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I am keen to know what strategies and treatment approaches works best for procrastination for people with ADHD?

People with ADHD seem to have a different level of complexity from the usual procrastination with neurotypical people. Another thread discussed how people with ADD/ADHD "often heavily discount the importance of an event if it's sufficiently far away from the current time", which does not seem to occur as much with neurotypicals.

ADHD research has increased recently and I was wondering whether there has been any evidence found to be effective with procrastination in this specific population as yet?

The difference between ADHD procrastination and usual procrastination was nicely discussed in this thread - Effectiveness of aversion therapy for procrastination

Usual procrastination is addressed here - What works for procrastination

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  • $\begingroup$ I have found a lot of great answers and tips in "InATTENTIVE ADHD/ADD ADULT - Info and support group" on Facebook, and on "How to ADHD" YouTube channel, to which I was lead by her TED talk about ADHD. I'm grateful every day for her existence! $\endgroup$ – Vesna Sunrider Feb 19 at 14:41
  • $\begingroup$ I'm not going to cite any academic sources, so here's a comment instead. My understanding is that part of the reason for losing focus while working on a task is "context-switching", or having to move one's focus onto a different task, screen, room, etc. to continue working on something. For example, working on a project in Word, and then having to switch to a todo app to add a task. This can be mentally taxing, and pull you out of the work. So, one way to retain focus then, is to reduce context-switching. I have some recommendations on tools that allow this, pm if you'd like to talk more. $\endgroup$ – Ross Keenan Feb 20 at 14:23
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This is an interesting question, and after mostly failing to find recent literature I've become fascinated at why this topic is not more heavily studied. It looks like a field ripe for disruption by new ideas and approaches.

I'm not convinced that procrastination is any different in those diagnosed with ADHD than in neurotypicals. As with many psychiatric diagnoses, behaviors are described in the DSM but mechanisms are usually unknown. Without knowing any mechanism (hand-waving a probable weakness of connection between prefrontal areas and motor areas, but no idea what may weaken it) it's hard to say whether an unknown mechanism in ADHD differs from an unknown mechanism in everyone else, or even that the distinction between ADHD and normal has clear boundaries. I'd really appreciate the education of being shown evidence I'm wrong here, but I've seen heated debates over defining ADHD, and Stack Exchange doesn't do extended back-and-forth discussions.

The slope of the curve representing what I've known as "delay discounting" (also called "time preference") was described by Green and Myerson and has been associated with ADHD, drug abuse and gambling, and lower socioeconomic status. But I don't see this as a mechanism, just another way to quantify the behavior.

The nature of procrastination by Piers Steel and Longitudinal study of procrastination, performance, stress, and health by Roy Baumeister seem to be the most relevant (highly cited) descriptions of procrastination, and both are over a decade old. Some intervention articles I've found are ADHD outcomes for children treated in community based pediatric settings by Jeffrey Epstein (not that one), et al and Academic interventions for academic procrastination by Zacks and Hen, but I can't find anything on interventions that seems to be highly cited and well-accepted.

I disclose that I often procrastinate on StackExchange. I'm currently reading and writing about procrastination rather than working on analyses I need done asap. :(

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  • $\begingroup$ You point about ADHD being "different" enough is valid but that applies to so much in psychiatry and medicine. How much is enough before it is different enough. I think ADHD highlights issues that may be underappreciated or not significant enough in the neurotypical population. For that reason it is significant and valid enough to examine on its own $\endgroup$ – Poidah Aug 20 '19 at 1:30
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    $\begingroup$ I completely agree it should be examined on its own, and treated as a specific diagnosis. It's a "real thing." And I think "different enough" is the critical question in almost all of psychiatry. I do argue, however, that we must be careful not to allow the existence of a label to convince us that we know more than we do about the causes of the label-worthy behaviors. $\endgroup$ – mightypile Aug 20 '19 at 1:43
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The problem with this question is that procrastination has many components and is not an explicit diagnostic category of ADHD. As the result, finding evidence for a phenomenon that is poorly described and measured plus not part of a diagnostic or treatment criteria is very difficult. Having said that, ADHD as a concept and a disease construct is still helpful and there are increasing studies examining ADHD and its associated phenomenologies.

A 2016 systematic review of cognitive-behavioural therapy by Jensen et al found CBT to be effective for ADHD. The study only found two studies that fitted their selection criteria and analysed their intervention in details. One study had two sessions focused on procrastination.

11 -Consequential Thinking - Application of Skills to Procrastination

13- Constructive Planning - Application of Skills to Procrastination

So in a round about way CBT is helpful for procrastination in ADHD.

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