When ADHD Gets Stuck on a Thought

Research Notes

A 2026 study of ADHD symptoms, rumination, racing thoughts, depression, and anxiety raises an interesting question about what happens when attention does not just wander, but becomes difficult to disengage.

Jason Joseph, LPC, LMHC, CPC · Updated August 2026 · 7 min read

Recent research on ADHD symptoms in adults has begun looking more closely at forms of repetitive thinking that do not fit neatly into the familiar picture of distractibility. One 2026 study by Devenish, Weiner, and Papadopoulos examined whether rumination and racing thoughts might help account for the association between ADHD symptoms and symptoms of depression and anxiety.

The researchers recruited 289 adults between the ages of 18 and 65. After excluding two multivariate outliers and three participants with missing data, 284 were included in the final analyses. Participants completed online self report measures of inattentive symptoms, hyperactive or impulsive symptoms, racing thoughts, rumination, depression, and anxiety.

Racing thoughts and rumination can overlap, but the study treated them as distinct constructs. Racing thoughts refer to an overproduction of thoughts that feel accelerated or difficult to slow down. Rumination involves repeatedly returning to negative feelings, distress, and their possible causes or consequences.

That difference showed up in the results. Racing thoughts significantly mediated the relationships between both inattentive symptoms and hyperactive or impulsive symptoms with depression and anxiety symptoms. Rumination showed a narrower pattern. It significantly mediated the relationships involving hyperactive or impulsive symptoms, but not those involving inattentive symptoms.

These findings do not mean that ADHD causes rumination or racing thoughts, or that either process is unique to ADHD. They do suggest that different forms of repetitive thinking may be involved in the relationship between ADHD symptoms and emotional distress, and that they may not operate in exactly the same way.

When Attention Does Not Readily Disengage

One reason I find this line of research useful is that it broadens the usual language of attentional difficulty. ADHD is often described in terms of attention wandering away from whatever a person is trying to do. There is also an experience in which attention remains attached to something emotionally significant long after continued analysis has stopped producing much new information.

That can happen around interpersonal uncertainty, mistakes, decisions, anticipated consequences, or unresolved questions. Someone may understand a situation very well and still find that understanding does not produce disengagement.

The current study did not directly measure attentional disengagement as the mechanism behind rumination. Still, the authors discuss prior models in which attentional and executive functioning difficulties can interfere with redirecting attention away from negative thoughts, and they raise the possibility that difficulty regulating the pace of thinking may worsen that problem.

My working formulation is that rumination may sometimes involve several interacting processes: difficulty disengaging from emotionally salient material, reduced inhibitory control once the thinking has started, urgency to resolve uncertainty, and repeated attempts to create safety through analysis.

The study itself supports only part of that formulation. I am treating the rest as a clinical hypothesis informed by this paper and by broader work on repetitive negative thinking, attention, and uncertainty.

Rumination as Attempted Problem Solving

The word rumination can make the process sound purposeless. From inside it, the thinking often feels quite purposeful.

Someone may be trying to determine whether they misunderstood a conversation, overlooked an important possibility, made the wrong decision, or could prevent the same problem from happening again. Reflection can be useful under those circumstances. The difficulty is that the mind does not necessarily provide a clear signal when useful reflection has become repetition.

A useful distinction is whether another round of analysis is producing information that was not available before. If the same possibilities are being reviewed repeatedly, the process may be doing something different from ordinary problem solving.

Continued thinking can also create the impression that certainty is still available if the problem is examined carefully enough. Even when someone knows there may be no definitive answer, stopping can feel premature because the problem still feels unfinished.

I prefer that distinction to simply describing someone as an overthinker. It leaves room for the original concern to be reasonable while still asking whether the thinking process remains useful.

Rumination as an Attempt to Create Safety

If continued analysis seems capable of preventing another mistake, clarifying another person’s intentions, or uncovering something important that has been missed, stopping can feel irresponsible. Someone may know they have been thinking about the issue for hours and still experience disengagement as leaving a threat unresolved.

The uncertainty itself may be real. Someone may genuinely not know what another person meant. A decision may actually have uncertain consequences. A social interaction may have contained real ambiguity. The clinical task is not necessarily to prove that the concern is irrational.

Sometimes the work is to notice when a reasonable attempt to understand something has turned into a repetitive attempt to eliminate uncertainty altogether.

I suspect this may be especially relevant for people whose histories include inconsistent performance, missed obligations, social misunderstanding, or experiences in which relatively small mistakes had meaningful consequences. Continued analysis may have developed for understandable reasons, even when it no longer accomplishes what the person hopes it will.

Possible Implications for Therapy

The study did not test treatment, so the implications here are clinical extrapolations rather than treatment conclusions from the study itself.

If repetitive thinking in ADHD is partly maintained by attentional capture, cognitive momentum, or the demand for resolution, then challenging the factual content of every thought may not address the process that keeps the loop going.

Therapy may involve learning to recognize when reflection has stopped generating useful information, identifying what uncertainty the person is trying to eliminate, and practicing disengagement before complete resolution has been achieved. For adults with ADHD, it may also be useful to treat disengagement itself as a skill rather than assuming that insight will naturally produce a shift in attention.

Acceptance based approaches fit this formulation because they do not require the concern itself to be dismissed as irrational. A person can acknowledge that a question is important and still decide that another hour of analysis is unlikely to answer it.

For highly analytical clients, I often find it more useful to ask what they expect continued analysis to accomplish than to debate each thought as true or false. Sometimes the answer reveals that the goal has shifted from understanding the problem to reaching a sense of safety that more thinking cannot reliably provide.

Limits and Open Questions

This was a cross sectional study based on self report data from a general population sample. The statistical mediation models can show that variables are related in a particular pattern, but they cannot establish what comes first or demonstrate causality. The authors also note that the sample may have included an opt in bias toward people with elevated ADHD, depression, or anxiety symptoms.

The study did not require participants to report whether they had formal diagnoses of ADHD, depression, anxiety, or other conditions. That makes the findings useful for understanding symptom relationships, but it limits how confidently they can be generalized to diagnosed clinical populations.

The study leaves open questions that are especially relevant clinically. Rumination is a broad category, and repeatedly revisiting a social interaction may not function in exactly the same way as depressive rumination, obsessive doubt, worry about a future event, or repeatedly analyzing a perceived rejection. It also is not yet clear how attentional disengagement, intolerance of uncertainty, inhibitory control, emotional regulation, cognitive pace, and other processes interact within these different forms of repetitive cognition.

For now, the paper gives me another reason to look beyond distractibility when thinking about ADHD. Some attentional problems involve attention moving away too readily. Others may involve difficulty redirecting it once something emotionally important has captured it. This study does not establish that attentional disengagement explains rumination. It does give me another reason to keep asking that question, which will require research that measures disengagement directly.