Executive functions in girls with and without childhood ADHD: developmental trajectories and associations with symptom change

Abstract

Background We prospectively followed an ethnically and socioeconomically diverse sample of girls with ADHD (n = 140) and a matched comparison sample (n = 88) from childhood through young adulthood to evaluate developmental trajectories of executive functions (EF) and associations between EF trajectories and dimensional measures of ADHD symptoms. We hypothesized that (a) EF trajectories would be similar in girls both with and without childhood ADHD, with the ADHD group showing greater impairment across time; and (b) changes in EF abilities would predict changes in ADHD symptoms across time, consistent with the theory that ADHD symptom reductions partially result from prefrontally-mediated EF development. Method Latent growth curve models were used to evaluate development of sustained attention, response inhibition, working memory, and global EF abilities, and associations between EF trajectories and ADHD symptom trajectories. Results Girls with childhood-diagnosed ADHD showed greater improvement across development on measures of sustained attention and global EF, but similar rates of improvement on measures of working memory and response inhibition. Changes in the global EF measure predicted changes in both inattentive and hyperactive-impulsive symptoms across time, whereas changes in response inhibition predicted changes in hyperactive-impulsive symptoms; associations between changes in other EF variables and symptoms were not significant. Conclusions Findings suggest variability in patterns of EF improvement over time in females with ADHD histories and indicate that EF development may play a role in symptom change.

Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change.

“…Vaughn et al (2011) found that improvements on continuous performance test variables (omissions, commissions, reaction time measures) were not related to changes in dimensional measures of ADHD symptoms over one year in middle childhood, again consistent with liability model although covering a relatively brief developmental window of one year. Consistent with the Biederman et al (2009) results, Miller et al (2013) found no relationships between verbal working memory and symptom change in their longitudinal sample of girls with ADHD assessed at three time points spaced 5-years apart between childhood and young adulthood. However, in contrast to prior findings from both Biederman et al (2009) and Vaughn et al (2011), improvements in global executive functioning and commission errors on the CPT did predict improvement in ADHD symptoms over time, implicating cognitive maturation in symptom remission.…”

Executive Function in Children and Adolescents with Critical Cyanotic Congenital Heart Disease

“…Significant factors for each respective EF outcome source were included as covariates in primary analyses. Consistent with the rationale proposed by Dennis et al (2009), IQ was not included as a covariate in any analysis (see also Miller, Loya, & Hinshaw, 2013). …”

Attention-Deficit/Hyperactivity Disorder, Trait Impulsivity, and Externalizing Behavior in a Longitudinal Sample

“…One challenge with the DSM is that only 3 out of the 9 HI symptoms are related to impulsivity. Although ADHD-related symptoms (especially HI) decrease over time (Barkley, 2014; Faraone et al, 2006), space limitations precluded analysis of the continuity of IA and HI symptoms into adolescence and early adulthood (see, for example, Hinshaw et al, 2012; Miller, Loya, & Hinshaw, 2013; Owens & Hinshaw, 2016). Next, in order to follow developmentally appropriate measurement strategies, we used parent and teacher reports to index externalizing behavior prior to adulthood, but parent and self-reports for the W3 externalizing outcomes.…”