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Set-Shifting in Adults with ADHD

Published online by Cambridge University Press:  22 May 2012

Helene Barone Halleland ,
Jan Haavik  and
Astri J. Lundervold
Helene Barone Halleland*
Affiliation:
Department of Biological and Medical Psychology, University of Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway Solli Hospital, Bergen, Norway
Jan Haavik
Affiliation:
K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway Department of Biomedicine, University of Bergen, Norway Department of Psychiatry, Haukeland University Hospital, Bergen, Norway
Astri J. Lundervold
Affiliation:
Department of Biological and Medical Psychology, University of Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
*
Correspondence and reprint requests to: Helene Barone Halleland, Department of Biological and Medical Psychology, University of Bergen, PO Box 7807, NO-5020 Bergen. E-mail: [email protected]
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Abstract

Difficulties related to inhibition and set-shifting have been suggested as possible endophenotypes of Attention Deficit Hyperactivity Disorder (ADHD). However, such difficulties have not been consistently found in studies using standard neuropsychological tests. This has been partly explained by the complexity of these tests and the need to include contrast measures which control for more basic functions. The purpose of the present study was to examine whether difficulties related to inhibition and set-shifting in adult ADHD patients could be revealed by the Color Word Interference Test (CWIT) from the Delis Kaplan Executive Function System (D-KEFS). A clinically recruited group of adults with ADHD (n = 60) obtained significantly lower scores than population derived controls (n = 60) on both primary summary (p < .001) and contrast measures (p = .004) of set-shifting. The differences between the groups remained statistically significant after controlling for intellectual function and working memory (p = .003). However, no significant differences between the groups were observed on any measure of inhibition. The study indicates that adults with ADHD have specific difficulties with set-shifting as measured by the CWIT, difficulties that probably also reflect problems related to executive function in their daily life. (JINS, 2012, 18, 1–10)

Keywords

Executive functioningD-KEFSContrast scoresAttention deficit hyperactivity disorderPure measuresStroop test
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 4 , July 2012 , pp. 728 - 737
Copyright
Copyright © The International Neuropsychological Society 2012

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References

Adolfsdottir, S., Sorensen, L., Lundervold, A.J. (2008). The attention network test: A characteristic pattern of deficits in children with ADHD. Behavioral and Brain Functions, 4, 9. doi:10.1186/1744-9081-4-9CrossRefGoogle Scholar
Anderson, P. (2002). Assessment and development of executive function (EF) during childhood. Child Neuropsychology, 8(2), 71–82.Google Scholar
Barkley, R.A. (1997a). ADHD and the nature of self-control. New York: Guilford Press.Google Scholar
Barkley, R.A. (1997b). Attention-deficit/hyperactivity disorder, self-regulation, and time: Toward a more comprehensive theory. Journal of Developmental and Behavioral Pediatrics, 18(4), 271–279.Google Scholar
Barkley, R.A. (1997c). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94.CrossRefGoogle ScholarPubMed
Barkley, R.A. (2010). Differential diagnosis of adults with ADHD: The role of executive function and self-regulation. The Journal of Clinical Psychiatry, 71(7), e17. doi:10.4088/JCP.9066tx1cCrossRefGoogle ScholarPubMed
Barkley, R.A., Murphy, K.R., Fischer, M. (2008). ADHD in adults: What the science says. New York: Guilford.Google Scholar
Boonstra, A.M., Kooij, J.J., Buitelaar, J.K., Oosterlaan, J., Sergeant, J.A., Heister, J.G., Franke, B. (2008). An exploratory study of the relationship between four candidate genes and neurocognitive performance in adult ADHD. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 147(3), 397–402. doi:10.1002/ajmg.b.30595CrossRefGoogle ScholarPubMed
Castellanos, F.X., Sonuga-Barke, E.J., Milham, M.P., Tannock, R. (2006). Characterizing cognition in ADHD: Beyond executive dysfunction. Trends in Cognitive Sciences, 10(3), 117–123. doi:10.1016/j.tics.2006.01.011CrossRefGoogle ScholarPubMed
Castellanos, F.X., Tannock, R. (2002). Neuroscience of attention-deficit/hyperactivity disorder: The search for endophenotypes. [Review]. Nature Reviews. Neuroscience, 3(8), 617–628. doi:10.1038/nrn896Google Scholar
Crawford, J.R., Sutherland, D., Garthwaite, P.H. (2008). On the reliability and standard errors of measurement of contrast measures from the D-KEFS. Journal of the International Neuropsychological Society, 14(6), 1069–1073. doi:10.1017/S1355617708081228CrossRefGoogle ScholarPubMed
Delis, D.C., Kaplan, E., Kramer, J.H. (2001). Delis-Kaplan Executive Function System. San Antonio, TX: The Psychological Corporation.Google Scholar
Denckla, M.B. (1996). A theory and model of executive function: A neuropsychological perspective. In G.R. Lyon & N.A. Krasnegor (Eds.), Attention, Memory, and Executive Function (pp. 263–277). Baltimore: Paul H. Brookes.Google Scholar
Faraone, S.V., Biederman, J. (2005). What is the prevalence of adult ADHD? Results of a population screen of 966 adults. Journal of Attention Disorders, 9(2), 384–391. doi:10.1177/1087054705281478CrossRefGoogle ScholarPubMed
Gallagher, R., Blader, J. (2001). The diagnosis and neuropsychological assessment of adult attention deficit/hyperactivity disorder. Scientific study and practical guidelines. Annals of the New York Academy of Sciences, 931, 148–171.CrossRefGoogle ScholarPubMed
Golden, C.J. (1978). Stroop Color and Word Test: A manual for clinical and experimental uses. Chicago: Skoelting.Google Scholar
Gronwall, D.M. (1977). Paced auditory serial-addition task: A measure of recovery from concussion. Perceptual and Motor Skills, 44(2), 367–373.CrossRefGoogle ScholarPubMed
Halleland, H., Lundervold, A.J., Halmoy, A., Haavik, J., Johansson, S. (2009). Association between catechol O-methyltransferase (COMT) haplotypes and severity of hyperactivity symptoms in adults. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 150B(3), 403–410. doi:10.1002/ajmg.b.30831Google Scholar
Halmoy, A., Halleland, H., Dramsdahl, M., Bergsholm, P., Fasmer, O.B., Haavik, J. (2010). Bipolar symptoms in adult attention-deficit/hyperactivity disorder: A cross-sectional study of 510 clinically diagnosed patients and 417 population-based controls. Journal of Clinical Psychiatry, 71(1), 48–57. doi:10.4088/JCP.08m04722oraGoogle Scholar
Heiervang, E., Stormark, K.M., Lundervold, A.J., Heimann, M., Goodman, R., Posserud, M.B., Gillberg, C. (2007). Psychiatric disorders in Norwegian 8- to 10-year-olds: An epidemiological survey of prevalence, risk factors, and service use. Journal of the American Academy of Child and Adolescent Psychiatry, 46(4), 438–447. doi:10.1097/chi.0b013e31803062bfCrossRefGoogle ScholarPubMed
Hervey, A.S., Epstein, J.N., Curry, J.F. (2004). Neuropsychology of adults with attention-deficit/hyperactivity disorder: A meta-analytic review. Neuropsychology, 18(3), 485–503. doi:10.1037/0894-4105.18.3.485Google Scholar
Homack, S., Riccio, C.A. (2004). A meta-analysis of the sensitivity and specificity of the Stroop Color and Word Test with children. Archives of Clinical Neuropsychology, 19(6), 725–743. doi:10.1016/j.acn.2003.09.003Google Scholar
Johansson, S., Halleland, H., Halmoy, A., Jacobsen, K.K., Landaas, E.T., Dramsdahl, M., Haavik, J. (2008). Genetic analyses of dopamine related genes in adult ADHD patients suggest an association with the DRD5-microsatellite repeat, but not with DRD4 or SLC6A3 VNTRs. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 147B(8), 1470–1475. doi:10.1002/ajmg.b.30662Google Scholar
Kessler, R.C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., Walters, E.E. (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.CrossRefGoogle Scholar
Kopp, B. (2011). Neuropsychologists must keep their eyes on the reliability of difference measures. Journal of the International Neuropsychological Society, 1–2. doi:10.1017/S1355617711000361CrossRefGoogle ScholarPubMed
Kramer, J.H., Quitania, L., Dean, D., Neuhaus, J., Rosen, H.J., Halabi, C., Miller, B.L. (2007). Magnetic resonance imaging correlates of set shifting. Journal of the International Neuropsychological Society, 13(3), 386–392. doi:10.1017/S1355617707070567Google Scholar
Lansbergen, M.M., Kenemans, J.L., van Engeland, H. (2007). Stroop interference and attention-deficit/hyperactivity disorder: A review and meta-analysis. Neuropsychology, 21(2), 251–262. doi:10.1037/0894-4105.21.2.251CrossRefGoogle ScholarPubMed
Lara, C., Fayyad, J., de Graaf, R., Kessler, R.C., Aguilar-Gaxiola, S., Angermeyer, M., Sampson, N. (2009). Childhood predictors of adult attention-deficit/hyperactivity disorder: Results from the World Health Organization World Mental Health Survey Initiative. Biological Psychiatry, 65(1), 46–54. doi:10.1016/j.biopsych.2008.10.005CrossRefGoogle ScholarPubMed
Lippa, S.M., Davis, R.N. (2010). Inhibition/switching is not necessarily harder than inhibition: An analysis of the D-KEFS color-word interference test. Archives of Clinical Neuropsychology, 25(2), 146–152. doi:10.1093/arclin/acq001CrossRefGoogle Scholar
Lundervold, A.J., Adolfsdottir, S., Halleland, H., Halmoy, A., Plessen, K., Haavik, J. (2011). Attention network test in adults with ADHD—the impact of affective fluctuations. Behavioral and Brain Functctions, 7, 27. doi:10.1186/1744-9081-7-27CrossRefGoogle ScholarPubMed
Mick, E., Faraone, S.V., Biederman, J. (2004). Age-dependent expression of attention-deficit/hyperactivity disorder symptoms. [Review]. Psychiatric Clinics of North America, 27(2), 215–224. doi:10.1016/j.psc.2004.01.003Google Scholar
Miyake, A., Friedman, N.P., Emerson, M.J., Witzki, A.H., Howerter, A., Wager, T.D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cognitive Psychology, 41(1), 49–100. doi:10.1006/cogp.1999.0734Google Scholar
Nigg, J.T. (2001). Is ADHD a disinhibitory disorder? Psychological Bulletin, 127(5), 571–598.CrossRefGoogle ScholarPubMed
Pa, J., Possin, K.L., Wilson, S.M., Quitania, L.C., Kramer, J.H., Boxer, A.L., Johnson, J.K. (2010). Gray matter correlates of set-shifting among neurodegenerative disease, mild cognitive impairment, and healthy older adults. Journal of the International Neuropsychological Society, 16(4), 640–650. doi:10.1017/S1355617710000408CrossRefGoogle ScholarPubMed
Piek, J.P., Dyck, M.J., Francis, M., Conwell, A. (2007). Working memory, processing speed, and set-shifting in children with developmental coordination disorder and attention-deficit-hyperactivity disorder. Developmental medicine and child neurology, 49(9), 678–683. doi:10.1111/j.1469-8749.2007.00678.xGoogle Scholar
Rasmussen, P., Gillberg, C. (2000). Natural outcome of ADHD with developmental coordination disorder at age 22 years: A controlled, longitudinal, community-based study. Journal of the American Academy of Child and Adolescent Psychiatry, 39(11), 1424–1431. doi:10.1097/00004583-200011000-00017Google Scholar
Ravizza, S.M., Ciranni, M.A. (2002). Contributions of the prefrontal cortex and basal ganglia to set shifting. Journal of Cognitive Neuroscience, 14(3), 472–483. doi:10.1162/089892902317361985Google Scholar
Rohlf, H., Jucksch, V., Gawrilow, C., Huss, M., Hein, J., Lehmkuhl, U., Salbach-Andrae, H. (2012). Set shifting and working memory in adults with attention-deficit/hyperactivity disorder. Journal of Neural Transmission, 119(1), 95–106. doi:10.1007/s00702-011-0660-3CrossRefGoogle ScholarPubMed
Rommelse, N.J., Buitelaar, J.K. (2008). Executive functioning in attention-deficit–hyperactivity disorder – Crucial or trivial? European Psychiatric Review, (2), 17–20.Google Scholar
Savla, G.N., Twamley, E.W., Thompson, W.K., Delis, D.C., Jeste, D.V., Palmer, B.W. (2011). Evaluation of specific executive functioning skills and the processes underlying executive control in schizophrenia. Journal of the International Neuropsychological Society, 17(1), 14–23. doi:10.1017/S1355617710001177Google Scholar
Schwartz, K., Verhaeghen, P. (2008). ADHD and Stroop interference from age 9 to age 41 years: A meta-analysis of developmental effects. Psychological Medicine, 38(11), 1607–1616. doi:10.1017/S003329170700267XCrossRefGoogle Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., Dunbar, G.C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl 20), 22–33; quiz, 34–57.Google ScholarPubMed
Sobanski, E., Bruggemann, D., Alm, B., Kern, S., Deschner, M., Schubert, T., Rietschel, M. (2007). Psychiatric comorbidity and functional impairment in a clinically referred sample of adults with attention-deficit/hyperactivity disorder (ADHD). European Archives of Psychiatry and Clinical Neuroscience, 257(7), 371–377. doi:10.1007/s00406-007-0712-8CrossRefGoogle Scholar
Tillman, C.M., Bohlin, G., Sorensen, L., Lundervold, A.J. (2009). Intellectual deficits in children with ADHD beyond central executive and non-executive functions. Archives of Clinical Neuropsychology, 24(8), 769–782. doi:10.1093/arclin/acp075Google Scholar
van Mourik, R., Oosterlaan, J., Sergeant, J.A. (2005). The Stroop revisited: A meta-analysis of interference control in AD/HD. Journal of Child Psychology and Psychiatry, 46(2), 150–165. doi:10.1111/j.1469-7610.2004.00345.xGoogle Scholar
Ward, M.F., Wender, P.H., Reimherr, F.W. (1993). The Wender Utah Rating Scale: An aid in the retrospective diagnosis of childhood attention deficit hyperactivity disorder. American Journal of Psychiatry, 150(6), 885–890.Google Scholar
Wechsler, D. (1999). Wechsler Abbreviated Scale of intelligence. WASI. Manual. San Antonio, TX: The Psychological Corporation.Google Scholar
Willcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., Pennington, B.F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biological Psychiatry, 57(11), 1336–1346. doi:10.1016/j.biopsych.2005.02.006Google Scholar
Wodka, E.L., Loftis, C., Mostofsky, S.H., Prahme, C., Larson, J.C., Denckla, M.B., Mahone, E.M. (2008). Prediction of ADHD in boys and girls using the D-KEFS. Archives of Clinical Neuropsychology, 23(3), 283–293. doi:10.1016/j.acn.2007.12.004Google Scholar