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Abstract
BackgroundPrevious studies suggest that childhood attention deficit hyperactivity disorder (ADHD) may continue in adulthood, producing adverse effects. Therefore, identifying factors that help to differentiate characteristics of ADHD persistence and remission has practical implications for evaluation and treatment. The first aim of this study was to analyze differences in executive functions (shift, working memory, inhibition, and plan/organize), symptoms associated with ADHD (inattention, hyperactivity, emotional lability, and self-concept), and functional impairments in adults with persistent ADHD (ADHD-P), with remittent ADHD (ADHD-R), and without ADHD (N-ADHD). The second aim was to study the contribution of functional impairments in these three groups based on executive functions and associated ADHD behaviors.MethodsParticipants were 115 adults, 61 with a childhood ADHD diagnosis (40 persisters and 21 remitters) and 54 individuals with typical development. Self-reports were collected on executive functions, symptoms associated with ADHD, and functional impairments. Multivariate Analyses of Variance were conducted to test differences between the ADHD-P, ADHD-R, and N-ADHD groups on the evaluated variables. In addition, analyses were performed using two structural equation models with observed variables (path analyses).ResultsThe results indicated that significant executive and behavioral impairments and adverse functional outcomes in different life domains are related to the diagnostic persistence of ADHD. Recovery from the disorder is associated with better results, although hyperactivity/restlessness behaviors and plan/organize deficits continue to be present in remitter individuals.ConclusionsThe ADHD-P and ADHD-R groups showed some differences in their executive, behavioral, and functional impairments. Furthermore, the impairments in each group can be predicted by different executive functions and other symptoms associated with the disorder. These results should be taken into account in order to improve clinical practice.
Highlights
Previous studies suggest that childhood attention deficit hyperactivity disorder (ADHD) may continue in adulthood, producing adverse effects
The ADHD persistent (ADHD-P) and ADHD remittent (ADHD-R) groups showed some differences in their executive, behavioral, and functional impairments
Study design and procedure This is a descriptive cross-sectional design between a group of adults with a childhood ADHD diagnosis twelve years after the initial diagnosis and a Without ADHD (N-ADHD) group, that were matched on sex, age and Intellectual Quotient (IQ) estimated Participants with ADHD came from the Spanish sample from the International Multicenter ADHD Genetics (IMAGE) study, a prospective study of children with ADHD with combined subtype (ADHD-C), recruited between 2003 and 2006
Summary
Previous studies suggest that childhood attention deficit hyperactivity disorder (ADHD) may continue in adulthood, producing adverse effects. The second aim was to study the contribution of functional impairments in these three groups based on executive functions and associated ADHD behaviors. ADHD is a disorder that frequently continues in adulthood For many people, it is chronic, even though the data on its persistence from follow-up studies are not congruent, with percentages ranging from 4 to 77%. It is chronic, even though the data on its persistence from follow-up studies are not congruent, with percentages ranging from 4 to 77% This great variability may be due, above all, to the variety of methods and cut-off points established to diagnose ADHD, the assessment procedures used, the age when beginning the study and follow-up, and the requirement (or not) of the presence of impairments. The complexity of the manifestations of ADHD and the diversity of the outcomes are not explained by a simple impairment, and a range of cognitive mechanisms have been proposed, including [5]: aversion to delay, dysfunctional responses to contingencies, increased intraindividual variability in response time due to attentional fluctuations or overall slow cognitive processing speed, and executive functioning impairments (EF)
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