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RESEARCH PRODUCT

Empirical examination of executive functioning, ADHD associated behaviors, and functional impairments in adults with persistent ADHD, remittent ADHD, and without ADHD

Jose Martinez-ragaÁLvaro MiraCarmen BerenguerAna MirandaInmaculada BaixauliBelén Roselló

subject

AdultPersistence (psychology)Multivariate analysislcsh:RC435-571Remissionbehavioral disciplines and activitiesStructural equation modelingAttention deficit hyperactivity disorderPersistenceExecutive Function03 medical and health sciences0302 clinical medicinelcsh:Psychiatrymental disordersmedicineHumansAttention deficit hyperactivity disorderAttention0501 psychology and cognitive sciencesAffective SymptomsPsiquiatriaChildPractical implicationsWorking memory05 social sciencesFunctional impairmentsExecutive functionsmedicine.disease030227 psychiatryPsychiatry and Mental healthMemory Short-TermEmpirical examinationAttention Deficit Disorder with HyperactivityExecutive functioningPsychologyResearch Article050104 developmental & child psychologyClinical psychology

description

Abstract Background Previous 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. Methods Participants 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). Results The 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. Conclusions The 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.

yearjournalcountryeditionlanguage
2019-08-12BMC Psychiatry
https://doi.org/10.1186/s12888-020-02542-y