Childhood ADHD diagnosis linked to lower adult religious attendance

A childhood diagnosis of attention-deficit/hyperactivity disorder is linked to lower religious service attendance in adulthood, though it does not appear to diminish private religious practices like prayer. The decline in public religious participation is especially pronounced among Black and Asian American adults. The research was published in the Journal for the Scientific Study of Religion.

Attention-deficit/hyperactivity disorder, or ADHD, is a highly prevalent neurodevelopmental condition characterized by persistent difficulties with attention, hyperactivity, and impulse regulation. These traits frequently extend well beyond childhood, affecting educational attainment, physical health, and social relationships into adulthood. One area of social life that researchers have rarely examined in relation to ADHD is religious participation. Religious communities often provide emotional support, coping resources, and a sense of belonging for individuals and families.

Sociologists Laura Upenieks and Samuel H. Fishman of Baylor University conducted the study to better understand how neurodiversity shapes lifelong religious engagement. A person with ADHD might struggle with behavioral inhibition, emotional regulation, and working memory. These constraints can make following a structured liturgy or sitting through long sermons physically and mentally exhausting. When people repeatedly fail to meet these behavioral expectations, they might feel excluded or judged, prompting them to permanently disengage from public worship.

To explore these dynamics, Upenieks and Fishman analyzed data from the National Longitudinal Study of Adolescent to Adult Health. This large, nationally representative study tracked participants from their teenage years in the mid-1990s into early midlife, between 2016 and 2018. The final sample included 9,785 adults from diverse racial and socioeconomic backgrounds. The researchers categorized participants based on whether they had been diagnosed with ADHD before age 18, after age 18, or never. They then looked at three different measures of adult religiosity: how often participants attended religious services, how often they prayed, and how important they considered religion to be in their daily lives.

The researchers built statistical models to assess the relationship between an ADHD diagnosis and later religious service attendance. They adjusted their models to account for childhood demographics, family structure, early-life health indicators like depression, and the participants’ religious habits as teenagers. They found that an ADHD diagnosis before age 18 was consistently associated with approximately 50 percent lower odds of regularly attending services in early midlife. A diagnosis received in adulthood did not show the same association.

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Next, the researchers examined private religious practices and beliefs. In initial models, individuals with a childhood diagnosis appeared less likely to pray frequently or view religion as highly important, but these associations disappeared once researchers adjusted for demographic backgrounds and adolescent religious involvement. This suggests that ADHD primarily disrupts the behavioral capacity to participate in socially structured religious settings, rather than diminishing personal spiritual commitments. Private practices like solitary prayer allow for personal control and flexibility without the interpersonal pressures required in congregational settings.

The researchers also investigated whether the relationship between ADHD and religious attendance varied across racial and ethnic lines. They built an additional model that allowed the influence of an ADHD diagnosis to interact with a participant’s race or ethnicity. They found that the decline in attendance was substantially larger for Black and Asian American adults than for White adults. Black participants diagnosed with ADHD in childhood had 78 percent lower odds of attending services weekly compared to White participants without an ADHD diagnosis. Asian American adults with a childhood diagnosis exhibited 90 percent lower odds of weekly attendance.

These outcomes might be shaped by differing congregational norms and structural inequalities. Black congregations often host much longer worship services than other religious groups, which may place higher demands on sustained attention and make regular attendance more difficult. Meanwhile, many Asian American religious traditions place a strong cultural emphasis on discipline and interdependence, which can make behavioral nonconformity stand out and increase feelings of alienation. Structural inequalities in healthcare also mean that Black and Asian American children are often under-diagnosed or face punitive disciplinary measures rather than medical treatment for behavioral struggles.

An early ADHD diagnosis serves as a marker for the presence of sustained symptoms and institutional labeling, rather than acting as a direct cause of religious disengagement. Because the study relied on self-reported diagnoses, some individuals who experienced ADHD symptoms but lacked access to a formal medical evaluation might have been grouped with those who never had the condition.

This is especially relevant for women, who are historically under-diagnosed because their symptoms often present as internal inattentiveness rather than disruptive hyperactivity. The reliance on a binary formal diagnosis means the researchers could not measure the exact severity of the ADHD traits or determine if hyperactivity and inattentiveness affect religious behavior differently.

Additionally, the study’s measures of religion primarily capture Christian traditions, which heavily dominate the United States religious landscape. The survey aggregates many non-Christian traditions into a single “other religion” category, masking important differences in worship styles and cultural expectations. Future studies will need to examine whether specific religious traditions with varied community norms might be more accommodating to neurodiverse individuals. As ADHD diagnoses continue to rise, religious institutions may need to consider offering sensory-friendly spaces, shorter service options, and more flexible expectations to support all members of their communities.

The study, “Paths of Faith and Focus? ADHD, Adult Religiosity, and Moderation by Race in the Add Health Study,” was authored by Laura Upenieks and Samuel H. Fishman.