Executive Functioning Among Finnish Adolescents With Attention-Deficit/Hyperactivity Disorder

University of California, Los Angeles, CA 90095, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 01/2008; 46(12):1594-604. DOI: 10.1097/chi.0b013e3181575014
Source: PubMed


The present study examined cognitive functioning in a population sample of adolescents with and without attention-deficit/hyperactivity disorder (ADHD) from the Northern Finland Birth Cohort 1986.
The sample consisted of 457 adolescents ages 16 to 18 who were assessed using a battery of cognitive tasks. Performance according to diagnostic group (control, behavior disorder, and ADHD) and sex was compared. Then, the effect of executive function deficit (EFD) was assessed by diagnostic group status on behavioral and cognitive measures.
When compared to non-ADHD groups, adolescents with ADHD exhibited deficits on almost all of the cognitive measures. The behavior disorder group obtained scores that were generally intermediate between the ADHD and control groups, but exhibited deficits in intelligence and executive function similar to the ADHD group. Approximately half the ADHD sample had EFD; however, the type and presence of EFDs were not differentially related to cognitive performance as a function of diagnosis.
These findings indicate that EFDs are more frequent in ADHD than control or behavior disorder groups. EFDs are a general risk factor for poor cognitive functioning across multiple domains, irrespective of diagnostic status.

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Available from: May Yang, Jan 13, 2014
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    • "However, co-morbid ODD was more frequent in subjects with deficits. Most earlier work has concluded that neurocognitive impairments are independent of co-morbid oppositional and aggressive symptoms, with greater ADHD symptom severity in co-morbid cases accounting for any differences [52]–[58]. This may apply here equally. "
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    ABSTRACT: Recent neurobiological models of ADHD suggest that deficits in different neurobiological pathways may independently lead to symptoms of this disorder. At least three independent pathways may be involved: a dorsal frontostriatal pathway involved in cognitive control, a ventral frontostriatal pathway involved in reward processing and a frontocerebellar pathway related to temporal processing. Importantly, we and others have suggested that disruptions in these three pathways should lead to separable deficits at the cognitive level. Furthermore, if these truly represent separate biological pathways to ADHD, these cognitive deficits should segregate between individuals with ADHD. The present study tests these hypotheses in a sample of children, adolescents and young adults with ADHD and controls. 149 Subjects participated in a short computerized battery assessing cognitive control, timing and reward sensitivity. We used Principal Component Analysis to find independent components underlying the variance in the data. The segregation of deficits between individuals was tested using Loglinear Analysis. We found four components, three of which were predicted by the model: Cognitive control, reward sensitivity and timing. Furthermore, 80% of subjects with ADHD that had a deficit were deficient on only one component. Loglinear Analysis statistically confirmed the independent segregation of deficits between individuals. We therefore conclude that cognitive control, timing and reward sensitivity were separable at a cognitive level and that deficits on these components segregated between individuals with ADHD. These results support a neurobiological framework of separate biological pathways to ADHD with separable cognitive deficits.
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    • "c o m / l o c a t e / s c h r e s population (Jennings et al., 2007; Zhou et al., 2011). Studies of attention network measures were also extensively conducted in clinical populations, including attention-deficit hyperactivity disorder (Loo et al., 2007; Adolfsdottir et al., 2008), borderline personality disorder (Posner et al., 2002; Rogosch and Cicchetti, 2005), deafness (Dye et al., 2007), depression (Murphy and Alexopoulos, 2006), dyslexia (Bednarek et al., 2004), and 22q11 deletion syndrome (Sobin et al., 2004; Bish et al., 2005). "
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    ABSTRACT: The Attention Network Test (ANT) is a well established behavioral measure in neuropsychological research to assess three different facets of selective attention, i.e., alerting, orienting, and conflict processing. Although the ANT has been applied in healthy individuals and various clinical populations, data on retest reliability are scarce in healthy samples and lacking for clinical populations. The objective of the present study was a longitudinal assessment of relevant ANT network measures in healthy controls and schizophrenic patients. Forty-five schizophrenic patients and 55 healthy controls were tested with ANT in a test-retest design with an average interval of 7.4 months between test sessions. Test-retest reliability was analyzed with Pearson and Intra-class correlations. Healthy controls revealed moderate to high test-retest correlations for mean reaction time, mean accuracy, conflict effect, and conflict error rates. In schizophrenic patients, moderate test-retest correlations for mean reaction time, orienting effect, and conflict effect were found. The analysis of error rates in schizophrenic patients revealed very low test-retest correlations. The current study provides converging statistical evidence that the conflict effect and mean reaction time of ANT yield acceptable test-retest reliabilities in healthy controls and, investigated longitudinally for the first time, also in schizophrenia. Obtained differences of alerting and orienting effects in schizophrenia case-control studies should be considered more carefully. The analysis of error rates revealed heterogeneous results and therefore is not recommended for case control studies in schizophrenia.
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    • "Finally, application of component or factor scores to define EFD reduced the number of impaired cases further, but essentially the different methods yielded similar results. Measurement of agreement suggests that although there is substantial overlap between methods as indicated by percentages of EFD found, the approaches by Biederman et al. (2004), Loo et al. (2007), or our age-adjusted scores do not identify all of the same children as impaired; thus, some caution may be warranted in trying to generalize across studies. "
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    ABSTRACT: The study examined executive function deficits (EFD) in school-age children (7 to 14 years) with ADHD. A clinical sample of children diagnosed with ADHD (n = 49) was compared to a population sample (n = 196) on eight executive function (EF) measures. Then, the prevalence of EFD in clinical and non-clinical children was examined at the individual level according to three methods previously applied to define EFD, and a fourth method was included to control for the effect of age on performance. Children with ADHD were significantly more impaired on measures of EF than children without ADHD at the group level. However, only about 50% of children with ADHD were found to have EFD at the individual level, and results appeared relatively robust across methods applied to define EFD. As a group, children with ADHD displayed more problems on neuropsychological measures of EF than non-clinical children; at the individual level, there appeared to be heterogeneity in EF impairment.
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