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Internalizing and somatic symptoms influence the discrepancy between subjective and objective cognitive difficulties in adults with ADHD who have valid and invalid test scores

Published online by Cambridge University Press:  18 September 2024

John-Christopher A. Finley Open the ORCID record for John-Christopher A. Finley [Opens in a new window] ,
Anthony D. Robinson Open the ORCID record for Anthony D. Robinson [Opens in a new window] ,
Hannah B. VanLandingham ,
Devin M. Ulrich ,
Matthew S. Phillips  and
Jason R. Soble Open the ORCID record for Jason R. Soble [Opens in a new window]
John-Christopher A. Finley*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Anthony D. Robinson
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
Hannah B. VanLandingham
Affiliation:
Department of Psychology, Rosalind Franklin University of Medicine and Science, Chicago, IL, USA
Devin M. Ulrich
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
Matthew S. Phillips
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA
Jason R. Soble
Affiliation:
Department of Psychiatry, University of Illinois College of Medicine, Chicago, IL, USA Department of Neurology, University of Illinois College of Medicine, Chicago, IL, USA
*
Corresponding author: John-Christopher A. Finley; Email: jfinley3045@gmail.com
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Abstract

Objectives:

This study investigated the relationship between various intrapersonal factors and the discrepancy between subjective and objective cognitive difficulties in adults with attention-deficit hyperactivity disorder (ADHD). The first aim was to examine these associations in patients with valid cognitive symptom reporting. The next aim was to investigate the same associations in patients with invalid scores on tests of cognitive symptom overreporting.

Method:

The sample comprised 154 adults who underwent a neuropsychological evaluation for ADHD. Patients were divided into groups based on whether they had valid cognitive symptom reporting and valid test performance (n = 117) or invalid cognitive symptom overreporting but valid test performance (n = 37). Scores from multiple symptom and performance validity tests were used to group patients. Using patients’ scores from a cognitive concerns self-report measure and composite index of objective performance tests, we created a subjective-objective discrepancy index to quantify the extent of cognitive concerns that exceeded difficulties on objective testing. Various measures were used to assess intrapersonal factors thought to influence the subjective-objective cognitive discrepancy, including demographics, estimated premorbid intellectual ability, internalizing symptoms, somatic symptoms, and perceived social support.

Results:

Patients reported greater cognitive difficulties on subjective measures than observed on objective testing. The discrepancy between subjective and objective scores was most strongly associated with internalizing and somatic symptoms. These associations were observed in both validity groups.

Conclusions:

Subjective cognitive concerns may be more indicative of the extent of internalizing and somatic symptoms than actual cognitive impairment in adults with ADHD, regardless if they have valid scores on cognitive symptom overreporting tests.

Keywords

ADHDsubjective cognitive impairmentcognitive complaintssymptom validity testingoverreportingneuropsychology
Type
Research Article
Information
Journal of the International Neuropsychological Society , First View , pp. 1 - 10
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Neuropsychological Society

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