The Prevalence and Effects of Adult Attention Deficit/Hyperactivity Disorder on Work Performance in a Nationally Representative Sample of Workers

Kessler, Ronald C.; Adler, Lenard A.; Ames, Minnie; Barkley, Russell A.; Birnbaum, Howard G.; Greenberg, Paul E.; Johnston, Joseph A.; Spencer, Thomas; Üstün, T. B.

doi:10.1097/01.jom.0000166863.33541.39

Cited by 282 publications

(230 citation statements)

References 37 publications

(45 reference statements)

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“…2,3 The phenotype consists of extreme manifestations of continuous traits, including hyperactivity, impulsivity, and dysfunction in executive and self-regulatory skills that involve working memory, temporal organization, planning, organizing, maintaining focus, effort and motivation. 4,5 Brain studies of patients with ADHD have shown abnormalities in frontal-striatal and cerebellar circuitry.…”

Section: Introductionmentioning

confidence: 99%

Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes

et al. 2009

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Attention-deficit/hyperactivity disorder (ADHD) is a common and highly heritable disorder, but specific genetic factors underlying risk remain elusive. To assess the role of structural variation in ADHD, we identified 222 inherited copy number variations (CNVs) within 335 ADHD patients and their parents that were not detected in 2026 unrelated healthy individuals. Although no excess CNVs, either deletions or duplications, were found in the ADHD cohort relative to controls, the inherited rare CNV-associated gene set was significantly enriched for genes reported as candidates in studies of autism, schizophrenia and Tourette syndrome, including A2BP1, AUTS2, CNTNAP2 and IMMP2L. The ADHD CNV gene set was also significantly enriched for genes known to be important for psychological and neurological functions, including learning, behavior, synaptic transmission and central nervous system development. Four independent deletions were located within the protein tyrosine phosphatase gene, PTPRD, recently implicated as a candidate gene for restless legs syndrome, which frequently presents with ADHD. A deletion within the glutamate receptor gene, GRM5, was found in an affected parent and all three affected offspring whose ADHD phenotypes closely resembled those of the GRM5 null mouse. Together, these results suggest that rare inherited structural variations play an important role in ADHD development and indicate a set of putative candidate genes for further study in the etiology of ADHD.

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Section: Introductionmentioning

confidence: 99%

Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes

et al. 2009

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“…However, much of the driving in this population, as in most young adults, likely occurs at night and on weekends, when these individuals might be less inclined to use medication, and these are the same times in which young adults consume alcohol. To date, one study has examined the effect of an ADHD medication (methylphenidate) on driving simulator performance in individuals with ADHD (Barkley et al, 2005). The results showed that the medication improved some aspects of driving behavior measured by the simulator, but not all.…”

Section: Discussionmentioning

confidence: 99%

“…Not surprisingly, for adults with ADHD, the cognitive impairments associated with the disorder are particularly problematic in the workplace. For example, adults with ADHD have difficulty organizing job-related activities, meeting deadlines, and remembering appointments (Barkley, Fischer, Smallish, & Fletcher, 2006;Kessler, et al, 2005;Mannuzza, Klein, Bessler, Malloy, & Hynes, 1997). As such, these individuals have considerable difficulty maintaining employment.…”

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confidence: 99%

Simulated driving performance of adults with ADHD: Comparisons with alcohol intoxication.

Weafer

Camarillo

Fillmore

et al. 2008

Experimental and Clinical Psychopharmacology

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Previous research has demonstrated that adults with ADHD are more likely to experience drivingrelated problems, which suggests that they may exhibit poorer driving performance. However, direct experimental evidence of this hypothesis is limited. The current study involved two experiments that evaluated driving performance in adults with ADHD in terms of the types of driving decrements typically associated with alcohol intoxication. Experiment 1 compared the simulated driving performance of 15 adults with ADHD to 23 adult control participants, who performed the task both while sober and intoxicated. Results showed that sober adults with ADHD exhibited decrements in driving performance compared to sober controls, and that the profile of impairment for the sober ADHD group did in fact resemble that of intoxicated drivers at the BAC level for legally impaired driving in the United States. Driving impairment of the intoxicated individuals was characterized by greater deviation of lane position, faster and more abrupt steering maneuvers, and increased speed variability. Experiment 2 was a dose-challenge study in which 8 adults with ADHD and 8 controls performed the driving simulation task under three doses of alcohol: 0.65 g/kg, 0.45 g/kg, and 0.0 g/kg (placebo). Results showed that driving performance in both groups was impaired in response to alcohol, and that individuals with ADHD exhibited generally poorer driving performance than did controls across all dose conditions. Together the findings provide compelling evidence to suggest that the cognitive and behavioral deficits associated with ADHD might impair driving performance in such a manner as to resemble that of an alcohol intoxicated driver. Moreover, alcohol might impair the performance of drivers with ADHD in an additive fashion that could considerably compromise their driving skill even at blood alcohol concentrations below the legal limit.The behavioral problems associated with attention deficit/hyperactivity disorder (ADHD) in adult populations have been the focus of increased interest among researchers in recent years. Although the majority of diagnoses occur during childhood, recent studies suggest that the disorder persists into adulthood in approximately 60% to 80% of cases (e.g., Barkley, Fischer, Smallish, & Fletcher, 2002;Weiss, Hechtman, & Weiss, 1999;Wender, 1995). During childhood, the problems associated with ADHD are characterized by heightened impulsivity and impaired inhibitory and attentional mechanisms. These cognitive and behavioral problems adversely impact the child's academic performance as evident by Correspondence concerning this article should be addressed to Mark Fillmore, Ph.D., Department of Psychology, University of Kentucky, Lexington, Fax (859) ; fillmore@uky.edu. NIH Public Access NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript poor grades and disruptive classroom behavior (Frazier, Youngstrom, Glutting, & Watkins, 2007). Not surprisingly, for adults with ADHD, the cognitive impairments ...

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“…Although ADHD is classically considered a disorder of children and adolescents, only a subset of affected individuals remit Faraone et al, 2006), and the prevalence in adults lies between 1 and 4% (Kessler et al, 2006;Polanczyk et al, 2007;Kooij et al, 2005). ADHD in adults causes a considerable burden to patients, their families, and society as a whole (Kessler et al, 2005a;Goodman, 2007;Bernfort et al, 2008). Adult patients have difficulties in social, educational, and professional fields, such as developing and maintaining stable social relationships, completing educational programs, and holding jobs.…”

Section: Introductionmentioning

confidence: 99%

Multicenter Analysis of the SLC6A3/DAT1 VNTR Haplotype in Persistent ADHD Suggests Differential Involvement of the Gene in Childhood and Persistent ADHD

Franke

Vásquez

Johansson

et al. 2009

Neuropsychopharmacol

168

156

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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neuropsychiatric disorders with a worldwide prevalence around 4-5% in children and 1-4% in adults. Although ADHD is highly heritable and familial risk may contribute most strongly to the persistent form of the disorder, there are few studies on the genetics of ADHD in adults. In this paper, we present the first results of the International Multicentre Persistent ADHD Genetics CollaboraTion (IMpACT) that has been set up with the goal of performing research into the genetics of persistent ADHD. In this study, we carried out a combined analysis as well as a meta-analysis of the association of the SLC6A3/DAT1 gene with persistent ADHD in 1440 patients and 1769 controls from IMpACT and an earlier report. DAT1, encoding the dopamine transporter, is one of the most frequently studied genes in ADHD, though results have been inconsistent. A variable number tandem repeat polymorphism (VNTR) in the 3 0 -untranslated region (UTR) of the gene and, more recently, a haplotype of this VNTR with another VNTR in intron 8 have been the target of most studies. Although the 10/10 genotype of the 3 0 -UTR VNTR and the 10-6 haplotype of the two VNTRs are thought to be risk factors for ADHD in children, we found the 9/9 genotype and the 9-6 haplotype associated with persistent ADHD. In conclusion, a differential association of DAT1 with ADHD in children and in adults might help explain the inconsistencies observed in earlier association studies. However, the data might also imply that DAT1 has a modulatory rather than causative role in ADHD.

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The Prevalence and Effects of Adult Attention Deficit/Hyperactivity Disorder on Work Performance in a Nationally Representative Sample of Workers

Abstract: ADHD is a common and costly workplace condition. Effectiveness trials are needed to estimate the region of interest of workplace ADHD screening and treatment programs.

Cited by 282 publications

References 37 publications

Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes

Rare structural variants found in attention-deficit hyperactivity disorder are preferentially associated with neurodevelopmental genes

Simulated driving performance of adults with ADHD: Comparisons with alcohol intoxication.

Multicenter Analysis of the SLC6A3/DAT1 VNTR Haplotype in Persistent ADHD Suggests Differential Involvement of the Gene in Childhood and Persistent ADHD

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