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Examining the validity of the ADHD concept in adults and older adults

Published online by Cambridge University Press:  08 October 2018

Brandy L. Callahan*
Affiliation:
Department of Psychology, University of Calgary, Calgary, Alberta, Canada Hotchkiss Brain Institute, Calgary, Alberta, Canada
André Plamondon
Affiliation:
Department of Foundations and Practices in Education, Laval University, Québec, Québec, Canada
*
*Address for correspondence: Brandy L. Callahan, PhD, Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary (AB) T2N 1N4, Canada. Email: brandy.callahan@ucalgary.ca

Abstract

Objective

It is crucial to clarify the structure of attention-deficit/hyperactivity disorder (ADHD) symptomatology in all age groups to determine how to best conceptualize this disorder across the lifespan. We tested the ADHD factor structure across adulthood and investigated independent associations with executive functions.

Method

Data from 645 adults aged 18–59 and 233 adults aged 60–85 were drawn from the Nathan Kline Institute Rockland Sample. Participants completed the Conners Adult ADHD Rating Scale and tests of executive functioning. Invariance of the ADHD factor structure was investigated using confirmatory factor analyses. Associations with cognition were explored using multiple linear regression.

Results

Results confirmed a bifactor model with 3 specific factors (inattention, hyperactivity, and impulsivity). Factor loadings and item intercepts were invariant across ages. Levels of hyperactivity and impulsivity were lower in older adults. Inattentive symptoms in young adults were positively related to cognitive flexibility. In older adults, ADHD symptoms predicted poorer working memory.

Conclusion

ADHD symptoms manifest similarly across adulthood. The lack of robust associations between ADHD symptomatology and executive functions raises concerns about the usefulness of neuropsychological measures in diagnosing adult ADHD. These results support the validity of the ADHD concept in older adults but suggest a need for age-appropriate normative criteria.

Type
Original Research
Copyright
© Cambridge University Press 2018 

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Footnotes

Both authors have contributed equally to this work.

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