Stability of executive function deficits into young adult years

a prospective longitudinal follow-up study of grown up males with ADHD

Biederman, J.
Petty, C. R.
Fried, R.
Doyle, A. E.
Spencer, T.
Seidman, L. J.
Gross, L.
Poetzl, K.
Faraone, S. V.

¹Pediatric Psychopharmacology Program, Massachusetts General Hospital, Boston, MA
²Department of Psychiatry, Harvard Medical School, Boston, MA
³Department of Psychiatry, SUNY Upstate Medical University, Syracuse, NY, USA

Joseph Biederman, MD, Massachusetts General Hospital, Pediatric Psychopharmacology Unit, Yawkey Center for Outpatient Care-YAW-6A-6900, 32 Fruit Street, Boston, MA 02114, USA. E-mail: [email protected].

Accepted for publication January 2 2007

Acta Psychiatrica Scandinavica 116(2):p 129-136, August 2007.

Objective

Although individuals with attention deficit-hyperactivity disorder (ADHD) commonly exhibit deficits in executive functions that greatly increase the morbidity of the disorder, all available information on the subject is cross sectional.

Method

Males (n = 85) 9–22 years with ADHD followed over 7 years into young adulthood were assessed on measures of sustained attention/vigilance, planning and organization, response inhibition, set shifting and categorization, selective attention and visual scanning, verbal and visual learning, and memory. A binary definition of executive function deficits (EFDs) was defined based on a subject manifesting at least two abnormal tests 1.5 standard deviations from controls.

Results

The majority of subjects maintained EFDs over time (kappa: 0.41, P < 0.001; sensitivity: 55%, specificity: 85%, positive predictive value: 69%, and negative predictive value: 75%).

Conclusion

Considering the morbidity of EFDs, these findings stress the importance of their early recognition for prevention and early intervention strategies. EFDs are stable over time.