Cognitive characterization of adult attention deficit hyperactivity disorder by domains: a systematic review

Abstract

Attention deficit hyperactivity disorder (ADHD) is reportedly the most frequent neurodevelopmental disorder diagnosed during childhood, and it is recognized as a common condition in adulthood. We review the evidence to help identify cognitive domains associated to deficits in adult ADHD. A systematic review with narrative synthesis was performed, assessing studies on adult ADHD, neuropsychology and research on involved cognitive domains in adults 18+ years old with an established diagnosis of ADHD, in seven electronic databases (PubMed, PsychInfo, WebOfScience, Embase, Scopus, OvidSPMedline, and Teseo), and Worldcat and OpenGrey grey literature databases. 93 studies were included for this review, encompassing findings from a total 5574 adults diagnosed only with ADHD, medication-naïve or non-medicated at the moment of the assessment and 4880 healthy controls. Adults diagnosed with ADHD may show, when compared to healthy controls, a cognitive profile characterized by deficits across all attention modalities, processing speed, executive function (mainly working memory and inhibition with emphasis on reward delay and interference control), verbal memory, reading skills, social cognition and arithmetic abilities. A cognitive characterization of adult ADHD by domains is established beyond the sole consideration of attention and executive function problems. Along with these, verbal memory, language (mainly reading), social cognition and arithmetic abilities may also contribute to a more comprehensive characterization of the cognitive profile in adult ADHD.

Attentive-executive functioning and compensatory strategies in adult ADHD: A retrospective case series study

“…Accordance with the present literature, many of the adult ADHD patients recruited had attention and processing speed deficits ( Onandia-Hinchado et al, 2021 ). The d2-R neuropsychological test might be considered a sensitive tool to identify the attentional dysfunction of this clinical population.…”

Scores in Self-Report Questionnaires Assessing Adult ADHD Can Be Influenced by Negative Response Bias but Are Unrelated to Performance on Executive Function and Attention Tests

“…However, this appears to be due to the lack of specificity and sensitivity of the tests of EF and attentional performance used here in assessing ADHD symptomatology. Research findings on the relationship of components of EF in particular to ADHD symptomatology are mixed (Barkley & Murphy, 2011;Boonstra et al, 2005;Butzbach et al, 2019;Duff & Sulla, 2015;Frazier-Wood et al, 2012;Gawrilow et al, 2011;Heine & Exner, 2021;Merkt et al, 2013;Onandia-Hinchado et al, 2021;Pinto et al, 2016;Rosch & Mostofsky, 2019;Sebastian et al, 2014). Heine and Exner (2021, p. 146) attribute this principally to the heterogeneity of ADHD symptoms and the plethora of different neuropsychological tests of performance employed in research in this area to date.…”

“…The present study used neuropsychological tests that primarily assess inhibitory processes and working memory, supplemented by TMT-B (Reitan, 1992). Drawing on recent research, we additionally included tests of processing speed in the test battery used (e.g., LeRoy et al, 2019;Onandia-Hinchado et al, 2021). Table 1 provides an overview of the neuropsychological tests selected for the study.…”

Feasibility of an Extensive Strategy for Adult Diagnosis of Attention Deficit Hyperactivity Disorder Among Patients Suffering From Substance Use Disorders

“…There have been a large number of reports for cognitive function in ADHD. However, those reports are discrepant ( 53 ), owing to the various nature of the samples included in terms of sociodemographic and clinical profiles ( 54 ).…”