Signal Saturday: Passive-Aggressive Behaviour and ADHD: Understanding the Hidden Communication Pattern
Adults with ADHD encounter a particularly complex relationship with passive-aggressive behaviour - both as recipients and, sometimes unexpectedly, as perpetrators.
This communication pattern, characterised by indirect resistance and concealed hostility, intersects with ADHD symptoms in ways that warrant closer examination.
Defining Passive-Aggressive Behaviour
Passive-aggressive behaviour represents a pattern of indirectly expressing negative feelings rather than openly addressing them. The American Psychological Association defines it as “a behaviour pattern characterised by indirect resistance to the demands or expectations of others and avoidance of direct confrontation.”
Dr Russell Barkley, clinical professor of psychiatry and leading ADHD researcher, notes that this behaviour style involves “saying yes when meaning no, making excuses, sulking, procrastinating, and using silence as a weapon.” These actions create confusion and frustration because the surface message contradicts the underlying intent.
Common manifestations include:
Agreeing to tasks but failing to complete them
Using sarcasm to mask genuine criticism
Deliberate inefficiency when fulfilling requests
The silent treatment following disagreements
Backhanded compliments
Subtle sabotage of plans or projects
The ADHD Connection: Executive Function and Emotional Regulation
Research indicates that adults with ADHD may both encounter and display passive-aggressive patterns more frequently than neurotypical populations, though the mechanisms differ substantially from personality-based passive aggression.
A 2019 study published in Journal of Attention Disorders by Surman and colleagues found that adults with ADHD demonstrated significantly higher rates of emotional dysregulation, with 70% reporting difficulty managing frustration compared to 30% of controls. This emotional volatility creates conditions where indirect communication patterns emerge.
Dr William Dodson, who specialises in ADHD and emotional regulation, explains: “Adults with ADHD often experience rejection sensitive dysphoria—an extreme emotional response to perceived rejection or criticism. This can lead to communication patterns that appear passive-aggressive but stem from emotional overwhelm rather than manipulative intent.”
The executive function deficits characteristic of ADHD contribute through several pathways:
Impaired impulse control and emotional regulation: Research by Shaw et al. (2014) in JAMA Psychiatry demonstrated that adults with ADHD show reduced activity in prefrontal cortex regions responsible for emotional regulation. This neurological difference means that when frustrated or upset, adults with ADHD may struggle to articulate feelings directly, instead letting emotions leak through indirect channels.
Working memory limitations: A 2018 meta-analysis in Neuropsychology Review by Kasper et al. found that adults with ADHD demonstrated moderate to large working memory deficits across multiple domains. These limitations can create scenarios that appear passive-aggressive: agreeing to requests but genuinely forgetting them, rather than deliberately avoiding them.
Time blindness and task initiation difficulties: Dr Ari Tuckman, psychologist and ADHD specialist, notes in his research that “what appears as procrastination or deliberate foot-dragging may actually represent genuine difficulty with task initiation and time estimation.” A neurotypical person might interpret missed deadlines as passive resistance when the ADHD individual genuinely struggled to begin the task.
When Passive-Aggressive Behaviour Emerges
Research identifies several high-risk scenarios where adults with ADHD either encounter or display passive-aggressive patterns:
Workplace environments with rigid structures: A 2020 study in ADHD Attention Deficit and Hyperactivity Disorders by Adamou et al. examined workplace experiences of adults with ADHD. The research found that 58% reported experiencing what they perceived as passive-aggressive management styles when requesting accommodations, with supervisors agreeing to modifications but implementing them inconsistently or expressing subtle disapproval.
Dr Kathleen Nadeau, clinical psychologist specialising in adult ADHD, observes: “Adults with ADHD frequently encounter passive-aggressive responses to accommodation requests because colleagues may view ADHD needs as preferential treatment rather than legitimate disability accommodations.”
Intimate relationships during conflict: Research by Wymbs et al. (2017) in Journal of Marital and Family Therapy found that couples where one partner had ADHD reported significantly higher rates of demand-withdraw patterns, with the ADHD partner often withdrawing during conflict. This withdrawal—stemming from emotional overwhelm—can appear passive-aggressive to neurotypical partners expecting direct confrontation.
Situations involving criticism or correction: The rejection sensitive dysphoria experience means that perceived criticism can trigger intense emotional responses. Rather than addressing feedback directly, adults with ADHD may respond with silent treatment or sulking—not from manipulation, but from genuine inability to regulate the emotional intensity in the moment.
Contexts with unclear expectations: Dr Thomas Brown, associate director of the Yale Clinic for Attention and Related Disorders, notes that “ADHD involves chronic difficulty with the ‘when’ and ‘how much’ of daily life.” When expectations remain implicit rather than explicit, adults with ADHD may fail to meet them, appearing deliberately resistant when actually confused about requirements.
The Subjective Experience: What It Feels Like
Understanding the phenomenological experience of passive-aggressive behaviour requires examining both perspectives: receiving it and displaying it.
Receiving Passive-Aggressive Behaviour
Adults with ADHD often report heightened sensitivity to passive-aggressive communication from others. Dr Edward Hallowell, founder of the Hallowell Centers and ADHD specialist, explains: “Adults with ADHD typically have a sixth sense for emotional undertones. They pick up on the disconnect between words and intent, which creates significant distress.”
Qualitative research by Young et al. (2020) in BMC Psychiatry interviewed 40 adults with ADHD about interpersonal experiences. Participants described receiving passive-aggressive behaviour as:
“Like walking through a minefield—you know something’s wrong, but nobody will say what, so you can’t fix it. Your brain goes into overdrive trying to decode the real message, which is exhausting when you’re already managing executive function challenges.”
“It triggers my rejection sensitivity immediately. I know they’re angry, but they’re denying it, which makes me feel gaslit. Then I ruminate about it for days.”
The combination of difficulty reading social cues (found in approximately 50-70% of adults with ADHD, according to a 2016 review in Clinical Psychology Review by Cordier et al.) and heightened emotional sensitivity creates a particularly difficult experience. Adults with ADHD may simultaneously sense something is wrong whilst struggling to identify precisely what, leading to anxiety and hypervigilance.
Displaying ADHD-Related Behaviours Misinterpreted as Passive-Aggressive
Many adults with ADHD report profound distress when their ADHD symptoms are misinterpreted as passive-aggressive manipulation.
Research by Ramsay (2017) in Cognitive and Behavioral Practice found that adults with ADHD frequently experience what he terms “intention-impact discrepancies”—situations where their intended action differs dramatically from how others perceive it.
Common examples include:
Task incompletion: An adult with ADHD genuinely intends to complete a requested task but experiences task initiation paralysis or becomes distracted. The requester interprets this as passive resistance or subtle rebellion. The ADHD individual feels misunderstood and unfairly accused of manipulation.
Dr Russell Ramsay notes: “The internal experience is one of trying and failing, not refusing. Being accused of passive-aggression when you’re genuinely struggling creates shame and often leads to avoiding the person entirely, which then reinforces their belief that you’re being passive-aggressive.”
Emotional withdrawal: When overwhelmed by emotional intensity, adults with ADHD may go silent or leave the situation—not to punish the other person, but because continuing feels neurologically impossible. A 2019 neuroimaging study by Hulvershorn et al. in Journal of the American Academy of Child & Adolescent Psychiatry found altered activation patterns in emotion regulation networks during frustration tasks in individuals with ADHD, supporting the neurological basis of this withdrawal.
Participants in qualitative research describe this experience: “My brain just shuts down when emotions get too intense. I can’t access words. I need space to regulate. But my partner thinks I’m giving them the silent treatment as punishment, which isn’t true at all.”
Indirect communication: Adults with ADHD may struggle to articulate needs directly, particularly around boundaries or disagreements, due to rejection sensitivity dysphoria. Dr Dodson’s clinical observations indicate that adults with ADHD often “hint” at problems rather than stating them directly because direct confrontation feels emotionally unbearable, fearing rejection or conflict.
This creates a painful bind: the ADHD brain struggles with direct confrontation, but indirect communication gets labelled manipulative.
Distinguishing ADHD Symptoms from Genuine Passive-Aggression
Dr J. Russell Ramsay, co-founder of the University of Pennsylvania’s Adult ADHD Treatment and Research Program, emphasises the importance of distinguishing ADHD-related difficulties from intentionally manipulative behaviour: “Intent matters enormously. True passive-aggressive behaviour involves conscious or semi-conscious manipulation. ADHD symptoms involve genuine executive function limitations.”
Key distinguishing factors include:
Pattern consistency: Passive-aggressive behaviour typically emerges in specific relational contexts or with particular individuals. ADHD-related difficulties appear across multiple life domains and relationships.
Response to interventions: When provided with appropriate support—external reminders, explicit expectations, emotional regulation strategies—ADHD-related behaviours improve. Personality-based passive-aggression resists such straightforward interventions.
Emotional aftermath: Adults with ADHD typically feel genuine distress about task incompletion or communication breakdowns. Those engaging in strategic passive-aggression may feel satisfaction or vindication.
Awareness level: Research by Solanto et al. (2018) in ADHD Attention Deficit and Hyperactivity Disorders found that adults with ADHD generally demonstrate good insight into their difficulties and express frustration about them, whereas passive-aggressive individuals often lack awareness or deny their behavioural patterns.
Evidence-Based Management Strategies
Research suggests several approaches for managing passive-aggressive dynamics involving ADHD:
For adults with ADHD receiving passive-aggressive behaviour: Dr Nadeau recommends direct meta-communication: “Name the pattern explicitly and calmly. ‘I notice you agreed to this change, but your tone suggests you’re unhappy. Can we discuss your actual concerns?’” This approach, supported by communication research, reduces ambiguity that ADHD brains find particularly challenging.
For ADHD-related behaviours misread as passive-aggressive: Studies on ADHD couples therapy by Robin and Payson (2002) in Cognitive and Behavioural Practice emphasise psychoeducation. When partners understand that task incompletion stems from executive dysfunction rather than resistance, conflict decreases significantly. Implementing external systems—shared calendars, explicit agreements, regular check-ins—reduces misinterpretation.
Developing assertive communication skills: Research by Young et al. (2021) in Journal of Attention Disorders found that adults with ADHD who received training in direct communication and emotional regulation demonstrated improved relationship satisfaction and reduced conflict. Dr Ari Tuckman’s work emphasises that adults with ADHD benefit from structured scripts for difficult conversations, which reduce the cognitive load of formulating responses whilst emotionally dysregulated.
Addressing underlying rejection sensitivity: Cognitive-behavioural therapy approaches specifically targeting rejection sensitive dysphoria, as outlined by Ramsay and Rostain (2015) in their clinical guide to adult ADHD, help adults with ADHD tolerate the discomfort of direct communication and reduce defensive responses that others may interpret as passive-aggressive.
The Broader Context
Understanding passive-aggressive behaviour in the context of ADHD requires moving beyond simplistic interpretations of “difficult” behaviour. The intersection of executive dysfunction, emotional dysregulation, and social communication challenges creates complex interpersonal dynamics that differ fundamentally from personality-based passive-aggression.
Dr Thomas Brown summarises: “When we understand that many behaviours attributed to passive-aggression in adults with ADHD actually reflect neurological differences in executive function and emotional regulation, we can respond with appropriate support rather than moral judgment.”
This reframing—from character flaw to neurological difference—opens pathways for more effective intervention and reduces the shame that so often accompanies ADHD-related interpersonal difficulties. For adults with ADHD navigating these challenges, recognising the distinction between ADHD symptoms and intentional manipulation represents a crucial step towards self-compassion and improved relationships.