Spatial working memory (SWM) is known to be impaired in children with ADHD-CT, whether anxiety is present or not. Yet, it remains unclear whether anxiety disorders add to the SWM impairments evident in ADHD-CT and whether these findings extend into adolescents with ADHD-CT and anxiety. Further, it is not yet known whether children and adolescents with carefully defined anxiety disorders alone, demonstrate SWM deficits. This study explored the association of SWM and its strategy and spatial span components in carefully defined children and adolescents (age 6-16 years) with ADHD-CT alone (N = 163; 14 % female), ADHD-CT and anxiety (N = 243; 23 % female), anxiety disorders alone (N = 69; 25 % female) compared to age- and gender-matched healthy control participants (N = 116; 19 % female). The relationship between SWM and its strategy and span components and core ADHD-CT symptoms and anxiety symptoms were also examined. There was no evidence of an additive effect of ADHD and anxiety on SWM, strategy and spatial span deficits. But, anxiety disorders alone were associated with impaired SWM and span performance compared to healthy control participants. In contrast, strategy did not differ between children and adolescents with anxiety disorders alone and healthy control participants, suggesting that with anxiety span is the most affected component. Further, these findings were age-independent. This study concurs with and extends current influential models about the cognitive effects of anxiety on performance in the setting of ADHD-CT. Clinical implications and future research directions are discussed.

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A future randomized controlled trial of the program would address potential placebo and selection bias effects.

The current study used latent profile analysis (LPA) to ascertain distinct groups of children with ADHD (N = 701) in terms of performance on working memory (WM) tasks that tapped visuospatial sketchpad, spatial central executive, and verbal central executive functions. It compared the WM performances of these classes with a clinical comparison group (N = 59). The participants' age ranged from 7 to 16 years (586 males, 71 females). The results of the LPA supported three classes. For all three WM tasks, class 1 (N = 196) had more difficulties than classes 2 (N = 394) and 3 (N = 111), and the clinical comparison group. Class 2 had more difficulties than class 3 and the clinical comparison group, and there was no difference between class 3 and the clinical comparison group. Class 1 had lower IQ and academic abilities, and relatively more individuals with depressive disorders. The implications of the findings for understanding ADHD and its treatment are discussed.