TY - JOUR

T1 - Delay Aversion and Executive Functioning in Adults with Attention-Deficit/Hyperactivity Disorder

T2 - Before and after Stimulant Treatment

AU - Low, Ann-Marie Agerbo

AU - le Sommer, Julijana

AU - Vangkilde, Signe Allerup

AU - Fagerlund, Birgitte

AU - Glenthøj, Birte Yding

AU - Sonuga-Barke, Edmund

AU - Habekost, Thomas

AU - Jepsen, Jens Richardt M.

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Background: Attention deficit hyperactivity disorder is a heterogeneous disorder, associated with deficits in motivation (e.g., delay aversion) and cognition. Methylphenidate is recommended as a first line treatment for attention deficit hyperactivity disorder symptoms, but little is known about its nonacute effects on motivational and cognitive deficits, particularly in adults with attention deficit hyperactivity disorder. Methods: We utilized a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 initially stimulant medication-nave adult patients with moderate to severe attention deficit hyperactivity disorder, and 42 age-and parental education-matched healthy controls. Delay aversion and executive functioning were assessed with 2 questionnaires and 5 performance-based tests. Results: At baseline, patients and controls differed significantly on performance-based measures (moderate to large effect sizes), and self-report of delay aversion and executive functioning (very large effect sizes). Treatment with methylphenidate medication (mean dose 65.54 mg/d, SD = 10.39) was not associated with improvements in performance-based measures of delay aversion and executive functioning compared to controls, although improvements in self-report executive functioning and delay aversion were found. Self-reported delay aversion was most consistently associated with ADHD symptomatology at baseline and after medication. Conclusion: Methylphenidate treatment does not have an effect on performance-based measures of delay aversion and executive functioning, but may have significant effects on self-reported delay aversion and executive functioning. The latter finding should be interpreted cautiously, given the subjective nature of these measures and design limitations. Self-reported delay aversion is most consistently associated with attention deficit hyperactivity disorder symptomatology.

AB - Background: Attention deficit hyperactivity disorder is a heterogeneous disorder, associated with deficits in motivation (e.g., delay aversion) and cognition. Methylphenidate is recommended as a first line treatment for attention deficit hyperactivity disorder symptoms, but little is known about its nonacute effects on motivational and cognitive deficits, particularly in adults with attention deficit hyperactivity disorder. Methods: We utilized a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 initially stimulant medication-nave adult patients with moderate to severe attention deficit hyperactivity disorder, and 42 age-and parental education-matched healthy controls. Delay aversion and executive functioning were assessed with 2 questionnaires and 5 performance-based tests. Results: At baseline, patients and controls differed significantly on performance-based measures (moderate to large effect sizes), and self-report of delay aversion and executive functioning (very large effect sizes). Treatment with methylphenidate medication (mean dose 65.54 mg/d, SD = 10.39) was not associated with improvements in performance-based measures of delay aversion and executive functioning compared to controls, although improvements in self-report executive functioning and delay aversion were found. Self-reported delay aversion was most consistently associated with ADHD symptomatology at baseline and after medication. Conclusion: Methylphenidate treatment does not have an effect on performance-based measures of delay aversion and executive functioning, but may have significant effects on self-reported delay aversion and executive functioning. The latter finding should be interpreted cautiously, given the subjective nature of these measures and design limitations. Self-reported delay aversion is most consistently associated with attention deficit hyperactivity disorder symptomatology.

KW - ADHD

KW - executive functions

KW - Methylphenidate

KW - motivation

U2 - 10.1093/ijnp/pyy070

DO - 10.1093/ijnp/pyy070

M3 - Journal article

C2 - 30124878

AN - SCOPUS:85055854193

VL - 21

SP - 997

EP - 1006

JO - International Journal of Neuropsychopharmacology

JF - International Journal of Neuropsychopharmacology

SN - 1461-1457

IS - 11

ER -