Panvino Fabiola, Zaccaria Valerio, Pica Michela, Amitrano Nunzia, Pisani Francesco, Di Brina Carlo
Unit of Child and Adolescent Neuropsychiatry, Department of Human Neuroscience, Sapienza University of Rome, Via dei Sabelli 108, 00185 Rome, Italy.
Children (Basel). 2025 Jun 18;12(6):798. doi: 10.3390/children12060798.
BACKGROUND/OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) and anxiety disorders (AD) are prevalent in childhood and adolescence, often presenting with overlapping symptoms. This study aimed to assess cognitive and executive functions-specifically attention, inhibition, and working memory-in children with ADHD, AD, and comorbid ADHD + AD. It also sought to identify potential neuropsychological markers that differentiate ADHD from AD and ADHD + AD comorbidity.
Cognitive and executive functions were assessed in a sample of 48 school-age children and adolescents (aged 8-15 years) using the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and the NEPSY-II battery. The MASC 2 self-report questionnaire was also used to assess anxiety symptoms. The participants were divided into three groups based on clinical diagnoses: ADHD, AD, and ADHD + AD.
No significant group differences emerged in cognitive performance, attention, or working memory. Significant differences emerged in inhibition performance, with children in the AD group demonstrating more efficient inhibition compared to both the ADHD and ADHD + AD groups. Children with ADHD showed longer response times. Better performance on inhibition tasks was associated with more severe anxiety symptoms.
These findings suggest that anxiety may modulate specific aspects of executive functioning during tasks requiring attentional and inhibitory control. However, the complex interaction between ADHD and anxiety requires further investigation. This study underscores the importance of distinguishing ADHD from AD based on cognitive and executive profiles, particularly inhibition. In this context, it supports the routine use of the NEPSY-II in combination with the MASC 2 questionnaire to facilitate differential diagnosis in clinical practice.
背景/目的：注意缺陷多动障碍（ADHD）和焦虑症（AD）在儿童和青少年中普遍存在，常常表现出重叠症状。本研究旨在评估患有ADHD、AD以及ADHD合并AD的儿童的认知和执行功能，特别是注意力、抑制能力和工作记忆。研究还试图确定能够区分ADHD与AD以及ADHD合并AD的潜在神经心理学标志物。
使用韦氏儿童智力量表第四版（WISC-IV）和NEPSY-II成套测验，对48名8至15岁的学龄儿童和青少年进行认知和执行功能评估。还使用MASC 2自陈问卷评估焦虑症状。根据临床诊断将参与者分为三组：ADHD组、AD组和ADHD合并AD组。
在认知表现、注意力或工作记忆方面，未出现显著的组间差异。在抑制能力表现上出现了显著差异，AD组儿童的抑制能力比ADHD组和ADHD合并AD组更有效。ADHD儿童的反应时间更长。抑制任务表现更好与更严重的焦虑症状相关。
这些发现表明，在需要注意力和抑制控制的任务中，焦虑可能会调节执行功能的特定方面。然而，ADHD与焦虑之间的复杂相互作用需要进一步研究。本研究强调了根据认知和执行特征，特别是抑制能力，区分ADHD与AD的重要性。在此背景下，它支持在临床实践中常规使用NEPSY-II并结合MASC 2问卷以促进鉴别诊断。
