French adult normative data for a Standard Executive Neuropsychological Test Battery.

OBJECTIVE: Executive impairments are frequent and may concern a large spectrum of health conditions throughout life. Given the complexity of the executive functions, their assessment requires the administration of multiple tests. There is only one source of French-language normative data for seven traditional executive tests for adults under age 50. The aim of the present study was to establish demographically adjusted normative data of four executive tests commonly used during the neuropsychological assessment in France for adults aged 18-65. METHOD: The following tools were administered to 518 community adults aged from 18 to 65: Digit Span, Trail Making Test, Color Word Interference Test, and Verbal Fluency Test. An Overall Test Battery Mean was computed. Multiple regressions were computed for normally distributed scores and percentiles were established for non-normally distributed scores. RESULTS: Multiple regression analyses indicated that younger age and higher education were both associated with better performance. Age did not predict the number of correct responses on the Verbal Fluency Test. Gender did not have any effect on executive performances. Regression equations to calculate Z-scores are presented. Percentiles are presented for the number of recorded errors on the Trail Making Test, Color Word Interference Test, and Verbal Fluency Test. CONCLUSIONS: We provide reliable and updated norms for four executive tests that are among the most used by clinical neuropsychologists in France. Our work represents a valuable addition to the limited norms currently available for the assessment of executive functions in French young and middle-aged adults.

Adaptation and Validation of a French Version of the Vaccination Attitudes Examination (VAX) Scale.

Over the past decades, vaccination has proven to be largely beneficial to global health. Despite vaccine efficacy, the French population has been recently affected by more anti-vaccination attitudes and vaccine refusal, and it is therefore necessary to validate tools to study this health issue. The Vaccination Attitudes Examination scale (VAX) is a 12-item questionnaire targeting adults that assesses general attitudes towards vaccination. The aims of the study were to translate and adapt the original English version of the scale into French and to test the psychometric properties of the scale in a French-population-based sample of adults. We included 450 French speaking adults that completed the French VAX and other questionnaires to assess convergent and divergent validities. Exploratory and confirmatory factor analyses showed that the French version of the VAX replicated the factorial structure of the original scale. Moreover, it demonstrated high internal consistency, good convergent and divergent validities, and excellent temporal stability. Furthermore, scores on the scale differentiated vaccinees from non-vaccinee respondents. Results on the scale provide us with insight into factors involved in vaccine hesitancy in France, therefore allowing French authorities and policy makers to address these specific concerns and improve vaccine acceptance rates in this country.

Attention-Deficit/Hyperactivity Disorder, Insomnia, and Sleepiness Symptoms among a Community Adult Sample: The Mediating Effect of Executive Behavioral Regulation and Metacognition Abilities.

OBJECTIVE: Adult attention-deficit/hyperactivity disorder (ADHD) is characterized by a dysexecutive syndrome reflected in cognitive, emotional, and behavioral areas. Independently of a formal diagnosis of ADHD, higher ADHD symptoms are associated with higher levels of insomnia and sleepiness symptoms in adult population-based samples. Insomnia and sleepiness are sleep disorders that are both associated with deficits in several aspects of executive functions which in turn are likely to mimic a range of ADHD symptoms. Our objective was to explore the interrelationships between ADHD, insomnia, and sleepiness symptoms and executive functioning in community-dwelling adults. METHOD: A total of 442 participants (18-89 years, 56% females) underwent a semistructured clinical interview and completed questionnaires for insomnia, sleepiness, and everyday behaviors in which executive functions are implicated. Mediation Models were applied. RESULTS: Insomnia and sleepiness symptoms did not play a mediating role between ADHD symptoms and executive functioning. Conversely, our results highlighted a mediating effect of daytime insomnia consequences and sleepiness on ADHD symptoms via behavioral regulation executive symptoms (respectively, ß = -0.32, p < .001, 95% CI [-0.46, -0.20]; ß = 0.09, p < .05, 95% CI [0.02, 0.16]) and metacognitive executive symptoms (respectively, ß = -0.30, p < .001, 95% CI [-0.44, -0.18]; ß = 0.12, p < .01, 95% CI [0.04, 0.22]). CONCLUSIONS: Daytime insomnia consequences and sleepiness symptoms could lead to ADHD-like symptoms through their associated executive symptoms expressed in daily life. When faced with symptoms suggestive of ADHD in adults, insomnia and sleepiness should be systematically screened with standardized instruments.

Mind-wandering and sleepiness in adults with attention-deficit/hyperactivity disorder.

Sleepiness and mind-wandering are frequently experienced by patients with attention-deficit/hyperactivity disorder (ADHD), without ever having been jointly explored. We aimed to investigate the co-occurrence of these two phenomena in ADHD adults. Drug-free ADHD adults (n = 25) and healthy controls (n = 28) underwent an online experience sampling of mind-wandering episodes and subjective sleepiness. Participants completed self-reported measures of mind-wandering and sleepiness in daily life. Higher trait of mind-wandering was observed in ADHD patients compared to controls. On the whole sample, self-reported mind-wandering propensity was strongly associated with the severity of inattentive, impulsive and hyperactive symptoms. During the probes, patients reported more frequent episodes of mind-wandering and mind-blanking, and higher sleepiness. Their mind-wandering episodes were less intentional and belonged less frequently to a structured succession of thoughts. In both groups, mind-wandering and mind-blanking were associated with higher sleepiness. On the SART, patients were less accurate than controls. We provide first initial evidence for higher propensity of mind-wandering and mind-blanking using experience sampling in patients with formal ADHD diagnosis. This propensity was associated with sleepiness without negatively impacting attention performances. Mind-wandering and sleepiness have common determinants potentially involved in ADHD pathophysiology. Correlates of mind-blanking in ADHD adults remain to be characterized.