Evaluating the Effect of ADHD on Occupational Outcomes in the U.S. Marine Corps

OBJECTIVE: Attention-deficit/hyperactivity disorder (ADHD) can potentially disqualify individuals for military service. However, some past research suggests the performance of individuals with ADHD in military service may be comparable to individuals without ADHD. The objective of the present research is to evaluate the effect of ADHD on occupational outcomes in the first enlistment term. We hypothesized that ADHD would be associated with weak or small performance decrements.

METHOD: Study 1 ( N  = 51,845) linked Recruit Assessment Program (RAP) survey data collected from U.S. Marine recruits between 2013 and 2018 with up to 4-years of active duty career records from the Defense Manpower Data Center. The RAP survey is a cross-sectional, baseline survey of mental, physical, and behavioral health-including self-reported ADHD diagnosis. Study 2 ( N  = 161,507) utilized the Career History Archival Medical and Personnel System (CHAMPS) to obtain a study population of all active duty U.S. Marine Corps enlistees who accessed between 2013 and 2018 with follow-up through 2023. ADHD cases were identified by diagnoses and prescriptions captured in CHAMPS medical data. Estimated propensity scores and military characteristics were adjusted for to mitigate confounding.

RESULTS: Across both studies, Marines with ADHD (2.0%-3.2%) performed at a comparable level to Marines without ADHD. The differences in occupational outcomes (e.g., promotions, demotions, deployments, and attrition) generally fell within ±3% and failed to reach statistical significance despite high statistical power. Subgroup analyses in Study 2 suggested those with treated ADHD performed significantly better than those with untreated ADHD.

CONCLUSION: Complementing past work using medical waivers, the present research suggests those with a prior or current ADHD diagnosis are just as likely to perform successfully in the U.S. Marine Corps as those without ADHD.