INS NYC 2024 Program

Poster	Poster Session 05 Program Schedule 02/15/2024 02:30 pm - 03:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 05: Neuropsychiatry \| Addiction/Dependence \| Stress/Coping \| Emotional/Social Processes Final Abstract #81 The Role of Internalizing Psychopathology in Executive Dysfunction Among Adults with ADHD Chris Perriello, UIC Department of Psychiatry, Chicago, United States Kailyn Bare, UIC Department of Psychiatry, Chicago, United States Gabriel Ovsiew, UIC Department of Psychiatry, Chicago, United States Brian Cerny, UIC Department of Psychiatry, Chicago, United States Matthew Phillips, UIC Department of Psychiatry, Chicago, United States Neil Pliskin, UIC Department of Psychiatry, Chicago, United States Kyle Jennette, UIC Department of Psychiatry, Chicago, United States Woojin Song, UIC Department of Psychiatry, Chicago, United States Jason Soble, UIC Department of Psychiatry, Chicago, United States Devin Ulrich, UIC Department of Psychiatry, Chicago, United States Category: Executive Functions/Frontal Lobes Keyword 1: attention deficit hyperactivity disorder Keyword 2: executive functions Keyword 3: neuropsychological assessment Objective: Executive dysfunction refers to difficulties using higher-order cognitive functions to coordinate lower-order abilities while engaging in goal-directed behavior and has been implicated in attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. However, research examining executive dysfunction in adults has produced mixed results. A potential explanation for these discrepancies is the significant comorbidity of internalizing disorders, such as generalized anxiety and major depression, often found in adult ADHD populations. Using Friedman and Miyake’s unity and diversity model of executive function, this study aimed to examine how internalizing comorbid psychopathology may impact executive dysfunction in an adult ADHD population. Participants and Methods: The sample included 592 adults (61.1% female) referred for neuropsychological evaluation for ADHD diagnostic clarification at an urban academic medical center. Patients were aged 18-60 years (M=28.4; SD=7.19) with an average of 15.93 years (SD=2.02) of education. Racially/ethnically, patients identified as White (44.3%), Black (22.8%), Hispanic (15.2%), Asian (11.5%), and other/multiracial (6.3%). All patients were administered a semi-structured interview and uniform neuropsychological battery, including neurocognitive testing and self-report measures of personality, internalizing psychopathology (i.e., depressive symptoms, anxiety, and PTSD symptoms), and ADHD symptoms. Executive functioning measures included Trail Making Test Part B (shifting), Stroop Color-Word Test (inhibition), and the working memory index from the Wechsler Adult Intelligence Scale, 4^thEdition (WAIS-IV WMI; updating). Patients were divided into groups based on final diagnosis: 197 patients met criteria for ADHD only, 111 met criteria for an internalizing disorder only (i.e., depression, anxiety, or PTSD), 258 met criteria for both ADHD and a comorbid internalizing psychological disorder, and 26 received no diagnosis. This cross-sectional study measured differences in executive functioning processes (i.e., shifting, inhibition, updating) based on patient diagnosis using a one-way analysis of variance (ANOVA) with planned post hoc analyses. Results: Significant differences emerged between groups for shifting (F(3, 588) = 5.47, p= .001) and inhibition (F(3, 585) = 3.20, p = .023), but not for updating (F(3, 588) = 0.82, p = .483). Mean shifting t-scores significantly differed between the no diagnosis and ADHD+internalizing groups (p = .003, 95% C.I. = [1.98, 13.34]). Post hoc analysis also revealed significant differences in inhibition based on group membership, such that those with no diagnosis had higher t-scores than the ADHD only (p = .012, 95% C.I. = [1.09, 12.42]) and ADHD+internalizing groups (p = .02, 95% C.I. = [0.69, 11.86]). Conclusions: Findings were mixed. Given the variability in findings between the three executive function domains (i.e., shifting, inhibition, updating), this approach demonstrates the importance of separating broad constructs, such as executive function, into more circumscribed and consistently defined domains. Additionally, though the ADHD+internalizing group differed from the no diagnosis group for both inhibition and shifting, the ADHD only group differed from the no diagnosis group for inhibition only. Accounting for comorbidity may help explain inconsistencies when examining executive function differences found among adults with ADHD.

Poster

02/15/2024
02:30 pm - 03:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 05: Neuropsychiatry | Addiction/Dependence | Stress/Coping | Emotional/Social Processes

Final Abstract #81

The Role of Internalizing Psychopathology in Executive Dysfunction Among Adults with ADHD

Chris Perriello, UIC Department of Psychiatry, Chicago, United States
Kailyn Bare, UIC Department of Psychiatry, Chicago, United States
Gabriel Ovsiew, UIC Department of Psychiatry, Chicago, United States
Brian Cerny, UIC Department of Psychiatry, Chicago, United States
Matthew Phillips, UIC Department of Psychiatry, Chicago, United States
Neil Pliskin, UIC Department of Psychiatry, Chicago, United States
Kyle Jennette, UIC Department of Psychiatry, Chicago, United States
Woojin Song, UIC Department of Psychiatry, Chicago, United States
Jason Soble, UIC Department of Psychiatry, Chicago, United States
Devin Ulrich, UIC Department of Psychiatry, Chicago, United States

Category: Executive Functions/Frontal Lobes

Keyword 1: attention deficit hyperactivity disorder
Keyword 2: executive functions
Keyword 3: neuropsychological assessment

Objective:

Executive dysfunction refers to difficulties using higher-order cognitive functions to coordinate lower-order abilities while engaging in goal-directed behavior and has been implicated in attention-deficit/hyperactivity disorder (ADHD) in children and adolescents. However, research examining executive dysfunction in adults has produced mixed results. A potential explanation for these discrepancies is the significant comorbidity of internalizing disorders, such as generalized anxiety and major depression, often found in adult ADHD populations. Using Friedman and Miyake’s unity and diversity model of executive function, this study aimed to examine how internalizing comorbid psychopathology may impact executive dysfunction in an adult ADHD population.

Participants and Methods:

The sample included 592 adults (61.1% female) referred for neuropsychological evaluation for ADHD diagnostic clarification at an urban academic medical center. Patients were aged 18-60 years (M=28.4; SD=7.19) with an average of 15.93 years (SD=2.02) of education. Racially/ethnically, patients identified as White (44.3%), Black (22.8%), Hispanic (15.2%), Asian (11.5%), and other/multiracial (6.3%). All patients were administered a semi-structured interview and uniform neuropsychological battery, including neurocognitive testing and self-report measures of personality, internalizing psychopathology (i.e., depressive symptoms, anxiety, and PTSD symptoms), and ADHD symptoms. Executive functioning measures included Trail Making Test Part B (shifting), Stroop Color-Word Test (inhibition), and the working memory index from the Wechsler Adult Intelligence Scale, 4^thEdition (WAIS-IV WMI; updating). Patients were divided into groups based on final diagnosis: 197 patients met criteria for ADHD only, 111 met criteria for an internalizing disorder only (i.e., depression, anxiety, or PTSD), 258 met criteria for both ADHD and a comorbid internalizing psychological disorder, and 26 received no diagnosis. This cross-sectional study measured differences in executive functioning processes (i.e., shifting, inhibition, updating) based on patient diagnosis using a one-way analysis of variance (ANOVA) with planned post hoc analyses.

Results:

Significant differences emerged between groups for shifting (F(3, 588) = 5.47, p= .001) and inhibition (F(3, 585) = 3.20, p = .023), but not for updating (F(3, 588) = 0.82, p = .483). Mean shifting t-scores significantly differed between the no diagnosis and ADHD+internalizing groups (p = .003, 95% C.I. = [1.98, 13.34]). Post hoc analysis also revealed significant differences in inhibition based on group membership, such that those with no diagnosis had higher t-scores than the ADHD only (p = .012, 95% C.I. = [1.09, 12.42]) and ADHD+internalizing groups (p = .02, 95% C.I. = [0.69, 11.86]).

Conclusions:

Findings were mixed. Given the variability in findings between the three executive function domains (i.e., shifting, inhibition, updating), this approach demonstrates the importance of separating broad constructs, such as executive function, into more circumscribed and consistently defined domains. Additionally, though the ADHD+internalizing group differed from the no diagnosis group for both inhibition and shifting, the ADHD only group differed from the no diagnosis group for inhibition only. Accounting for comorbidity may help explain inconsistencies when examining executive function differences found among adults with ADHD.