Functional impairments among adults with ADHD: A comparison with adults with other psychiatric disorders and links to executive deficits.

The aim of the present study was to investigate daily life functioning in adults with ADHD and adults with other psychiatric disorders and to compare ADHD subgroups with or without executive deficits. Daily life functioning was assessed using self-ratings covering the following domains: academic/occupational functioning, social relations, daily life problems, and criminality. Executive deficits were assessed using self-ratings and laboratory tests of working memory, inhibition, and shifting. The results showed that adults with ADHD were more impaired with regard to academic functioning, current occupational status, daily life functioning, criminality, and some aspects of social functioning. The ADHD subgroup with executive deficits had more impairments than the subgroup without executive deficits with regard to academic functioning, current occupational status, and criminality. Conclusively, ADHD in adulthood is related to significant impairment in many areas of daily functioning, also compared to patients with other psychiatric disorders. Executive functioning deficits appear to at least partly explain these impairments.

Quality of life in older adults with ADHD: links to ADHD symptom levels and executive functioning deficits.

Purpose and aim: The overall aim of the present study was to examine quality of life in attention deficit hyperactivity disorder (ADHD) patients age ≥60 years. First, we compared older adults with ADHD to both healthy controls of the same age and younger adults with ADHD. Second, we examined executive functioning as a possible underlying factor for quality of life among older adults with ADHD. Methods: The study included 158 participants in three groups: (1) older adults (60-75 years of age) with ADHD (n = 42), (2) healthy controls of the same age (n = 58), and (3) younger adults (age 18-45 years of age) with ADHD (n = 56). The patients with ADHD were clinically-referred. Quality of life was examined through self-ratings and executive functioning was examined using both self-ratings and tests. Results: Older adults with ADHD differed significantly from controls the same age on all aspects of quality of life, with large effect sizes. However, they showed similar levels of quality of life compared to younger adults with ADHD. The exception was psychological health, for which older adults displayed better quality of life compared to younger adults with ADHD. Executive deficits measured through self-ratings, especially working memory, were related to quality of life, sometimes also beyond the influence of ADHD symptom levels. Conclusions: Older adults with ADHD show serious impairments in quality of life, that are comparable to the levels found for younger adults. Impairments may increase further as these individuals grow older and clinics need to meet the needs of this increasingly larger group of patients.

Adult executive functioning inventory (ADEXI): Validity, reliability, and relations to ADHD.

This study examined the psychometric properties of the Adult Executive Functioning Inventory (ADEXI). This new executive functioning (EF) rating instrument has the advantage of being brief (14 items) and focusing specifically on working memory and inhibitory control. Results showed that scores on the ADEXI had high internal consistency and adequate test-retest reliability, but low concurrence between self-ratings and other ratings. High and statistically significant correlations were found between ADEXI scores and scores from another EF rating instrument, whereas the correlations between ADEXI scores and neuropsychological test scores were weak and often non-significant. Furthermore, with regard to discriminant validity, individuals with attention deficit hyperactivity disorder (ADHD) had significantly higher scores on both the inhibition and working memory subscales compared to clinical as well as non-clinical controls. The results showed high specificity, but relatively low sensitivity, when discriminating between adults with ADHD and non-clinical controls. Conclusively, the ADEXI can be a valuable screening instrument for assessing deficits in working memory and inhibitory control. However, similarly to other EF ratings, the ADEXI should be used as a complement rather than as a replacement for neuropsychological tests, and the low interrater reliability suggests that ratings from multiple sources is preferable compared to relying solely on self-ratings.

Neuropsychological Functioning in Adults With ADHD and Adults With Other Psychiatric Disorders.

OBJECTIVE: The aim was to investigate how well neuropsychological measures can discriminate between adults with ADHD and those with other psychiatric disorders. METHOD: Adults with ADHD and a clinical control group ( n = 110) were included. Neuropsychological functioning was investigated using measures of inhibition, working memory, set shifting, planning, fluency, reaction-time variability, and delay aversion. RESULTS: Adults with ADHD performed more poorly compared with clinical controls with regard to all constructs. The effects of verbal memory, inhibition, set shifting, fluency, and delay aversion remained significant when controlling for IQ. However, when controlling for basic cognitive functions, only the effects of inhibition, fluency, and delay aversion were significant. Sensitivity ranged between 64% and 75%, and specificity between 66% and 81%. CONCLUSION: Neuropsychological tests have a relatively poor ability to discriminate between adults with ADHD and clinical controls, but they may be used to identify individuals at particularly high risk for poor daily functioning.