Subclinical Scores in Self-Report Based Screening Tools for Attention Deficits Correlate With Cognitive Traits in Typical Evening-Type Adults Tested in the Morning.

Maria Korman,Avi Karni,Rinatia Maaravi-Hesseg,Ishay Levy,Adi Eshed-Mantel

doi:10.3389/fpsyg.2019.01397

Maria Korman, Avi Karni + Show 3 more

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https://doi.org/10.3389/fpsyg.2019.01397

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Abstract

Previous studies suggest that in adolescents and young adults, evening chronotype is a subclinical factor in physical, cognitive, and psychiatric fitness; poor sleep habits and larger misalignment with the social schedule constraints may exacerbate symptoms of inattention, impulsivity and the risks for detrimental behaviors. The influence of chronotype on neurocognitive performance during morning hours and scores in self-reports about attention deficit symptoms (ADS) and executive functioning, was explored in 42 healthy young university students (29 women), divided to evening type (ET) and combined morning/intermediate type (MT/IT) groups. Evening chronotypes scored significantly higher in the questionnaires of inattention Adult ADHD Self-Report Scale (ASRS-6) (MT/IT: 1.62 ± 1.59; ET: 2.71 ± 1.62, p < 0.05) and day-time sleepiness Epworth scale (MT/IT: 7.19 ± 5.17; ET: 11.48 ± 5.26, p < 0.01), reported lower subjective alertness (MT/IT: 63.02 ± 21.40; ET: 40.76 ± 17.43, p < 0.001), and had slower reaction times (MT/IT: 321.47 ± 76.81; ET: 358.94 ± 75.16, p < 0.05) during tests, compared to non-evening chronotypes. Nevertheless, ETs did not significantly differ in self-reports of executive functioning in the Behavioral Rating Inventory of Executive Functions-A (BRIEF-A) from non-ETs. The scores on standard self-report screening tools for ADS and executive functioning (ASRS-6, BRIEF-A-Metacognition) correlated with eveningness. We conclude that eveningness, subjective sleepiness and low arousal levels during morning can present as subclinical Attention Deficit and Hyperactivity Disorder (ADHD) symptoms in typical young adults with no evident sleep problems. Self-report based screening tools for ADS and executive functioning reflect chronotype-related traits in healthy young adults. Strong eveningness may bias the results of neurocognitive performance screening for ADHD when administered at morning hours.

Highlights

Circadian rhythms exhibit a high inter-individual variability and are classified to three main types along a continuum from morningness to eveningness, based on the preferred timing of sleep-wake activity (Horne and Ostberg, 1976; Adan et al, 2012): morning type (MT), intermediated type (IT), and evening type (ET)
In the morning/intermediate type (MT/IT) group 1/21, in the ET group 3/21 participants had a score > 4 with all other participants scoring below the clinical threshold on the adult ADHD self-report scale (ASRS-6)
The current exploratory study investigated in young healthy adults the influence of chronotype on neurocognitive performance during morning hours and scores in self-reports about attention deficit symptoms (ADS) and executive functioning

Summary

Introduction

Circadian rhythms exhibit a high inter-individual variability and are classified to three main types along a continuum from morningness to eveningness, based on the preferred timing of sleep-wake activity (Horne and Ostberg, 1976; Adan et al, 2012): MT, IT, and ET. MTs tend to reach their best performance levels in the morning, while ITs and ETs in the afternoon, a “synchrony effect” (Adan et al, 2012). This effect was suggested to be explained by the co-occurrence of peaks in alertness, core body temperature, and arousal

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