Researchers in the US followed 106 adults from the community, aged 18 to 75, for 6 days. Most were women, and most were White. Only 11 people (10.4%) reported an ADHD diagnosis, and ADHD symptoms were measured on a scale. A short survey ran five times a day.
The study looked at "avoidant automatic thoughts." These are thoughts about delaying the start or end of a task. They showed up at 44.9% of the sampled moments, and 97% of people reported them at least once.
People with more ADHD symptoms reported these thoughts more often. They also reported more inattention, avoidance, negative emotion and negative automatic thoughts, and less positive emotion. When these thoughts were present, people avoided tasks more and paid less attention in that moment. Their negative mood was slightly higher, not lower. The links with avoidance and inattention were stronger in people with more ADHD symptoms. In an exploratory check, the thoughts did not predict later avoidance once earlier avoidance was taken into account.
Work tasks and household chores were the most avoided activities. Screen time and work tasks were the most common things people did instead.
The sample was mostly White, female, relatively well educated and US-based, and some data may be missing in a biased way.
The authors suggest that clinicians using skills-based approaches could assess clients for these thoughts and build them into tools such as a daily thought record, though this comes from a community sample not recruited for ADHD.
The numbers Stats and what the terms mean
The statistics behind the plain-language claims above.
- Knouse, 2025: higher baseline ADHD symptoms and more inattention in the moment, b = 0.84, SE 0.10, p <.001.
- Knouse, 2025: higher baseline ADHD symptoms and more task avoidance, b = 0.63, SE 0.11, p <.001.
- Knouse, 2025: higher baseline ADHD symptoms and more negative emotion, b = 0.34, SE 0.07, p <.001.
- Knouse, 2025: higher baseline ADHD symptoms and more frequent avoidant automatic thoughts, b = 1.47, OR = 4.33, p <.001.
- Knouse, 2025: higher baseline ADHD symptoms and more frequent negative automatic thoughts, b = 2.98, OR = 19.65, p <.001.
- Knouse, 2025: higher baseline ADHD symptoms and lower positive emotion, b = −0.42, p = .004.
- Knouse, 2025: avoidant thoughts in the moment and inattention, b = 0.29, SE 0.04.
- Knouse, 2025: avoidant thoughts in the moment and task avoidance, b = 0.75, SE 0.06.
- Knouse, 2025: avoidant thoughts in the moment and negative emotion, b = 0.05, SE 0.02.
- Knouse, 2025: link between avoidant thoughts and inattention at low, average and high ADHD symptoms (1 SD below the mean, the mean, 1 SD above), 0.20, 0.28 and 0.37 (all p < .001).
- Knouse, 2025: link between avoidant thoughts and task avoidance at the same three levels, 0.59, 0.73 and 0.88 (all p < .001).
- Knouse, 2025: avoidant thoughts predicting avoidance at the next survey, 0.19, SE = 0.05, p < .001; after earlier avoidance was added, −.02, SE = 0.05, p = .63.
- Knouse, 2025: share of 1,058 avoidance moments where work tasks were avoided, 32.80%, and household chores, 24.20%; most common alternatives were screen time, 21.17%, and work tasks, 15.78%. What the terms mean:
- b How much the outcome changed for each step up in the predictor; a minus sign shows the direction, not the size.
- SE The standard error, a measure of how precise an estimate is; smaller means more precise.
- OR The odds ratio, how many times higher the odds of the outcome were for each step up in the predictor.
- p How likely a result this strong would be if there were no real link; below .05 is usually read as unlikely to be down to chance.
- SD Standard deviation, how spread out scores were around the average.
Source: Knouse L, Fan Y, Narayanan A, et al.. Avoidant Automatic Thoughts Are Associated With Task Avoidance and Inattention in the Moment: Replication in a Community Sample. Journal of Attention Disorders (2025). doi:10.1177/10870547251314924