Associations of intellectual ability, inhibitory control, impulsiveness, cognitive flexibility and functional impairment in adults with ADHD Symptoms

Izabella Trinta  Paes; Mayara Miyahara Moraes  Silva; Ana Paula Roim  Micieli; Maria Cristina Triguero Veloz  Teixeira; Luiz Renato Rodrigues Carreiro

doi:10.31686/ijier.vol7.iss12.2038

Authors

Izabella Trinta Paes Developmental Disorders Graduate Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University
Mayara Miyahara Moraes Silva Developmental Disorders Graduate Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University
Ana Paula Roim Micieli Developmental Disorders Graduate Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University
Maria Cristina Triguero Veloz Teixeira Developmental Disorders Graduate Program, Center for Health and Biological Sciences, Mackenzie Presbyterian University
Luiz Renato Rodrigues Carreiro Universidade Presbiteriana Mackenzie https://orcid.org/0000-0001-8249-1832

DOI:

https://doi.org/10.31686/ijier.vol7.iss12.2038

Keywords:

Attention deficit hyperactivity disorder, Impulsiveness, Cognitive flexibility, Inhibitory control, intellectual

Abstract

Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder with persistent levels of inattention, hyperactivity or impulsivity. Recommendations for ADHD diagnosis involve: six or more symptoms (or five considering adults), early childhood onset, presence of symptoms in two or more contexts and presence of functional impairment. Cognitive deficits, that affect inhibitory control, cognitive flexibility and impulsiveness, are present in ADHD and affect the course of the disorder. On the other hand, intellectual skill is a factor of protection to improve the development in people with ADHD. This article explores how traits relate to functional impairments are relevant to ADHD description in terms of behavioral expression of the cognitive profile. Method: Forty-nine adults, between 20 and 68 years old, with symptoms of inattention and hyperactivity/impulsivity compatible with ADHD, with more than 4 years of schooling and absence of chronic illness, took part of this study. We collected data using screening instruments (ASRS-18, MMSE, and WASI) and main instruments (FDT, BIS-11, and EPF-ADHD). Results: The results have shown that higher intellectual indexes were associated with lower frequencies of academic impairment, while higher impulsivity levels, cognitive flexibility difficulties and inhibitory control, were associated with academic and social impairment. Conclusion: The results show that cognitive deficits were associated to impairment, in different life areas, of people with ADHD, and that some factors, as intellectual abilities, may prevent impairment in ADHD.

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References

American Psychiatric Association. (2014). DSM-5: Manual diagnóstico e estatístico de transtornos mentais. Artmed Editora.
Asherson, P., Buitelaar, J., Faraone, S. V., & Rohde, L. A. (2016). Adult attention-deficit hyperactivity disorder: key conceptual issues. The Lancet Psychiatry, 3(6), 568-578.
Barkley, R. A. (2009). Transtorno de déficit de atenção/hiperatividade: manual para diagnóstico e tratamento. Artmed Editora.
Brucki, S., Nitrini, R., Caramelli, P., Bertolucci, P. H., & Okamoto, I. H. (2003). Suggestions for utilization of the mini-mental state examination in Brazil. Arquivos de neuro-psiquiatria, 61(3B), 777-781.
Canela, C., Buadze, A., Dube, A., Eich, D., & Liebrenz, M. (2017). Skills and compensation strategies in adult ADHD–A qualitative study. PloS one, 12(9), e0184964.
de Paula, J. J., Oliveira, T. Dell’Oro, Querino, E. H. Gonçalves, & Malloy-Diniz, L. F. (2017). The Five Digits Test in the assessment of older adults with low formal education: construct validity and reliability in a Brazilian clinical sample. Trends in Psychiatry and Psychotherapy, 39(3), 173-179. https://dx.doi.org/10.1590/2237-6089-2016-0060
Fuermaier, A. B., Fricke, J. A., de Vries, S. M., Tucha, L., & Tucha, O. (2019). Neuropsychological assessment of adults with ADHD: a Delphi consensus study. Applied Neuropsychology: Adult, 26(4), 340-354.
Goodman, D. W., Mitchell, S., Rhodewalt, L., & Surman, C. B. (2016). Clinical presentation, diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD) in older adults: a review of the evidence and its implications for clinical care. Drugs & aging, 33(1), 27-36.
Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E. V. A., ... & Ustun, T. B. (2005). The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychological medicine, 35(2), 245-256.
Kooij, J. S., Michielsen, M., Kruithof, H., & Bijlenga, D. (2016). ADHD in old age: a review of the literature and proposal for assessment and treatment. Expert review of neurotherapeutics, 16(12), 1371-1381.
Kooij, S. J., Bejerot, S., Blackwell, A., Caci, H., Casas-Brugué, M., Carpentier, P. J., ... & Gaillac, V. (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC psychiatry, 10(1), 67.
Malloy-Diniz, L. F., Mattos, P., Leite, W. B., Abreu, N., Coutinho, G., de Paula, J. J., ... & Fuentes, D. (2010). Tradução e adaptação cultural da Barratt Impulsiveness Scale (BIS-11) para aplicação em adultos brasileiros. J Bras psiquiatr, 59(2), 99-105.
Malloy-Diniz, L. F., Paula, J. J. D., Vasconcelos, A. G., Almondes, K. M. D., Pessoa, R., Faria, L., ... & Corrêa, H. (2015). Normative data of the Barratt Impulsiveness Scale 11 (BIS-11) for Brazilian adults. Brazilian Journal of Psychiatry, 37(3), 245-248.
Mattos, P., Segenreich, D., Saboya, E., Louzã, M., Dias, G., & Romano, M. (2006). Adaptação transcultural para o português da escala Adult Self-Report Scale para avaliação do transtorno de déficit de atenção/hiperatividade (TDAH) em adultos. Archives of Clinical Psychiatry, 33(4), 188-194.
Mostert, J. C., Onnink, A. M. H., Klein, M., Dammers, J., Harneit, A., Schulten, T., ... & Franke, B. (2015). Cognitive heterogeneity in adult attention deficit/hyperactivity disorder: a systematic analysis of neuropsychological measurements. European Neuropsychopharmacology, 25(11), 2062-2074.
Oliveira, A. P. A. De; Nascimento, E. de. EPF-TDAH: Escala de prejuízos funcionais – TDAH. 1ª ed. São Paulo: Hografe, 1ª ed. 2016.
Sedó, M.; Paula, F.J.; Malloy-Diniz, L.F. (2017). O Teste dos cinco dígitos. Editora Hografe.
Thorell, L. B., Holst, Y., Chistiansen, H., Kooij, J. S., Bijlenga, D., & Sjöwall, D. (2017). Neuropsychological deficits in adults age 60 and above with attention deficit hyperactivity disorder. European Psychiatry, 45, 90-96.
Trentini, C. M.; Yates, D. B.; Heck, V. S. Escala de Inteligência Wechsler Abreviada (WASI). Casa do Psicólogo.
Zalsman, G., & Shilton, T. (2016). Adult ADHD: A new disease? International journal of psychiatry in clinical practice, 20(2), 70-76.