An Investigation into the Relationship Among ADHD Symptomatology,Creativity, and Neuropsychological Functioning in Children

This paper examined the relationship between creativity and ADHD symptomatology. First, the presence of ADHD symptomatology within a creative sample was explored. Secondly, the relationship between cognitive functioning and ADHD symptomatology was examined by comparing four groups, aged 10–12 years: 1) 29 ADHD children without creativity, 2) 12 creative children with ADHD symptomatology, 3) 18 creative children without ADHD symptomatology, and 4) 30 controls. Creativity, intelligence, processing speed, reaction time, working memory, and inhibitory control were measured. Results showed that 40% of the creative children displayed clinically elevated levels of ADHD symptomatology, but none met full criteria for ADHD. With regard to cognitive functioning, both ADHD and creative children with ADHD symptoms had deficits in naming speed, processing speed, and reaction time. For all other cognitive measures the creative group with ADHD symptoms outperformed the ADHD group. These findings have implications for the development and management of creative children.     

An investigation into the psychosocial functioning of creative children: The impact of ADHD symptomatology

This study examined the relationship among creativity, ADHD symptomatology, temperament, and psychosocial functioning by comparing four groups of children aged 10–12 years: (1) 29 ADHD children without creativity, (2) 16 highly creative children displaying ADHD symptomatology, (3) 18 highly creative children without ADHD symptomatology, and (4) 30 normal controls. Children completed the TTCT, Child Depression Inventory, Revised Child Manifest Anxiety Scale, and Rosenberg Self‐Esteem Scale. Parents completed the Junior Temperament and Character Inventory, Family Environment Scale, and the parent version of the Kastan Children's Attributional Style Questionnaire. Parents completed the Conner's Rating Scales and Child Behavior Checklist, and teachers completed the Child Behaviour Checklist. Results showed that the presence of ADHD symptomatology in creative children was related to their temperamental characteristics, and parent reports of children's levels of anxiety and depression. However, family environment and mother's attributions did not appear to be related to the presence of ADHD symptomatology in creative children. These findings have implications for the development and management of creative children.     

Applying a psychoeducational perspective to ADHD

This article examines whether various cognitive abilities are associated with symptoms of ADHD. Cognitive ability is conceptualized using Cattell-Horn-Carroll (CHC) theory as measured using the Woodcock-Johnson Tests of Cognitive Ability (3rd ed.). This article also examines whether test session behavior mediates the association between cognitive ability and ADHD. Participants are children ages 6 to 12 with (n= 33) and without (n= 19) ADHD. Results show that inattentive symptoms of ADHD are significantly related to the CHC ability of processing speed above and beyond the effect of test session behavior. Symptoms of ADHD (both inattention and hyperactivity/impulsivity) are also significantly associated with visual spatial processing, but this is completely mediated by test session behavior. It is concluded that inattentive symptoms of ADHD are associated with slower processing speed and that this relationship is not explained by test session behavior.     

A preliminary investigation of reaction time variability in relation to social functioning in children evaluated for ADHD

Reaction time variability (RTV) is a ubiquitous phenomenon in Attention-Deficit/Hyperactivity Disorder (ADHD). Few studies have examined RTV in relation to functional outcomes such as social impairment in children with ADHD. In this exploratory study, we investigated whether RTV is associated with social functioning in children at risk for ADHD. Specifically, we explored the association between RTV (tau derived from correct go trials of a Stop-Signal task) and social functioning in 198 children ages 7–12 years referred for an ADHD evaluation. Social functioning measures included child and/or parent ratings of social competence, aggression, social problems, and impairment in relationships. In regression analyses that also included Oppositional Defiant Disorder symptoms and sex, higher RTV was significantly associated with lower ratings of social competence, and higher proactive/reactive aggression ratings on the child self-report measures. RTV was not significantly associated with parent report of social functioning or relationship impairment. This study provides preliminary evidence that RTV may be associated with social functioning in children at risk for ADHD. We propose that lapses of attention affecting cognitive control may also negatively impact social information processing thereby affecting social functioning. Replication is warranted and longitudinal studies are needed to investigate whether RTV predicts social dysfunction in ADHD.     

Relation Between Outcomes on a Continuous Performance Test and ADHD Symptoms Over Time

This study examined the relationship between the developmental trajectories of neuropsychological functioning and ADHD symptomatology in a longitudinal sample of children ages 9 to 14. Participants and measures were derived from the Multimodal Treatment Study for ADHD including 534MTA participants and 254 normal controls. Despite improvement over time, MTA participants continued to receive higher ratings of ADHD symptomatology and exhibit greater difficulties across the majority of neuropsychological outcomes. No relations were found between improvements in neuropsychological functioning and ADHD symptomatology over time. Findings provide support for the persistence of neuropsychological functioning and ADHD symptomatology. Findings did not support the hypothesized relation between improvements in frontally-mediated neuropsychological functioning and ADHD symptomatology possibly due to the brief 1-year lag and limited assessment battery. Findings are discussed in relation to neuropsychological development including recommendations for future research.     

Are sluggish cognitive tempo symptoms associated with executive functioning in preschoolers?

The aim of this study is to investigate whether sluggish cognitive tempo (SCT) symptoms are associated with neurocognitive task performance and ratings of real-world executive functioning (EF) in preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD). The associations between parent- and teacher-rated SCT symptoms and neuropsychological task performance and ratings of EF in 61 4-year-old preschool children (51 boys, 10 girls) with self-regulation difficulties were examined, with regression analyses controlling for the effects of ADHD inattention symptoms. In the study sample, higher teacher-rated SCT symptoms are significantly associated with poorer performance on tasks of visual-perceptual abilities, auditory and visual attention, sustained and selective attention, inhibitory control, pre-numerical/numerical concepts, and slower processing speed, but SCT symptoms are not significantly associated with working memory, attention shifting or cognitive flexibility when controlling for ADHD inattention. Higher parent-rated SCT symptoms are significantly associated with visual-perceptual abilities. ADHD inattention symptoms are more strongly associated than SCT with daily life EF ratings; neither parent- nor teacher-rated SCT symptoms are significantly associated with daily life ratings of inhibition, working memory, or planning/organization after controlling for ADHD inattention. This study suggests that SCT symptoms contribute to EF deficits at least on neurocognitive tasks assessing visual-perceptual/spatial abilities, attention to detail and processing speed, as observed in this sample of young children at risk for ADHD, and may be an important intervention target.     

Executive functioning and its relation to ASD and ADHD symptomatology in 22q11.2 deletion syndrome*

Children with 22q11.2 deletion syndrome (22q11DS; velo-cardio-facial-syndrome) are at risk for the developmental disorders, attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). In this study, the relation between executive functioning (EF) and the severity of ADHD and ASD symptoms is examined, since EF is known to be important in relation to emotional and behavioral problems. The participants consist of 58 children (38 females) with a mean age of 13.5 years (SD 2.6). Standardized assessment was used to evaluate the severity of ASD and ADHD symptomatology. The major aspects of EF, i.e., cognitive flexibility, inhibition, sustained attention, distractibility, working memory and reaction speed, were evaluated. The profile of EF in 22q11DS was found to be characterized by weaker performance compared to the norms on all subdomains of EF. Poor cognitive flexibility and inhibition, as well as high distractibility, were found to be related to more severe ASD symptoms, while poor quality of sustained attention and high distractibility were found to be related to more severe ADHD symptoms. It is concluded that children with 22q11DS experience impairments in EF, and that the degree of impairment on specific EF subdomains is related to the severity of ASD and/or ADHD symptomatology. These results may help in defining the mediating role of neurocognitive dysfunctions in the development of social and behavioral problems in 22q11DS.     

Predicting Parenting Stress in Families of Children with ADHD: Parent and Contextual Factors

We examined parental ADHD symptoms and contextual (parental education, social support, marital status) predictors of parent domain parenting stress (parental distress) as a function of child ADHD symptoms in a sample of 95 parents of 8 to 12 year-old children with and without ADHD. Parents’ perceptions of parental distress and social support were inversely-related. Parental ADHD symptomatology was the strongest predictor of parental distress of the variables considered. Models using teacher reports of child ADHD symptomatology and oppositionality differed from ones using parent reports, in that child oppositionality was only predictive of parental distress in the parent-report model. A post-hoc analysis showed that child factors did not predict parental distress over and above parent ADHD symptoms and contextual factors. These results suggest that parental ADHD symptomatology and parenting stress reduction should be considered in development of interventions for families of children with ADHD.     

Characteristics of ADHD Related to Executive Function: Differential Predictions for Creativity-Related Traits

Although the relationship between creativity and ADHD is uncertain, recent studies examining how dimensionally assessed characteristics of ADHD relate to creativity and divergent thinking in adults suggest an occasional positive, linear relationship between the constructs. However, the executive functions proposed to underlie characteristics of ADHD have not been examined in relation to creativity. This study was conducted to determine how different characteristics of ADHD related to executive functioning (as assessed by the Brown ADD Scales) predict different components of figural divergent thinking, intellectual risk-taking, and creative self-efficacy. Undergraduate engineering students (N = 60) completed the Brown ADD Scales, a figural divergent thinking task, and self-report measures of intellectual risk-taking and creative self-efficacy. A series of multivariate regression models demonstrated that several components of divergent thinking (i.e., fluency, originality, and resistance to closure) were predicted by different characteristics of ADHD. Although fluency was predicted by affect only and originality was predicted by activation only, resistance to closure was predicted by activation, effort, and attention. Additionally, intellectual risk-taking was predicted by memory, effort, and activation, whereas creative self-efficacy was predicted by effort. The implications of these results relating to the relationship between ADHD and creativity, as well as for engineering undergraduate education are discussed.     

Increased Intrasubject Variability in Boys with ADHD Across Tests of Motor and Cognitive Control

Increased intrasubject variability (ISV), or short-term, within-person fluctuations in behavioral performance is consistently found in Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is also associated with impairments in motor control, particularly in boys. The results of the few studies that have examined variability in self-generated motor output in children with ADHD have been inconsistent. The current study examined variability in motor control during a finger sequencing task among boys with and without ADHD as well as the relationship between intrasubject variability during motor and cognitive control tasks. Changes in performance over the course of the task and associations with ADHD symptom domains were also examined to elucidate the nature of impaired motor control in children with ADHD. Fifty-one boys (ages 8 to 12 years) participated in the study, including 28 boys with ADHD and 23 typically developing (TD) boys. Participants completed a finger sequencing task and a Go/No-Go task providing multiple measures of response speed and variability. Boys with ADHD were slower and more variable in both intertap interval on the finger sequencing task and reaction time on the Go/No-Go task, with measures of speed and variability correlated across the two tasks. For the entire cohort, the only unique predictor of parent ratings of hyperactive-impulsive symptoms was variability in intertap interval during finger sequencing, whereas inattentive symptoms were only predicted by reaction time variability on the Go/No-Go task. These findings suggest that inefficient motor control is implicated in the pathophysiology of ADHD, particularly in regards to developmentally inappropriate levels of hyperactivity and impulsivity.     

Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots?

Emotional Lability (EL) is a source of impairment in multiple mental disorders of children, including attention-deficit/hyperactivity disorder (ADHD). It has been proposed that the overlap between EL and ADHD symptoms is the result of common neuropsychological deficits. The aim of the present study was to test this hypothesis by using a multi-method approach. In a mixed sample of 61 children (49 community sample and 12 children with an ADHD diagnosis) aged between 8 and 12 years, we examined the relationship between parental reports of ADHD and EL, real-time children’s emotional expressions in an experimental context, children’s performance on neuropsychological tasks and parental ratings of neuropsychological functioning. Parental EL ratings were significantly predicted by task-based reaction time variability and by questionnaire measures of Self-Direction & Organization and Arousal Regulation. Parental EL ratings were also significantly related to both ADHD symptom dimensions. After controlling for shared neuropsychological factors, ADHD symptoms no longer predicted parental EL ratings. Neuropsychological task performance was not significantly related to real time emotional expressions. However, positive emotional expressions were significantly predicted by higher parental ratings of Cognition and negative emotional expressions by parental ratings of low Effort engagement – accounting for some of the correlation with ADHD symptoms. The current results highlight the plausible role of cognitive energetic processes in explaining the EL and ADHD symptom association.

     

Emotional Intelligence,Relationship Satisfaction,and the Moderating Effect of ADHD Symptomatology

The present cross-sectional study examined the extent to which ADHD symptomatology moderated the association between emotional intelligence (EI) and relationship satisfaction. A sample of 139 undergraduate students completed self-report measures of ADHD symptomatology, romantic relationship satisfaction, and EI. Hierarchical regression analysis found a significant interaction between emotional intelligence and ADHD symptomatology in their associations with relationship satisfaction while controlling for comorbid depressive symptoms. Simple slopes analyses revealed that EI was positively associated with relationship satisfaction among individuals with higher ADHD symptomatology, but not significantly associated among individuals with lower ADHD symptomatology. These results suggest that EI might play a particularly important role in the relationship quality of individuals with ADHD symptomatology and suggest an important topic for future research.     

Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms

Sluggish cognitive tempo (SCT) was introduced in 1980s in the field of attention deficit hyperactivity disorder (ADHD). Studies indicate that symptoms of SCT are separate from symptoms of ADHD and independently associated with multiple domains of functioning in clinical groups and in typical development. We assessed whether similar pattern would apply to higher functioning autism spectrum disorders (ASD). Children with higher functioning ASD (N = 55; 5?15 years) were divided into the ASD+High SCT (n = 17), the ASD+Medium SCT (n = 18) and the ASD+Low SCT (n = 20) groups based on parent‐rated daydreaming and slowness on the Five to Fifteen questionnaire (FTF). The groups were compared on SCT‐related impairments found in previous studies: social skills, academic functioning, psychiatric symptoms, and processing speed. Assessment methods were the FTF, the Development and Well‐Being Assessment, and the Coding subtest of the WISC‐III. The ADHD symptoms were statistically controlled due to the overlap between SCT and ADHD. The ASD+High SCT and ASD+Medium SCT groups were significantly more likely to have the most pronounced social impairments, and the ASD+High SCT group had significantly higher rate of internalizing disorders compared to the ASD+Low SCT group. Our results suggest that children with higher functioning ASD and high or medium levels of SCT symptoms could be at higher risk for psychosocial impairments than children with higher functioning ASD with low levels of SCT symptoms. Co‐occurring ADHD symptoms do not explain the finding. Recognizing SCT symptoms in higher functioning ASD would be important to targeting preventive support.     

Developmental change in the relation between executive functions and symptoms of ADHD and co‐occurring behaviour problems

In a sample of 92 children aged 6–13 years this study investigates the normal developmental change in the relation between executive functioning (EF) and the core behavioural symptoms associated with attention deficit hyperactivity disorder (ADHD) (hyperactivity/impulsivity and inattention) as well as symptoms often co‐occurring with childhood hyperactivity (conduct‐ and internalizing problems). EF was assessed by using multiple tests grouped through prior factor analysis, resulting in cognitive measures relating to disinhibition, speed/arousal, verbal working memory, non‐verbal working memory, and fluency. The results showed that although disinhibition was positively related to hyperactivity/impulsivity and inattention mainly for the youngest age group, there were no significant age effects for these relations. Instead, age effects were found for the relations between speed/arousal and inattention as well as for the relations between verbal working memory/fluency and inattention. In the oldest age group poor performance on these cognitive measures was associated with high ratings of inattention. For the total sample a relation was obtained between disinhibition and hyperactivity/impulsivity as well as between both working memory measures and internalizing problems. In conclusion, the results from this study suggest that poor inhibition is most clearly associated with ADHD symptoms for younger children, whereas poor functioning with regard to later developing and more complex executive functions such as working memory and fluency is associated with ADHD symptoms for older children. Copyright © 2006 John Wiley & Sons, Ltd.     

Probing Linear and Nonlinear Relations Among Schizotypy,Hypomania, Cognitive Inhibition,and Creativity

This study explored the relationship between schizotypy, hypomania, and indicators of creativity in 152 adult undergraduate students. We were interested in exploring a possible inverted U-shaped relationship between mental illness and creativity where moderate (vs. high or low) amounts of pathology are associated with facilitating creative responses. An indicator of cognitive inhibition derived from Stroop mismatch reaction times was also evaluated as a potential moderating factor between symptomatology and levels of creativity. College students (n = 152) were recruited from an introductory psychology class and completed a series of questionnaires (Schizotypal Personality Questionnaire-BR; Hypomania Checklist-32; Creative Achievement Questionnaire) and experimental tasks (color Stroop task; Wallach-Kogan Creativity Test) with a research assistant in a controlled environment. Polynomial regression results suggested that creative accomplishments were predicted by levels of disorganized schizotypy, but negatively associated with levels of interpersonal schizotypy. Scores on two divergent thinking indices were predicted by levels of disorganized schizotypy, yet surprisingly negatively associated with scores of hypomania. Although the relationship between disorganized symptoms and creative processes was not anticipated, these results may reflect certain nonconforming characteristics (e.g., tendency to wander off the topic in conversations) associated with this symptom domain. Although there was no definitive evidence supporting an inverted-U relationship between symptom severity and creativity within our sample, several linear relationships emerged suggesting that cognitive inhibition acted as a moderator variable for originality in those with higher levels of interpersonal schizotypy. Limitations and recommendations for future research are discussed.     

WISC-III Cognitive Profiles in Children with ADHD: Specific Cognitive Impairments and Diagnostic Utility

This study aimed to investigate the presence of specific cognitive impairments and the diagnostic utility of the WISC-III in children with ADHD. Ninety-eight children with ADHD and 81 children without ADHD matched by age and gender (control group), between the ages of 6 and 12?years, participated in the study. Children with ADHD revealed the most pronounced deficits in the subtests tapping working memory and processing speed. Freedom from Distractibility was the cognitive profile most impaired and that showed the highest diagnostic accuracy to discriminate children with ADHD. The optimal cutoff scores of the most common WISC-III cognitive profiles revealed greater diagnostic accuracy than the traditional approach of full or partial profiles. Taken together, these results suggested that in the context of a comprehensive psychological assessment, the WISC may provide knowledge about the specific cognitive strengths and weaknesses that characterize this disorder and may be useful in the decision-making process relative to ADHD diagnosis.     

Mediators and Moderators of the Relation between Parental ADHD Symptomatology and the Early Development of Child ADHD and ODD Symptoms

The present study examined mediators and moderators of the relation between parental ADHD symptomatology and the development of child attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms across the preschool years. Participants included 258 (138 boys) 3-year-old children (M = 44.13 months, SD = 3.39) with and without behavior problems and their parents who took part in a 3-year longitudinal study. Maternal ADHD symptoms predicted later ADHD symptoms in children, controlling for early child symptomatology. Both family history of ADHD and paternal comorbid psychopathology predicted later child ADHD and ODD symptoms, but they did not account for the association between maternal and child ADHD symptoms. Although paternal ADHD symptoms were associated with age 3 child ADHD symptoms, they did not significantly predict later child ADHD symptoms controlling for early symptomatology. Family adversity moderated the relation between maternal ADHD and child ADHD symptoms, such that the relation between maternal and child ADHD symptoms was stronger for families with less adversity. Maternal overreactive parenting mediated the relation between maternal ADHD symptoms and later child ADHD and ODD symptoms. Our findings suggest that targeting paternal comorbid psychopathology and maternal parenting holds promise for attenuating the effects of parental ADHD on children’s ADHD.     

Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7–15 years assigned to three diagnostic groups:ADHD (n?=?509), ASD (n?=?97), and controls (n?=?301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability. Specific processes contributing to response variability were examined using a drift diffusion model, which separately quantified drift rate (i.e., efficiency of information processing), boundary separation (i.e., speed-accuracy trade-offs), and non-decision time. Children with ADHD and ASD were impaired on attention/arousal, processing speed, working memory, and response inhibition, but did not differ from controls on measures of delayed reward discounting, set-shifting, or interference control. Overall, impairments in the ASD group were not attributable to ADHD symptoms using either continuous symptom measures or latent categorical grouping approaches. Similarly, impairments in the ADHD group were not attributable to ASD symptoms. When specific RT parameters were considered, children with ADHD and ASD shared impairments in drift rate. However, children with ASD were uniquely characterized by a wider boundary separation. Findings suggest a combination of overlapping and unique patterns of cognitive impairment for children with ASD as compared to those with ADHD, particularly when the processes underlying reaction time measures are considered separately.     

Academic Underachievement and Attention-Deficit/Hyperactivity Disorder: The Negative Impact of Symptom Severity on School Performance

Many children with Attention-Deficit/Hyperactivity Disorder (ADHD) achieve academically at a lower level than would be predicted given their intellectual abilities. However, the extent to which this is due to behavioral problems versus cognitive deficits associated with the disorder is unclear. In the present study, a group of children with ADHD (with average intellectual abilities) performed significantly below prediction in reading, writing, and mathematics skills and demonstrated a greater discrepancy between actual and predicted achievement than did a group of non-ADHD children. Even when controlling for performance on a measure of executive functioning, severity of ADHD symptoms, based on parent report, significantly predicted academic underachievement in reading, writing, and mathematics. These results indicate that the more severe the behavioral symptomatology of children with ADHD is, the more negatively impacted their school performance may be. Results are discussed in terms of diagnostic and intervention implications.     

The relationship between motor performance and parent-rated executive functioning in 3- to 5-year-old children: What is the role of confounding variables?

It is generally agreed that motor performance and executive functioning (EF) are intertwined. As the literature on this issue concerning preschool children is scarce, we examined the relationship between motor performance and parent-rated EF in a sample of 3- to 5-year-old children with different levels of motor skill proficiency, while controlling for age, gender, socio-economic status (SES), and attention-deficit-hyperactivity disorder (ADHD) symptomatology. EF was reported by parents of 153 children (mean age 4 years 1 months, SD 8 months; 75 male) by means of the Behaviour Rating Inventory of Executive Function–Preschool version (BRIEF-P). Parent-reported ADHD symptoms were assessed using the Hyperactivity-Inattention subscale of the Strengths and Difficulties Questionnaire3-4. In addition, the children performed the Movement Assessment Battery for Children-2 (MABC-2). Several weak to moderate relationships were found between the MABC-2 Total Score and the EF subscales. Once other variables such as age, gender, SES, and ADHD symptomatology were taken into account, the only BRIEF-P subscale that was associated with the MABC-2 Total Score was the Working Memory subscale. Compared to their typically developing peers, children who are at risk for motor coordination difficulties (⩽the 16th percentile on the MABC-2) performed poorly on the Working Memory subscale, which confirms the results of the regression analyses. The at risk group also performed significantly worse on the Planning/Organize subscale, however. This is one of the first studies investigating the relationship between motor performance and parent-rated EF in such a young age group. It shows that the relationship between motor performance and EF in young children is complex and may be influenced by the presence of confounding variables such as ADHD symptomatology.