Objective: We aimed to compare the visually dependent neuropsychological functioning among adults with Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) ADHD who recalled symptom onset by and after age 7 and non-ADHD controls. Method: We divided the participants, aged 17 to 40 years, into three groups—(a) ADHD, onset <7 years (early-onset, n = 142); (b) ADHD, onset between 7 and <12 years (late-onset, n = 41); (c) non-ADHD controls (n = 148)—and compared their neuropsychological functioning, measured by the Cambridge Neuropsychological Testing Automated Battery. Results: Both ADHD groups had deficits in attention and signal detectability, spatial working memory, and short-term spatial memory, but only the early-onset group showed deficits in alertness, set-shifting, and planning after controlling for age, sex, and psychiatric comorbidities. There was no statistical difference between the two ADHD groups in neuropsychological functioning. Conclusion:DSM-5 criteria for diagnosing adult ADHD are not too lax regarding neuropsychological functioning.
AdlerL. A.ChuaH. C. (2002). Management of ADHD in adults. The Journal of Clinical Psychiatry, 63(Suppl. 12), 29-35.
2.
AldersonR. M.KasperL. J.HudecK. L.PatrosC. H. (2013). Attention-deficit/hyperactivity disorder (ADHD) and working memory in adults: A meta-analytic review. Neuropsychology, 27, 287-302.
3.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
4.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
5.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
6.
ApplegateB.LaheyB. B.HartE. L.BiedermanJ.HyndG. W.BarkleyR. A.. . . ShafferD. (1997). Validity of the age-of-onset criterion for ADHD: A report from the DSM-IV field trials. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1211-1221.
7.
BarkleyR. A.BiedermanJ. (1997). Toward a broader definition of the age-of-onset criterion for attention-deficit hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1204-1210.
8.
BarkleyR. A.FischerM.SmallishL.FletcherK. (2002). The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. Journal of Abnormal Psychology, 111, 279-289.
9.
BarkleyR. A.FischerM.SmallishL.FletcherK. (2006). Young adult outcome of hyperactive children: Adaptive functioning in major life activities. Journal of the American Academy of Child & Adolescent Psychiatry, 45, 192-202.
10.
BatstraL.FrancesA. (2012). DSM-5 further inflates attention deficit hyperactivity disorder. The Journal of Nervous and Mental Disease, 200, 486-488.
11.
BauneB. T.FuhrM.AirT.HeringC. (2014). Neuropsychological functioning in adolescents and young adults with major depressive disorder—A review. Psychiatry Research, 218, 261-271.
12.
BiedermanJ.FaraoneS. V.SpencerT.WilensT.NormanD.LapeyK. A.. . . DoyleA. (1993). Patterns of psychiatric comorbidity, cognition, and psychosocial functioning in adults with attention deficit hyperactivity disorder. The American Journal of Psychiatry, 150, 1792-1798.
13.
BiedermanJ.MickE.SpencerT.SurmanC.HammernessP.DoyleR.. . . SchweitzerK. (2006). An open-label trial of OROS methylphenidate in adults with late-onset ADHD. CNS Spectrums, 11, 390-396.
14.
CastellanosF. X.TannockR. (2002). Neuroscience of attention-deficit/hyperactivity disorder: The search for endophenotypes. Nature Review Neuroscience, 3, 617-628.
15.
ChandraS.BiedermanJ.FaraoneS. (2016). Assessing the validity of the age at onset criterion for diagnosing ADHD in DSM-5. Journal of Attention Disorders. Advance online publication. doi: 10.1177/1087054716629717
16.
ConnersC. K.ErhardtD.SparrowE. (1999). Conners’ Adult ADHD Rating Scales (CAARS). New York, NY: Multi-Health Systems.
17.
CorteseS.KellyC.ChabernaudC.ProalE.Di MartinoA.MilhamM. P.. . . CastellanosF. X. (2012). Toward systems neuroscience of ADHD: A meta-analysis of 55 fMRI studies. The American Journal of Psychiatry, 169, 1038-1055.
18.
FaraoneS. V.BiedermanJ.DoyleA.MurrayK.PettyC.AdamsonJ. J.. . . SeidmanL. (2006a). Neuropsychological studies of late onset and subthreshold diagnoses of adult attention-deficit/hyperactivity disorder. Biological Psychiatry, 60, 1081-1087.
19.
FaraoneS. V.BiedermanJ.SpencerT.MickE.MurrayK.PettyC.. . . MonuteauxM. C. (2006b). Diagnosing adult attention deficit hyperactivity disorder: Are late onset and subthreshold diagnoses valid?The American Journal of Psychiatry, 163, 1720-1729.
20.
FaraoneS. V.BiedermanJ.SpencerT.WilensT.SeidmanL. J.MickE.. . . DoyleA. E. (2000). Attention-deficit/hyperactivity disorder in adults: An overview. Biological Psychiatry, 48, 9-20.
21.
FriedR.Hirshfeld-BeckerD.PettyC.BatchelderH.BiedermanJ. (2015). How informative is the CANTAB to assess executive functioning in children with ADHD? A controlled study. Journal of Attention Disorders, 19, 468-475.
22.
GauS. S. (2007). Parental and family factors for attention-deficit hyperactivity disorder in Taiwanese children. Australian & New Zealand Journal of Psychiatry, 41, 688-696.
23.
GauS. S.ChangJ. P. (2013). Maternal parenting styles and mother-child relationship among adolescents with and without persistent attention-deficit/hyperactivity disorder. Research in Developmental Disabilities, 34, 1581-1594.
24.
GauS. S.ChiuC. D.ShangC. Y.ChengA. T.SoongW. T. (2009). Executive function in adolescence among children with attention-deficit/hyperactivity disorder in Taiwan. Journal of Developmental & Behavioral Pediatrics, 30, 525-534.
25.
GauS. S.HuangW. L. (2014). Rapid visual information processing as a cognitive endophenotype of attention deficit hyperactivity disorder. Psychological Medicine, 44, 435-446.
26.
GauS. S.ShangC. Y. (2010). Executive functions as endophenotypes in ADHD: Evidence from the Cambridge Neuropsychological Test Battery (CANTAB). The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 51, 838-849.
27.
HartH.RaduaJ.NakaoT.Mataix-ColsD.RubiaK. (2013). Meta-analysis of functional magnetic resonance imaging studies of inhibition and attention in attention-deficit/hyperactivity disorder: Exploring task-specific, stimulant medication, and age effects. JAMA Psychiatry, 70, 185-198.
28.
HerveyA. S.EpsteinJ. N.CurryJ. F. (2004). Neuropsychology of adults with attention-deficit/hyperactivity disorder: A meta-analytic review. Neuropsychology, 18, 485-503.
29.
HymanS. E. (2007). Can neuroscience be integrated into the DSM-V?Nature Review Neuroscience, 8, 725-732.
30.
KesslerR. C.BerglundP.DemlerO.JinR.MerikangasK. R.WaltersE. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593-602.
31.
KielingC.KielingR. R.RohdeL. A.FrickP. J.MoffittT.NiggJ. T.. . . CastellanosF. X. (2010). The age at onset of attention deficit hyperactivity disorder. The American Journal of Psychiatry, 167, 14-16.
32.
KlingbergT. (2006). Development of a superior frontal-intraparietal network for visuo-spatial working memory. Neuropsychologia, 44, 2171-2177.
33.
LevauxM. N.PotvinS.SepehryA. A.SablierJ.MendrekA.StipE. (2007). Computerized assessment of cognition in schizophrenia: Promises and pitfalls of CANTAB. European Psychiatry, 22, 104-115.
34.
LinY. J.ChenW. J.GauS. S. (2013). Neuropsychological functions among adolescents with persistent, subsyndromal and remitted attention deficit hyperactivity disorder. Psychological Medicine, 27, 1-13.
35.
LinY. J.GauS. S. (2017). Differential neuropsychological functioning between adolescents with attention-deficit/hyperactivity disorder with and without conduct disorder. Journal of the Formosan Medical Association, 116(12), 946-955. doi:10.1016/j.jfma.2017.02.009
36.
LinY. J.LoK. W.YangL. K.GauS. S. (2015). Validation of DSM-5 age-of-onset criterion of attention deficit/hyperactivity disorder (ADHD) in adults: Comparison of life quality, functional impairment, and family function. Research in Developmental Disabilities, 47, 48-60.
37.
LinY. J.YangL. K.GauS. S. (2016). Psychiatric comorbidities of adults with early- and late-onset attention-deficit/hyperactivity disorder. Australian and New Zealand Journal of Psychiatry, 50, 548-556.
38.
LucianaM. (2003). Practitioner review: Computerized assessment of neuropsychological function in children: Clinical and research applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB). The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 44, 649-663.
39.
LucianaM.NelsonC. A. (1998). The functional emergence of prefrontally-guided working memory systems in four- to eight-year-old children. Neuropsychologia, 36, 273-293.
40.
MilnerB. (1971). Interhemispheric differences in the localization of psychological processes in man. British Medical Bulletin, 27, 272-277.
41.
MoffittT. E.HoutsR.AshersonP.BelskyD. W.CorcoranD. L.HammerleM.. . . CaspiA. (2015). Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. The American Journal of Psychiatry, 172, 967-977.
42.
NiH. C.LinY. J.GauS. S.HuangH. C.YangL. K. (2017). An open-label, randomized trial of methylphenidate and atomoxetine treatment in adults with ADHD. Journal of Attention Disorders, 21, 27-39.
43.
NiggJ. T. (2001). Is ADHD a disinhibitory disorder?Psychological Bulletin, 127, 571-598.
44.
NiggJ. T. (2005). Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: The state of the field and salient challenges for the coming decade. Biological Psychiatry, 57, 1424-1435. doi:10.1016/j.biopsych.2004.11.011
45.
OltonD. S. (1987). The radial arm maze as a tool in behavioral pharmacology. Physiology & Behavior, 40, 793-797.
46.
OwenA. M.DoyonJ.PetridesM.EvansA. C. (1996). Planning and spatial working memory: A positron emission tomography study in humans. European Journal of Neuroscience, 8, 353-364.
47.
PetridesM.MilnerB. (1982). Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man. Neuropsychologia, 20, 249-262.
48.
PolanczykG.CaspiA.HoutsR.KollinsS. H.RohdeL. A.MoffittT. E. (2010). Implications of extending the ADHD age-of-onset criterion to age 12: Results from a prospectively studied birth cohort. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 210-216.
49.
PribramK. H.McGuinnessD. (1975). Arousal, activation, and effort in the control of attention. Psychological Review, 82, 116-149.
50.
ProsserB.ReidR. (2013). The DSM-5 changes and ADHD: More than a tweak of terms. Australian & New Zealand Journal of Psychiatry, 47, 1196-1197.
51.
ReinhardtM. C.BenettiL.VictorM. M.GrevetE. H.Belmonte-de-AbreuP.FaraoneS. V.. . . RohdeL. A. (2007). Is age-at-onset criterion relevant for the response to methylphenidate in attention-deficit/hyperactivity disorder?The Journal of Clinical Psychiatry, 68, 1109-1116.
52.
RhodesS. M.CoghillD. R.MatthewsK. (2005). Neuropsychological functioning in stimulant-naive boys with hyperkinetic disorder. Psychological Medicine, 35, 1109-1120.
53.
RohdeL. A.BiedermanJ.ZimmermannH.SchmitzM.MartinsS.TramontinaS. (2000). Exploring ADHD age-of-onset criterion in Brazilian adolescents. European Child & Adolescent Psychiatry, 9, 212-218.
54.
SahgalA. (1987). Some limitations of indices derived from signal detection theory: Evaluation of an alternative index for measuring bias in memory tasks. Psychopharmacology, 91, 517-520.
55.
SchoechlinC.EngelR. R. (2005). Neuropsychological performance in adult attention-deficit hyperactivity disorder: Meta-analysis of empirical data. Archives of Clinical Neuropsycholog, 20, 727-744.
56.
SeidmanL. J. (2006). Neuropsychological functioning in people with ADHD across the lifespan. Clinical Psychology Review, 26, 466-485.
57.
SeidmanL. J.BiedermanJ.WeberW.HatchM.FaraoneS. V. (1998). Neuropsychological function in adults with attention-deficit hyperactivity disorder. Biological Psychiatry, 44, 260-268.
58.
SergeantJ. A.GeurtsH.OosterlaanJ. (2002). How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder?Behavioural Brain Research, 130, 3-28.
59.
ShafferD. (1994). Attention deficit hyperactivity disorder in adults. The American Journal of Psychiatry, 151, 633-638.
60.
Sonuga-BarkeE. J. (2005). Causal models of attention-deficit/hyperactivity disorder: From common simple deficits to multiple developmental pathways. Biological Psychiatry, 57, 1231-1238.
61.
TannockR. (2013). Rethinking ADHD and LD in DSM-5: Proposed changes in diagnostic criteria. Journal of Learning Disabilities, 46, 5-25.
62.
ToddR. D.HuangH.HendersonC. A. (2008). Poor utility of the age of onset criterion for DSM-IV attention deficit/hyperactivity disorder: Recommendations for DSM-V and ICD-11. The Journal of Child Psychology and Psychiatry, and Allied Disciplines, 49, 942-949.
63.
VaidyaC. J. (2012). Neurodevelopmental abnormalities in ADHD. Current Topics in Behavioral Neurosciences, 9, 49-66.
64.
van der MeereJ.ShalevR.BorgerN.Gross-TsurV. (1995). Sustained attention, activation and MPH in ADHD: A research note. The Journal of Child Psychology and Psychiatry, 36, 697-703.
65.
Vande VoortJ. L.HeJ. P.JamesonN. D.MerikangasK. R. (2014). Impact of the DSM-5 attention-deficit/hyperactivity disorder age-of-onset criterion in the US adolescent population. Journal of the American Academy of Child & Adolescent Psychiatry, 53, 736-744.
66.
WillcuttE. G.DoyleA. E.NiggJ. T.FaraoneS. V.PenningtonB. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336-1346.
67.
WilloughbyM. T.CurranP. J.CostelloE. J.AngoldA. (2000). Implications of early versus late onset of attention-deficit/hyperactivity disorder symptoms. Journal of the American Academy of Child & Adolescent Psychiatry, 39, 1512-1519.
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