Executive Function Assessment and Adult Attention-Deficit/Hyperactivity Disorder: Tasks Versus Ratings on the Barkley Deficits in Executive Functioning Scale

• Published in: Psychological assessment Vol. 26; no. 4; pp. 1095 - 1105
• Main Authors: Kamradt, Jaclyn M., Ullsperger, Josie M., Nikolas, Molly A.
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-12-2014
• Subjects: Adolescent; Adult; Adult and adolescent clinical studies; Attention Deficit Disorder with Hyperactivity; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - physiopathology; Attention deficit hyperactivity disorder; Biological and medical sciences; Cognition & reasoning; Cognitive Assessment; Executive Function; Executive Function - physiology; Female; Human; Humans; Male; Medical sciences; Memory; Miscellaneous; Neuropsychological Assessment; Neuropsychological Tests - statistics & numerical data; Neuropsychology; Psychology. Psychoanalysis. Psychiatry; Psychometrics. Diagnostic aid systems; Psychopathology. Psychiatry; Rating; Regression analysis; Severity of Illness Index; Task Performance and Analysis; Techniques and methods; Young Adult; adult attention-deficit/hyperactivity disorder; executive functioning; neuropsychological functioning; ratings; tasks; Human; Executive function; Cognitive disorder; Neuropsychological test; Psychometrics; Cognition; Adult; Attention disorder with hyperactivity
• ISSN: 1040-3590; 1939-134X
• DOI: 10.1037/pas0000006

Adults with attention-deficit/hyperactivity disorder (ADHD) exhibit variable impairments on executive function (EF) tasks. Due to this variability, ratings of EF (rather than tasks) have been proposed as an alternative method that better captures symptom severity and impairment among adults with ADHD. However, few studies have jointly examined performance across multiple neuropsychological domains and EF ratings as predictors of severity and impairment among adults with ADHD. Adults (N = 273) ages 18-38 years (M = 22.6 years, 55.3% male, 62.2% with ADHD) completed a comprehensive diagnostic and neurocognitive assessment, which included self and informant ratings of ADHD symptom severity and EF and tasks of arousal/activation, response inhibition, set shifting, interference control, and working memory. Hierarchical linear regression models indicated that tasks of arousal/activation and response inhibition uniquely predicted ADHD symptom dimensions and related impairments. Over and above EF task performance, EF ratings of time management significantly predicted increased inattention (β = .209, p < .001, ΔR2 = 3.9%), whereas ratings of restraint predicted increased hyperactivity/impulsivity (β = .259, p < .001, ΔR2 = 6.4%). Furthermore, EF ratings of time management, restraint, and emotion regulation incrementally accounted for variance in relationship, professional, and daily living impairments over and above EF task performance (ΔR2 range = 1.7-7.7%). Results may help refine neurobiological theories and assessment of adult ADHD.