Executive functioning in adult ADHD: a meta-analytic review

Abstract

Background. Several theoretical explanations of ADHD in children have focused on executive functioning as the main explanatory neuropsychological domain for the disorder. In order to establish if these theoretical accounts are supported by research data for adults with ADHD, we compared neuropsychological executive functioning and non-executive functioning between adults with ADHD and normal controls in a meta-analytic design.

Effects of subtype of attention-deficit/hyperactivity disorder in adults on lateralized readiness potentials during a go/no-go choice reaction time task.

“…Similarly, the excessive inhibition failures and normal RTs in the ADHD/combined sample resemble past findings (Boonstra et al, 2005;Lijffijt, Kenemans, Verbaten, & van Engeland, 2005) for samples composed entirely or partly of adults with the ADHD/combined subtype.…”

Effects of methylphenidate on memory functions of adults with ADHD

“…The time in seconds to complete each trial was registered. As dependent variable, a difference score was calculated by subtracting the time needed for completion of the Color Block condition from the Color-Word Interference condition (Boonstra et al, 2005).…”

“…A clinical evaluation of symptoms and impairments of patients with ADHD benefits from an objective assessment of neuropsychological functions using standardized psychometric tests. Most theories on neuropsychological functions of adults with ADHD proposed a primary deficit of inhibitory executive functions (Barkley, 1997;Castellanos, Sonuga-Barke, Milham, & Tannock, 2006;Tannock, 1998) which resulted in a large body of research examining various functions associated with executive control, including focused attention, divided attention, vigilance, working memory, inhibition, set-shifting, verbal fluency, and problem solving (Boonstra, Kooij, Oosterlaan, Sergeant, & Buitelaar, 2010;Boonstra, Oosterlaan, Sergeant, & Buitelaar, 2005;Dinn, Robbins, & Harris, 2011;Fuermaier et al, 2015;Hervey, Epstein, & Curry, 2004;Lange et al, 2014;Schoechlin & Engel, 2005;O. Tucha et al, 2005, L. Tucha et al, 2008, 2009.…”

Executive function assessment and adult attention-deficit/hyperactivity disorder: Tasks versus ratings on the Barkley Deficits in Executive Functioning Scale.

“…First, the predictive validity of individual-level impairments on any one task for determining diagnosis has been poor (Barkley & Fischer, 2011;Boonstra et al, 2005;Schoechlin & Engel, 2005). For example, Barkley and Fischer (2011) found that EF tasks shared less than 4% of the variance with ADHD symptom severity, indicating that performance on EF tasks did not significantly predict the severity of ADHD symptoms and therefore might not be a valid indicator for identifying ADHD.…”

“…However, results have been inconsistent, as other work has failed to find any EF deficits among adults with ADHD (Johnson et al, 2001;Weyandt, Linterman, & Rice, 1995). In fact, one study estimated that only about 30% of adults diagnosed with ADHD appear to have EF deficits when measured by performance-based tasks (Brown, 2006), and the predictive validity of EF performance on any one task appears to be poor (Boonstra, Oosterlaan, Sergeant, & Buitelaar, 2005). Several factors may account for these disparate results regarding the role of EF deficits in adult ADHD, including IQ (Antshel et al, 2010;Jung, Yeo, Chiulli, Sibbitt, & Brooks, 2000;Mahone et al, 2002) and methodological inconsistencies across studies (e.g., size of battery and domains assessed; see Woods, Lovejoy, & Ball, 2002).…”