CoChat
Sign Up
Cited by 142Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesDevelopmental and Educational Neuropsychology

Cognitive heterogeneity in adult attention deficit/hyperactivity disorder: A systematic analysis of neuropsychological measurements

Open access
Mostert, Jeanette C., Onnink, A. Marten H., Klein, Marieke, Dammers, Janneke, Harneit, Anais, Schulten, Theresa, van Hulzen, Kimm J.E., Kan, Cornelis C. +4 more·2015·European Neuropsychopharmacology
DOI 10.1016/j.euroneuro.2015.08.010PMC PMC4788979
Open this paper in CoChat — free accountOpen PDF

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA's comparing patients with persistent ADHD (N=133, 42% male, mean age 36) and healthy adults (N=132, 40% male, mean age 36). In addition, we tested which combination of variables provided the highest accuracy in predicting ADHD diagnosis. We also estimated for each individual the severity of neuropsychological dysfunctioning. Lastly, we investigated potential effects of stimulant medication and a history of comorbid major depressive disorder (MDD) on performance. Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding. However, effect sizes were small to moderate (range: 0.05-0.70) and 11% of patients did not show neuropsychological dysfunctioning. The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity). Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired. To conclude, while adults with ADHD as a group are impaired on several cognitive domains, the results confirm that adult ADHD is neuropsychologically heterogeneous. This provides a starting point to investigate individual differences in terms of impaired cognitive pathways.

Integrity signals

Registry

Crossref · 10.1016/j.euroneuro.2015.08.010

Cites

Statistics

Nothing to recompute.

Claims the paper makes

0 of 45 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    In exploratory analyses, group effects for stimulant medication were in the same direction as the main case-control analysis but smaller.

    “Group effects where all in the same direction as in the main case-control analysis, although smaller”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The medicated versus medication-naïve patient groups and the MDD-history versus no-MDD-history patient groups differ only in the variable of interest in ways relevant to cognition.
  • Findingown data

    In the present study, patients and controls did not differ on timing accuracy in a one-second time estimation task.

    “In the present study, patients did not differ from controls on timing accuracy using a time estimation task with an interval of one second.”
    Quote in the paperSubstantial claim
  • Findingown data

    Patients were more variable in reaction times than controls across several tasks.

    “Across several tasks, patients were also more variable in their reaction times than controls.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.
  • Findingown data

    Effect sizes for case-control differences were small to moderate, ranging from 0.05 to 0.70.

    “However, effect sizes were small to moderate (range: 0.05 – 0.70)”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.
  • Findingown data

    Patients did not differ from controls in verbal fluency measures.

    “Lastly, patients did not differ from controls in verbal fluency measures”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.
  • May combine two claims. 35
  • Classified as probably not a substantial claim. 17
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    ADHD symptom levels were higher in patients according to both interview and self-report.

    “As expected, patients had significantly more ADHD symptoms based on the diagnostic interview and self-report.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    On several measures, patients with a history of MDD did not differ from controls and patients without MDD, despite a main effect of group.

    “However, on several measures patients with a history of MDD did not differ from controls and patients without MDD, despite a main effect of group.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The medicated versus medication-naïve patient groups and the MDD-history versus no-MDD-history patient groups differ only in the variable of interest in ways relevant to cognition.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Patients had fewer years of education than controls.

    “Patients had received fewer years of education than controls.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The best-fitting model predicting ADHD diagnosis included measures from distinct cognitive domains and achieved 82.1% specificity and 64.9% sensitivity.

    “The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    There was large variability between individual patients in deficient scores: 11% had none, 5% were severely impaired, 62% mildly impaired, and 23% impaired.

    “there was a large variability between individual patients, with some patients not having any deficient scores (11%), while others were severely impaired (5%). The majority (62%) of patients was mildly impaired, and 23% was impaired.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    Patients performed worse than controls on delay discounting, but not on time estimation.

    “In the domain of delay aversion patients performed worse than controls on the delay discounting task, but not in the domain of timing (time estimation task).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    Patients receiving stimulant medication or with a history of MDD were not distinctively impaired.

    “Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The medicated versus medication-naïve patient groups and the MDD-history versus no-MDD-history patient groups differ only in the variable of interest in ways relevant to cognition.

  • May combine two claims.

    Findingown data

    On the SART, the number of commission errors (measuring inhibition) and omission errors (measuring attention) did not differ between patients and controls.

    “Second, on the SART, the number of commission errors (measuring inhibition) did not differ between patients and controls, nor did the number of omission errors (measuring attention).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    Compared with healthy controls, adults with persistent ADHD showed impaired executive function, greater delay discounting, and increased response variability.

    “Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Withholding stimulant medication for 24 hours before testing was sufficient to eliminate medication effects on neuropsychological performance.
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    The SA-dots task had the largest effect, with patients fluctuating more in errors across blocks (effect size = −0.71).

    “with the largest effect on the SA-dots task where patients showed more fluctuation in errors across blocks (effect size = −0.71).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    Most tasks showed no group difference in response speed, but both Trailmaking conditions did.

    “Response speed did not differ between patients and controls in most tasks, except for both conditions of the Trailmaking tasks.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingcitation

    Patients were slower on Trailmaking part B but equally slow on part A, which measures motor speed.

    “Even though patients were slower on this part of the task, they were equally slow on part A, which measures motor speed”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nigg et al., 2005a

      Not checked in the free run.

    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    Patients showed executive-function deficits in working memory and attention, while inhibition on Flanker and SART and verbal fluency did not differ from controls.

    “In the domain of EF patients were impaired on working memory and attention, but no group differences were found for inhibition (Flanker and SART task) and verbal fluency.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Findingown data

    The best fitting predictive model included six measures from different cognitive domains and had 82.1% specificity and 64.9% sensitivity.

    “The best fitting predictive model included six measures from different cognitive domains (EF, response variability, timing and delay aversion) and reached 82.1% specificity and 64.9% sensitivity.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Medication use did not influence task performance in the exploratory analysis; medication-naïve patients performed similarly to medicated patients.

    “Medication use did not influence task performance in our exploratory analysis; medication naïve patients performed similar to medicated patients.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Several cognitive domains are affected in the adult ADHD population, with moderate effect sizes.

    “Our comprehensive analysis of cognitive performance in a large sample of patients with persistent ADHD and well-matched healthy control participants confirms that several cognitive domains are affected in the adult ADHD population, with moderate effect sizes.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Both ADHD and control samples were heterogeneous in cognitive performance, with large differences in the number of deficient tasks.

    “Both the ADHD and the control sample were heterogeneous in their cognitive performance, with large differences in the number of tasks on which participants scored deficient.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The Flanker task showed a ceiling effect in inhibition errors, consistent with findings in early adolescence, and may lack sensitivity to measure inhibition impairments in adult ADHD.

    “First, the Flanker task showed a ceiling effect in inhibition errors, which is consistent with findings in early adolescence”
    • Also stated in: § DISCUSSION · hedged
      “This task may therefore lack sensitivity to measure inhibition impairments in adult ADHD.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Drechsler et al., 2005; Harms et al., 2014

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Interpretationreasoning

    The lack of verbal fluency differences may be due to good IQ-matching between patients and controls, whereas other studies had lower IQ in patients.

    “This could be due to the good IQ-matching between patients and controls in our sample, whereas in other studies patients had lower IQ than controls.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Age and gender were entered as covariates to reduce error variance, justified because they did not differ between groups.

    “Age and gender were entered as covariates of no interest in order to reduce error variance”
    • Also stated in: § Data analysis of neuropsychological tasks · plain
      “This was justified as age and gender did not differ between the groups.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Miller & Chapman 2001 source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    ADHD is characterized by substantial neuropsychological heterogeneity, with only a minority of patients impaired in any given domain and some performing normally.

    “From the childhood literature, we know that ADHD is characterized by large heterogeneity at the neuropsychological level, which means that only a minority of ADHD patients shows deficits in each domain and that some patients with ADHD will perform in the normal range”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nigg et al., 2005b

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Because groups did not differ in IQ and covarying for IQ did not alter results, IQ is unlikely to explain working memory and attention deficits in adult ADHD.

    “However, as the groups did not differ on IQ, and covarying for IQ did not alter the results, this explanation is unlikely.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Major depressive disorder is the most common comorbidity in ADHD, co-occurring in up to 50% of cases.

    “Major depressive disorder (MDD) is the most frequently observed comorbidity, and can co-occur with ADHD in up to 50% of the cases”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wilens et al., 2009

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Previous literature shows neuropsychological measurements have relatively poor ability to discriminate between children with ADHD and typically developing controls, or between adults with ADHD and psychiatric patients without ADHD.

    “Previous literature showed however that neuropsychological measurements have a relatively poor ability to discriminate between children with ADHD and typically developing controls”
    • Also stated in: § INTRODUCTION · plain
      “or adults with ADHD and psychiatric patients without ADHD”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sjowall et al., 2013; Holst and Thorell, 2013

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    Multiple comparison correction was performed by estimating the effective number of independent tests (Meff), and 27 measures resulted in 22 independent tests, so only p < 0.0023 was considered significant.

    “Multiple comparison correction was performed by estimating the effective number of independent tests (Meff)”
    • Also stated in: § Data analysis of neuropsychological tasks · plain
      “Twenty-seven measures resulted in twenty-two independent tests and therefore, only effects with a p-value < 0.0023 were considered significant.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Li and Ji, 2005

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The study provides evidence for impairment in EF and reward processing, but not temporal processing, in persistent ADHD.

    “We report evidence for impairment in EF and reward processing, but not in temporal processing in patients with persistent ADHD.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

  • May combine two claims.

    Premisecitation

    In a study of boys with ADHD, 18-36% were impaired per cognitive domain and 25% showed no deficient performance in any domain.

    “Per cognitive domain merely 18–36% of the patients had an impairment, while 25% of the sample did not show deficient performance in any of the cognitive domains.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Coghill et al., 2013

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Only two studies have examined comorbid MDD in ADHD, and both suggest current comorbid MDD symptoms may not influence neuropsychological profiles in ADHD.

    “Only two studies examined comorbid MDD in ADHD to date, both suggesting that current comorbid MDD symptoms may not influence neuropsychological profiles in ADHD”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Katz et al., 1998; Riordan et al., 1999

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Twenty-two patients and 12 controls did not participate in the clinical interview and were included in the main analysis based on prior diagnosis and self-report threshold; they were excluded from comorbidity analysis.

    “Twenty-two patients and 12 controls did not participate in the clinical interview. These participants were included in the main analysis based on a prior diagnosis of ADHD by a psychiatrist and if they reached clinical threshold for ADHD based on the self-report scale. They were excluded from the analysis of comorbidity”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    It is unknown whether adult ADHD patients with remitted MDD are distinctively impaired on cognitive performance.

    “It is currently not known whether adult ADHD patients with MDD in remission are distinctively impaired on cognitive performance”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The preference for immediate smaller rewards over delayed larger rewards is regarded as an impulsivity aspect that may matter for substance use disorder development.

    “The tendency to prefer immediate (smaller) over delayed (larger) rewards is also considered to be an aspect of impulsivity potentially important for the development of substance use disorders (Dick et al., 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Dick et al., 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Adults with persistent ADHD show cognitive impairments similar to those in children, with moderate effect sizes.

    “Studies of cognitive functioning in adults with ADHD suggest that cognitive impairments found in adults resemble those observed in children with ADHD, showing equally moderate effects sizes”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Boonstra et al., 2005; Hervey et al., 2004; Schoechlin and Engel, 2005

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Stimulants are effective for treating clinical symptoms in adult ADHD.

    “Stimulants are effective for the treatment of clinical symptoms in adult ADHD”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Faraone et al., 2004 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Delay aversion may be a second neuropsychological pathway to ADHD, associated with altered reward processing.

    “Delay aversion may represent a second neuropsychological pathway towards ADHD, linked to altered processing of rewards (Sonuga-Barke, 2002).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sonuga-Barke, 2002 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    ADHD patients with comorbid psychiatric disorders show greater neuropsychological deficits than those without comorbidity and may form a distinct subgroup with different cognitive profiles.

    “Similarly, ADHD patients with a comorbid psychiatric disorder showed greater neuropsychological deficits than ADHD patients without comorbidity”
    • Also stated in: § INTRODUCTION · hedged
      “may represent a distinct subgroup, with different cognitive profiles”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Hervey et al., 2004; Fischer et al., 2007

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Study design and conductown data

    The groups were comparable on age, handedness, and estimated IQ, and gender was balanced.

    “Patients and controls did not differ in age, handedness, and estimated IQ. Gender was equally distributed across groups.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Cognitive deficits in adult ADHD cannot be accounted for by comorbid disorders.

    “However, it has also been shown that cognitive deficits in adult ADHD cannot be accounted for by comorbid disorders”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nigg et al., 2005a; Silva et al., 2013

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    Outliers were defined as scores more extreme than four standard deviations above or below the group mean, and if a participant was an outlier on one outcome variable of a task, all outcome variables from that task were excluded.

    “Outliers were defined as having a score more extreme than four times the standard deviation above or below the mean per group”
    • Also stated in: § Data analysis of neuropsychological tasks · plain
      “If a participant's score was an outlier on one outcome variable of a task, his/her scores on all outcome variables from that task were excluded.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Leth-Steensen et al., 2000; Nigg et al., 2005a

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    All extreme outliers were removed before analysis, reducing the effect of erroneous data on the model.

    “However, all extreme outliers were removed from the data before data analysis, reducing the effect of erroneous data on the model.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The study has a large, well-defined naturalistic patient sample and a well-matched control sample.

    “This study is unique in its large, well-defined naturalistic sample of patients and a well-matched control sample.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premiseown data

    The theory of multiple pathways leading to impairment in ADHD.

    “This is in agreement with the theory of multiple pathways leading to impairment in ADHD (Sonuga-Barke et al., 2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sonuga-Barke et al., 2010

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The sample was large enough to investigate effects of at least one comorbidity.

    “Our sample was large enough to investigate effects of (at least one) comorbidity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The findings are limited by the tasks included in the testing battery.

    “Additionally, our findings are limited by the tasks included in our testing battery.”
    Quote in the paperNot a substantial claim
43 of 43

  • The paper relies on this without support.

    Withholding stimulant medication for 24 hours before testing was sufficient to eliminate medication effects on neuropsychological performance.

    “For session 2, participants were requested to withhold stimulant medication 24 hours prior to testing.”

  • The paper relies on this without support.

    The neuropsychological tasks used are valid and sensitive measures of the targeted cognitive domains in adults.

    “The neuropsychological test battery included measures tapping into EF (working memory, attention, inhibition, set-shifting, verbal fluency), delay discounting, and time estimation.”

  • The paper relies on this without support.

    The medicated versus medication-naïve patient groups and the MDD-history versus no-MDD-history patient groups differ only in the variable of interest in ways relevant to cognition.

    “we used separate ANCOVA's for each neuropsychological measure comparing medication naïve patients (N = 20), medicated patients (N = 83), and healthy control participants (N = 132)”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Core attentional and organizational difficulties in ADHD are widely implicated as deficits in executive functions.

    “The core attentional and organizational difficulties in ADHD are widely implicated as deficits in executive functions (EFs)”

    From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [92]

    The Discussion identifies sustained attention as an area of executive-function impairment in adults with persistent ADHD and says this agrees with the adult ADHD literature. The Introduction also describes EF deficits as one proposed pathway in ADHD. The paper does not specifically link organizational difficulties to EF deficits, so it supports only the attentional part of the claim. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • Deficits in adult ADHD are frequently observed in sustained and divided attention, planning and set-shifting, response inhibition, and interference control.

    “Deficits are frequently observed in sustained and divided attention, planning and set-shifting (e.g., Tower of London), response inhibition (e.g., Continuous Performance Test), and interference control (e.g., Stroop) [92,93,96].”

    From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [92]

    The Discussion reports sustained-attention impairment, and the Introduction cites earlier adult-ADHD studies finding set-shifting and inhibition deficits. But this study found no group differences in inhibition or set-shifting; the cited passages do not establish deficits in divided attention, planning, or interference control. The paper also describes a continuous performance task as a measure of sustained attention, not response inhibition. Page numbers are unavailable in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • One large neuropsychological survey found that effect sizes for differences between diagnosed individuals and controls ranged only from small to medium (Hedges' g ≈ 0.05-0.70).

    “One large neuropsychological survey found that effect sizes for differences between diagnosed individuals and controls ranged only from small to medium (Hedges’ g ≈ 0.05–0.70) [92].”

    From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [92]

    The Results section (‘Effect of diagnosis on cognitive performance’; page unavailable) describes the case–control effect sizes as small to medium, with the largest having a magnitude of 0.71. But the Data analysis section says the paper calculated Cohen’s d, not Hedges’ g, and the passages do not establish the claimed lower bound of approximately 0.05. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • On average, adults with ADHD perform worse than healthy controls on executive function tests, but effect sizes tend to be small to moderate.

    “On average, adults with the condition perform worse than healthy controls on EF tests, but effect sizes tend to be small to moderate [92].”

    From ADHD in Adulthood: Clinical Presentation, Comorbidities, and Treatment Perspectives (2025) · cites this paper as [92]

  • The 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 [92]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • MDD subgroup counts exceed the number eligible for comorbidity analysis

    Major

    The paper reports 133 ADHD patients and says 22 were excluded from the comorbidity analysis because they lacked a clinical interview, leaving at most 111. The two ADHD groups in that analysis total 123 patients (55 + 68).

  • Reported effect-size range omits the stated largest effect

    Minor

    The abstract gives an effect-size range ending at 0.70, but the results identify an effect of −0.71 as the largest. Its magnitude is 0.71, outside the stated range.

2 of 2

The citation lists haven’t been fetched yet

References 64 · Cited by 142

Research works printed but not linked: 1

  1. Skodzik, 2013, Long-term memory performance in adult ADHD: a meta-analysis, J. Atten. Disord., 10.1177/1087054713510561 · DOI · Paper page

Authors
Mostert, J. C., Onnink, A. M. H., Klein, M., Dammers, J., Harneit, A., Schulten, T., van Hulzen, K. J. E., Kan, C. C., Slaats-Willemse, D., Buitelaar, J. K., Franke, B., & Hoogman, M.
Affiliations
  • Radboud University Nijmegen (NL)
  • Radboud University Medical Center (NL)
  • Karakter (NL)
Corresponding author
Franke, Barbara
ORCID
Venue
European Neuropsychopharmacology
Publisher
Elsevier BV
Published
2015-11
Volume
25
Issue
11
Pages
2062-2074
ISSN
0924-977X (ISSN-L)
DOI
10.1016/j.euroneuro.2015.08.010
PMC
PMC4788979
OpenAlex
W1155917932
Semantic Scholar
70e9f732e7511209bbe5b3283c554105b2367460
Cited by
142
References
64
Citations by year
2026: 9 · 2025: 6 · 2024: 13 · 2023: 16 · 2022: 13 · 2021: 21 · 2020: 16 · 2019: 15 · 2018: 14 · 2017: 9 · 2016: 7 · 2015: 3
FWCI
8.92
Type
journal article
Language
en
Open access
Licence
Locations
  • European Neuropsychopharmacology (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion, other-oa)
Funders
  • Nederlandse Organisatie voor Wetenschappelijk Onderzoek (602805, 602450, 016‐130‐669, 433‐09‐229)
  • National Institutes of Health (EB020403)
  • Horizon 2020 Framework Programme (643051, U54 EB020403)
  • National Institute of Biomedical Imaging and Bioengineering (U54EB020403)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
adult ADHD, persistent ADHD, executive function, delay discounting, time estimation, response variability, impulsivity, stimulant medication, major depressive disorder comorbidity, cognitive impairment
MeSH terms
Adult, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Cognition, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Models, Psychological, Netherlands, Neuropsychological Tests, Psychiatric Status Rating Scales, Sensitivity and Specificity, Time Perception, Cohort Studies, Comorbidity, Young Adult, Executive Function, Delay Discounting

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.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

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.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review