Relationships at work: friend or foe? The perspective of ADHD employees

Neurodiversity describes a naturally occurring variation in neurological functioning within the human population (Lefevre-Levy et al., 2023). The neurodiversity paradigm represents a conceptual shift from framing neurodivergent conditions primarily as deficits or disorders toward understanding them as natural human variations encompassing distinctive strengths, abilities and ways of processing information, alongside context-dependent needs and challenges (Bruyère and Colella, 2022; Singer, 1999). This paradigm has increasingly informed debates in organizational research, where neurodivergent individuals are no longer viewed solely through medical or accommodation-based lenses but as potential contributors of valuable cognitive diversity to organizations (Praslova, 2024).

Neurodivergent (or neuroatypical) individuals include those whose neurocognitive functioning diverges from dominant norms (Singer, 1999), such as, inter alia, individuals with autism spectrum disorder (ASD) (Patton, 2019), attention deficit and hyperactivity disorder (ADHD), learning disabilities (i.e. dyslexia, dysgraphia, dyspraxia, dyscalculia) and Tourette syndrome. Recent estimates show that approximately 15–20% of the population worldwide can be classified as neurodivergent (Doyle and McDowall, 2022). Importantly, these figures likely underrepresent the true extent of neurodivergence in the population. In this respect, a large-scale UK population-based cohort study documented a 787% exponential increase in the recorded incidence of autism diagnoses between 1998 and 2018, with the steepest growth observed among adults – a trend attributed to improved diagnostic criteria, greater awareness and enhanced recognition and reporting of symptoms rather than to abrupt changes in underlying prevalence (Russell et al., 2022). Thus, understanding how these people experience the workplace and identifying ways to foster their inclusion is of paramount importance.

Despite growing recognition of neurodiversity and improvements in policy frameworks, neurodivergent individuals continue to experience considerable stigma, biases and structural disadvantage in the labor market (Ali et al., 2024). These disadvantages manifest in lower employment rates, reduced job stability and difficulties in job retention compared to neurotypical individuals (Hennekam and Follmer, 2024). A core challenge lies in organizations' limited understanding of how neurodivergent individuals experience everyday work processes, particularly interpersonal dynamics. While the “neuroinclusion” movement emphasizes valuing diverse cognitive styles and rethinking standardized notions of productivity (Praslova, 2024), empirical research has lagged behind normative prescriptions, especially with respect to the social and relational mechanisms through which inclusion – or exclusion – unfolds in daily work life.

Among the different neurodivergent conditions, ADHD is particularly salient in organizational contexts; ADHD employees ^[1] are estimated to represent approximately 3.5% of the global workforce (Lauder et al., 2022), and prevalence appears to be increasing over time (Xu et al., 2018). Prior research has predominantly focused on individual-level deficits and work-related challenges associated with ADHD, such as short attention spans, distractibility, hyperactivity, procrastination and impairments in social functioning (Carnes and Holloway, 2009). These specificities in ADHDers functioning make them often misunderstood by colleagues: not coincidentally, they tend to be labeled as “troublemakers,” “uncaring,” “uneducated” and “reckless” (Rowe et al., 2021) or characterized as “procrastinators” and “strange” (Tromans et al., 2023). Workplace stigma and misunderstanding negatively impact these individuals' self-efficacy, especially in relationally intensive work settings, where collaboration, informal coordination and social expectations are central to effective performance.

Work relationships are pivotal for effective occupational engagement, identity construction and career sustainability (Willerton, 2010). For ADHD employees, difficulties in social interactions may therefore represent not only a personal challenge but also a structural barrier that shapes access to support, accommodations and opportunities for advancement. However, despite the relational nature of work, existing research on ADHD in organizational settings has paid limited attention to how ADHD employees experience and navigate work relationships (Lauder et al., 2022; McDowall et al., 2024) – both with internal stakeholders (e.g. coworkers, supervisors) and external ones (e.g. clients, suppliers, state, society) (Hueske and Guenther, 2015).

From a theoretical standpoint, focusing on work relationships allows us to move beyond deficit-oriented accounts and offer a novel contribution concerning the essential role that the social environment plays in shaping agency, self-efficacy and goal-directed behavior among ADHDers through everyday social interactions. From a practical perspective, understanding relational dynamics is essential for designing inclusive workplaces that do not merely accommodate neurodivergent individuals but actively support their inclusion and flourishing (Shore et al., 2011).

Accordingly, we aim to fill these gaps by addressing the following research question: How do ADHD employees experience relationships in the workplace? We adopt an exploratory qualitative approach, drawing on in-depth interviews with a purposeful sample (Patton, 2015) of individuals diagnosed with ADHD. The study contributes theoretically to the diversity (and neurodiversity) literature by deepening our understanding of the relational mechanisms through which inclusion and exclusion are enacted in everyday organizational life, and it offers managerial suggestions to valorize neurodivergent employees and foster neuroinclusive practices.

The concept of diversity management has its roots in the United States in the 1960s, emerging as an evolution of earlier affirmative action programs aimed at promoting the employment and career advancement of marginalized groups. Originally, the movement developed to favor the inclusion of Black individuals and later women (Kelly and Dobbin, 1998); nonetheless, over time, diversity management has become a widespread managerial practice across most Western industrialized countries (Syed and Özbilgin, 2009) and, more recently, in many emerging economies as well (Nkomo et al., 2019). Broadly defined, diversity management refers to organizational policies and practices aimed at recognizing, valuing and leveraging individual differences to foster inclusion and improve organizational performance.

Over the years, the scope of diversity management has progressively expanded beyond gender and race to encompass a wide range of individual characteristics, including age, nationality, sexual orientation and disability (Calluso and Devetag, 2024; Gardenswartz and Rowe, 1998; Klarsfeld, 2010). Despite this expansion, diversity research and practice have continued to privilege visible and easily categorizable differences while paying comparatively less attention to invisible forms of diversity, such as differences in cognitive styles, information processing and neurocognitive functioning (Santuzzi et al., 2014).

This gap is particularly consequential from a managerial perspective. Invisible differences are less likely to be formally recognized, more difficult to disclose and more prone to misinterpretation, increasing the risk of stigma, misattribution and exclusion in everyday work interactions (Hennekam and Follmer, 2024; Santuzzi et al., 2014). Neurodiversity exemplifies this challenge. Although neurodivergent individuals may bring distinctive strengths and perspectives to organizations, their differences often remain unacknowledged or are framed in deficit-oriented terms, limiting both inclusion and performance potential (Bruyère and Colella, 2022; Kirby and Smith, 2021).

Existing diversity management frameworks tend to emphasize formal policies, representation and compliance while devoting less attention to the relational and interactional processes through which inclusion is enacted in daily organizational life (Shore et al., 2011). As a result, we still know relatively little about how employees with invisible differences experience work relationships and how these relationships shape access to support, recognition and opportunities. Addressing this gap requires moving beyond policy-level analyses and examining the social and relational mechanisms through which diversity is lived at work.

Within the broader diversity management discourse, neurodiversity has gained increasing attention as a category of difference that challenges traditional approaches to inclusion. Unlike visible forms of diversity, neurodiversity concerns differences in cognitive processing, attention, sensory perception and social interaction, which are often not immediately observable and may remain undisclosed in organizational settings (Bruyère and Colella, 2022; Kirby and Smith, 2021).

The neurodiversity paradigm has been influential in reframing neurological differences as natural variations rather than deficits, emphasizing strengths such as creativity, pattern recognition and problem solving (Doyle and McDowall, 2022; Praslova, 2024). However, organizational research has only partially embraced this paradigm. Much of the literature focuses on formal accommodations, legal compliance and HR practices, while paying limited attention to how neurodivergent employees experience inclusion and exclusion in daily work life.

Recent scholarship highlights that inclusion is not solely the outcome of policies but is enacted through social processes, such as communication norms, informal expectations and relational dynamics (Shore et al., 2018). For neurodivergent individuals, these processes are particularly consequential, as misunderstandings and misattributions may arise from non-normative behaviors, leading to stigmatization even in formally inclusive contexts (Santuzzi et al., 2014). This disconnection between policy-level inclusion and lived experience points to the need for research that foregrounds relational and interactional dimensions of neurodiversity at work.

Among neurodivergent conditions, ADHD represents a particularly relevant and understudied case in organizational research. ADHD employees are often evaluated against implicit norms of attention regulation, time management, emotional control and social appropriateness that characterize many contemporary workplaces (Harris, 2020).

Most of the research conducted on ADHD employees has focused primarily on identifying the barriers they may experience (Högstedt et al., 2023), hence predominantly adopting a deficit-oriented perspective, emphasizing negative outcomes such as lower job stability, absenteeism, tardiness and perceived unreliability (Barkley et al., 2008; Kessler et al., 2005). Emotional challenges, including anxiety and reduced self-esteem, further exacerbate these difficulties (Newark et al., 2016). Furthermore, fear of stigma and discrimination often discourages disclosure, limiting their access to accommodations and social support (McIntosh et al., 2023).

While this literature has been instrumental in documenting disadvantage, it has devoted comparatively little attention to how interpersonal relationships shape these outcomes (Khalifa et al., 2019). Yet, work relationships are central to performance evaluation, access to informal support and identity construction (Dutton et al., 2006; Huy, 2002; Willerton, 2010). This insight resonates with Leader–Member Exchange (LMX) theory, which emphasizes how the quality of supervisor–subordinate relationships shapes access to trust, support, resources and opportunities at work (Graen and Uhl-Bien, 1995). Although LMX has rarely been applied to neurodiversity research, it offers a useful complementary perspective for understanding why hierarchical relationships may be particularly consequential for ADHD employees. Work relationships can therefore function as a double-edged sword for neurodivergent employees: prior research shows that neurodivergent individuals often experience difficulties in workplace interactions due to limited understanding and misattributions of non-normative behaviors, even though such relationships may also be perceived as highly rewarding (Baldwin et al., 2014; Patton, 2019; Waisman-Nitzan et al., 2021). Indeed, ADHDers' characteristic traits may negatively affect the quality of work relationships, with implications for turnover, career advancement and pay (Biederman and Faraone, 2006; Hall et al., 2013; Murphy and Schachar, 2000; Painter et al., 2008). Despite this evidence, diversity and inclusion programs in organizations still insufficiently address neurodiversity, especially with respect to interpersonal relationships at work (Bruyère and Colella, 2022; Khalifa et al., 2019). Accordingly, this study addresses this gap by investigating whether relational dynamics function as a key mechanism through which ADHD-related differences translate into occupational disadvantage – or, conversely, into inclusion and thriving.

To examine these relational mechanisms, we draw on social cognitive theory (SCT; Bandura, 1977, 1986, 1997, 2000), which offers a robust framework for understanding how individual agency is shaped through interaction with the social environment. SCT conceptualizes human functioning as the result of reciprocal interactions between personal factors, behavior and environmental influences. Central to this framework is the concept of self-efficacy – individuals’ beliefs in their ability to organize and execute actions required to achieve desired outcomes (Bandura, 2000). Figure 1 illustrates the model advanced by Bandura (2000).

Importantly, SCT does not treat self-efficacy as a static individual trait. Rather, it is continuously shaped by social feedback, relational experiences and perceived support or obstruction within one's environment (Bandura, 1997). This perspective is particularly relevant to the present study because it explains how individuals interpret and learn from their social environment, regulate their behavior and develop beliefs about their own capabilities through everyday interactions. Bandura further emphasizes the role of socio-structural factors, defined as contextual facilitators and barriers that influence whether self-efficacy can be translated into goal attainment. These factors include not only formal structures but also informal relational dynamics, such as trust, validation and social support.

In organizational contexts, work relationships constitute a critical socio-structural factor. SCT enables us to examine how relational experiences shape individuals' sense of agency and their perceived ability to pursue and attain work-related goals. This focus is particularly relevant for ADHD employees, whose workplace experiences are often mediated by social feedback, expectations and opportunities for self-regulation. High-quality relationships can enhance self-efficacy through encouragement, instrumental assistance and positive feedback – what Bandura terms the “enabling effect” (Benight and Bandura, 2004). Conversely, strained or stigmatizing relationships may erode self-efficacy, reduce motivation and constrain agency. For neurodivergent employees, and ADHDers in particular, work relationships may therefore play a pivotal role in shaping occupational trajectories.

Despite the relevance of SCT for understanding these dynamics, few studies have explicitly applied this framework to investigate how neurodivergent employees experience and navigate workplace relationships. By integrating SCT with the neurodiversity and diversity management literature, this study advances a relational perspective on inclusion, highlighting how everyday interactions function as mechanisms through which organizational contexts enable or constrain agency, self-efficacy and goal attainment.

To answer the advanced research question, we choose a qualitative research design based on in-depth interviews and a thematic analysis approach to develop themes (and subthemes). This choice is dictated by the exploratory nature of the study (Patton, 1990), which calls for a qualitative research approach. We adopt a constructivist epistemological position to understand reality as subjectively constructed by the respondents and not objectively discovered (Byrne, 2022).

The participants were recruited through a purposeful sampling method (Patton, 2015) in three private psychotherapy practices in Italy through personal acquaintances. All the participants agreed to participate in the study after responding to the promotion made by the psychotherapists working there. The psychotherapists involved were able to identify 12 participants; 10 of them (mean age = 35.2 ± 6.43; 2 F, 8 M) agreed to take part in the interview (Table 1). All participants were asked to provide written informed consent for their participation in the research, upon being informed about its aims, in compliance with the Declaration of Helsinki and the APA ethical standards for the treatment of human samples. The study received formal approval from the university ethics committee. The participants were informed of their right to discontinue participation and revoke their consent at any time and that their data would have been treated anonymously for research purposes only.

The participants were selected on the basis of the following inclusion and exclusion criteria.

1. Formal diagnosis of ADHD (i.e. no self-diagnosis).

2. Age between 18 and 60 years (male/female).

3. Being employed or having recent employment experience.

4. Work context: we favor those organizational contexts in which the relational dimension is important for the deployment of work activities (e.g. work involves interaction with colleagues/supervisors/external stakeholders).

1. Individuals with primary comorbidities (such as autism spectrum, psychosis, intellectual disability) that interfere with ADHD.

2. Unemployed individuals.

Table 1 provides details of the participants' sex, age, educational background, job position, year of diagnosis, drug treatment (Y/N) and interview length.

The ten interviews were conducted between November and December 2024 via Zoom. The final interviews did not yield additional insights into the phenomenon under study; therefore, we considered that data saturation had been reached and that further data collection was unlikely to generate substantially new themes or interpretations. The decision to include participants working in relationally intensive contexts was aligned with the focus of the study, which examines how ADHD employees experience and navigate workplace relationships. Given this focus, selecting contexts in which interpersonal interactions were central to everyday work was necessary to generate rich and relevant accounts of relational dynamics.

To interview our participants, we employed a semi-structured interview scheme (see  Appendix), which included key questions regarding relationships with colleagues/bosses/collaborators, as well as with external stakeholders. These questions also explore the impact of these relationships on self-efficacy and goal attainment. During the interviews, we sought to establish communicative validity with our interviewees (Kvale, 1995) by clearly explaining our research objectives. We also asked follow-up questions, clarifications and examples whenever we needed to gain a deeper understanding of specific aspects mentioned by participants. The interviews were conducted in Italian, transcribed verbatim in Italian and analyzed primarily in the original language. Relevant quotations and thematic labels were subsequently translated into English for reporting purposes. To preserve meaning and minimize the risk of interpretive distortion, translations were cross-checked against the original Italian transcripts during manuscript preparation.

To analyze the interviews, we followed a thematic analysis approach, a method for identifying, analyzing and interpreting patterns (themes) within qualitative data (Braun and Clarke, 2006). In line with the inductive or “bottom up” approach to thematic analysis (e.g. Frith and Gleeson, 2004), we opted for a data-driven analysis, so that the identified themes are closely linked to the collected data rather than being exclusively theoretically driven (Patton, 1990) and can expand on the specific questions posed to participants. We follow the six phases for data analysis as recommended by the authors. First, we became familiar with the data, and we manually coded the interview transcripts by using Microsoft Word to generate initial codes; then, we analyzed the coded data to identify how different codes could be combined based on shared meanings, thereby forming sub-themes and, subsequently, themes. The process of theme generation and naming was developed through ongoing collaborative discussions between the first two authors, consistent with Braun and Clarke's (2006) reflexive thematic analysis approach. Below, we present our emerging findings.

The data analysis allowed us to identify four emerging themes and a total of 15 related subthemes concerning the way ADHDers navigate the workplace and experience work relationships. We present these findings in the following tables, which also include participants' quotations. Below each table, we provide additional details on the results and further quotes from the interviews.

Table 2 summarizes the first theme which captures the challenges and preferences expressed by ADHD employees in relation to workplace structures and demands, emphasizing how flexibility can mitigate difficulties and support their productivity and well-being. This theme is composed of five subthemes. The first one is “striving to respect fixed rules and working hours”: all of the participants (N = 10) highlighted the effort required to adhere to traditional workplace norms, such as fixed schedules and rigid protocols, and the frustration with these constraints, often leading to stress or feelings of overwhelm. For instance, as pointed out by S.V.:

Many participants emphasized that even small adjustments significantly improved their experience. As reported for example by F.C.:

The second sub-theme we identified is “struggling to perform repetitive and boring tasks”. Most participants agreed that monotonous and bureaucratic tasks were a consistent source of difficulty, often leading to disengagement and frustration. For instance, S.D.C. underlined:

Some of the participants reported using coping strategies, such as seeking distractions. As highlighted by W.R.:

The third sub-theme consists of the “need for autonomy and dynamism in work management”: the participants expressed a preference for roles that allow them to work independently, with the freedom to manage their own projects and tasks. Conversely, participants in more rigid environments, dominated by traditional methods and “set ways”, found the lack of autonomy stifling, leading to dissatisfaction and a desire for change. A number of participants, especially those working in this kind of organizational context, expressed their frustration. As reported for instance by W.R.:

Conversely, other participants have found their way to express themselves in the workplace. As highlighted by F.M.:

The fourth sub-theme is the “need for innovation”: the majority of participants preferred creative, problem-solving roles that offer innovation, stimulation, and variety, aligning with their need for novelty and mental engagement. As highlighted by S.C.:

Finally, the fifth identified sub-theme lies in “managing inattention and perfectionism”: most of the participants described struggling with forgetfulness and distractibility, even when using reminders to stay organized. Perfectionism emerged as both a strength and a source of stress, as the pursuit of flawlessness often resulted in excessive attention to minor details, ultimately hindering productivity. As highlighted by F.M:

Managing this tension was a key coping strategy. As underlined by S.A:

Taken together, these findings suggest that flexibility functions as a socio-structural facilitator that enables participants to align work demands with their cognitive preferences. Participants consistently described greater confidence and engagement when afforded autonomy and discretion in managing their work, indicating a positive influence on their perceived self-efficacy.

The second theme emerging from the interviews (Table 3) concerns the way ADHD employees experience work relationships. The results clearly showed almost all interviewees' (N = 9) preferences for informal and friendly work relationships, which make them feel included and encourage self-expression. This theme includes four subthemes. The first one is “Disclosure with trusted colleagues”: after receiving the diagnosis of ADHD, a number of participants opted to disclose it with close and trusted colleagues to explain work-related challenges and strengthen the relationship. Disclosure is facilitated by an informal work environment with a high psychological safety. As highlighted by P.C.:

The second sub-theme is named “at ease with friendly and open-minded colleagues” and reveals that the majority of our interviewees feel closer to friendly and open-minded colleagues. This emerges from S.A.’s narrative:

Someone highlights that informal relationships also enhance professional collaboration. This aspect is well-expressed in L.Q.’s words:

The third sub-theme is “building personal relationships with external stakeholders”: a number of our respondents established close ties with informal and like-minded external stakeholders, noting that social events (e.g. dinners, trade fairs) also strengthen professional relationships. As highlighted by S.D.C:

The fourth sub-theme regards “organizational rituals”: most of our interviewees reveal that they enjoy institutional moments, such as corporate parties, and networking events, but provided that informal interactions prevail, allowing them to share ideas and connect with colleagues and external stakeholders. This perspective emerges clearly from W.R.’s words, as follows:

These experiences suggest that supportive work relationships provide social feedback and validation that reinforce participants' beliefs in their ability to perform effectively and express themselves authentically. In SCT terms, such relational environments appear to function as socio-structural facilitators that strengthen self-efficacy and encourage goal-directed behavior.

The third emerging theme, reported in Table 4, concerns the way ADHD employees experience work relationships. Mirroring the second theme, almost all of our interviewees (N = 9) felt uncomfortable in formal, inflexible work relationships, which limited their self-expression and made them feel inauthentic. This theme is further nuanced into four subthemes. The first is “authoritarian leadership style” which translates into an aversion toward leaders with an imposing and conservative attitude (e.g. “it's always that way” attitude) which makes them feel misunderstood and limits their self-expression, lateral thinking and innovative ideas. This feeling is clearly evident from W.R.’s words:

The second sub-theme concerns the “Negative judgment and lack of understanding”: most of our respondents felt most uncomfortable with judgmental, closed-minded colleagues, who made them fear self-expression and reinforced masking behaviors. As highlighted by W.R:

The lack of psychological safety leads to hiding the diagnosis, as reported by A.L.:

The third sub-theme concerns “performance anxiety”: a number of participants showed heightened anxiety in performative contexts; urgent requests triggered impulsive reactions, making it challenging to remain diplomatic. As well-described by F.M.:

The fourth sub-theme concerns “organizational rituals”: institutional moments such as corporate parties and events are experienced by most of our participants as stressful moments when they are very formal (e.g. gala dinners) demanding composed and controlled behavior. In these settings, ADHD employees feel trapped, with heightened restlessness. As highlighted by F.M.:

Formal and judgmental relationships appear to function as socio-structural impediments. Participants often reported concealing their diagnosis, limiting self-expression or avoiding certain interactions, suggesting that negative relational experiences may undermine self-efficacy and constrain behavioral engagement.

The last theme (illustrated in Table 5) has emerged as a recurrent pattern across participants (N = 6) and illustrates how ADHD employees use their personal experiences to implement a leadership style focused on empathy, trust, and flexibility. Two subthemes emerged, namely 1) empathy and trust and 2) granting flexibility. The former highlight participants' ability to connect with others through empathy, often drawing from their personal challenges. Their personal experiences fostered their trust with subordinates (such as lower level employees) and external stakeholders (e.g. students, patients, clients). As reported by S.A.:

At the same time, their openness to vulnerabilities deepened their connections and enhanced their effectiveness in professions where empathy is needed, such as caregivers, psychotherapists, or teachers.

These aspects clearly emerge from W.R.’s words:

And also from F.C.’s narrative:

The second sub-theme mirrors all participants' need for flexibility, which translates into their ability to ensure flexibility as leaders and to favor collaborative and non-authoritarian approaches, in order to foster supportive environments grounded in shared responsibility and mutual understanding. This approach is well expressed by the experience of S.V.:

Beyond describing a preferred leadership style, these accounts suggest that participants actively sought to recreate the relational conditions they themselves perceive as enabling. Experiences of rigid supervision, limited understanding and low psychological safety appeared to inform subsequent efforts to build relationships characterized by empathy, trust, and flexibility. Rather than merely adapting to workplace environments, participants described shaping them in ways that reflected their own experiences and values.

Taken together, the four themes depict a coherent pattern in how ADHD employees navigate workplaces and experience work relationships in organizational contexts. The need for flexibility emerges as a foundational condition shaping participants' engagement with work, intertwining closely with the relational environments in which they operate. Supportive and informal work relationships enable self-expression, disclosure and collaboration, thereby facilitating the enactment of flexibility in everyday work practices. In contrast, formal and rigid work relationships – characterized by authoritarian leadership, judgment and limited psychological safety – constrain flexibility, heighten performance anxiety and reinforce masking behaviors. The relational leadership style exhibited by neurodivergent participants emerged as a key novel finding of the analysis and suggests that participants do not merely adapt to relational environments but actively seek to shape them. Drawing on their own experiences, they attempt to recreate relational contexts characterized by empathy, trust and flexibility, which they perceive as enabling both for themselves and for others. Figure 2 visually summarizes these interrelations, highlighting how supportive work relationships function as enabling conditions that foster flexibility, self-expression, self-efficacy, and relational agency, whereas formal and rigid relationships operate as constraining forces that inhibit these processes.

This study advances understanding of how ADHD employees navigate workplaces and work relationships by showing that the latter are not merely a background condition, but a central socio-structural context through which these individuals negotiate flexibility, self-expression, engagement and leadership. Through a thematic analysis, we identified four interrelated themes, each comprising multiple subthemes – need for flexibility, supportive/informal work relationships, formal/rigid work relationships and relational leadership style – that together depict a relational pattern rather than a set of isolated experiences. Although the first theme concerns flexibility in work structures and demands, it is central to our relational framing because it defines the socio-structural conditions through which workplace relationships are experienced and enacted.

The first theme, “need for flexibility”, focuses on the challenges, preferences and coping mechanisms adopted by ADHD employees in relation to workplace structures and demands. The theme aligns with the extant research, showing that these individuals often struggle with rigid organizational arrangements, fixed schedules and standardized protocols that clash with their time management and attentional profiles, leading to stress and frustration (Kessler et al., 2005). Our interviewees reported that even small adjustments significantly improve productivity and well-being, echoing prior evidence showing that minor accommodations can enhance job satisfaction and support psychological safety, disclosure and thriving at work (McIntosh et al., 2023). Participants also expressed a strong preference for task autonomy, noting that rigid environments hinder engagement and performance – consistent with research showing improved outcomes when ADHD employees can exercise control over their work structure (Hallowell and Ratey, 2011), and with recent evidence emphasizing the importance of flexible, individually adapted support for sustainable work participation among ADHD adults (Högstedt et al., 2023). More broadly, the need for flexibility was closely intertwined with participants' preference for innovation, novelty and dynamism, which have been shown to support sustained engagement among ADHD employees (Hallowell and Ratey, 2011; Kessler et al., 2005). Interestingly, the prevalence of self-employment and hybrid career arrangements among participants represents a novel finding that further underscores the centrality of autonomy and flexibility in managing work activities. The choice to leave some organizational contexts to carry out self-employed activities might reflect the lack of effective diversity management programs in Italian firms (EY, 2024). From an SCT perspective, these findings suggest that flexibility functions not only as an accommodation but also as a socio-structural facilitator that supports autonomy, self-regulation and perceived self-efficacy.

The second and third themes are closely interconnected, capturing contrasting relational contexts in which ADHD employees experience work relationships. Participants consistently described thriving in informal and flexible work relationships that allow authentic self-expression while struggling in formal and rigid relational environments that constrain their thinking and behavior. Among the functions of positive work relationships (Colbert et al., 2016), emotional support and friendship were particularly salient: feeling accepted and understood reduced performance anxiety and fostered trust, thereby enabling engagement and initiative. As suggested by Kaaria and Karemu (2024), empathetic and open communication plays a key role in fostering accommodating work relationships with neurodivergent employees. These findings also resonate with emerging research showing that relational dynamics, stigma, disclosure concerns, psychological safety and workplace support shape the employment experiences of ADHD adults and other neurodivergent workers (Högstedt et al., 2023; McIntosh et al., 2023; Rowe et al., 2021). Interestingly, compared with supervisors/bosses and, in some cases, coworkers, many participants found relationships with subordinates or external stakeholders easier to manage. These supportive relational contexts – which resonate with ADHDers' needs – contrasted sharply with more hierarchical and judgmental relationships that participants associated with heightened anxiety, masking behaviors and reduced willingness to speak up. This pattern extends prior work by showing how contrasting relational contexts may operate, in SCT terms, as socio-structural facilitators or impediments that shape self-efficacy, self-expression and agency at work (Rowe et al., 2021). It also reflects participants' emphasis on empathy and mutual understanding – qualities they perceived as less prevalent in rigid supervisory relationships but central to their own relational orientation.

The fourth theme, relational leadership style, emerges from these relational experiences and illustrates how ADHD employees develop leadership practices centered on empathy, trust and flexibility. Participants intentionally created nonauthoritarian and supportive environments that mirror the relational conditions they themselves experienced as enabling. In doing so, they emphasized collaboration, shared responsibility and openness to vulnerability. These findings enrich prior research highlighting the socio-affective skills and flexibility of ADHD individuals, which are often marked by empathy and prosociality (Shippers et al., 2022) by showing how such resources may be translated into relational leadership practices. Rather than positioning ADHD adults only as recipients of support or accommodation, this theme suggests that they may also act as relational agents who recreate enabling conditions for others.

This study shows how everyday work relationships shape the inclusion or exclusion of employees with invisible diversity at work, highlighting their role in enabling or constraining agency among ADHD individuals. More specifically, it contributes to diversity and inclusion, work relationship and neurodiversity research by theorizing workplace relationships as socio-structural conditions through which ADHD adults develop, protect or restrict self-efficacy, self-expression and relational agency.

First, the study advances the diversity and inclusion literature by reinforcing a relational understanding of inclusion. Consistent with influential distinctions between diversity as representation and inclusion as lived experience (Shore et al., 2011, 2018), our findings show that inclusion for ADHD individuals is not secured through formal policies alone but enacted through everyday interactions characterized by psychological safety, informality and trust. Selective disclosure, authentic self-expression and reduced masking emerge primarily in psychologically safe and trusting contexts. Inclusion thus appears as an ongoing relational accomplishment rather than a static organizational attribute. This is particularly important in the case of invisible diversity, where inclusion depends not only on whether difference is formally acknowledged but also on whether individuals feel able to disclose, regulate visibility and participate without fear of judgment or misattribution. In this sense, our study extends inclusion theory by showing how inclusion is continuously negotiated through relational cues that either legitimize or inhibit self-expression.

Second, the study contributes to the work relationship literature by conceptualizing relationships not merely as sources of social support, but as mechanisms that shape individuals' capacity to act. In doing so, our findings also complement insights from LMX theory (Graen and Uhl-Bien, 1995), suggesting that the quality of relationships with supervisors may be particularly consequential for ADHD employees. Participants consistently contrasted supportive, trusting relationships with hierarchical and judgmental ones, highlighting how relational quality influences disclosure, self-expression and engagement at work. Prior research has emphasized the emotional and instrumental functions of positive work relationships (Colbert et al., 2016; Dutton and Heaphy, 2003). Our findings extend this work by showing that, for ADHD employees, relational contexts determine whether effort, competence and creativity translate into sustained engagement and meaningful outcomes. Informal and empathetic relationships foster initiative, confidence and experimentation, whereas authoritarian leadership and rigid relational norms inhibit self-expression and heighten performance anxiety. In this sense, work relationships operate as socio-structural conditions that differentially enable or constrain agency across employees (Huy, 2002). By bringing SCT into the analysis of workplace relationships, we further specify the mechanisms through which relationships matter: they provide, or withhold, social persuasion, validation, modeling and opportunities for agentic action. Thus, relationships do not simply surround individual behavior; they actively shape perceived self-efficacy and the behavioral possibilities available to ADHD employees.

Third, the study advances the neurodiversity literature by foregrounding ADHD as a paradigmatic case of invisible diversity at work. In line with research on invisible disabilities, our findings show that many challenges attributed to individual deficits are relationally produced through misunderstanding, misattribution and lack of psychological safety (Bruyère and Colella, 2022; Santuzzi et al., 2014). This perspective contributes to neurodiversity research by moving beyond deficit-based or accommodation-centered accounts and by showing how ADHD-related experiences are embedded in relational systems that can either amplify difficulties or convert difference into adaptive and relational resources. Importantly, the emergence of a relational leadership style among participants illustrates how ADHD individuals actively shape their social environments, transforming lived challenges into relational resources. This perspective shifts attention from accommodation as an individual adjustment to inclusion as a collective and relational process (Randel et al., 2018; Uhl-Bien, 2006). The theme of relational leadership style is especially theoretically generative because it positions ADHD adults not only as recipients of support but also as agentic contributors to inclusive relational climates. Participants' accounts suggest that experiences of rigidity, judgment and low psychological safety can inform efforts to create leadership practices centered on empathy, trust, flexibility and shared responsibility. In doing so, the study extends emerging ADHD-at-work research by showing how lived neurodivergent experience may become a basis for relational leadership and inclusive organizing.

Our findings offer multi-level implications for building more neuroinclusive workplaces. These implications are particularly relevant in the Italian context, where ADHD in adulthood is not covered by a dedicated employment regulation and formal protection generally depends on broader disability-related frameworks, such as recognized civil disability (Law n. 68, 1999; Law n. 104, 1992) targeted employment provisions, or the obligation to provide reasonable accommodations for workers with disabilities. However, many ADHD adults, including those in our sample, may not have a condition formally recognized as disabling or severely impairing their capacity to work. This creates a practical gap: neurodivergent employees may experience significant relational and organizational barriers even when they do not fall within formal disability categories. For this reason, organizations should move beyond a purely compliance-based approach and develop internal neuroinclusive practices that anticipate the likely presence of ADHD and other forms of invisible diversity in the workforce.

At the individual level, our findings suggest that ADHD employees should be supported in identifying and communicating the conditions under which they work most effectively, without being required to disclose a diagnosis. Participants described flexibility not simply as a preference for convenience, but as a condition that allowed them to align work demands with their attentional rhythms, energy fluctuations and preferred ways of organizing tasks. Individual-level support may therefore include structured opportunities for employees to discuss work preferences, task sequencing, focus needs, communication styles and recovery time. Such practices can help employees exercise agency and self-regulation while reducing the burden of masking or managing difficulties privately.

At the managerial level, our findings highlight the importance of the relational climate created by supervisors and team leaders. Participants distinguished sharply between supportive/informal relationships and formal/rigid relationships. Supportive relationships were associated with trust, authentic self-expression, reduced masking and greater engagement, whereas judgmental and hierarchical relationships were associated with anxiety, concealment and reduced willingness to speak up. Managers should therefore avoid treating flexibility as an exceptional favor granted only after disclosure. Instead, they can build psychologically safe relationships by asking employees how they work best, giving feedback in clear and non-stigmatizing ways, reducing unnecessary surveillance and public correction, offering predictable one-to-one check-ins and evaluating performance through outputs rather than constant visibility or availability. These practices translate the finding about supportive relationships into concrete supervisory behaviors.

At the organizational level, our findings suggest that neuroinclusion should be embedded in work design, team rituals and retention strategies. First, organizations can introduce “flexibility by default” options, such as protected focus time, hybrid work arrangements, autonomy over task sequencing, flexible planning routines and individualized workload conversations. Second, organizations should redesign informal rituals and social events so that they support belonging without producing pressure, ambiguity, or forced exposure. Our findings show that organizational rituals can function differently depending on the relational context: they may be supportive when they are voluntary, predictable and trust-based, but stressful when they involve forced sociability, unclear expectations or implicit judgment. Inclusive rituals should therefore include explicit agendas, multiple ways of participating, low-pressure social formats and alternatives to high-stimulation or after-hours activities. Third, the finding on self-employment and hybrid career arrangements suggests that organizations concerned with retaining neurodivergent employees should examine what employees seek in self-employment: autonomy, flexibility and relief from rigid relational expectations. Retention strategies may therefore include job crafting, project-based work, intrapreneurial assignments, portfolio-like career paths, temporary role redesign and flexible progression models.

At the societal and policy level, our findings point to the limitations of relying exclusively on formal disability recognition to support neurodivergent workers. In contexts such as Italy, where ADHD-specific employment protections are limited, many ADHD adults may remain outside formal accommodation systems despite experiencing relational and organizational barriers. This suggests the need for broader awareness of neurodivergence in employment policy, occupational health and diversity management practice. At the same time, organizations need not wait for legal reform to act. Internal neuroinclusive policies can provide a bridge between legal compliance and lived inclusion by recognizing that flexibility, psychological safety and relational trust are not only individual accommodations, but structural conditions that make participation sustainable.

Importantly, these practices should not be understood as benefiting neurodivergent employees alone. Although flexibility, psychological safety, explicit communication and relational trust are particularly consequential for ADHD employees because they allow them to align their needs with workplace expectations, they can also improve the broader work climate and support the well-being, engagement and sustainable participation of all employees. In this sense, accommodating neurodivergent needs may generate wider organizational benefits by encouraging more humane, flexible and inclusive ways of working.

Finally, across these levels, organizations should recognize the relational leadership potential of ADHD employees. Participants who occupied leadership or responsibility roles often described creating the kinds of relational environments they themselves had needed: empathetic, flexible, non-authoritarian and based on trust. Supporting neurodivergent employees' leadership development may therefore involve valuing relational forms of leadership, mentoring employees into responsibility roles and avoiding narrow leadership models based only on control, constant availability or micromanagement. Rather than seeing ADHD only as a condition requiring accommodation, organizations may benefit from recognizing how lived neurodivergent experiences can inform more inclusive leadership practices.

This study aimed to investigate how ADHD employees experience workplace relationships. Through a qualitative study involving ten in-depth interviews, we find four emerging themes: 1) the need for flexibility, 2) the supportiveness of informal/friendly work relationships, 3) the unsupportiveness of formal/rigid work relationships and 4) the relational leadership style.

Taken together, these themes contribute to the literature on diversity and inclusion, work relationships and neurodiversity by showing how workplace relationships function as key mechanisms through which inclusion and exclusion are enacted in everyday organizational life. In particular, the findings highlight how relational contexts enable or constrain agency, self-expression and occupational outcomes for individuals whose neurodivergence, such as ADHD, may constitute an invisible (or less visible) form of diversity.

Our study has three main limitations. First, the sample is limited to ten participants, and all of them were recruited in Italy; thus, the findings are context-dependent and may not be readily transferable to other sociocultural contexts. Moreover, because participants were selected from relationally intensive work contexts, future research could examine whether our findings may transfer to work settings in which interpersonal interaction is less central or more episodic.

Second, the fact that all participants were diagnosed in adulthood likely interfered with the development of coping strategies earlier in life, thus possibly affecting their relational and occupational outcomes. Third, the interviews were conducted over a specific time range (November–December 2024), thus not providing a longitudinal perspective. Future research could adopt longitudinal and mixed-methods designs to examine how relational dynamics and inclusion experiences evolve over time and across different organizational and cultural contexts.

We would like to express our sincere gratitude to the psychotherapists who supported and promoted our study and to the participants for sharing their insightful experiences.

1. How did you receive a diagnosis of ADHD?

2. Have you disclosed your condition in your work environment? (if yes/if no, why?)

3. Can you describe your professional path?

4. What is the organizational culture of your work environment like (rigid rules/flexibility/more or less performative context etc.)?

5. What is a typical working day like for you?

6. How is workflow managed within the work team? Do you easily manage it, or does it cause difficulties? If yes, which ones? How does he manage them?

7. Can you describe your relationships with colleagues/bosses/collaborators?

   • Interaction with colleagues of the same rank helps you feel integrated and not uncomfortable in daily working life. Why? If yes, how? Provide some examples. If not, how does it make you feel inadequate?

   • Interaction with leaders helps you feel integrated and not uncomfortable in daily working life. Why? If yes, how? Provide some examples. If not, how does it make you feel inadequate?

   • The interaction with your collaborators helps you feel integrated and not uncomfortable in your daily working life? Why? If yes, how? Provide some examples. If not, how does it make you feel inadequate?

8. Do you have daily/frequent interactions with subjects that are external to the organization (customers, suppliers, students and so on)? How do you manage relationships with them? Are they a source of discomfort in daily working life? Why? If yes, how do they cause you discomfort? Provide some examples.

9. How do you live the moments of institutional sociality that are part of working life (occasions such as company parties, team building, training)?

10. Have you developed some informal relationships with colleagues outside the professional sphere (e.g. aperitifs/dinners)? How would you describe these relationships? How did these relationships extend outside the workplace?