = [.58, .76]), emotional lability ( r = .74, 95% CI = [.66, .81]), impairment ( r = .81, 95% CI = [.74, .86]), and ADHD affection status ( r = .67, 95% CI = [.55, .77]). The strongest correlation was between MW and impairment (see Table 3 ). Moderate to large positive correlations were also seen between MW and ADHD symptom dimensions and impairment in both cases and controls analyzed separately (see online supplementary material).

Investigation of change scores also revealed a temporal relationship. Analyses indicated significant covariation of change in MW with change in inattention ( r = .53, 95% CI = [.25, .71], p < .0001), hyperactivity/impulsivity ( r = .31, 95% CI = [.01, .52], p = .02), emotional lability ( r = .43, 95% CI = [.19, .62], p = .001), and impairment ( r = .62, 95% CI = [.37, .78], p < .0001). MW and impairment showed the strongest relationship (see Table 4 ).

Data from 108 participants were used in regression analysis with the WFIRS-S total impairment score. Inattention and hyperactivity/impulsivity accounted for 71.3% of the variability in functional impairment ( R 2 = .713). The addition of MW as a predictor led to a significant increase in predictive power of the model ( R 2 Δ = .076), with the variability accounted for by the model increasing to 78.9%, F Δ(1, 104) = 37.17, p < .0001. MW carried the most importance in the model (β = .49), followed by inattention (β = .29) and hyperactivity/impulsivity (β = .17). Only MW ( p < .0001) and inattention ( p = .002) significantly contributed to the model.

Within the ADHD group, MW had an independent effect on impairment in life-skills, R 2 Δ = .18, F Δ(1, 75) = 24.79, p < .0001; self-concept, R 2 Δ = .10, F Δ(1, 75) = 9.72, p = .003; social problems, R 2 Δ = .10, F Δ(1, 75) = 9.92, p = .002; and risk taking, R 2 Δ = .09, F Δ(1, 75) = 9.37, p = .003. MW carried the most importance in the model for life-skills (β = .52), self-concept (β = .39), and social problems (β = .39), and was the only significant contributor to the model for the self-concept ( p = .003) and social problems ( p = .002) domains. Interpretation of the family and work domains was not possible due to heteroskedasticity in the data.

We report the psychometric properties and initial validation findings for a new self-report scale of excessive MW in adults with ADHD. Using two independent samples, we found that MEWS scores functioned extremely well as a measure of the mental phenomenon of MW in ADHD, with good reliability and high sensitivity and specificity for ADHD case-control differences. We found that elevated levels of MW (as indexed by the MEWS) in participants with ADHD were related to self-report measures of functional impairment. Furthermore, the contribution of MW to impairment was independent of the core ADHD symptoms of inattention and hyperactivity/impulsivity. These findings suggest that excessive MW is a characteristic feature of adult ADHD that has specific effects on impairment.

Principal components analysis indicated a unidimensional structure to the scale and other psychometric properties of the MEWS were comparable with existing rating scales of ADHD core symptoms, including good internal consistency and test–retest reliability. The MEWS was able to differentiate between those with and without ADHD with high sensitivity and specificity of the scale, using a threshold score of 15. This is remarkable given that patients were selected for high ADHD symptoms and not specifically for subjective reports of internal thought processes as measured by the MEWS.

In both studies, item total correlations with the full 15-item scale and factor loadings were high apart from Items 6 (Because my mind is “on the go” at bedtime, I have difficulty falling off to sleep), 10 (I try to distract myself from my thoughts by doing something else or listening to music), and 14 (I use alcohol or other drugs to slow down my thoughts and stop constant “mental chatter”). This is likely explained by the nature of these items, which refer to how individuals cope with MW or how it directly affects their functioning, as opposed to a description of the mental phenomenon. To investigate whether the scale could be shortened by dropping Items 6, 10, and 14 without reducing its sensitivity and specificity, we repeated the ROC analysis, finding the shorter 12-item scale had a sensitivity of .89 and specificity of .90 (see online supplementary material). Further analyses in larger data sets could be used to further refine the scale, but based on these data we recommend that future studies use the reduced 12-item scale.

Our findings are in line with previous studies which report elevated levels of MW in ADHD compared with controls, whether measured using clinical rating scales ( Franklin et al., 2017 ; Seli et al., 2015 ; Weyandt et al., 2003 ) or experience sampling of TUTs during a sustained attention task ( Shaw & Giambra, 1993 ). Furthermore, the strength of case-control differences for MEWS scores was comparable with that seen for rating scale measures of core ADHD symptoms, for which clinical cases of ADHD are selected on. MEWS scores were also found to be highly correlated with ADHD symptoms and impairment in the total sample, as well as in cases and controls analyzed separately, replicating previous studies of the association between spontaneous MW and ADHD ( Franklin et al., 2017 ; Seli et al., 2015 ). These results indicate that the MEWS is a marker of symptom severity in both cases and controls, in line with previous data indicating that ADHD symptoms lie along a continuum in the general population ( Chen et al., 2008 ; Salum et al., 2014 ).

Change scores for MW also covaried with ADHD symptoms and impairments over time, indicating a close temporal relationship consistent with a potential causal role of MW in ADHD. The finding of significant pre–post treatment effects of methylphenidate in a subset of Study 1 participants raises the possibility that treatment effects on ADHD might be mediated by reductions in MW. However, we were unable to test specifically for treatment effects of methylphenidate because we did not randomize to treatment or include a placebo control arm.

The link between MW and impairment was particularly strong, indicating the clinical importance of MW in adults with ADHD. Of specific interest was the finding that MW showed a main effect on impairment beyond the influence of inattention and hyperactivity/impulsivity and was overall the strongest predictor of impairment in Study 2. Investigating specific domains of impairment, MW was found to be an independent predictor of self-concept and social problems in both studies, and additionally life-skills and risk taking in Study 2. The reasons the MEWS is a particularly good predictor of impairment in ADHD are not well understood, but could be explained by both clinical and theoretical considerations. One possible explanation is that the scale items are rooted in qualitative accounts from adult ADHD patients of experiences of their mental state. When asked to describe the subjective experience of the flow of their thoughts, adults with ADHD repeatedly give descriptions of ceaseless, short-lived, and unfocused thoughts that flit from one topic to another ( Asherson, 2005 ). Such a distractible and poorly regulated mental state could be impairing for several reasons.

First, excessive MW may have a specific effect on functional outcomes due to the failure to deal with distraction and deficient mental processing of “task”relevant events. In social situations, an individual with excessive MW may miss verbal and non-verbal information and effectively not listen or lack awareness of social cues. MW may make it difficult to follow a single line of thought and interrupting others during conversations could be a strategy to avoid losing their train of thought. Behaviors such as these are likely to have negative effects on an individual’s social interactions.

Second, lack of attention paid to events due to one’s mind constantly being “on the go” in a non-focused way can also create difficulties with thinking through and planning activities, linked to forgetfulness and disorganization and leading to impairments in basic life-skills. Impaired self-concept may then arise as a bi-product of the effect of excessive MW on other domains of functioning, but could also be due to distress from the constant effort to focus or the experience of having a mind constantly full of unfocused distractible thoughts. Many patients report a sense of calm and relief when the flow of their thoughts becomes more focused and regulated following stimulants or other treatments for ADHD.

Third, the connection between MW and risk-taking behavior is less obvious, but could be due to the impact of highly salient activities, which engage the attention of individuals, leading to a reduction of spontaneous MW and a sense of relief. For the same reasons, some patients with even severe levels of ADHD may excel at activities such as exciting/stimulating sports. Although there is as yet no direct evidence for this hypothesis, studies investigating default mode deactivation ( Liddle et al., 2011 ) and reaction time variability (RTV; Andreou et al., 2007 ) during tasks requiring sustained attention have shown reduced or absent case-control differences when conducted under highly salient conditions. Reductions in default mode activity under rewarding conditions have been hypothesized to reflect reductions in excessive MW ( Liddle et al., 2011 ). Thus, risky behavior may reflect individuals seeking out activities with salient content, which decreases MW and helps individuals with ADHD to focus their attention.

These accounts of MW leading to impairment in ADHD remain speculative because of the lack of research on MW in ADHD. However, an increase in understanding of MW states in control participants provides a strong theoretical basis for the hypothesis that excessive MW may underlie many of the behavioral symptoms and impairments seen in ADHD. In healthy control samples, MW is associated with performance deficits that overlap with impairments seen in ADHD, including educational performance, driving accidents, and performance on cognitive tasks including errors of commission and RTV during sustained attention and inhibition tasks ( Smallwood & Schooler, 2015 ). Understanding of the neural processes involved in the regulation of internal thought, involving default mode network (DMN) and executive control networks, has advanced in recent years, and overlaps with neural mechanisms implicated in ADHD. TUTs are strongly associated with deficient task-induced deactivation of the DMN (correlation about .9; McKiernan, D’Angelo, Kaufman, & Binder, 2006 ), and deficient DMN deactivation during task conditions is strongly associated with ADHD ( Christakou et al., 2013 ). Spontaneous MW that is detrimental to performance has, therefore, been proposed as a mechanism that explains many of the symptoms and functional impairments of ADHD ( Seli et al., 2015 ; Weyandt et al., 2003 ), reflecting aberrant inter-relationships between default and task positive networks ( Fox, Spreng, Ellamil, Andrews-Hanna, & Christoff, 2015 ; Sripada, Kessler, & Angstadt, 2014 ).

Interestingly, in one study, meta-awareness of MW (being aware that your mind has wandered) was found to mediate the relationship between ADHD symptoms and detrimental forms of MW, suggesting that psychological treatments aimed at enhancing meta-awareness of MW, such as mindfulness-based interventions (MBIs), might ameliorate the negative consequences of MW in ADHD ( Franklin et al., 2017 ). Recent studies support the beneficial effects of MBIs on ADHD, with the largest study to date showing an effect of d = .85 on ADHD symptoms compared with a treatment as usual group ( Hepark et al., 2019 ). Future large-scale controlled experimental designs are therefore indicated to investigate the potential role of MW as a treatment target for the control of ADHD symptoms and impairments using both pharmacological and non-pharmacological interventions.

Current screening tools for adult ADHD consist of rating scales for inattention and hyperactivity/impulsivity. Our findings suggest potential utility of the MEWS as an additional screening tool for adult ADHD in clinical practice, particularly as the MEWS is a strong predictor of impairment. Furthermore, as discussed above MW may also be measured more objectively using experience sampling methods in daily life or during experimental paradigms. Measures of MW may therefore assist in the accurate diagnosis of individuals based on their mental state rather than descriptions of behavior, which may be more subject to bias or influenced by an individual’s ability to develop compensatory behavioral strategies.

However, currently we do not know the role that excessive MW, as measured by the MEWS, plays in other clinical disorders. For example, in depression depressive rumination represents another form of MW. Thus, the specificity of the MEWS across common mental health disorders needs to be explored. Therefore, we do not currently recommend the routine use of the MEWS to identify patients with ADHD until the scale has been comprehensively evaluated in other psychiatric disorders with overlapping clinical features, although high MEWS scores could be used to support the diagnosis. Investigation of the role of excessive MW in childhood and early adolescent ADHD is also recommended, including use of the scale in this population. Whether children and young adolescents would be able to conceptualize MW and reliably report on their mental state requires investigation.

Limitations and Future Research

Some participants in Study 2 presented with co-occurring anxiety and depression, raising the possibility that MW might be linked to comorbid conditions. However, in Study 1 participants were free from co-occurring disorders ( Skirrow & Asherson, 2013 ), yet similar results were found. Nevertheless, TUTs are a common feature of most mental health disorders and future research will need to investigate the distinction of excessive MW in ADHD from depressive ruminations, anxious worrying, and other sources of MW.

In relation to ADHD, a key question is whether MW differs conceptually from the inattentive symptoms currently used to define the disorder or whether the mental phenomenon of MW underlies the behavioral expression of inattention. As discussed above, it is feasible that measures of MW in ADHD are a more direct reflection of the neurobiology, leading to the inattentive symptoms of ADHD. Further work is required to evaluate the plausible hypothesis that aberrant regulation of DMN activity linked to excessive MW leads to ADHD symptoms and impairments. The study of MW has several potential advantages over behavioral inattention for research, because it may be measured using rating scales, as reported here, as well as experience sampling during daily life ( Killingsworth & Gilbert, 2010 ), or during sustained attention tasks ( Shaw & Giambra, 1993 ) and neuroimaging studies ( Baird, Smallwood, Lutz, & Schooler, 2014 ; Christoff, Gordon, Smallwood, Smith, & Schooler, 2009 ).

A fruitful next step in this research will be to take the MEWS into experimental paradigms. For example, an experimental trial of methylphenidate could be used to formally evaluate whether improvements in MW mediate improvements in ADHD symptoms and impairments, and to investigate the underlying neural mechanisms. Yet, currently, there are very little data that link rating scale measures of MW to experimentally derived measures in ADHD. Validation of MW in ADHD is therefore required across the various levels of measurement (rating scale, experience sampling, and experimental paradigms including neuroimaging studies). We hypothesize that MW is a phenomenon that can be reliably measured, and it will be highly informative to see to what extent MEWS scores reflect TUTs measured during cognitive task performance in ADHD. It will also be advantageous to see how it relates to various cognitive measures such as omission and commission errors ( Losier, McGrath, & Klein, 1996 ), and RTV ( Kofler et al., 2013 ), which may reveal further information about the underlying neurobiology of ADHD.

This research provides further insight into the mental phenomenon of MW in ADHD. We investigate a questionnaire-based measure of excessive MW recently developed in our research group. The MEWS was found to be a valid and reliable measure, with comparable sensitivity and specificity for case-control differences as existing rating scale measures of core ADHD symptoms currently used in clinical practice. The MEWS functioned extremely well for a brief 15-item measure and is potentially a useful measure to incorporate in future clinical and etiological research. MEWS scores were found to be a particularly good predictor of impairment, highlighting the clinical utility of the tool for diagnosis and treatment. Based on these findings, there is strong premise to view MW as a common co-occurring feature of adult ADHD with a specific effect on impairment, potentially explaining a variety of deficits not easily accounted for by the core symptom dimensions.

Supplemental Material

Acknowledgments.

We wish to thank all those who made this research possible: The National Adult ADHD Clinic at the South London and Maudsley Hospital (SLaM) and all individuals who participated in the studies.

Author Biographies

Florence D. Mowlem is a PhD student at King’s College London. Her research interests include the long-term outcomes of ADHD, specifically the educational and occupational outcomes.

Caroline Skirrow is an honorary research associate at King’s College London. Her research looks at aetiology, brain function, and cognition in developmental disorders.

Peter Reid , MSc, is a member of the U.K. Adult ADHD Network (UKAAN) Advisory Committee. His research interests include the aetiology and treatment of mental health problems in adults with ADHD.

Stefanos Maltezos is a consultant psychiatrist at the Adult ADHD/Autism Service at the South London & Maudsley NHS Foundation Trust. His research interests include the aetiology, diagnosis, and treatment of ADHD and autism in adults.

Simrit K. Nijjar is an academic foundation trainee at Barts Health NHS Trust, affiliated with Queen Mary University of London.

Andrew Merwood is a final year trainee clinical psychologist at the University of Bath and an honorary research associate at the Institute of Psychiatry, Psychology, and Neuroscience, King’s College London. His research interests include ADHD, exploring the evidence base of psychological therapies, and health service development and improvement.

Edward Barker is a reader in developmental psychopathology at King’s College London. He is interested in how stressful environments exacerbate underlying genetic vulnerabilities to affect children’s development

Ruth Cooper is a senior researcher at Newham Centre for Mental Health, Queen Mary University of London. She completed her PhD at King’s College London.

Jonna Kuntsi is professor of developmental disorders and neuropsychiatry at King’s College London.

Philip Asherson is a professor of psychiatry at King’s College London. His research interests include the aetiology, diagnosis, and treatment of ADHD in adults.

Authors’ Note: The views expressed in this study are those of the authors.

Declaration of Conflicting Interests: The author(s) disclosed receipt of the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: P. Asherson has received funds for consultancy on behalf of KCL to Shire, Eli-Lilly, and Novartis, regarding the diagnosis and treatment of ADHD; educational/research awards from Shire, Eli-Lilly, Novartis, Vifor Pharma, GW Pharma, and QbTech; speaker at sponsored events for Shire, Eli-Lilly, and Novartis. All funds are used for studies of ADHD. The other author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This article represents independent research part funded by the National Institute for Health Research (NIHR) Biomedical Research Centre and Dementia Unit at South London and Maudsley NHS Foundation Trust and King’s College London. F. Mowlem is supported by a 1+3 PhD studentship awarded jointly by the Medical Research Council (MRC) and the Institute of Psychiatry (IoP) Excellence Fund. The MIRIAD study was supported by a grant from the Research for Innovation, Speculation and Creativity (RISC) funding program of the National Institute for Health Research (NIHR; reference: RCPG0308-10245) to P. Asherson, D. Murphy, and C. Skirrow. The OCEAN study was funded by Vifor Pharma (PADWUDB), awarded to P. Asherson with King’s College London as sponsors (this funding included a PhD studentship for R. Cooper).

Supplemental Material: Supplemental material for this article is available online.