34 Attention-Deficit/Hyperactivity Disorder, Emotion Regulation, and Executive Functioning Associated with Educational and Occupational Outcomes in Adults

Weerawardhena, Himanthri; Callahan, Brandy · 2023 · Crossref

DOI: 10.1017/s1355617723008093

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Summary

This text presents abstracts from two distinct studies regarding Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. The first study, by Skymba et al., investigates whether comorbid depression impacts executive function (EF) performance in clinically referred adults. The second study, by Weerawardhena and Callahan, examines how emotion regulation strategies and EF abilities moderate the relationship between ADHD symptoms and functional outcomes, specifically educational attainment and occupational status. Skymba et al. analyzed data from 404 adults referred for neuropsychological evaluation, comprising 343 individuals with ADHD and 61 with non-ADHD psychopathology. Participants were categorized by depression severity using the Beck Depression Inventory-II. The study utilized one-way MANOVAs to assess EF differences across groups using five tests, including the Letter Fluency and Trail Making Test–Part B. Results indicated that while there were statistically significant differences in EF performance between groups when distinguishing by diagnosis and depression level, post-hoc Tukey’s HSD tests revealed no significant mean differences in specific EF measures like the Flanker Attentional Set Task between ADHD subgroups with varying depression levels. The authors concluded that clinically referred patients with ADHD perform comparably on EF tests regardless of comorbid depression, suggesting that EF weaknesses in ADHD should be conceptualized independently of depressive symptoms. Weerawardhena and Callahan utilized data from 109 adults from the Nathan Kline Institute Rockland Sample to test if emotion regulation (suppression vs. reappraisal) and EF moderate the link between ADHD symptoms and life outcomes. Using hierarchical regression models, they found significant two- and three-way interactions predicting both educational attainment and occupational status. For instance, educational attainment was predicted by interactions involving inattention, shifting, and reappraisal, as well as impulsivity, fluency, and reappraisal. Occupational status was similarly predicted by interactions such as inattention and reappraisal. Notably, the study found no independent association between ADHD symptoms or emotion regulation strategies and functional outcomes; rather, these outcomes depended heavily on the interaction between intrinsic traits, EF abilities, and regulation strategies. The authors suggest that individual differences in EF and emotion regulation explain the heterogeneity in functional outcomes among adults with ADHD, though they note the need for validation in samples with clinically significant ADHD.

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• executive function