Ceroni Martino, Rossi Stefania, Zerboni Giorgia, Biglia Elena, Soldini Emiliano, Izzo Alessia, Morellini Lucia, Sacco Leonardo
Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland.
Competence Centre for Healthcare Practices and Policies, Department of Business Economics, Health, and Social Care (DEASS), University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
Front Psychol. 2022 Oct 13;13:1015102. doi: 10.3389/fpsyg.2022.1015102. eCollection 2022.
Adults with ADHD exhibit a neuropsychological profile that may present deficits in many cognitive domains, particularly attention and executive functions (EFs). However, some authors do not consider executive disfunction as an important part of the clinical profile of the syndrome; this could be related to the use of inappropriate neuropsychological tests, probably not adapted and not sufficiently ecological. Moreover, new data are required on specific correlation of attentive-executive symptoms with socio-demographic factors. Therefore, the aim of this study is to analyze the neuropsychological performance of a group of adults with ADHD, also evaluating the influence of gender, age and education level.
We retrospectively collected health-related personal data of 40 adult ADHD patients, clinically diagnosed and evaluated a battery of 4 neuropsychological tests and 1 self-administered questionnaire. Gender, age and years of education differences were assessed.
Attention and EFs deficits have been highlighted mainly on the d2-R and 5-point neuropsychological tests, which therefore seem to be more sensitive in measuring the attention-executive dysfunction in an adult ADHD population, than TAP Go/No-go and ROCFT. ADHD patients also manifested subjective behavioral impulsivity disorders on BIS-11. There were no statistically significant gender differences in cognitive performance. On the contrary, younger patients performed worse on subscales TAP Go/No-go errors and 5-points number of drawings, while participants with a higher education level performed better on subscales d2-R speed of execution and d2-R errors. This supports a reduction in the number of errors and the execution time as a function of older age and a higher level of education. Finally, patients with higher education also self-reported greater impulsivity in planning.
Our preliminary findings suggest that adult ADHD is not a lifelong stable disorder, but it may change over time. Moreover, attention-executive deficits may be influenced and partially counterbalanced by experience (i.e., advancing age) and a higher level of education. This could underlie the development of specific psycho-behavioral and cognitive compensatory strategies. The use of self-administered questionnaires is therefore recommended to highlight attentional and executive difficulties that may not result in neuropsychological tests.
患有注意力缺陷多动障碍（ADHD）的成年人表现出一种神经心理学特征，可能在许多认知领域存在缺陷，尤其是注意力和执行功能（EFs）。然而，一些作者并不认为执行功能障碍是该综合征临床特征的重要组成部分；这可能与使用不适当的神经心理学测试有关，这些测试可能未经过调整且生态效度不足。此外，还需要关于注意力 - 执行症状与社会人口统计学因素具体相关性的新数据。因此，本研究的目的是分析一组患有ADHD的成年人的神经心理学表现，同时评估性别、年龄和教育水平的影响。
我们回顾性收集了40名成年ADHD患者的健康相关个人数据，对他们进行了临床诊断，并评估了一组4项神经心理学测试和1份自我管理问卷。评估了性别、年龄和受教育年限的差异。
注意力和执行功能缺陷主要在d2 - R和5分制神经心理学测试中凸显出来，因此，与TAP Go/No-go和ROCFT相比，这两项测试在测量成年ADHD人群的注意力 - 执行功能障碍方面似乎更敏感。ADHD患者在BIS - 11上也表现出主观行为冲动障碍。认知表现上没有统计学显著的性别差异。相反，较年轻的患者在TAP Go/No-go错误和5分制绘图数量子量表上表现较差，而受教育水平较高的参与者在d2 - R执行速度和d2 - R错误子量表上表现较好。这支持了随着年龄增长和教育水平提高，错误数量和执行时间会减少。最后，受教育程度较高的患者在自我报告中也显示出在计划方面有更大的冲动性。
我们的初步研究结果表明，成人ADHD不是一种终身稳定的疾病，而是可能随时间变化。此外，注意力 - 执行功能缺陷可能会受到经验（即年龄增长）和较高教育水平的影响，并部分得到平衡。这可能是特定心理行为和认知补偿策略发展的基础。因此，建议使用自我管理问卷来突出可能在神经心理学测试中未体现的注意力和执行功能困难。
