Set-Shifting in Adults with ADHD

AbstractDifficulties related to inhibition and set-shifting have been suggested as possible endophenotypes of Attention Deficit Hyperactivity Disorder (ADHD). However, such difficulties have not been consistently found in studies using standard neuropsychological tests. This has been partly explained by the complexity of these tests and the need to include contrast measures which control for more basic functions. The purpose of the present study was to examine whether difficulties related to inhibition and set-shifting in adult ADHD patients could be revealed by the Color Word Interference Test (CWIT) from the Delis Kaplan Executive Function System (D-KEFS). A clinically recruited group of adults with ADHD (n = 60) obtained significantly lower scores than population derived controls (n = 60) on both primary summary (p < .001) and contrast measures (p = .004) of set-shifting. The differences between the groups remained statistically significant after controlling for intellectual function and working memory (p = .003). However, no significant differences between the groups were observed on any measure of inhibition. The study indicates that adults with ADHD have specific difficulties with set-shifting as measured by the CWIT, difficulties that probably also reflect problems related to executive function in their daily life. (JINS, 2012, 18, 1–10)

Download Full-text

Samuel, D.B. & Ranseen, J.R. (2006, October). Stimulant medication’s effects on adult ADHD symptoms and NEO PI-R personality traits

10.31234/osf.io/6drtx ◽

2018 ◽

Author(s):

Douglas Samuel ◽

John D. Ranseen

Keyword(s):

Personality Traits ◽

Neuropsychological Tests ◽

Adult Adhd ◽

Self Report ◽

Emotional States ◽

Limited Information ◽

Stimulant Treatment ◽

Hyperactivity Disorder ◽

Dsm Iv ◽

Adhd Symptomatology

Previous studies have indicated a consistent profile of basic personality traits correlated with adult Attention Deficit Hyperactivity Disorder (ADHD) (e.g., Ranseen, Campbell, & Baer, 1998; Nigg et al., 2002). In particular, research has found that low scores of the Conscientiousness trait and high scores on Neuroticism have been correlated with ADHD symptomatology. However, to date there is limited information concerning the range of effect resulting from medication treatment for adult ADHD. During an 18 month period, 60 adults were diagnosed with ADHD based on strict, DSM-IV criteria at an outpatient clinic. This evaluation included a battery of neuropsychological tests and a measure of general personality (i.e., the NEO PI-R). Eleven of these participants returned to complete the battery a second time. The pre-post comparisons revealed significant changes following sustained stimulant treatment on both the neuropsychological and self-report measures. These individuals also displayed significant changes on two domains of the NEO PI-R. They showed a significant decrease on the domain of Neuroticism, indicating that now see themselves as less prone to experience negative emotional states such as anxiety and depression. Additionally, they also reported a significant increase on their scores on the domain of conscientiousness. This increase suggests that they see themselves as more organized and dependable.

Download Full-text

Basic and complex cognitive functions in Adult ADHD

PLoS ONE ◽

10.1371/journal.pone.0256228 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0256228

Author(s):

Saleh M. H. Mohamed ◽

Marah Butzbach ◽

Anselm B. M Fuermaier ◽

Matthias Weisbrod ◽

Steffen Aschenbrenner ◽

...

Keyword(s):

Working Memory ◽

Selective Attention ◽

Cognitive Flexibility ◽

Processing Speed ◽

Cognitive Functions ◽

Neuropsychological Tests ◽

Adult Adhd ◽

Verbal Learning ◽

Test Word ◽

Basic Functions

Background Many clinical studies reported deficits in basic and complex cognitive functions in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the extent in which deficits in basic functions (i.e., processing speed and distractibility) contribute to complex cognitive impairments (i.e., working memory, planning, cognitive flexibility, memory functions) in adults with ADHD is not well-studied. So far, literature show only one study, revealing that basic functions explain 27–74% of executive dysfunctions. Yet, the authors reported that findings could be affected by the selection of neuropsychological tests. The goal of the present research is to replicate such a finding using a different sample and a different set of neuropsychological tests. Methods Forty-eight adult patients with ADHD were compared with 48 healthy controls in basic cognitive functions, namely processing speed and distractibility and more complex cognitive functions, namely selective attention, cognitive flexibility, planning, working memory, verbal fluency, and verbal memory. Basic and complex cognitive functions were assessed using the Vigilance and Sustained Attention, Selective Attention, N-Back, Tower of London, Trail Making Test, Word Fluency, and Verbal Learning and Memory. Results and conclusion Logistic regression analyses showed that impairments in complex cognitive functions explained 25% of the variance in ADHD diagnosis. The explained variance dropped from 25% to 9% after considering basic functions of processing speed and distractibility. This 64% reduction highlights the importance of basic functions for impairments in complex functions in patients with ADHD.

Download Full-text

A-042 Incongruence Between Self- and Parent- Report Measures of Executive Function on the Behavior Rating Inventory of Executive Function (BRIEF) in Adolescents with Attention Deficit Hyperactivity Disorder

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.042 ◽

2020 ◽

Vol 35 (6) ◽

pp. 832-832

Author(s):

Garagozzo A ◽

Hunter S ◽

Smith D

Keyword(s):

Executive Function ◽

Interrater Reliability ◽

Color Word ◽

Executive Dysfunction ◽

Parent Report ◽

Self Report ◽

Clinical Database ◽

Hyperactivity Disorder ◽

Behavior Rating Inventory ◽

The Relationship

Abstract Objective Research has demonstrated that adolescents with ADHD show executive dysfunction, although they do not always endorse such difficulties. We investigated inter-rater agreement between parent- and self-reported executive function (EF) in adolescents with ADHD, using the BRIEF. We also sought to investigate the relationship between scores on parent and self-report EF measures with performance on objective EF measures. Method Utilizing a clinical database, we identified 75 participants (13-17 years; Mage = 14.9; 60% male; 27% African American, 63% White, 3% Hispanic, 7% Other) with a diagnosis of ADHD. We examined inter-rater reliability between parent and self-reported factors on the BRIEF. We then examined the association between parent and self-report BRIEF Inhibition scores and the D-KEFS Color Word Interference (CWI) Inhibition trial, and parent and self-report BRIEF Shift scores and the D-KEFS CWI Inhibition/Switching trial and Trails Letter Number Sequencing trial. Results Significant associations were found between parent and self-ratings on BRIEF Inhibition (ICC = .22; 95% CI = -.24-.50), Shift (ICC = .24; 95% CI = -.21-.52), Emotional Control (ICC = .45, 95% CI = .137-.655), Plan/Organize (ICC = -.143; 95% CI = -.81–28), and Working Memory (ICC = -.193; 95% CI = -.89-.25) subscales. Correlation comparisons were significant for BRIEF self-report Inhibition and CWI Inhibition (r(73) = −.405, p = .000) only. Conclusion Results support standing findings regarding poor interrater reliability between parent and self-ratings of daily executive functioning in adolescents with ADHD. Self-report was seen to correlate with performance on objective EF tasks. Clinically, these results highlight the need for multidimensional assessment of ADHD in adolescents.

Download Full-text

A-219 Cross-validation of a Delis-Kaplan Executive Function System Color Word Interference Test embedded performance validity test

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa068.219 ◽

2020 ◽

Vol 35 (6) ◽

pp. 1014-1014

Author(s):

Schroeder R ◽

Clark H ◽

Martin P

Keyword(s):

Executive Function ◽

Operating Characteristic ◽

Color Word ◽

Characteristic Curve ◽

Area Under The Curve ◽

Function System ◽

Performance Validity ◽

Validity Test ◽

Interference Test ◽

Neuropsychological Evaluations

Abstract Objective Eglit and colleagues (2019) found that the sum of the four age-corrected scaled scores from the Color Word Interference Test (CWIT) of the Delis-Kaplan Executive Function System (D-KEFS) could act as a useful embedded performance validity test (PVT). As such, we attempted to cross-validate their findings. Method Patients included 312 individuals who completed neuropsychological evaluations. Individuals were excluded if they were not administered CWIT, were not administered at least 4 criterion PVTs, had diagnoses of dementia or intellectual disability, or had indeterminate validity results (i.e., failure of one PVT). Valid performers (n = 231) were those who passed all criterion PVTs while invalid performers (n = 81) failed two or more criterion PVTs. A receiver operating characteristic curve was conducted for the CWIT embedded PVT. Results Area under the curve (AUC) was .804. At a cutoff of < 26, specificity was 90% and sensitivity was 48%. At a cutoff of < 20 (the first cutoff at which 90% specificity was found by Eglit et al.), specificity was 95% and sensitivity was 32%. At an even more conservative cutoff of < 18 (the cutoff recommended by Eglit et al.), specificity was 96% and sensitivity was 22%. Conclusions These results cross-validate Eglit et al.’s findings, indicating that the sum of age-corrected scaled scores across the four CWIT trials can effectively serve as an embedded PVT. A more liberal cutoff was able to be applied in our sample but, even at conservative cutoffs documented in Eglit et al., sensitivity rates were adequate enough to warrant use of the index as an embedded PVT.

Download Full-text

Mixed Amphetamine Salts Extended Release for the Treatment of ADHD

CNS Spectrums ◽

10.1017/s1092852900002388 ◽

2005 ◽

Vol 10 (S20) ◽

pp. 5-5

Author(s):

Joseph Biederman

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Executive Function ◽

Attention Deficit ◽

Adult Adhd ◽

Extended Release ◽

Pharmacologic Treatment ◽

First Line ◽

Safety And Efficacy ◽

Hyperactivity Disorder ◽

Adolescents And Adults

Attention-deficit/hyperactivity disorder (ADHD) is widely recognized as one of the most common psychiatric disorders initially diagnosed and treated in childhood; however, it is less widely recognized as a disorder that often persists into adolescence and adulthood. In recent years, there has been increased awareness that adult ADHD is marked by significant impulsivity and impairments of attention and executive function, symptoms that can be linked to, personal, social, and professional dysfunction. Clinicians are increasingly recognizing adult ADHD as a disorder linked to considerable dysfunction and distress, warranting appropriate pharmacologic treatment.Psychostimulants, such as amphetamines and methylphenidate, are recommended as first-line pharmacotherapeutic agents for the management of ADHD in children, adolescents, and adults. Because most research on psychostimulant use has involved pediatric ADHD patients, little is known about the safety and efficacy of these agents in adult ADHD.

Download Full-text

Attenuated Readiness Potential in the Absence of Executive Dysfunction in Adults With ADHD

Journal of Attention Disorders ◽

10.1177/1087054713508602 ◽

2016 ◽

Vol 21 (4) ◽

pp. 331-342 ◽

Cited By ~ 2

Author(s):

Bo-Kyung Seo ◽

Gudrun Sartory ◽

Bernhard Kis ◽

Norbert Scherbaum ◽

Bernhard W. Müller

Keyword(s):

Executive Function ◽

Neuropsychological Tests ◽

Adult Adhd ◽

Motor Planning ◽

Executive Dysfunction ◽

Readiness Potential ◽

Group Differences ◽

Healthy Controls ◽

Significant Group ◽

Verbal Iq

Objective: Patients with ADHD display a decreased contingent negative variation in Go/NoGo tasks. It is unclear whether the attenuation is due to deficits of executive function or to disorder of motor planning. The readiness potential (RP) recorded during self-initiated movements could cast light on this question. Method: RP was recorded in 25 stably medicated adult ADHD patients and 21 healthy controls matched for age, education, and verbal IQ. Participants also completed neuropsychological tests of executive function. Results: Compared with healthy controls, ADHD patients showed significantly diminished RP peaks and also decreased negativity in preparation of the movement at frontal locations. There were no significant group differences with regard to tests of executive function. Conclusion: In adults with ADHD, deficits of motor organization are also manifest in situations not involving external stimulus processing. The attenuated RP occurred in the absence of executive dysfunction. Results are consistent with partial independence between motor and executive dysfunction in ADHD.

Download Full-text

Neuropsychological Functioning and Psychosocial Outcome in Adults with Attention-Deficit/ Hyperactivity Disorder

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000129 ◽

2015 ◽

Vol 26 (1) ◽

pp. 17-26 ◽

Cited By ~ 4

Author(s):

Esther Sobanski ◽

Alexandra Sirtl ◽

Barbara Alm ◽

Oliver Hennig ◽

Tobias Banaschewski

Keyword(s):

Psychosocial Functioning ◽

Neuropsychological Tests ◽

Adult Adhd ◽

Clinical Sample ◽

Neuropsychological Functioning ◽

Neuropsychological Impairment ◽

Adhd Symptoms ◽

Global Assessment Of Functioning ◽

Psychosocial Impairment ◽

Hyperactivity Disorder

This study explores the association of neuropsychological functioning with ADHD-symptoms and psychosocial functioning in a clinical sample of 131 adults with ADHD. Neuropsychological functioning was assessed with the computerized Test Battery of Attentional Performance (TAP). Overall psychosocial impairment was assessed with the Global Assessment of Functioning Scale (GAF). Neuropsychological performance was impaired in 39.6 % of the ADHD-patients meeting a predefined impairment criterion of a perfomance reduction of 1.5 standard deviations below normative controls in ≥ 2 TAP-subtests; 28.4 % of the patients showed regular performance in all neuropsychological tests. Severity of neuropsychological impairment was inversely correlated to severity of psychosocial impairment (GAF score; = -.24, p < .001) but not to childhood or adult ADHD symptoms. Overall severity of neuropsychological impairment explained 10 % (p < .05) of variance of psychosocial impairment.

Download Full-text

Do ADHD Symptoms, Executive Function, and Study Strategies Predict Temporal Reward Discounting in College Students with Varying Levels of ADHD Symptoms? A Pilot Study

Brain Sciences ◽

10.3390/brainsci11020181 ◽

2021 ◽

Vol 11 (2) ◽

pp. 181

Author(s):

Anouk Scheres ◽

Mary V. Solanto

Keyword(s):

College Students ◽

Executive Function ◽

Daily Life ◽

Temporal Discounting ◽

Study Strategies ◽

Adhd Symptoms ◽

Hyperactivity Disorder ◽

Life Challenges ◽

Students With Adhd ◽

Learning And Study Strategies

The purpose of this study was to examine the relationship between temporal reward discounting and attention deficit hyperactivity disorder (ADHD) symptoms in college students. Additionally, we examined whether temporal reward discounting was associated with executive functioning in daily life and with learning and study strategies in this group. Thirty-nine college students (19 with ADHD and 20 controls) participated after meeting criteria for ADHD or non-ADHD based on standardized assessment. Strong preferences for small immediate rewards were specifically associated with the ADHD symptom domain hyperactivity–impulsivity. Additionally, these preferences were associated with daily life executive function problems and with weak learning and study strategies. This suggests that steep temporal discounting may be a key mechanism playing a role in the daily life challenges that college students with ADHD symptoms face. If these findings are replicated in larger samples, then intervention strategies may profitably be developed to counteract this strong preference for small immediate rewards in college students with ADHD symptoms.

Download Full-text