Examination of Spatial Working Memory Performance in Children and Adolescents with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT) and Anxiety

Abstract

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.

Attention, memory, visuoconstructive, and executive task performance in adolescents with anxiety disorders: a case-control community study

“…Our study, in contrast with others, 12,16,18,19 25 Inhibitory control is one of the main functions of the prefrontal cortex and is important to the ability to resist task-irrelevant stimuli. 54 Additionally, we can also hypothesize that children with mild anxiety do not have amygdala hyper-responsivity and prefrontal underrecruitment.…”

Cognitive Functioning in Adolescents with Self-Reported ADHD and Depression: Results from a Population-Based Study

“…Apart from age-related cognitive deficits, the presence of comorbidities may also explain the heterogeneity of cognitive profiles associated with ADHD. Previously, studies have shown that comorbid anxiety and oppositional defiant disorder can markedly change the cognitive profiles of children and adolescents with ADHD (Rhodes et al 2012; Vance et al 2013). Our results also show cognitive differences amongst adolescents with and without comorbid depression, and further reveal that these profiles vary with age.…”

Is Clinical Anxiety a Risk or a Protective Factor for Executive Functioning in Youth with ADHD? A Meta-regression Analysis

“…In all but one study (Rodríguez et al 2014) anxiety was determined based on formal DSM (-III, -IV, -5) diagnosis using the following clinical interviews: ADIS-C/P (Jarrett et al 2016;), PICS-IV (Korenblum et al 2007), DICA-R-P (Manassis et al 2000), DISC (Newcorn et al 2001), a structured DSM-III-R interview (Pliszka 1992), K-SADS-PL (Trani et al 2011;Vance et al 2013;Yurtbasi et al 2015), and KDIPS (Vloet et al 2010). In Rodríguez et al (2014) study, inclusion in the ADHD + AD group was based on the trait score on STAI-C questionnaire and all cases had a score higher than 90%.…”