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, 26 (1)

The Structure of Adult ADHD


The Structure of Adult ADHD

Lenard A Adler et al. Int J Methods Psychiatr Res.


Although DSM-5 stipulates that symptoms of attention-deficit hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functioning and emotional control. Previous psychometric analyses to evaluate these observations have been limited in ways addressed in the current study, which analyzes the structure of an expanded set of adult ADHD symptoms in three pooled US samples: a national household sample, a sample of health plan members, and a sample of adults referred for evaluation at an adult ADHD clinic. Exploratory factor analysis found four factors representing executive dysfunction/inattention (including, but not limited to, all the DSM-5 inattentive symptoms, with non-DSM symptoms having factor loadings comparable to those of DSM symptoms), hyperactivity, impulsivity, and emotional dyscontrol. Empirically-derived multivariate symptom profiles were broadly consistent with the DSM-5 inattentive-only, hyperactive/impulsive-only, and combined presentations, but with inattention including executive dysfunction/inattention and hyperactivity-only limited to hyperactivity without high symptoms of impulsivity. These results show that executive dysfunction is as central as DSM-5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but nonetheless part of the combined presentation of adult ADHD.

Keywords: ADHD; adults; attention-deficit hyperactivity disorder; epidemiology.

Conflict of interest statement

Declaration of Interest

L.A.A has had Grant/Research support from Sunovian Pharmaceuticals, Purdue Pharmaceuticals, Enzymotec, Shire Pharmaceuticals, Lundbeck; served as a consulatant for Enzymotec, Alcobra Pharmaceuticals, Rhodes Pharmaceuticals Shire Pharmaceuticals, National Football League, Major League Baseball; and received royalty payments (as inventor) from NYU for license of adult ADHD scales and training materials since 2004. T.J.S. has had research support and/or served as a consultant for Alcobra, Lundbeck, Shire Laboratories Inc, Sunovion, the FDA and the Department of Defense; and served on an advisory board for Alcobra. T.J.S. receives research support from Royalties and Licensing fees on copyrighted ADHD scales through MGH Corporate Sponsored Research and Licensing. T.J.S. has a US Patent Application pending (Provisional Number 61/233,686), through MGH corporate licensing, on a method to prevent stimulant abuse. R.C.K. has served as a consultant for Johnson & Johnson Wellness and Prevention Lake Nona Life Project. R.C.K. has served on advisory boards for Mensante Corporation, Johnson & Johnson Services Inc. Lake Nona Life Project, and U.S. Preventive Medicine. R.C.K. is a co-owner of DataStat, Inc. None of the other authors has any conflicts to declare.

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