Abstract
BackgroundThere is an ongoing debate as to whether attention-deficit hyperactivity disorder (ADHD) in highly intelligent individuals has a similar presentation as in average intelligent individuals. The aim of this study was to examine the cognitive correlates of ADHD in highly intelligent children and adolescents with ADHD.MethodTwo independent samples (N = 204 and N = 84) of (1) high intelligence quotient (IQ) (IQ ≥ 120) children and adolescents with ADHD were used, carefully matched on age, gender, ADHD severity, and IQ with (2) control participants with high intelligence, (3) participants with ADHD with an average intelligence (IQ 90–110), and (4) control participants with an average intelligence. These samples were selected from the Dutch node of the International Multicenter ADHD Genetics (NeuroIMAGE) and Tracking Adolescents’ Individual Lives Survey (TRAILS) cohorts, respectively, in which a large battery of cognitive tasks was administered. Linear mixed models were used to examine the main effects of ADHD and IQ and their interaction on cognitive performance.ResultsADHD-control group differences were not moderated by IQ; mostly equally large ADHD-control differences in cognitive performance were found for high versus average intelligent groups. The small moderating effects found mostly indicated somewhat milder cognitive problems in highly intelligent individuals with ADHD. Overall, highly intelligent children and adolescents with ADHD performed at the level of the average intelligent control children.ConclusionsOur findings indicate the cognitive profile of ADHD is similar in highly versus average intelligent individuals with ADHD, although ADHD-related cognitive deficits may be easily overlooked in the high intelligence population when compared to the typical (i.e., average intelligent) control group.
Highlights
There is an ongoing debate as to whether attention-deficit hyperactivity disorder (ADHD) in highly intelligent individuals has a similar presentation as in average intelligent individuals
Our findings indicate the cognitive profile of ADHD is similar in highly versus average intelligent individuals with ADHD, ADHD-related cognitive deficits may be overlooked in the high intelligence population when compared to the typical control group
Cognitive correlates in relation to ADHD and high intelligence No significant interaction effects were found (Additional file 2: Table S2), indicating that ADHD-control differences were similar for average and highly intelligent participants
Summary
There is an ongoing debate as to whether attention-deficit hyperactivity disorder (ADHD) in highly intelligent individuals has a similar presentation as in average intelligent individuals. There is an ongoing debate as to Previously, it has been argued that high intelligence “mimics” ADHD [10, 11] According to this hypothesis, Cadenas et al Journal of Neurodevelopmental Disorders (2020) 12:6 individuals with high intelligence frequently show high levels of activity, attention difficulties, and problems following rules and with task persistence [10,11,12,13]. Individuals with high intelligence can achieve at a level lower than expected considering their cognitive abilities and experience social difficulties [14, 15]. Based on the hypothesis that high intelligence may mimic ADHD without the “true” disorder being present, it can be hypothesized that highly intelligent individuals with ADHD symptoms will not show the cognitive impairments that are usually found in (average intelligent) individuals with ADHD (Fig. 1a: “mimicing-hypothesis”)
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