Skip to main content Accessibility help

Questionnaire ratings of attention-deficit/hyperactivity disorder (ADHD) in adults are associated with spatial working memory

  • Jonathan H. Dowson (a1), Andrew D. Blackwell (a1), Danielle C. Turner (a1), Elizabeth Harvey (a1), Tina Malhotra (a1), Trevor W. Robbins (a2) and Barbara J. Sahakian (a1)...



Data related to brain function may have the potential to improve the reliability and validity of assessments for the aetiologically and clinically heterogeneous syndrome of attention-deficit/hyperactivity disorder (ADHD). This study investigated associations between questionnaire assessments of behavioural features of adults with ADHD and an aspect of neurocognitive performance which has been reported to be impaired in adults with ADHD.


Fifty-nine adult patients with a DSM-IV diagnosis of ADHD, and their informants, completed questionnaires related to aspects of severity of ADHD. Associations were examined between questionnaire ratings and performance on a computer-administered task of spatial working memory (SWM).


Correlations between ratings of ADHD and SWM indicated moderate but significant correlations for patients' ratings, but not for informants' ratings. Also, patients who reported a past history of ‘self-harm’ (N = 33) had a significantly worse mean performance on both measures of SWM (p = 0.004, 0.003).


The results indicate that aspects of impulsivity, i.e. self-ratings of ‘emotive’ behaviour (involving rapid response to stimuli and marked reactivity of mood) and of past ‘self-harm’, show relatively strong associations with SWM performance in adults selected on the basis of an ADHD diagnosis. A profile of neurocognitive performances may have a role in the assessment of ADHD.


Corresponding author

*Corresponding author. Department of Psychiatry, Box 189, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. Tel.: +44 01223 336965; fax: +44 01223 336968. E-mail (J.H. Dowson).


Hide All
[1]American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed.Washington, DC: American Psychiatric Association; 1994.
[2]Barkley, R.A.Murphy, K.A.Attention-deficit hyperactivity disorder. A clinical workbook. 2nd ed.New York: The Guilford Press; 1998.
[3]Barkley, R.A.Murphy, K.R.Bush, T.Time perception and reproduction in young adults with attention deficit hyperactivity disorder. Neuropsychology 2001;15:351360.
[4]Barnett, R.Maruff, P.Vance, A.Luk, E.S.L.Costin, J.Wood, al.Abnormal executive function in attention deficit hyperactivity disorder: the effect of stimulant medication and age on spatial working memory. Psychol Med 2001;31:11071115.
[5]Bright, P.Jaidow, E.Kopelman, M.D.The National Adult Reading Test as a measure of premorbid intelligence: a comparison with estimates derived from demographic variables. J Int Neuropsychol Soc 2002;8(6):847854.
[6]Castellanos, F.X.Lee, P.P.Sharp, W.Jeffries, N.O.Greenstein, D.K.Clasen, al.Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. JAMA 2002;288(14):17401748.
[7]Conners, C.K.Rating scales in attention-deficit/hyperactivity disorder: use is assessment and treatment monitoring. J Clin Psychiatry 1998;59:2430.
[8]Conners, C.K.Erhardt, D.Epstein, J.N.Parker, J.D.A.Sitarenios, G.Sparrow, E.Self-ratings of ADHD symptoms in adults: I factor structure and normative data. J Atten Disord 1999;3(3):141151.
[9]Conners, C.K.Erhardt, D.Sparrow, M.A.Conners' adult ADHD rating scales (CAARS). New York: Multi-Health Systems; 1999. p. 922.
[10]Crawford, J.R.Allan, K.M.Cochrane, R.H.Parker, D.M.Assessing the validity of NART-estimated premorbid IQs in the individual case. Br J Clin Psychol 1990;29(4):435436.
[11]Daruna, J.Barnes, P.A.A neurodevelopmental view of impulsivity. In: McCann, W.G.Johnson, J.L.Shire, M.B., editors. The impulsive client: theory, research and treatment. Washington, DC: American Psychological Association; 1993.
[12]De Quiros, G.B.Kinsbaume, M.Adult ADHD. Analysis of self-ratings on a behaviour questionnaire. Ann NY Acad Sci 2001;931:1993. p. 140147.
[13]Derogatis, L.R.Brief symptom inventory (BSI): administration, scoring and procedures manual. 3rd ed.Minneapolis MN: National Computer Systems; 1993.
[14]Dinn, W.M.Robbins, N.C.Harris, C.L.Adult attention-deficit/hyperactivity disorder: neuropsychological correlates and clinical presentation. Brain Cogn 2001;46(1–2):114121.
[15]Erhardt, D.Epstein, J.N.Conners, C.K.Parker, J.D.A.Sitarenios, G.Sparrow, E.Self-ratings of ADHD symptoms in adults: II. Reliability, validity and diagnostic sensitivity. J Atten Disord 1999;3(3):153158.
[16]Dowson, J.H.Bazanis, E.Rogers, R.Prevost, A.Taylor, P.Meux, al.Impulsivity in patients with borderline personality disorder. Compr Psychiatr 2004;45(1):2936.
[17]Dowson, J.H.McLean, A.Bazanis, E.Toone, B.Young, S.Robbins, al.Impaired spatial working memory in adults with attention-deficit/hyperactivity disorder: comparisons with performance in adults and borderline personality disorder and in control subjects. Acta Psychiatr Scand 2004;109:110.
[18]Dowson, J.H.McLean, A.Bazanis, E.Toone, B.Young, S.Robbins, al.The specificity of clinical characteristics in adults with attention-deficit/hyperactivity disorder: a comparison with patients with borderline personality disorder. Eur Psychiatry 2004;19(2):7278.
[19]Doyle, A.E.Faraone, S.V.Seidman, al.Are endophenotypes based on measures of executive functions useful for molecular genetic studies of ADHD? J Child Psychcol Psychiatry 2005;46(7):774803.
[20]Epstein, J.N.Conners, C.K.Sitarentos, G.Erhardt, D.Continuous performance test results of adults with attention deficit hyperactivity disorders. Clin Neuropsychol 1998;12:155168.
[21]Erhardt, D.Epstein, J.N.Conners, C.K.Parker, J.D.A.Sitarenios, G.Self-ratings of ADHD symptoms in adults: II reliability, validity and diagnostic sensitivity. J Atten Disord 1999;3(3):153158.
[22]Evenden, J.Impulsivity: a discussion of clinical and experimental findings. J Psychopharmacology 1999;13(2):180192.
[23]Faraone, S.V.Biederman, J.Spencer, T.Wilens, T.Seidman, L.J.Mick, al.Attention-deficit/hyperactivity disorder in adults: an overview. Biol Psychiatry 2000;48:920.
[24]First, M.B.Gibbon, M.Spitzer, R.L.Williams, J.B.W.Benjamin, L.S.Structured clinical interview for DSM-IV Axis II personality disorders. Washington, DC: American Psychiatric Press; 1997.
[25]First, M.B.Gibbon, M.Spitzer, R.L.Williams, J.B.W.Benjamin, L.S.SCID-II personality questionnaire. Washington, DC: American Psychiatric Press; 1997.
[26]Gallagher, R.Blader, J.The diagnosis and neuropsychological assessment of adult attention deficit hyperactivity disorder. Scientific study and practical guidelines. Ann N Y Acad Sci 2001;931:148171.
[27]Gansler, D.A.Fucetola, R.Krengel, M.Stetson, S.Zimering, R.Makary, al.Are the cognitive subtypes in adult attention deficit/hyperactivity disorder? J Nerv Ment Dis 1998;186:776781.
[28]Howell, D.C.Statistical methods for psychology. 4th ed.London Duxbury Press; 1997.
[29]Jenkins, M.Cohen, P.Malloy, P.Salloway, S.Johnson, E.Penn, al.Neuropsychological measures which discriminate among adults with residual symptoms of attention deficit disorder and other attentional complaints. Clin Neuropsychol 1998;12:7483.
[30]Karatekin, C.Asarnow, R.F.Working memory in childhood-onset schizophrenia and attention-deficit/hyperactivity disorder. Psychiatry Res 1998;80:165176.
[31]Kempton, S.Vance, A.Maruff, P.Luk, E.Costin, J.Pantelis, al.Executive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children. Psychol Med 1999;29:527538.
[32]Levy, F.Hay, D.A.McStephen, M.Wood, C.Waldman, I.Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study. J Am Acad Child Adolesc Psychiatry 1997;36(6):737744.
[33]Lockwood, K.A.Marcotte, A.C.Stern, C.Differentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsychological model of attention. J Clin Exp Neuropsychol 2001;23(3):317330.
[34]Lovejoy, D.W.Ball, J.D.Keats, M.Stutts, H.L.Spain, E.H.Janda, al.Neuropsychological performance of adults with attention-deficit hyperactivity disorder (ADHD): diagnostic classification estimates for measure of frontal lobe/executive functioning. J Int Neuropsychol Soc 1999;5:222233.
[35]McLean, A.Dowson, J.H.Toone, B.Young, S.Bazanis, E.Robbins, al.Characteristic neurocognitive profile associated with adult attention-deficit/hyperactivity disorder. Psychol Med 2004;34:112.
[36]Moeller, F.G.Barrett, E.S.Dougherty, D.M.Schmitz, J.M.Swann, A.C.Psychiatric aspects of impulsivity. Am J Psychiatry 2001;158:17831793.
[37]Murphy, P.Inhibitory control in adults with attention-deficit/hyperactivity disorder. J Atten Disord 2002;6(1):14.
[38]Murphy, P.Cognitive functioning in adults with attention-deficit/hyperactivity disorder. J Atten Disord 2002;5(4):203209.
[39]Murphy, P.Schahar, R.Use of self-ratings in the assessment of symptoms of attention-deficit hyperactivity disorder adults. Am J Psychiatry 2000;157:11561159.
[40]Nelson, H.E.National adult reading test (NART): test manual. Windsor: NFER-Nelson; 1982.
[41]Nigg, J.T.Neuropsychological theory and findings in attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 2005;57(11):13361346.
[42]Nigg, J.T.Blaskey, L.G.Huang-Pollock, C.L.Rappley, M.D.Neuropsychological executive functions and DSM-IV ADHD subtypes. J Am Acad Child Adolesc Psychiatry 2002;41:5966.
[43]Nigg, J.T.Butler, K.M.Huang-Pollock, C.L.Henderson, J.M.Inhibitory processes in adults with persistent childhood onset ADHD. J Consult Clin Psychol 2002;70(1):153157.
[44]Norusis, M.J.SPSS 9.0 guide to data analysis. New Jersey: Prentice-Hall Inc.; 1999.
[45]Owen, A.M.Downes, J.J.Sahakian, B.J.Polkey, C.E.Robbins, T.W.Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia 1990;28:10211034.
[46]Owen, A.M.Evans, A.C.Petrides, M.Evidence for a two-stage model of spatial working memory processing within the lateral frontal cortex: a positron emission tomography study. Cereb Cortex 1996;6:3138.
[47]Patton, J.H.Stanford, M.S.Barrett, E.S.Factor structure of the Barrett impulsiveness scale. J Clin Psychol 1995;51:768774.
[48]Pennington, B.F.Towards a new neuropsychological model of attention-deficit/hyperactivity disorder: subtypes and multiple deficits. Biol Psychiatry 2005;57(11):12211223.
[49]Pineda, D.Ardila, A.Rosselli, M.Cadavid, C.Mancheno, S.Mejia, S.Executive dysfunctions in children with attention deficit hyperactivity disorder. Int J Neurosci 1998;96:177196.
[50]Plutchik, R.van Praag, H.M.The measurement of suicidality, aggressivity and impulsivity. Prog Neuropsychopharmacol Biol Psychiatry 1989;13:523534.
[51]Plutchik, R.Van Praag, H.M.The nature of impulsivity: definition, aetiology, genetics and relations to aggression. In: Hollander, E.Stein, D., editors. Impulsivity and aggression. Chichester UK: Wiley; 1995. p. 724.
[52]Sachdev, P.Attention deficit hyperactivity disorder in adults. Psychol Med 1999;29:507514.
[53]Seidman, L.J.Beiderman, J.Weber, W.Hatch, M.Faraone, S.V.Neuropsychological functions in adults with attention-deficit hyperactivity disorder. Biol Psychiatry 1998;44:260268.
[54]Shue, K.L.Douglas, V.I.Attention deficit hyperactivity disorder and the frontal lobe syndrome. Brain Cogn 1992;20:104124.
[55]Sim, T.Simon, S.L.Domier, C.P.Richardson, K.Rawson, R.A.Ling, al.Cognitive deficits among methamphetamine users with attention-deficit hyperactivity disorder symptomatology. J Addict Dis 2002;21(1):7589.
[56]Triolo, S.J.Murphy, K.R.Attention-deficit scales for adults (ADSA). Manual for scoring and interpretation. New York, NY: Brunner/Maze Inc.; 1996.
[57]Walker, A.J.Shores, E.A.Trollor, J.N.Lee, T.Sachdev, P.S.Neuropsychological functioning of adults with attention deficit hyperactivity disorder. J Clin Exp Neuropsychol 2000;22 4:115124.
[58]Ward, M.F.Wender, P.H.Reimherr, F.W.The Wender Utah rating scale: an aid in the retrospective diagnosis of childhood attention-deficit hyperactivity disorder. Am J Psychiatry 1993;150:885890.
[59]Wender, P.H.Wolf, L.E.Wasserstein, J.Adults with ADHD. An overview. Ann N Y Acad Sci 2001;931:116.
[60]Willcutt, E.G.Doyle, A.E.Nigg, J.T.Faraone, S.V.Pennington, B.F.Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analysis review. Biol Psychiatry 2005;57(11):13361346.
[61]Williams, D.Stott, C.M.Goodyer, I.M.Sahakian, B.J.Specific language impairment with or without hyperactivity: neuropsychological evidence for frontostriatal dysfunction. Dev Med Child Neurol 2000;42:368375.
[62]Young, S.Channon, S.Toone, B.Neuropsychological assessment of attention deficit hyperactivity disorder in adulthood. Clin Neuropsychol Assessment 2000;4:283294.


Questionnaire ratings of attention-deficit/hyperactivity disorder (ADHD) in adults are associated with spatial working memory

  • Jonathan H. Dowson (a1), Andrew D. Blackwell (a1), Danielle C. Turner (a1), Elizabeth Harvey (a1), Tina Malhotra (a1), Trevor W. Robbins (a2) and Barbara J. Sahakian (a1)...


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.

Questionnaire ratings of attention-deficit/hyperactivity disorder (ADHD) in adults are associated with spatial working memory

  • Jonathan H. Dowson (a1), Andrew D. Blackwell (a1), Danielle C. Turner (a1), Elizabeth Harvey (a1), Tina Malhotra (a1), Trevor W. Robbins (a2) and Barbara J. Sahakian (a1)...
Submit a response


No Comments have been published for this article.


Reply to: Submit a response

Your details

Conflicting interests

Do you have any conflicting interests? *