Neuropsychological Measures in the Diagnosis of ADHD in Preschool: Can Developmental Research Inform Diagnostic Practice?

Objective: The diagnosis of ADHD in preschool is challenging. Behavioral ratings are less reliable, but the value of neuropsychological tests in the diagnosis of ADHD has been debated. Method: This article provides an overview of neuropsychological measures utilized in preschoolers with ADHD (3-5 years). In addition, the manuscript discusses the extent to which these measures have been tested for their diagnostic capacity. Results: The diagnostic utility of computerized continuous performance tests and working memory subtests from IQ-batteries has been demonstrated in a number of studies by assessing their psychometric properties, sensitivity, and specificity. However, findings from developmental and basic research attempting to describe risk factors that explain variance in ADHD show the most consistent associations of ADHD with measures of delay aversion. Conclusion: Results from developmental research could benefit studies that improve ADHD diagnosis at the individual level. It might be helpful to consider testing as a structured situation for behavioral observation by the clinician.

Health, Dietary Habits, and Achievement Motivation in College Students With Self-Reported ADHD Diagnosis.

OBJECTIVE: The present study aimed to investigate aspects of health and motivation in a subpopulation of college students with ADHD. METHOD: Seventy-seven college students with self-reported ADHD (49 women; M age = 25.82, SD = 4.62) and 120 college students without ADHD (65 women; M age = 25.17, SD = 5.41) participated in an online survey assessing their health, dietary habits, and achievement motivation. RESULTS: College students with ADHD showed impairment in psychological functioning, impairment in their mental health, and reported more ambition and less self-control. Furthermore, we found gender differences: Women with ADHD reported worse psychological functioning, and the gender differences in obsessive-compulsive behavior and compensatory effort were mediated by the timing of diagnosis. CONCLUSION: College students, especially women, with ADHD struggle with health-related issues. Some of these gender differences might be due to under diagnosis of girls in childhood. Differences in achievement motivation might indicate compensatory mechanisms.

A framework of psychological compensation in attention deficit hyperactivity disorder.

The term compensation is widely used in the context of attention deficit hyperactivity disorder (ADHD), yet, it is neither defined nor theory driven. Adapting a model of psychological compensation (Bäckman and Dixon, 1992) to fit ADHD research is the aim of this review: we will (1) introduce the existing theoretical framework of psychological compensation, (2) discuss its applicability to ADHD and adapt the model to fit ADHD research, and (3) set up requirements for research on psychological compensation in ADHD. According to the framework psychological compensation can be inferred if a deficit (i.e., a mismatch between skill and environmental demand) is counterbalanced by the investment of more effort, the utilization of latent skills, or the acquisition of new skills. The framework has to be adapted because ADHD deficits are developmental and in individuals with ADHD compensation can appear independent of awareness of the deficit. A better understanding of psychological compensation in ADHD could foster diagnosis and interventions. Therefore, we suggest that future studies should follow a research design incorporating independent measures of deficit, compensation, and outcome as well as include individuals who compensate for their ADHD related deficits.

[Clinical diagnostics of ADHD in preschool-aged children]. / Klinische Diagnostik der ADHS im Vorschulalter.

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent psychiatric disorders in childhood and adolescence and has many negative consequences for both the child and the family. Early identification of children with ADHD would be helpful for the prevention of long-term consequences. This review appraises questionnaires and clinical interviews that can be used for the diagnosis of ADHD in preschool-aged children (3-5 years). We compare and discuss both German and international methods. The role of questionnaires and clinical interviews in the diagnostic process of ADHD is discussed.

Flanker performance in female college students with ADHD: a diffusion model analysis.

Attention-deficit hyperactivity disorder (ADHD) is characterized by poor adaptation to environmental demands, which leads to various everyday life problems. The present study had four aims: (1) to compare performance in a flanker task in female college students with and without ADHD (N = 39) in a classical analyses of reaction time and error rate and studying the underlying processes using a diffusion model, (2) to compare the amount of focused attention, (3) to explore the adaptation of focused attention, and (4) to relate adaptation to psychological functioning. The study followed a 2-between (group: ADHD vs. control) × 2-within (flanker conflict: incongruent vs. congruent) × 2-within (conflict frequency: 20 vs. 80 %) design. Compared to a control group, the ADHD group displayed prolonged response times accompanied by fewer errors in a flanker task. Results from the diffusion model analyses revealed that the members of the ADHD group showed deficits in non-decisional processes (i.e., higher non-decision time) and leaned more toward accuracy than participants without ADHD (i.e., setting higher boundaries). The ADHD group showed a more focused attention and less adaptation to the task conditions which is related to psychological functioning. Deficient non-decisional processes and poor adaptation are in line with theories of ADHD and presumably typical for the ADHD population, although this has not been shown using a diffusion model. However, we assume that the cautious strategy of trading speed of for accuracy is specific to the subgroup of female college students with ADHD and might be interpreted as a compensation mechanism.

Multitasking in adults with ADHD.

Adults with ADHD have problems in everyday multitasking situations presumably because of deficits in executive functions. The present study aims to find out (a) whether adults with ADHD show deficient multitasking performance in a standardized task, (b) how they perceive the multitasking situation, and (c) which task structure might be beneficial for them as compared with adults without ADHD. Therefore, we experimentally compared task performance, mood, and motivation in a group of 45 men with ADHD (M-age = 34.47, SD = 9.95) with a comparison group of 42 men without ADHD (M-age = 31.12, SD = 10.59) in three conditions: (a) a multitasking paradigm, (b) an interleaving condition in which tasks had to be performed without planning or monitoring, and (c) a non-interleaving condition. Our results showed no impaired multitasking performance in adults with ADHD. However, they showed better mood and more motivation in the non-interleaving condition.