Executive functioning in adult ADHD: a meta-analytic review.
BACKGROUND
Several theoretical explanations of ADHD in children have focused on executive functioning as the main explanatory neuropsychological domain for the disorder. In order to establish if these theoretical accounts are supported by research data for adults with ADHD, we compared neuropsychological executive functioning and non-executive functioning between adults with ADHD and normal controls in a meta-analytic design.


METHODS
We compared 13 studies that (1) included at least one executive functioning measure, (2) compared the performance of an adult ADHD group with that of an adult normal control group, (3) provided sufficient information for calculation of effect sizes, and (4) used DSM-III-R or DSM-IV criteria to diagnose ADHD.


RESULTS
We found medium effect sizes both in executive functioning areas [verbal fluency (d= 0-62), inhibition (d = 0-64 and d = 0.89), and set shifting (d = 0.65)] and in non-executive functioning domains [consistency of response (d = 0.57), word reading (d = 0.60) and color naming (d = 0.62)].


CONCLUSIONS
Neuropsychological difficulties in adult ADHD may not be confined to executive functioning. The field is in urgent need of better-designed executive functioning tests, methodological improvements, and direct comparisons with multiple clinical groups to answer questions of specificity.
Boonstra
A Marije
AM
Department of Psychology, Erasmus University, Rotterdam, The Netherlands. boonstra@fsw.eur.nl
Oosterlaan
Jaap
J
Sergeant
Joseph A
JA
Buitelaar
Jan K
JK
D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D009483:Neuropsychological Tests; D012720:Severity of Illness Index