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Abstract
We investigated performance-derived measures of executive control, and their relationship with self- and informant reported executive functions in everyday life, in treatment-naive adults with newly diagnosed Attention Deficit Hyperactivity Disorder (ADHD; n = 36) and in healthy controls (n = 35). Sustained attentional control and response inhibition were examined with the Test of Variables of Attention (T.O.V.A.). Delayed responses, increased reaction time variability, and higher omission error rate to Go signals in ADHD patients relative to controls indicated fluctuating levels of attention in the patients. Furthermore, an increment in NoGo commission errors when Go stimuli increased relative to NoGo stimuli suggests reduced inhibition of task-irrelevant stimuli in conditions demanding frequent responding. The ADHD group reported significantly more cognitive and behavioral executive problems than the control group on the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). There were overall not strong associations between task performance and ratings of everyday executive function. However, for the ADHD group, T.O.V.A. omission errors predicted self-reported difficulties on the Organization of Materials scale, and commission errors predicted informant reported difficulties on the same scale. Although ADHD patients endorsed more symptoms of depression and anxiety on the Achenbach System of Empirically Based Assessment (ASEBA) than controls, ASEBA scores were not significantly associated with T.O.V.A. performance scores. Altogether, the results indicate multifaceted alteration of attentional control in adult ADHD, and accompanying subjective difficulties with several aspects of executive function in everyday living. The relationships between the two sets of data were modest, indicating that the measures represent non-redundant features of adult ADHD.
Highlights
Attention Deficit Hyperactivity Disorder (ADHD) is a common early-onset neurodevelopmental syndrome with an estimated prevalence of 2.2% for males and 0.7% for females [1]
Due to accruing evidence that performance on tasks considered void of emotionally charged content can be influenced by emotional states [52, 53], and because adult ADHD is associated with inceased risk of coexisting psychophatology such as depressed mood and anxiety [53, 54], we explored the relationship between scores on the T.O.V.A. and self-reported symptoms of low mood and anxiety on the Adult-Self-Report (ASR) of the Achenbach System of Empirical Based Assessment (ASEBA) [55]
Theoretical models postulating multiple cognitive deficits and associated large-scale neural networks dysfunction are likely needed to explain the diversity in behavioral expression of brain dysfunction in ADHD. To explore this model we examined whether adults with ADHD experienced problems of executive function in their daily lives, and whether any perceived difficulties were associated with performance on a laboratory-based task demanding sustained attention and dynamic response control
Summary
Attention Deficit Hyperactivity Disorder (ADHD) is a common early-onset neurodevelopmental syndrome with an estimated prevalence of 2.2% for males and 0.7% for females [1]. The recent clinical understanding that ADHD may persist into adulthood has resulted in an increase in referrals of adults without a childhood diagnosis. This poses challenges of diagnosis as it is difficult retrospectively to obtain accurate information on childhood behavior, and because the diagnostic criteria give limited consideration to the heterogeneity of the disorder and its developmental course [12, 13]. Compared with childhood ADHD, there is still limited empirical knowledge about clinical features and neurocognitive function in adult ADHD [14,15,16]
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