We tested the hypotheses that (1) a diagnosis of ADHD in childhood or adolescence is associated with reduced quality of life (QoL) and everyday functioning in emerging adulthood, and (2) executive function (EF) deficits, internalizing difficulties, and ADHD symptoms predict reduced QoL and more functional impairments.
Method:
We assessed 85 children and adolescents with ADHD and 50 typically developing (TD) peers at baseline (Mage = 11.6 years, 58% males), 2-year follow-up, and 10-year follow-up with neuropsychological tests of EF and self-reports.
Results:
Individuals with ADHD reported lower QoL and functional impairments in emerging adulthood compared to TD peers. More internalizing difficulties and ADHD symptoms at baseline and 2-year follow-up significantly predicted lower QoL and more functional impairments at the 10-year follow-up.
Conclusion
ADHD and internalizing difficulties in childhood or adolescence have a negative impact on QoL and everyday functioning in emerging adulthood.
AchenbachT. M.RescorlaL. A. (2001). Manual for the ASEBA school-age forms & profiles: An integrated system of multi-informant assessment. Aseba.
2.
AgrestiA.FinlayB. (2014). Statistical methods for the social sciences (4th ed.). Pearson Education.
3.
AngoldA.CostelloE. J.MesserS. C.PicklesA. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5(4), 237–249.
4.
BaggioS.StuderJ.IglesiasK.DaeppenJ.-B.GmelG. (2017). Emerging adulthood: A time of changes in psychosocial well-being. Evaluation & the Health Professions, 40(4), 383–400. https://doi.org/10.1177/0163278716663602
5.
BaronI. S. (2005). Test review: Wechsler intelligence scale for children-fourth edition (WISC-IV). Child Neuropsychology, 11(5), 471–475. https://doi.org/10.1080/09297040590951587
6.
CanuW. H.HartungC. M.StevensA. E.LeflerE. K. (2020). Psychometric properties of the weiss functional impairment rating scale: Evidence for utility in research, assessment, and treatment of ADHD in emerging adults. Journal of Attention Disorders, 24(12), 1648–1660. https://doi.org/10.1177/1087054716661421
7.
CayeA.SwansonJ.ThaparA.SibleyM.ArseneaultL.HechtmanL.ArnoldL. E.NiclasenJ.MoffittT.RohdeL. A. (2016). Life span studies of ADHD—Conceptual challenges and predictors of persistence and outcome. Current Psychiatry Reports, 18(12), 111. https://doi.org/10.1007/s11920-016-0750-x
8.
CherkasovaM. V.RoyA.MolinaB. S. G.ScottG.WeissG.BarkleyR. A.BiedermanJ.UchidaM.HinshawS. P.OwensE. B.HechtmanL. (2021). Review: Adult outcome as seen through controlled prospective follow-up studies of children with attention-deficit/hyperactivity disorder followed into adulthood. Journal of the American Academy of Child & Adolescent Psychiatry. Advance online publication. https://doi.org/10.1016/j.jaac.2021.05.019
DelisD.KaplanE.KramerJ. (2001). Delis-Kaplan executive function system (D-KEFS). Norwegian version. Pearson Assessments.
11.
DennisM.FrancisD. J.CrinoP. T.SchacharR.BarnesM. A.FletcherJ. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15(3), 331–343. https://doi.org/10.1017/S1355617709090481
12.
DeyM.LandoltM. A.Mohler-KuoM. (2012). Health-related quality of life among children with mental disorders: A systematic review. Quality of Life Research, 21(10), 1797–1814. https://doi.org/10.1007/s11136-012-0109-7
DuPaulG. J.PowerT. J.McGoeyK. E.IkedaM. J.AnastopoulosA. D. (1998c). Reliability and validity of parent and teacher ratings of attention-deficit/hyperactivity disorder symptoms. Journal of Psychoeducational Assessment, 16(1), 55–68. https://doi.org/10.1177/073428299801600104
17.
EtkinR. G.ShimshoniY.LebowitzE. R.SilvermanW. K. (2021). Using evaluative criteria to review youth anxiety measures, part I: Self-report. Journal of Clinical Child & Adolescent Psychology, 50(1), 58–76. https://doi.org/10.1080/15374416.2020.1802736
18.
FaraoneS. V.BanaschewskiT.CoghillD.ZhengY.BiedermanJ.BellgroveM. A.NewcornJ. H.GignacM.Al SaudN. M.ManorI.RohdeL. A.YangL.CorteseS.AlmagorD.SteinM. A.AlbattiT. H.AljoudiH. F.AlqahtaniM. M. J.AshersonP.. . . WangY. (2021). The world federation of ADHD international consensus statement: 208 Evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022
19.
FaraoneS. V.BiedermanJ.MickE. (2006). The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies. Psychological Medicine, 36(2), 159–165. https://doi.org/10.1017/S003329170500471X
20.
FossumI. N.AndersenP. N.ØieM. G.SkogliE. W. (2021). Development of executive functioning from childhood to young adulthood in autism spectrum disorder and attention-deficit/hyperactivity disorder: A 10-year longitudinal study. Neuropsychology, 35(8), 809–821. https://doi.org/10.1037/neu0000768
21.
FuhrmannD.KnollL. J.BlakemoreS.-J. (2015). Adolescence as a sensitive period of brain development. Trends in Cognitive Sciences, 19(10), 558–566. https://doi.org/10.1016/j.tics.2015.07.008
22.
GordonC. T.HinshawS. P. (2020). Executive functions in girls with and without childhood ADHD followed through emerging adulthood: Developmental trajectories. Journal of Clinical Child & Adolescent Psychology, 49(4), 509–523. https://doi.org/10.1080/15374416.2019.1602840
23.
HaaveE.SkumlienS.EngvikH. (2007). Livskvalitet hos pasienter med alvorlig kronisk obstruktiv lungesykdom: Norsk versjon av the perceived quality of life scale. Tidsskrift for Norsk psykologforening, 44(6), 735–740.
24.
HalldorsdottirT.OllendickT. H. (2014). Comorbid ADHD: Implications for the treatment of anxiety disorders in children and adolescents. Cognitive and Behavioral Practice, 21(3), 310–322. https://doi.org/10.1016/j.cbpra.2013.08.003
25.
HauganA.-L. J.SundA. M.ThomsenP. H.LydersenS.NøvikT. S. (2021). Psychometric properties of the Weiss Functional Impairment Rating Scale parent and self-reports in a Norwegian clinical sample of adolescents treated for ADHD. Nordic Journal of Psychiatry, 75(1), 63–72. https://doi.org/10.1080/08039488.2020.1795252
26.
HayesA. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach (2nd ed.). Guilford Press.
27.
HinshawS. P.OwensE. B.ZaleckiC.HugginsS. P.Montenegro-NevadoA. J.SchrodekE.SwansonE. N. (2012). Prospective follow-up of girls with attention-deficit/hyperactivity disorder into early adulthood: Continuing impairment includes elevated risk for suicide attempts and self-injury. Journal of Consulting and Clinical Psychology, 80(6), 1041–1051. https://doi.org/10.1037/a0029451
28.
HolstY.ThorellL. B. (2020). Functional impairments among adults with ADHD: A comparison with adults with other psychiatric disorders and links to executive deficits. Applied Neuropsychology: Adult, 27(3), 243–255. https://doi.org/10.1080/23279095.2018.1532429
29.
HomackS.LeeD.RiccioC. A. (2005). Test review: Delis-Kaplan executive function system. Journal of Clinical and Experimental Neuropsychology, 27(5), 599–609. https://doi.org/10.1080/13803390490918444
30.
JensenC. M.SteinhausenH.-C. (2015). Comorbid mental disorders in children and adolescents with attention-deficit/hyperactivity disorder in a large nationwide study. ADHD Attention Deficit and Hyperactivity Disorders, 7(1), 27–38. https://doi.org/10.1007/s12402-014-0142-1
31.
KarrJ. E.AreshenkoffC. N.RastP.HoferS. M.IversonG. L.Garcia-BarreraM. A. (2018). The unity and diversity of executive functions: A systematic review and re-analysis of latent variable studies. Psychological Bulletin, 144(11), 1147–1185. https://doi.org/10.1037/bul0000160
32.
KaufmanJ.BirmaherB.BrentD.RaoU.FlynnC.MoreciP.WilliamsonD.RyanN. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36(7), 980–988. https://doi.org/10.1097/00004583-199707000-00021
33.
KelesS.IdsoeT. (2018). A meta-analysis of group Cognitive Behavioral Therapy (CBT) interventions for adolescents with depression. Journal of Adolescence, 67, 129–139. https://doi.org/10.1016/j.adolescence.2018.05.011
34.
KodalA.FjermestadK.BjellandI.GjestadR.ÖstL.-G.BjaastadJ. F.HauglandB. S. M.HavikO. E.HeiervangE.WergelandG. J. (2018). Long-term effectiveness of cognitive behavioral therapy for youth with anxiety disorders. Journal of Anxiety Disorders, 53, 58–67. https://doi.org/10.1016/j.janxdis.2017.11.003
35.
KuoE. S.StoepA. V.StewartD. G. (2005). Using the short mood and feelings questionnaire to detect depression in detained adolescents. Assessment, 12(4), 374–383. https://doi.org/10.1177/1073191105279984
36.
LorenzoR. D.BalducciJ.PoppiC.ArcolinE.CutinoA.FerriP.D’AmicoR.FilippiniT. (2021). Children and adolescents with ADHD followed up to adulthood: A systematic review of long-term outcomes. Acta Neuropsychiatrica, 33(6), 283–298. https://doi.org/10.1017/neu.2021.23
37.
MauriziL. K.Grogan-KaylorA.GranilloM. T.DelvaJ. (2013). The role of social relationships in the association between adolescents’ depressive symptoms and academic achievement. Children and Youth Services Review, 35(4), 618–625. https://doi.org/10.1016/j.childyouth.2013.01.006
38.
McLaughlinK. A.KingK. (2015). Developmental trajectories of anxiety and depression in early adolescence. Journal of Abnormal Child Psychology, 43(2), 311–323. https://doi.org/10.1007/s10802-014-9898-1
39.
ØieM. G.HovikK. T.AndersenP. N.CzajkowskiN. O.SkogliE. W. (2018). Gender differences in the relationship between changes in ADHD symptoms, Executive functions, and self- and parent-report depression symptoms in boys and girls with ADHD: A 2-year follow-up study. Journal of Attention Disorders, 22(5), 446–459. https://doi.org/10.1177/1087054716664407
40.
ØieM. G.SundetK.HaugE.ZeinerP.KlungsøyrO.RundB. R. (2021). Cognitive performance in early-onset schizophrenia and attention-deficit/hyperactivity disorder: A 25-year follow-up study. Frontiers in Psychology, 11, 606365. https://doi.org/10.3389/fpsyg.2020.606365
41.
OrmS.AndersenP. N.TeicherM. H.FossumI. N.ØieM. G.SkogliE. W. (2022). Childhood executive functions and ADHD symptoms predict psychopathology symptoms in emerging adults with and without ADHD: A 10-year longitudinal study. Research on Child and Adolescent Psychopathology. Advance online publication. https://doi.org/10.1007/s10802-022-00957-7
42.
OrmS.ØieM. G.FossumI. N.AndersenP. N.SkogliE. W. (2021). Declining trajectories of co-occurring psychopathology symptoms in attention-deficit/hyperactivity disorder and autism spectrum disorder: A 10-year longitudinal study. Frontiers in Psychiatry, 12, 1774. https://doi.org/10.3389/fpsyt.2021.724759
43.
OrmS.PollakY.FossumI. N.AndersenP. N.ØieM. G.SkogliE. W. (2022). Decision-making and risky behavior in individuals with attention-deficit/hyperactivity disorder: A 10-year longitudinal study. Developmental Neuropsychology, 47(4), 193–209. https://doi.org/10.1080/87565641.2022.2082430
44.
OwensE. B.HinshawS. P. (2016). Pathways from neurocognitive vulnerability to co-occurring internalizing and externalizing problems among women with and without attention-deficit/hyperactivity disorder followed prospectively for 16 years. Development and Psychopathology, 28(4pt1), 1013–1031. https://doi.org/10.1017/S0954579416000675
45.
PatrickD. L.DanisM.SoutherlandL. I.HongG. (1988). Quality of life following intensive care. Journal of General Internal Medicine, 3(3), 218–223. https://doi.org/10.1007/BF02596335
46.
PatrickD. L.KinneS.EngelbergR. A.PearlmanR. A. (2000). Functional status and perceived quality of life in adults with and without chronic conditions. Journal of Clinical Epidemiology, 53(8), 779–785. https://doi.org/10.1016/S0895-4356(00)00205-5
47.
PievskyM. A.McGrathR. E. (2018). The neurocognitive profile of attention-deficit/hyperactivity disorder: A review of meta-analyses. Archives of Clinical Neuropsychology, 33(2), 143–157. https://doi.org/10.1093/arclin/acx055
48.
PinhoT. D.ManzP. H.DuPaulG. J.AnastopoulosA. D.WeyandtL. L. (2019). Predictors and moderators of quality of life among college students with ADHD. Journal of Attention Disorders, 23(14), 1736–1745. https://doi.org/10.1177/1087054717734645
49.
ReynoldsC. R.RichmondB. O. (1985). Revised children’s manifest anxiety scale (RCMAS). Western Psychological Services.
50.
RinskyJ. R.HinshawS. P. (2011). Linkages between childhood executive functioning and adolescent social functioning and psychopathology in girls with ADHD. Child Neuropsychology, 17(4), 368–390. https://doi.org/10.1080/09297049.2010.544649
51.
RomerA. L.PizzagalliD. A. (2021). Is executive dysfunction a risk marker or consequence of psychopathology? A test of executive function as a prospective predictor and outcome of general psychopathology in the adolescent brain cognitive development study®. Developmental Cognitive Neuroscience, 51, 100994. https://doi.org/10.1016/j.dcn.2021.100994
52.
RuegerS. Y.MaleckiC. K.PyunY.AycockC.CoyleS. (2016). A meta-analytic review of the association between perceived social support and depression in childhood and adolescence. Psychological Bulletin, 142, 1017–1067. https://doi.org/10.1037/bul0000058
53.
San Miguel MontesL. E.AllenD. N.PuenteA. E.NeblinaC. (2010). Validity of the WISC–IV Spanish for a clinically referred sample of Hispanic children. Psychological Assessment, 22(2), 465–469. https://doi.org/10.1037/a0018895
54.
SchwartzS. J.PetrovaM. (2019). Prevention science in emerging adulthood: A field coming of age. Prevention Science, 20(3), 305–309. https://doi.org/10.1007/s11121-019-0975-0
55.
SchwörerM. C.ReineltT.PetermannF.PetermannU. (2020). Influence of executive functions on the self-reported health-related quality of life of children with ADHD. Quality of Life Research, 29(5), 1183–1192. https://doi.org/10.1007/s11136-019-02394-4
56.
SharpC.GoodyerI. M.CroudaceT. J. (2006). The short mood and feelings questionnaire (SMFQ): A unidimensional item response theory and categorical data factor analysis of self-report ratings from a community sample of 7-through 11-year-old children. Journal of Abnormal Child Psychology, 34(3), 365–377. https://doi.org/10.1007/s10802-006-9027-x
57.
SibleyM. H.MitchellJ. T.BeckerS. P. (2016). Method of adult diagnosis influences estimated persistence of childhood ADHD: A systematic review of longitudinal studies. The Lancet Psychiatry, 3(12), 1157–1165. https://doi.org/10.1016/S2215-0366(16)30190-0
58.
SkogliE. W.AndersenP. N.HovikK. T.ØieM. (2017). Development of hot and cold executive function in boys and girls with ADHD: A 2-year longitudinal study. Journal of Attention Disorders, 21(4), 305–315. https://doi.org/10.1177/1087054714524984
59.
SkogliE. W.AndersenP. N.OrmS.HovikK. T.ØieM. G. (2022). Executive functioning in everyday life in youth with attention-deficit/hyperactivity disorder and autism spectrum disorders: A two-year longitudinal study. International Journal of Disability, Development and Education, Advance online publication. https://doi.org/10.1080/1034912X.2022.2095360
60.
SkogliE. W.TeicherM. H.AndersenP. N.HovikK. T.ØieM. (2013). ADHD in girls and boys – gender differences in co-existing symptoms and executive function measures. BMC Psychiatry, 13(1), 298. https://doi.org/10.1186/1471-244X-13-298
61.
SternA.PollakY.BonneO.MalikE.MaeirA. (2017). The relationship between executive functions and quality of life in adults with ADHD. Journal of Attention Disorders, 21(4), 323–330. https://doi.org/10.1177/1087054713504133
62.
SuchyY.BrothersS. L. (2022). Reliability and validity of composite scores from the timed subtests of the D-KEFS battery. Psychological Assessment, 34(5), 483–495. https://doi.org/10.1037/pas0001081
63.
SwansonE. N.OwensE. B.HinshawS. P. (2014). Pathways to self-harmful behaviors in young women with and without ADHD: A longitudinal examination of mediating factors. Journal of Child Psychology and Psychiatry, 55(5), 505–515. https://doi.org/10.1111/jcpp.12193
64.
TammL.LorenR. E. A.PeughJ.CiesielskiH. A. (2021). The association of executive functioning with academic, behavior, and social performance ratings in children with ADHD. Journal of Learning Disabilities, 54(2), 124–138. https://doi.org/10.1177/0022219420961338
65.
ToplakM. E.WestR. F.StanovichK. E. (2013). Practitioner review: Do performance-based measures and ratings of executive function assess the same construct?Journal of Child Psychology and Psychiatry, 54(2), 131–143. https://doi.org/10.1111/jcpp.12001
66.
WagnerS.HelmreichI.DahmenN.LiebK.TadićA. (2011). Reliability of three alternate forms of the trail making tests A and B. Archives of Clinical Neuropsychology, 26(4), 314–321. https://doi.org/10.1093/arclin/acr024
67.
WechslerD. (2004). Wechsler intelligence scale for children—Fourth edition: Norwegian version. The Psychological Corporation.
68.
WeissM. D. (2000). Weiss functional impairment rating scale (WFIRS) self-report. University of British Columbia.
69.
WeissM. D.McBrideN. M.CraigS.JensenP. (2018). Conceptual review of measuring functional impairment: Findings from the Weiss Functional Impairment Rating Scale. Evidence-Based Mental Health, 21(4), 155–164. https://doi.org/10.1136/ebmental-2018-300025
70.
YangH.-N.TaiY.-M.YangL.-K.GauS. S.-F. (2013). Prediction of childhood ADHD symptoms to quality of life in young adults: Adult ADHD and anxiety/depression as mediators. Research in Developmental Disabilities, 34(10), 3168–3181. https://doi.org/10.1016/j.ridd.2013.06.011
71.
ZendarskiN.MensahF.HiscockH.SciberrasE. (2021). Trajectories of emotional and conduct problems and their association with early high school achievement and engagement for adolescents with ADHD. Journal of Attention Disorders, 25(5), 623–635. https://doi.org/10.1177/1087054719833167
72.
ZhangS.-Y.FariesD. E.VowlesM.MichelsonD. (2005). ADHD rating scale IV: Psychometric properties from a multinational study as clinician-administered instrument. International Journal of Methods in Psychiatric Research, 14(4), 186–201. https://doi.org/10.1002/mpr.7
73.
ZhangS.-Y.QiuS.-W.PanM.-R.ZhaoM.-J.ZhaoR.-J.LiuL.LiH.-M.WangY.-F.QianQ.-J. (2021). Adult ADHD, executive function, depressive/anxiety symptoms, and quality of life: A serial two-mediator model. Journal of Affective Disorders, 293, 97–108. https://doi.org/10.1016/j.jad.2021.06.020
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