Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-10T16:55:30.250Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological functions among adolescents with persistent, subsyndromal and remitted attention deficit hyperactivity disorder

Published online by Cambridge University Press:  27 September 2013

Y. J. Lin ,
W. J. Chen  and
S. S. Gau
Y. J. Lin
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Department of Psychiatry, Far Eastern Memorial Hospital, Taipei, Taiwan Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
W. J. Chen
Affiliation:
Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
S. S. Gau*
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Department of Psychology, School of Occupational Therapy, Graduate Institute of Clinical Medicine, and Graduate Institute of Brain and Mind Sciences, National Taiwan University, Taipei, Taiwan
*
* Address for correspondence: S. S. Gau, M.D., Ph.D., Department of Psychiatry, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei 10002, Taiwan. (Email: gaushufe@ntu.edu.tw)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Previous studies have reported mixed results on neuropsychological deficits in attention deficit hyperactivity disorder (ADHD) and only a few studies have focused on adolescents. There is also a debate about whether the executive function (EF) impairments in ADHD are primary deficits or have some contribution from the underlying non-EF processes. The aim of this study was to investigate the impairments in EF and neuropsychological function with relatively low executive demand (low-EF) in adolescents with childhood diagnosis of ADHD as a function of current ADHD status.

Method

Psychiatric diagnostic interviews and computerized neuropsychological tests classified into EF and low-EF tasks were completed by 435 adolescents with a childhood diagnosis of ADHD (300 adolescents classified as persistent ADHD, 109 as subsyndromal ADHD and 26 as remitted ADHD based on the current diagnosis) and 263 typically developing (TD) adolescents.

Results

There were significant EF (spatial working memory, spatial planning and verbal working memory) and low-EF (signal detectability, spatial span and visual recognition memory) impairments in persistent and subsyndromal ADHD. The impairments in EF were independent of low-EF despite significant moderate correlations between any two of these tasks. Adolescents with remitted ADHD showed no deficit in either EF or low-EF.

Conclusions

This study suggests that adolescents with persistent and subsyndromal ADHD have EF and low-EF impairments that might contribute to ADHD independently.

Keywords

Adolescentsattention deficit hyperactivity disorderneuropsychological functioningpersistenceworking memory
Type
Original Articles
Information
Psychological Medicine , Volume 44 , Issue 8 , June 2014 , pp. 1765 - 1777
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baddeley, A (2003). Working memory: looking back and looking forward. Nature Reviews Neuroscience 4, 829–839.Google Scholar
Barkley, RA, Edwards, G, Laneri, M, Fletcher, K, Metevia, L (2001). Executive functioning, temporal discounting, and sense of time in adolescents with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). Jouranl of Abnormal Child Psychology 29, 541–556.Google Scholar
Barkley, RA, Fischer, M, Edelbrock, CS, Smallish, L (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry 29, 546–587.Google Scholar
Barkley, RA, Fischer, M, Smallish, L, Fletcher, K (2006). Young adult outcome of hyperactive children: adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry 45, 192–202.Google Scholar
Biederman, J, Faraone, S, Milberger, S, Guite, J, Mick, E, Chen, L, Mennin, D, Marrs, A, Ouellette, C, Moore, P, Spencer, T, Norman, D, Wilens, T, Kraus, I, Perrin, J (1996). A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Archives of General Psychiatry 53, 437–446.Google Scholar
Biederman, J, Mick, E, Faraone, SV (2000). Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. American Journal of Psychiatry 157, 816–818.Google Scholar
Biederman, J, Petty, CR, Ball, SW, Fried, R, Doyle, AE, Cohen, D, Henderson, C, Faraone, SV (2009). Are cognitive deficits in attention deficit/hyperactivity disorder related to the course of the disorder? A prospective controlled follow-up study of grown up boys with persistent and remitting course. Psychiatry Research 170, 177–182.CrossRefGoogle Scholar
Biederman, J, Petty, CR, Evans, M, Small, J, Faraone, SV (2010). How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD. Psychiatry Research 177, 299–304.Google Scholar
Castellanos, FX, Sonuga-Barke, EJ, Milham, MP, Tannock, R (2006). Characterizing cognition in ADHD: beyond executive dysfunction. Trends in Cognitive Sciences 10, 117–123.Google Scholar
Chen, WJ, Hsiao, CK, Lin, CC (1997). Schizotypy in community samples: the three-factor structure and correlation with sustained attention. Journal of Abnormal Psychology 106, 649–654.Google Scholar
Clark, C, Prior, M, Kinsella, G (2002). The relationship between executive function abilities, adaptive behaviour, and academic achievement in children with externalising behaviour problems. Journal of Child Psychology and Psychiatry, and Allied Disciplines 43, 785–796.Google Scholar
Coghill, DR, Rhodes, SM, Matthews, K (2007). The neuropsychological effects of chronic methylphenidate on drug-naive boys with attention-deficit/hyperactivity disorder. Biological Psychiatry 62, 954–962.Google Scholar
Epstein, JN, Conners, CK, Hervey, AS, Tonev, ST, Arnold, LE, Abikoff, HB, Elliott, G, Greenhill, LL, Hechtman, L, Hoagwood, K, Hinshaw, SP, Hoza, B, Jensen, PS, March, JS, Newcorn, JH, Pelham, WE, Severe, JB, Swanson, JM, Wells, K, Vitiello, B, Wigal, T (2006). Assessing medication effects in the MTA study using neuropsychological outcomes. Journal of Child Psychology and Psychiatry, and Allied Disciplines 47, 446–456.Google Scholar
Fischer, M, Barkley, RA, Edelbrock, CS, Smallish, L (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. Journal of Consulting and Clinical Psychology 58, 580–588.Google Scholar
Fischer, M, Barkley, RA, Smallish, L, Fletcher, K (2005). Executive functioning in hyperactive children as young adults: attention, inhibition, response perseveration, and the impact of comorbidity. Developmental Neuropsychology 27, 107–133.Google Scholar
Frazier, TW, Demaree, HA, Youngstrom, EA (2004). Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology 18, 543–555.Google Scholar
Fuster, JM (2002). Frontal lobe and cognitive development. Journal of Neurocytology 31, 373–385.Google Scholar
Gau, SS, Chiang, HL (2009). Sleep problems and disorders among adolescents with persistent and subthreshold attention-deficit/hyperactivity disorders. Sleep 32, 671–679.Google Scholar
Gau, SS, Chiang, HL (2013). Association between early attention-deficit/hyperactivity symptoms and current verbal and visuo-spatial short-term memory. Research in Developmental Disabilities 34, 710–720.CrossRefGoogle ScholarPubMed
Gau, SS, Chiu, CD, Shang, CY, Cheng, AT, Soong, WT (2009). Executive function in adolescence among children with attention-deficit/hyperactivity disorder in Taiwan. Journal of Developmental and Behavioral Pediatrics 30, 525–534.Google Scholar
Gau, SS, Lin, YJ, Cheng, AT, Chiu, YN, Tsai, WC, Soong, WT (2010). Psychopathology and symptom remission at adolescence among children with attention-deficit-hyperactivity disorder. Australian and New Zealand Journal of Psychiatry 44, 323–332.Google Scholar
Gropper, RJ, Tannock, R (2009). A pilot study of working memory and academic achievement in college students with ADHD. Journal of Attention Disorders 12, 574–581.Google Scholar
Halperin, JM, Healey, DM (2011). The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: can we alter the developmental trajectory of ADHD? Neuroscience and Biobehavioral Reviews 35, 621–634.Google Scholar
Halperin, JM, Schulz, KP (2006). Revisiting the role of the prefrontal cortex in the pathophysiology of attention-deficit/hyperactivity disorder. Psychological Bulletin 132, 560–581.Google Scholar
Halperin, JM, Trampush, JW, Miller, CJ, Marks, DJ, Newcorn, JH (2008). Neuropsychological outcome in adolescents/young adults with childhood ADHD: profiles of persisters, remitters and controls. Journal of Child Psychology and Psychiatry, and Allied Disciplines 49, 958–966.Google Scholar
Kessler, RC, Green, JG, Adler, LA, Barkley, RA, Chatterji, S, Faraone, SV, Finkelman, M, Greenhill, LL, Gruber, MJ, Jewell, M, Russo, LJ, Sampson, NA, Van Brunt, DL (2010). Structure and diagnosis of adult attention-deficit/hyperactivity disorder: analysis of expanded symptom criteria from the Adult ADHD Clinical Diagnostic Scale. Archives of General Psychiatry 67, 1168–1178.Google Scholar
Klingberg, T (2006). Development of a superior frontal-intraparietal network for visuo-spatial working memory. Neuropsychologia 44, 2171–2177.Google Scholar
Kofler, MJ, Rapport, MD, Bolden, J, Sarver, DE, Raiker, JS (2010). ADHD and working memory: the impact of central executive deficits and exceeding storage/rehearsal capacity on observed inattentive behavior. Journal of Abnormal Child Psychology 38, 149–161.Google Scholar
Luciana, M (2003). Practitioner review: computerized assessment of neuropsychological function in children: clinical and research applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB). Journal of Child Psychology and Psychiatry, and Allied Disciplines 44, 649–663.Google Scholar
Luciana, M, Nelson, CA (1998). The functional emergence of prefrontally-guided working memory systems in four- to eight-year-old children. Neuropsychologia 36, 273–293.Google Scholar
Martel, M, Nikolas, M, Nigg, JT (2007). Executive function in adolescents with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 46, 1437–1444.Google Scholar
Martinussen, R, Hayden, J, Hogg-Johnson, S, Tannock, R (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry 44, 377–384.Google Scholar
Miller, GA, Chapman, JP (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology 110, 40–48.CrossRefGoogle ScholarPubMed
Milner, B (1971). Interhemispheric differences in the localization of psychological processes in man. British Medical Bulletin 27, 272–277.Google Scholar
Miyake, A, Friedman, NP, Emerson, MJ, Witzki, AH, Howerter, A, Wager, TD (2000). The unity and diversity of executive functions and their contributions to complex ‘Frontal Lobe’ tasks: a latent variable analysis. Cognitive Psychology 41, 49–100.Google Scholar
Miyake, A, Friedman, NP, Rettinger, DA, Shah, P, Hegarty, M (2001). How are visuospatial working memory, executive functioning, and spatial abilities related? A latent-variable analysis. Journal of Experimental Psychology General 130, 621–640.Google Scholar
Nigg, JT (2005). Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Biological Psychiatry 57, 1424–1435.Google Scholar
Olton, DS (1987). The radial arm maze as a tool in behavioral pharmacology. Physiology and Behavior 40, 793–797.Google Scholar
Pennington, BF, Ozonoff, S (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, and Allied Disciplines 37, 51–87.Google Scholar
Petrides, M, Milner, B (1982). Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man. Neuropsychologia 20, 249–262.Google Scholar
Posner, MI, Petersen, SE (1990). The attention system of the human brain. Annual Review of Neuroscience 13, 25–42.Google Scholar
Pribram, KH, McGuinness, D (1975). Arousal, activation, and effort in the control of attention. Psychololgical Review 82, 116–149.Google Scholar
Rhodes, SM, Coghill, DR, Matthews, K (2005). Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder. Psychological Medicine 35, 1109–1120.Google Scholar
Rogers, M, Hwang, H, Toplak, M, Weiss, M, Tannock, R (2011). Inattention, working memory, and academic achievement in adolescents referred for attention deficit/hyperactivity disorder (ADHD). Child Neuropsychology 17, 444–458.Google Scholar
Sahgal, A (1987). Some limitations of indices derived from signal detection theory: evaluation of an alternative index for measuring bias in memory tasks. Psychopharmacology (Berlin) 91, 517–520.Google Scholar
Scheres, A, Oosterlaan, J, Geurts, H, Morein-Zamir, S, Meiran, N, Schut, H, Vlasveld, L, Sergeant, JA (2004). Executive functioning in boys with ADHD: primarily an inhibition deficit? Archives of Clinical Neuropsychology 19, 569–594.Google Scholar
Seidman, LJ (2006). Neuropsychological functioning in people with ADHD across the lifespan. Clinical Psychology Review 26, 466–485.Google Scholar
Seidman, LJ, Biederman, J, Faraone, SV, Weber, W, Ouellette, C (1997). Toward defining a neuropsychology of attention deficit-hyperactivity disorder: performance of children and adolescents from a large clinically referred sample. Journal of Consulting and Clinical Psychology 65, 150–160.Google Scholar
Seidman, LJ, Biederman, J, Monuteaux, MC, Valera, E, Doyle, AE, Faraone, SV (2005). Impact of gender and age on executive functioning: do girls and boys with and without attention deficit hyperactivity disorder differ neuropsychologically in preteen and teenage years? Developmental Neuropsychology 27, 79–105.CrossRefGoogle ScholarPubMed
Sergeant, JA, Geurts, H, Huijbregts, S, Scheres, A, Oosterlaan, J (2003). The top and the bottom of ADHD: a neuropsychological perspective. Neuroscience and Biobehavioral Reviews 27, 583–592.Google Scholar
Sergeant, JA, Geurts, H, Oosterlaan, J (2002). How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behavioural Brain Research 130, 3–28.Google Scholar
Shallice, T (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London, Series B. Biological Sciences 298, 199–209.Google Scholar
Shang, CY, Gau, SS (2011). Visual memory as a potential cognitive endophenotype of attention deficit hyperactivity disorder. Psychological Medicine 41, 2603–2614.Google Scholar
Sonuga-Barke, EJ (2005). Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biological Psychiatry 57, 1231–1238.Google Scholar
Tillman, C, Eninger, L, Forssman, L, Bohlin, G (2011). The relation between working memory components and ADHD symptoms from a developmental perspective. Developmental Neuropsychology 36, 181–198.Google Scholar
Toplak, ME, Bucciarelli, SM, Jain, U, Tannock, R (2009). Executive functions: performance-based measures and the behavior rating inventory of executive function (BRIEF) in adolescents with attention deficit/hyperactivity disorder (ADHD). Child Neuropsychology 15, 53–72.Google Scholar
Tucker, DM, Williamson, PA (1984). Asymmetric neural control systems in human self-regulation. Psychological Review 91, 185–215.Google Scholar
van der Meere, J, Shalev, R, Borger, N, Gross-Tsur, V (1995). Sustained attention, activation and MPH in ADHD: a research note. Journal of Child Psychology and Psychiatry, and Allied Disciplines 36, 697–703.Google Scholar
Wahlstedt, C, Thorell, LB, Bohlin, G (2009). Heterogeneity in ADHD: neuropsychological pathways, comorbidity and symptom domains. Journal Abnormal Child Psychology 37, 551–564.Google Scholar
Watkins, JM, Cool, VA, Usner, D, Stehbens, JA, Nichols, S, Loveland, KA, Bordeaux, JD, Donfield, S, Asarnow, RF, Nuechterlein, KH (2000). Attention in HIV-infected children: results from the Hemophilia Growth and Development Study. Journal of the International Neuropsychological Society 6, 443–454.Google Scholar
Weiss, G, Hechtman, L, Milroy, T, Perlman, T (1985). Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children. Journal of the American Academy of Child Psychiatry 24, 211–220.Google Scholar
Willcutt, EG, Doyle, AE, Nigg, JT, Faraone, SV, Pennington, BF (2005 a). Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biological Psychiatry 57, 1336–1346.CrossRefGoogle ScholarPubMed
Willcutt, EG, Pennington, BF, Olson, RK, Chhabildas, N, Hulslander, J (2005 b). Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: in search of the common deficit. Developmental Neuropsychology 27, 35–78.Google Scholar