5. Memory and learning problems with ADHD

Author: Ulrich Brennecke
Review: Dipl.-Psych. Waldemar Zdero

Forgetfulness, learning problems and memory problems are common in ADHD. It is almost phenotypical that people with ADHD find it difficult to remember details from their childhood, which can be a disadvantage when diagnosing adults.
Forgetfulness can be caused by distractibility or memory problems. Children with ADHD often lose everyday objects. Adults have difficulty remembering actions, events or agreements.
In ADHD, the ability to learn is impaired because certain neurotrophic substances in the brain, such as dopamine and GABA, are reduced. People with ADHD learn less well through punishment, but react more sensitively to it by building up cumulative negative emotional reactions (frustration tolerance¹
Forgetfulness and memory problems are typical symptoms of stress. Stress impairs implicit memory, declarative memory and working memory. These impairments also occur in ADHD.

• 5.1. Forgetfulness
• 5.2. Learning problems
• 5.3. Poor memory of childhood events
• 5.4. Memory problems as symptoms of stress

5.1. Forgetfulness¶

• Forgetfulness
  Forgetfulness can result from distractibility, when another stimulus has attracted attention in such a way that the previous object of attention is lost sight of.
  Forgetfulness can also result from memory problems if no other stimulus changes the focus of attention or suppresses the previous topic from memory.

  • Children:
    • Is often forgetful in everyday activities (DSM IV / 5)
    • Frequently loses objects needed for everyday activities (DSM IV / 5)
  • Adults:
    • Inability to remember actions/incidents/agreements²
    • Initial situations are no longer remembered², which can lead to the feeling of constantly being in unforeseen situations
    • Subjective feeling of suffering from Alzheimer’s disease²

Like attention, forgetfulness could also depend heavily on intrinsic interest.
An online survey in the ADHD forum of ADxS.org (61 participants, as of 09.03.24) revealed:

Question: is forgetfulness also driven by motivation or is it independent of it?

Scale:
sometimes: from time to time, not only rarely
frequently: more than just once in a while
often: more than often

I forget things/tasks/todos/appointments or lose things:

23% often, and REGARDLESS of whether they are important to me or not
21% often, and mainly when they are NOT important to me
20% frequently, and REGARDLESS of whether they are important to me or not
18% sometimes, and mainly when they are NOT important to me
8% frequently, and mainly when they are NOT important to me
6% sometimes, and REGARDLESS of whether they are important to me or not
2% frequently, and mainly when they are important to me
2% sometimes, and mainly when they are important to me
0% often, and mainly when they are important to me

To summarize:

49 % often / frequently / sometimes, and REGARDLESS of whether they are important to me
47 % often / frequently / sometimes mainly when they are NOT important to me
4 % often / frequently / sometimes mainly when they are important to me

It is probably normal for people to forget things that are important to them less frequently. It would be interesting to see how the rate differs for those who are not affected.
The survey did not ask whether there was a diagnosis of ADHD. A more detailed survey is required for this.

5.2. Learning problems¶

With ADHD, the ability to learn is often impaired.
The ADHD-specific learning problems result, among other things, from reduced levels of dopamine, GABA, growth hormone and BDNF, which are neurotrophic substances required for neuroplasticity (the formation of new synapses). More on this at ⇒ Neurophysiological correlates of learning problems. Learning problems also result from executive problems (organizational problems).³

• Learning ability requires immediate feedback
• Barely any learning takes place through punishment
  • Penalties are usually issued with a time delay due to the principle
  • Punishments are therefore fundamentally poor learning reinforcers.
  • Punishments inhibit behavior, they do not act as behavior reinforcers.
  • (School) learning is (neurophysiologically speaking) a process of reinforcement rather than inhibition.
  • Even those who are not affected learn better through praise and motivation than through punishment.
  • However, people with ADHD learn even worse through punishment than people without ADHD
  • Irrespective of this, children with ADHD reacted more sensitively to punishments than people without ADHD.⁴
• Learning ability in ADHD appears to be independent of delay aversion or working memory problems.⁵

5.3. Poor memory of childhood events¶

Our impression is that many people with ADHD have difficulty remembering situations or moods from their childhood. It is difficult to answer questions about examples of interaction with parents or siblings. However, such memories are difficult in principle and are usually (positively) distorted.

This may be consistent with our hypothesis that ADHD symptoms are mediated by the same neurotransmitter shifts as chronic stress. Chronic stress causes the brain to store experiences in a less consciously reconstructable way. Psychotherapists often find that people with ADHD have a good memory of the events before the trauma if the trauma was a singular, surprising event. In contrast, traumas that occurred in a stressful overall situation (chronic stress) (e.g. ongoing sexual abuse / ongoing physical abuse) are much harder to remember. This could also be understood as a protective mechanism

5.4. Memory problems as symptoms of stress¶

Forgetfulness⁶ and memory problems^{76 8} are typical symptoms of stress.

Stress impairs

• The implicit memory⁹
• The declarative memory⁹
• The working memory⁹

Impairments in all of these memory areas are also described in ADHD, although not every person with ADHD has impairments in all memory areas at the same time.¹⁰

Forgetfulness is known to be a typical symptom of severe stress.⁶ Memory problems as well⁶¹¹

For information on memory impairments caused by stress, see above at ⇒ Distractibility and attention problems are symptoms of stress.