Under pressure: burnout as a pathway linking attention-deficit/hyperactivity disorder symptoms to substance-based cognitive enhancement use

Abstract Aim Modern work environments are increasingly characterized by high cognitive demands and sustained performance pressure, which can heighten stress and the risk of burnout. Individuals with elevated attention-deficit/hyperactivity disorder (ADHD) symptoms may be particularly vulnerable to such stressors due to difficulties with attention regulation, impulsivity, and executive functioning. These vulnerabilities may also increase the likelihood of adopting maladaptive coping strategies, including the use of substances for cognitive enhancement. Therefore, this study aims to examine the relationship between undiagnosed ADHD symptoms, burnout, and the frequency of use across three classes of substances used to enhance cognitive performance (namely, legal, prescription, and illegal substances). Subject and methods This study analyzed self-report data from a large working sample in Germany. Among undiagnosed individuals with ADHD symptoms, it measured ADHD symptoms, personal burnout, and the frequency of use of legal, prescription, and illegal substances intended to enhance cognitive performance. Mediation analysis was used to examine the expected relations. Results In a sample of 7768 participants (aged 18 and older), the obtained significant results are consistent with the assumption that burnout mediates the association between ADHD symptoms and the frequency of using cognitive-enhancing substances—particularly legal ones. Conclusion From a stress and health perspective, these findings are consistent with the view that burnout may function as a stress-related mechanism linking ADHD symptomatology to maladaptive coping behaviours in the workplace. This interpretation highlights the potential value of early identification and support for employees experiencing ADHD-related difficulties, in order to mitigate stress exposure and reduce reliance on potentially health-risky substance-based coping strategies.