Neuropsychological functioning of individuals at clinical evaluation of adult ADHD
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OBJECTIVES: Numerous studies showed that adults with attention deficit hyperactivity disorder (ADHD) suffer from impairments in a range of cognitive functions when compared to healthy controls. However, only little is known about the neuropsychological functions when compared to various clinical control groups and whether a distinct neuropsychological profile can be identified for adult ADHD. METHOD: This retrospective study examined data of 199 outpatients referred for clinical evaluation of adult ADHD, allocated either to an ADHD group (n = 78) or to one of two clinical comparison groups, depending on whether they show indications (n = 71) or no indications (n = 50) for the presence of psychiatric disorders other than ADHD. All individuals performed a comprehensive neuropsychological test battery. RESULTS: Data analysis revealed impairments in a range of cognitive functions in a substantial number of patients of all three groups. However, profiles of neuropsychological impairments were similar between groups. Furthermore, significant small- to medium-sized correlations between basic and higher-order cognitive functions were revealed in the ADHD group and the clinical comparison group with indications for psychiatric disorders other than ADHD. CONCLUSION: Neuropsychological impairments are prominent in psychiatric outpatients seeking a clinical evaluation of adult ADHD but are not specific for ADHD. It is concluded that neuropsychological test performance may have limited incremental value to support the psychiatric differential diagnosis. Furthermore, a clinical trajectory may need to take into account that deficits in a range of higher-order cognitive functions can be substantially explained by deficits in basic cognitive functions.
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Deficits in basic processing speed and focused attention explain a large share of the variance in complex executive function tasks.
“deficits in basic processing speed and focused attention explain a large share of the variance in complex EF tasks [98]”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [98]
The Introduction (page unavailable) says deficits in processing speed and attention focus may explain a considerable proportion of impairments in complex functions, including executive functions; the Conclusions likewise say lower-order deficits can substantially explain deficits across cognitive domains. But the Results (page unavailable) report small-to-medium correlations, not a large share of variance explained across complex executive-function tasks. The claim overstates the measured finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredNo single cognitive test reliably diagnoses ADHD.
“The large individual differences and overlap with other conditions imply that no single cognitive test reliably “diagnoses” it [98].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [98]
The Introduction (page unavailable) describes substantial variation in cognitive test performance among adults with ADHD, and the Conclusions (page unavailable) find that cognitive deficits did not meaningfully distinguish ADHD from the clinical comparison groups. Those findings support caution about using a cognitive test to diagnose adult ADHD, but the paper hedges its conclusion—that test assessment may have limited incremental diagnostic value in this setting—rather than establishing the categorical claim that no single test reliably diagnoses ADHD. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe magnitude of executive deficits in adult ADHD is modest and varies widely across individuals.
“However, the magnitude of these executive deficits in adult ADHD is modest and varies widely across individuals [92,98].”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [98]
The Introduction (page unavailable) says adults with ADHD do not all share the same type or degree of cognitive impairment, supporting variation across individuals. The Results (page unavailable) find mostly negligible-to-small differences from clinical comparison groups, but the Conclusions describe marked impairments among patients seeking evaluation. Thus, “modest” is supported for differences from clinical controls, not as an unqualified description of executive deficits in adult ADHD. (LLM, conf=0.84)
Experimental — accuracy not yet measuredLower-level impairments, such as slow processing speed or brief lapses of attention, account for much of the apparent executive dysfunction in adult ADHD.
“studies have found that lower-level impairments, such as slow processing speed or brief lapses of attention, account for much of the apparent executive dysfunction [98]”
From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [98]
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ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives
Bogdańska-Chomczyk, E., Majewski, M. K., & Kozłowska, A. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms262211020 · Cited by 15 · see citing works
“For example, deficits in basic processing speed and focused attention explain a large share of the variance in complex EF tasks [98].”
Influential
- Authors
- Guo, N., Fuermaier, A. B. M., Koerts, J., Mueller, B. W., Diers, K., Mroß, A., Mette, C., Tucha, L., & Tucha, O.
- Affiliations
- University of Groningen (NL)
- University of Wuppertal (DE)
- University of Duisburg-Essen (DE)
- Protestant University of Applied Sciences Rhineland-Westphalia-Lippe (DE)
- Corresponding author
- Guo, Nana
- Venue
- Journal of Neural Transmission
- Published
- 2020-12-23
- Volume
- 128
- Issue
- 7
- Pages
- 877-891
- ISSN
- 0300-9564 (ISSN-L)
- 1435-1463
- PMC
- PMC8295106
- OpenAlex
- W3115780644
- Cited by
- 37
- References
- 90
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 7 · 2023: 12 · 2022: 6 · 2021: 3
- FWCI
- 3.82
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Neural Transmission (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Funders
- University of Groningen
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- adult ADHD, neuropsychological performance, cognitive impairment, neuropsychological profile, psychiatric outpatients, differential diagnosis, psychiatric comorbidity, cognitive test battery
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Cognition, Diagnosis, Differential, Humans, Neuropsychological Tests, Retrospective Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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