GLOBAL PERSPECTIVES ON ADHD STIGMA: A MULTI-NATIONAL CROSS-SECTIONAL STUDY OF PERCEIVED AND INTERNALISED EXPERIENCES
Author(s)
Holly Puzsar, BPsych(Hons)1, Yunhe Huang, PhD1, Claudia Chung, PhD2, Melissa Mulraney, PhD, MPsych(Ed&Dev)1, Yasemin Mehmed, BSc(Hons)1, David Coghill, PhD, MD1.
1University of Melbourne, Melbourne, Australia, 2HKU, Hong Kong, Hong Kong.
1University of Melbourne, Melbourne, Australia, 2HKU, Hong Kong, Hong Kong.
OBJECTIVES: Stigma is a well-established issue in ADHD that can have a range of detrimental effects. Despite its significance, cross-cultural research remains limited, with almost all existing evidence coming from Western, high-income countries. This study investigates the nature, extent, and impact of ADHD stigma across 30 countries, presenting preliminary findings from Australia, China, and Poland.
METHODS: This international, cross-sectional online survey used validated self-report scales to measure internalised stigma (ISMI), perceived stigma (ASQ), ADHD symptom severity (ASRS-v1.1), wellbeing (WHO-5), and health-related quality-of-life (QoL; EQ-5D-5L). Adults (18+) with ADHD were recruited using purposive, self-selecting, and snowball sampling with support from ADHD associations, international collaborators, and social media. The survey is available in 10 languages, having undergone a rigorous front/backward translation process to ensure linguistic accuracy and conceptual equivalence.
RESULTS: Data collection remains ongoing in 30 countries across the Asia-Pacific, Africa, Latin America, and Europe. Preliminary data collected between March-June 2026 from Australia (n=3,241), China (n=2,820), and Poland (n=489) revealed comparable levels of low-to-mild internalised stigma (ISMI mean range = 1.99-2.07) and moderate perceived stigma (ASQ mean range = 2.62-2.69). Across all countries, higher levels of internalised stigma were significantly (p < .001) associated with poorer wellbeing and QoL. The strongest correlations were observed in Poland (wellbeing: r= -.41; QoL: r = -.38), followed by Australia (r = -.39; r = -.28), and China (r = -.25; r = -.25).
CONCLUSIONS: Despite strong cultural differences between countries, preliminary findings revealed a consistent, yet perhaps surprising, pattern. Stigma levels were very similar across countries, with perceived stigma consistently higher than internalised stigma. The consistent relationship between higher stigma and worse wellbeing and QoL highlights the global impact of ADHD stigma, and the need for practical, culturally appropriate, stigma reduction strategies. As data collection continues, this study will continue to build the global evidence base on ADHD stigma.
METHODS: This international, cross-sectional online survey used validated self-report scales to measure internalised stigma (ISMI), perceived stigma (ASQ), ADHD symptom severity (ASRS-v1.1), wellbeing (WHO-5), and health-related quality-of-life (QoL; EQ-5D-5L). Adults (18+) with ADHD were recruited using purposive, self-selecting, and snowball sampling with support from ADHD associations, international collaborators, and social media. The survey is available in 10 languages, having undergone a rigorous front/backward translation process to ensure linguistic accuracy and conceptual equivalence.
RESULTS: Data collection remains ongoing in 30 countries across the Asia-Pacific, Africa, Latin America, and Europe. Preliminary data collected between March-June 2026 from Australia (n=3,241), China (n=2,820), and Poland (n=489) revealed comparable levels of low-to-mild internalised stigma (ISMI mean range = 1.99-2.07) and moderate perceived stigma (ASQ mean range = 2.62-2.69). Across all countries, higher levels of internalised stigma were significantly (p < .001) associated with poorer wellbeing and QoL. The strongest correlations were observed in Poland (wellbeing: r= -.41; QoL: r = -.38), followed by Australia (r = -.39; r = -.28), and China (r = -.25; r = -.25).
CONCLUSIONS: Despite strong cultural differences between countries, preliminary findings revealed a consistent, yet perhaps surprising, pattern. Stigma levels were very similar across countries, with perceived stigma consistently higher than internalised stigma. The consistent relationship between higher stigma and worse wellbeing and QoL highlights the global impact of ADHD stigma, and the need for practical, culturally appropriate, stigma reduction strategies. As data collection continues, this study will continue to build the global evidence base on ADHD stigma.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
PCR169
Topic
Methodological & Statistical Research, Patient-Centered Research, Study Approaches
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Mental Health (including addiction)