Abstract
Objectives. The aim of this study was to compare the cognitive neuropsychological and the behavioral rating profiles of attention deficit/hyperactivity disorder (ADHD). Methods. Forty-two children diagnosed with ADHD (M=11.5 years, SD=1.1) and 43 typically developing children (M=11.2 years, SD=1.7) participated. We measured symptom severity with behavioral rating scales, and we administered neuropsychological tasks to measure inhibitory performance, updating/working memory, and shifting ability. Results. On the basis of the three neuropsychological variables, the hierarchical cluster analytic method yielded a six-cluster structure. The clusters, according to the severity of the impairment, were labeled as follows: none or few symptoms, Moderate inhibition and mild shifting, moderate to severe shifting with moderate updating, moderate updating, severe updating with mild shifting, and severe updating with severe shifting. There were no systematic differences in inattention and hyperactive-impulsive behavior across the clusters. The comorbid learning disorder appeared more likely only in severe neuropsychological forms of ADHD. Conclusion. In sum, our results suggest that behavioral ratings and neuropsychological profiles converge only in the dimension of symptom severity and that atypicalities in executive functions may manifest in nonspecific everyday problems.
Highlights
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent psychiatric disorders affecting approximately 5% of children [1, 2]
Members of the ADHD group were significantly older than those in the typically developing (TD) group, t(195) = −7.64, P < .001; by this reason we tested the effect of age on cluster structure
The Silhouette coefficient
Summary
Attention deficit/hyperactivity disorder (ADHD) is one of the most frequent psychiatric disorders affecting approximately 5% of children [1, 2]. The diagnosis of ADHD (DSM-5; [4]) is mostly based on clinical observations, parental (and rarely teacher) interviews, or rating scales, but the neuropsychological information is often missing from the protocol [5]. In order to develop a sufficient treatment plan, it is necessary to evaluate various impairments— including cognitive deficits in attention, executive functions (EF), and memory—affecting day-to-day functioning, and to determine the presence of any deficiency in adaptive skills and key competences. To point at this shortcoming of the diagnostic protocol, the aim of this study was to compare the cognitive neuropsychological and the behavioral rating profiles of ADHD
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