Abstract
Objective: This study examined the hypothesis that individuals with attention deficit hyperactivity disorder, predominantly inattentive type (ADHD-I), show both executive function (EF) deficits and non-EF deficits. Method: A group with ADHD-I (n = 16) and a paired control group (n = 21) completed a battery of tasks covering the major domains of EF (planning, working memory, flexibility and inhibition) and non-EF (alertness, divided attention, flexibility, sustained attention, visual field and visual scanning). Results: EF impairments in planning, spatial working memory, flexibility, and inhibition as well as non-EF impairments in divided attention, flexibility, sustained attention and visual scanning were observed in the ADHD-I group. Conclusion: Our results do not support the traditional model of ADHD. Given that neither EF nor non-EF tests typically distinguish ADHD-I from ADHD-C, alternative methodologies are required to confirm the validity of ADHD subtypes in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.
Highlights
Executive function (EF) is an umbrella term in psychology that refers to the processes that control other cognitive processes [1]
Our findings indicate that the higher memory load task affected the attention deficit hyperactivity disorder (ADHD)-I group more than the controls
These results suggest that working memory is impaired in both ADHD-C and ADHD-I
Summary
Executive function (EF) is an umbrella term in psychology that refers to the processes that control other cognitive processes [1]. Researchers have identified four distinct domains of EF: planning, working memory, flexibility, and response inhibition [2,3,4,5,6]. A deficit in EF is postulated to account for core symptoms in psychiatric patients with no focal frontal lesions, such as those diagnosed with attention deficit hyperactivity disorder (ADHD). The Diagnostic and Statistical Manual of Mental Disorders [15] categorizes the symptoms of ADHD into three subtypes: ADHD, predominantly inattentive type (ADHD-I); ADHD, predominantly hyperactive-impulsive type (HD or ADHDH); and ADHD, combined type (ADHD-C). Barkley postulated a model of ADHD in which only ADHD-C and ADHD-H, but not ADHD-I, were associated with EF deficits [16], yet it remained unclear whether the DSM-IV inattentive subtype involved distinct deficits [17]
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