Association Between Psychiatric Symptoms and Executive Function in Adults With Attention Deficit Hyperactivity Disorder

Objective: Psychiatric comorbidities and reduced executive function (EF) are common in adults with attention deficit hyperactivity disorder (ADHD); however, it is not clear which EF difficulties can be attributed to ADHD and which to the associated psychiatric symptomatology. The present study aimed to determine the correlation between EF and associated psychiatric symptoms in ADHD adults. Method: We studied 37 adults (20-35 years old) with ADHD. We used the Personality Assessment Inventory (PAI) to measure psychiatric symptoms, two EF tests (d2 and Paced Auditory Serial Addition Test, PASAT), and EF ratings (Behavior Rating Inventory of Executive Function-Adult Version, BRIEF-A). Results: Significant correlations were found between several PAI clinical scales and BRIEF-A subscales, as well as with performance of d2 and PASAT. Current ADHD symptomatology was also associated with most EF measures. When ADHD symptoms were controlled, correlations remained significant only between a few PAI subscales and some BRIEF-A Scales; specifically, between the Anxiety and Anxiety Related Disorders scales and Emotional Control; Borderline Features and Initiate and Plan/Organize; and Antisocial Features and Inhibit. All correlations were positive, meaning more severe clinical symptoms were associated with worst executive function. Conclusions: EF mainly correlated with ADHD symptoms, although specific EFs were associated with certain psychiatric comorbidities. It is important to conduct further studies to better understand the relationship between psychiatric comorbidities in adults with ADHD and reported EF deficits. Public Significance Statement Determining the executive function components related to psychiatric comorbidities of ADHD can improve understanding of adult ADHD, its diagnosis, and treatment. The present study reveals a positive correlation between reduced executive function and comorbid symptoms in ADHD, particularly with respect to anxiety, borderline features, and antisocial features. The findings support the influence of psychiatric symptoms on only some aspects of executive functioning of adults with ADHD.