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Executive functioning in high-IQ adults with ADHD

Published online by Cambridge University Press:  20 January 2010

K. M. Antshel ,
S. V. Faraone ,
K. Maglione ,
A. E. Doyle ,
R. Fried ,
L. J. Seidman  and
J. Biederman
K. M. Antshel
Affiliation:
Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
S. V. Faraone*
Affiliation:
Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
K. Maglione
Affiliation:
Department of Psychiatry and Behavioral Sciences, State University of New York Upstate Medical University, Syracuse, NY, USA
A. E. Doyle
Affiliation:
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
R. Fried
Affiliation:
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
L. J. Seidman
Affiliation:
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
J. Biederman
Affiliation:
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
*
*Address for correspondence: S. V. Faraone, Ph.D., State University of New York Upstate Medical University, Department of Psychiatry and Behavioral Sciences, Syracuse, NY, USA. (Email: faraones@upstate.edu)
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Abstract

Background

To examine the association between psychological tests of executive functioning and functional outcomes among high-IQ adults with attention deficit hyperactivity disorder (ADHD).

Method

Subjects were high-IQ adults with (n=64) and without ADHD (n=53). Subjects were administered a battery of neuropsychological tests assessing executive functioning.

Results

High-IQ adults with ADHD performed less well than those without ADHD on several psychological tests of executive functioning, including the Wisconsin Card Sorting Test (WCST), Stroop Color and Word Test, Rey–Osterrieth Complex Figure Test (ROCF), California Verbal Learning Test (CVLT) and an auditory continuous performance test (CPT). Test performance in the high-IQ adult ADHD group, however, was average. In the entire sample, performance on several tests of executive functioning including the ROCF and the CVLT were significant predictors of real-world functioning.

Conclusions

High-IQ adults with ADHD perform less well on tests of executive functioning relative to high-IQ control participants. Performance on several tests of executive functioning was a significant predictor of functioning.

Keywords

Adult ADHDexecutive functioningIQ
Type
Original Articles
Information
Psychological Medicine , Volume 40 , Issue 11 , November 2010 , pp. 1909 - 1918
Copyright
Copyright © Cambridge University Press 2010

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References

Antshel, KM, Faraone, SV, Maglione, K, Doyle, A, Fried, R, Seidman, L, Biederman, J (2008). Temporal stability of ADHD in the high-IQ population: results from the MGH Longitudinal Family Studies of ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 47, 817–825.CrossRefGoogle ScholarPubMed
Antshel, KM, Faraone, SV, Maglione, K, Doyle, A, Fried, R, Seidman, L, Biederman, J (2009). Is adult attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? Psychological Medicine 39, 1325–1335.CrossRefGoogle ScholarPubMed
Antshel, KM, Faraone, SV, Stallone, K, Nave, A, Kaufmann, FA, Doyle, A, Fried, R, Seidman, L, Biederman, J (2007). Is attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? Results from the MGH Longitudinal Family Studies of ADHD. Journal of Child Psychology and Psychiatry 48, 687–694.CrossRefGoogle ScholarPubMed
Barkley, RA, Fischer, M, Smallish, L, Fletcher, K (2006). Young adult outcome of hyperactive children: adaptive functioning in major life activities. Journal of the American Academy of Child and Adolescent Psychiatry 45, 192–202.CrossRefGoogle ScholarPubMed
Barkley, R, Murphy, K (2006). ADHD: A Clinical Workbook, 3rd edn. Guilford Press: New York.Google Scholar
Barkley, R, Murphy, K, Fischer, M (2007). ADHD in Adults: What the Science Says. Guilford Press: New York.Google Scholar
Biederman, J, Faraone, SV, Spencer, TJ, Mick, E, Monuteaux, MC, Aleardi, M (2006 a). Functional impairments in adults with self-reports of diagnosed ADHD: a controlled study of 1001 adults in the community. Journal of Clinical Psychiatry 67, 524–540.CrossRefGoogle ScholarPubMed
Biederman, J, Monuteaux, MC, Doyle, AE, Seidman, LJ, Wilens, TE, Ferrero, F, Morgan, CL, Faraone, SV (2004). Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. Journal of Consulting and Clinical Psychology 72, 757–766.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, C, Fried, R, Fontanella, J, Doyle, AE, Seidman, LJ, Faraone, SV (2006 b). Impact of psychometrically defined deficits of executive functioning in adults with attention deficit hyperactivity disorder. American Journal of Psychiatry 163, 1730–1738.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, CR, Doyle, AE, Spencer, T, Henderson, CS, Marion, B, Fried, R, Faraone, SV (2008 a). Stability of executive function deficits in girls with ADHD: a prospective longitudinal followup study into adolescence. Developmental Neuropsychology 33, 44–61.CrossRefGoogle ScholarPubMed
Biederman, J, Petty, CR, Fried, R, Doyle, AE, Spencer, T, Seidman, LJ, Gross, L, Poetzl, K, Faraone, SV (2007). Stability of executive function deficits into young adult years: a prospective longitudinal follow-up study of grown up males with ADHD. Acta Psychiatrica Scandinavica 116, 129–136.CrossRefGoogle Scholar
Biederman, J, Seidman, LJ, Petty, CR, Fried, R, Doyle, AE, Cohen, DR, Kenealy, DC, Faraone, SV (2008 b). Effects of stimulant medication on neuropsychological functioning in young adults with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry 69, 1150–1156.CrossRefGoogle ScholarPubMed
Delis, DC, Freeland, J, Kramer, JH, Kaplan, E (1988). Integrating clinical assessment with cognitive neuroscience: construct validation of the California Verbal Learning Test. Journal of Consulting and Clinical Psychology 56, 123–130.CrossRefGoogle ScholarPubMed
Delis, DC, Kramer, JH, Kaplan, E, Ober, BA (1987). CVLT: California Verbal Learning Test. The Psychological Corporation: San Antonio, TX.Google Scholar
Denckla, MB (1996). A theory and model of executive function: a neuropsychological perspective. In Attention, Memory and Executive Function (ed. Lyon, G. R. and Krasnegor, N. A.), pp. 263–278. Paul H. Brookes Publishing: Baltimore, MD.Google Scholar
Downey, KK, Stelson, FW, Pomerleau, OF, Giordani, B (1997). Adult attention deficit hyperactivity disorder: psychological test profiles in a clinical population. Journal of Nervous and Mental Disease 185, 32–38.CrossRefGoogle ScholarPubMed
Doyle, AE, Biederman, J, Seidman, LJ, Weber, W, Faraone, SV (2000). Diagnostic efficiency of neuropsychological test scores for discriminating boys with and without attention deficit-hyperactivity disorder. Journal of Consulting and Clinical Psychology 68, 477–488.CrossRefGoogle ScholarPubMed
Endicott, J, Nee, J, Harrison, W, Blumenthal, R (1993). Quality of Life Enjoyment and Satisfaction Questionnaire: a new measure. Psychopharmacology Bulletin 29, 321–326.Google ScholarPubMed
Faraone, SV, Biederman, J, Doyle, A, Murray, K, Petty, C, Adamson, JJ, Seidman, L (2006 a). Neuropsychological studies of late onset and subthreshold diagnoses of adult attention-deficit/hyperactivity disorder. Biological Psychiatry 60, 1081–1087.CrossRefGoogle ScholarPubMed
Faraone, SV, Biederman, J, Spencer, T, Mick, E, Murray, K, Petty, C, Adamson, JJ, Monuteaux, MC (2006 b). Diagnosing adult attention deficit hyperactivity disorder: are late onset and subthreshold diagnoses valid? American Journal of Psychiatry 163, 1720–1729; quiz 1859.CrossRefGoogle ScholarPubMed
Faraone, SV, Wilens, TE, Petty, C, Antshel, K, Spencer, T, Biederman, J (2007). Substance use among ADHD adults: implications of late onset and subthreshold diagnoses. American Journal on Addictions 16 (Suppl. 1), 24–32; quiz 33–34.CrossRefGoogle ScholarPubMed
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (1997). Structured Clinical Interview for DSM-IV Clinical Version (SCID-CV) (User's Guide and Interview). American Psychiatric Press: Washington, DC.Google Scholar
Frazier, TW, Demaree, HA, Youngstrom, EA (2004). Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology 18, 543–555.CrossRefGoogle ScholarPubMed
Friedman, NP, Miyake, A, Corley, RP, Young, SE, Defries, JC, Hewitt, JK (2006). Not all executive functions are related to intelligence. Psychological Science 17, 172–179.CrossRefGoogle ScholarPubMed
Golden, JC (1978). Stroop Color and Word Test. Stoelting Company: Chicago, IL.Google Scholar
Harrison, AG, Edwards, MJ, Parker, KC (2007). Identifying students faking ADHD: preliminary findings and strategies for detection. Archives of Clinical Neuropsychology 22, 577–588.CrossRefGoogle ScholarPubMed
Heaton, RK, Chelune, GJ, Talley, JL, Kay, GG, Curtiss, G (1993). Wisconsin Card Sorting Test Manual: Revised and Expanded. Psychological Assessment Resources: Odessa, FL.Google Scholar
Hervey, AS, Epstein, JN, Curry, JF (2004). Neuropsychology of adults with attention-deficit/hyperactivity disorder: a meta-analytic review. Neuropsychology 18, 485–503.CrossRefGoogle ScholarPubMed
Hollingshead, AB (1975). Four Factor Index of Social Status. Yale Press: New Haven, CT.Google Scholar
Holmes-Bernstein, J, Waber, DP (1996). Developmental Scoring System for the Rey–Osterrieth Complex Figure. Psychological Assessment Resources: Odessa, FL.Google Scholar
Jung, RE, Yeo, RA, Chiulli, SJ, Sibbitt, WL Jr., Brooks, WM (2000). Myths of neuropsychology: intelligence, neurometabolism, and cognitive ability. Clinical Neuropsychologist 14, 535–545.CrossRefGoogle ScholarPubMed
Kremen, WS, Seidman, LJ, Faraone, SV, Tsuang, MT (2008). IQ decline in cross-sectional studies of schizophrenia: methodology and interpretation. Psychiatry Research 158, 181–194.CrossRefGoogle ScholarPubMed
Lovecky, DV, Silverman, LK (1998). Gifted children with AD/HD. Paper presented to the Panel of the NIH Consensus Development Conference on Diagnosis and Treatment of Attention Deficit/Hyperactivity Disorder, Bethesda, MD, 16–18 November 1998.Google Scholar
Lovett, BJ, Lewandowski, LJ (2006). Gifted students with learning disabilities: who are they? Journal of Learning Disabilities 39, 515–527.CrossRefGoogle Scholar
Mahone, EM, Hagelthorn, KM, Cutting, LE, Schuerholz, LJ, Pelletier, SF, Rawlins, C, Singer, HS, Denckla, MB (2002). Effects of IQ on executive function measures in children with ADHD. Child Neuropsychology 8, 52–65.CrossRefGoogle ScholarPubMed
Orvaschel, H (1994). Schedule for Affective Disorders and Schizophrenia for School-Aged Children – Epidemiologic Version 5 (K-SADS-E). Nova Southeastern University: Ft Lauderdale, FL.Google Scholar
Reader, MJ, Harris, EL, Schuerholz, LJ, Denckla, MB (1994). Attention deficit hyperactivity disorder and executive dysfunction. Developmental Neuropsychology 10, 493–512.CrossRefGoogle Scholar
Rey, A (1941). Psychological examination of traumatic encephalopathy. Archives de Psychologie 28, 286–340.Google Scholar
Sattler, J (2001). Assessment of Children: Cognitive Applications, 4th edn. Jerome M. Sattler Publishers: San Diego, CA.Google Scholar
Schuck, SE, Crinella, FM (2005). Why children with ADHD do not have low IQs. Journal of Learning Disabilities 38, 262–280.CrossRefGoogle Scholar
Seidman, LJ, Breiter, HC, Goodman, JM, Goldstein, JM, Woodruff, PW, O'Craven, K, Savoy, R, Tsuang, MT, Rosen, BR (1998). A functional magnetic resonance imaging study of auditory vigilance with low and high information processing demands. Neuropsychology 12, 505–518.CrossRefGoogle ScholarPubMed
Sullivan, BK, May, K, Galbally, L (2007). Symptom exaggeration by college adults in attention deficit hyperactivity disorder and learning disorder assessments. Applied Neuropsychology 14, 189–207.CrossRefGoogle ScholarPubMed
Teknos, KS, Bernstein, JH, Seidman, LJ (2003). Performance of attention-deficit/hyperactivity disordered children on the Rey–Osterrieth complex figure. In The Rey–Osterrieth Handbook (ed. Knight, J. and Kaplan, E. F.), pp. 433–438. Psychological Assessment Resources: Odessa, FL.Google Scholar
Vance, AL, Maruff, P, Barnett, R (2003). Attention deficit hyperactivity disorder, combined type: better executive function performance with longer-term psychostimulant medication. Australian and New Zealand Journal of Psychiatry 37, 570–576.CrossRefGoogle ScholarPubMed
Wechsler, D (1993). Wechsler Adult Intelligence Scale – Third Edition. Psychological Corporation: San Antonio, TX.Google Scholar
Weiss, G, Hechtman, L (1993). Hyperactive Children Grown Up, 2nd edn. Guilford Press: New York.Google Scholar
Weiss, MD, Weiss, JR (2004). A guide to the treatment of adults with ADHD. Journal of Clinical Psychiatry 65 (Suppl. 3), 27–37.Google Scholar
Wender, PH (1995). Attention-Deficit Hyperactivity Disorder in Adults. Oxford University Press: New York.Google Scholar