Diagnosis acceptance, masking, and perceived benefits and challenges in adults with ADHD and ASD: associations with quality of life

This study surveyed 1,056 adults with ADHD and/or autism spectrum disorder (ASD) to examine how diagnosis acceptance, masking, and perceived benefits/challenges relate to quality of life. Nearly all participants agreed with their diagnosis, but responses on whether they liked having the diagnosis varied much more, with only 29% agreeing "somewhat" or "fully" that they liked it, suggesting cognitive acceptance and emotional acceptance are distinct processes. Masking was found to be context-dependent rather than a fixed trait, occurring most in school/work and family settings. Participants reported both benefits (e.g., honesty, hyperfocus) and near-universal challenges such as mental exhaustion. Quality of life was most strongly associated with perceived benefits of the diagnosis, followed by diagnosis liking and masking behavior, underscoring the clinical value of fostering a positive relationship with one's neurodevelopmental diagnosis rather than focusing solely on deficits.