Executive functioning in adults with attention deficit hyperactivity disorder: A systematic review

Abstract

Introduction: Executive function deficits are associated with attention deficit hyperactivity disorder (ADHD) in both children and adults. The inattentive subtype is primary related to “cold” executive functions, while the hyperactive subtype is related to “warm” executive functions. Objective: To systematically review studies on executive functioning in adults with attention deficit hyperactivity disorder published during the last decade. Methodology: A documentary research was conducted, encompassing 33 articles retrieved from PubMed, Web of Science and EBSCO platforms. The analysis considered years and countries of publication, attention deficit hyperactivity disorder diagnostic criteria, participants, comorbidities, subtypes, medication use, assessment tools, and processes of executive functions evaluated. Results: It was evidenced that there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests. However, the results varied depending on specific characteristics of the study and/or participants, which confirms the heterogeneity of the disorder. In addition, the main instruments for measuring executive functions and diagnostic criteria for adult attention deficit hyperactivity disorder were identified. Discussion: These results support the established links between attention deficit hyperactivity disorder , impaired executive functions, and major life activities found in the adult attention deficit hyperactivity disorder literature. However, some of the limitations were the poorly controlled variables such as comorbidities, attention deficit hyperactivity disorder subtypes that were not assessed, and usage of instruments that measure executive functions that can lead to reduced credibility of the results presented here. Conclusions: According to the results presented, there is a high percentage of adults with attention deficit hyperactivity disorder who present a deficit or lower performance in executive function tests, compared to both neurotypical adults and those with other psychiatric disorders. Further research is recommended to continue studies on the topic and to include other variables.