Developmental and Educational Psychology, University of Valencia, Valencia, Spain.
Catholic University of Valencia S. Vicente Martir, Valencia, Spain.
BMC Psychiatry. 2020 Mar 24;20(1):134. doi: 10.1186/s12888-020-02542-y.
Previous studies suggest that childhood attention deficit hyperactivity disorder (ADHD) may continue in adulthood, producing adverse effects. Therefore, identifying factors that help to differentiate characteristics of ADHD persistence and remission has practical implications for evaluation and treatment. The first aim of this study was to analyze differences in executive functions (shift, working memory, inhibition, and plan/organize), symptoms associated with ADHD (inattention, hyperactivity, emotional lability, and self-concept), and functional impairments in adults with persistent ADHD (ADHD-P), with remittent ADHD (ADHD-R), and without ADHD (N-ADHD). The second aim was to study the contribution of functional impairments in these three groups based on executive functions and associated ADHD behaviors.
Participants were 115 adults, 61 with a childhood ADHD diagnosis (40 persisters and 21 remitters) and 54 individuals with typical development. Self-reports were collected on executive functions, symptoms associated with ADHD, and functional impairments. Multivariate Analyses of Variance were conducted to test differences between the ADHD-P, ADHD-R, and N-ADHD groups on the evaluated variables. In addition, analyses were performed using two structural equation models with observed variables (path analyses).
The results indicated that significant executive and behavioral impairments and adverse functional outcomes in different life domains are related to the diagnostic persistence of ADHD. Recovery from the disorder is associated with better results, although hyperactivity/restlessness behaviors and plan/organize deficits continue to be present in remitter individuals.
The ADHD-P and ADHD-R groups showed some differences in their executive, behavioral, and functional impairments. Furthermore, the impairments in each group can be predicted by different executive functions and other symptoms associated with the disorder. These results should be taken into account in order to improve clinical practice.
先前的研究表明，儿童注意缺陷多动障碍（ADHD）在成年后可能会持续存在，产生不良影响。因此，识别有助于区分 ADHD 持续和缓解特征的因素对于评估和治疗具有实际意义。本研究的第一个目的是分析持续 ADHD（ADHD-P）、缓解 ADHD（ADHD-R）和无 ADHD（N-ADHD）成年患者的执行功能（转换、工作记忆、抑制和计划/组织）、与 ADHD 相关的症状（注意力不集中、多动、情绪不稳定和自我概念）以及功能障碍方面的差异。第二个目的是研究基于执行功能和相关 ADHD 行为，这三组患者的功能障碍的贡献。
参与者为 115 名成年人，其中 61 人有儿童 ADHD 诊断（40 名持续者和 21 名缓解者），54 名个体具有典型发育。自我报告收集了执行功能、与 ADHD 相关的症状和功能障碍。使用多变量方差分析检验 ADHD-P、ADHD-R 和 N-ADHD 三组在评估变量上的差异。此外，还使用两个具有观测变量的结构方程模型（路径分析）进行了分析。
结果表明，不同生活领域的显著执行和行为障碍以及不良的功能结果与 ADHD 的诊断持续性有关。该疾病的恢复与更好的结果相关，尽管多动/不安行为和计划/组织缺陷在缓解者中仍然存在。
ADHD-P 和 ADHD-R 组在执行、行为和功能障碍方面存在一些差异。此外，每组的障碍可以由不同的执行功能和其他与该疾病相关的症状来预测。这些结果应在临床实践中加以考虑。
