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Which executive functioning deficits are associated with AD/HD, ODD/CD and comorbid AD/HD+ODD/CD?

Jaap Oosterlaan1, Anouk Scheres, Joseph A Sergeant

  • 1Department of Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. j.oosterlaan@psy.vu.nl

Journal of Abnormal Child Psychology
|March 12, 2005
PubMed
Summary

Attention deficit/hyperactivity disorder (AD/HD) is uniquely linked to executive functioning deficits in children, specifically in planning and working memory. Oppositional defiant disorder/conduct disorder (ODD/CD) showed no association with these cognitive impairments.

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Area of Science:

  • Neurodevelopmental Disorders
  • Cognitive Psychology
  • Child Psychiatry

Background:

  • Attention deficit/hyperactivity disorder (AD/HD) and oppositional defiant disorder/conduct disorder (ODD/CD) frequently co-occur in children.
  • Executive functioning (EF) deficits are commonly reported in children with AD/HD, but the specificity of this association is debated, especially when ODD/CD is present.

Purpose of the Study:

  • To determine if AD/HD is associated with EF deficits independently of ODD/CD.
  • To examine if ODD/CD is associated with EF deficits independently of AD/HD.
  • To investigate the EF profile of children with comorbid AD/HD and ODD/CD.

Main Methods:

  • A cohort of 99 children aged 6-12 years with varying presentations of AD/HD and ODD/CD was assessed.
  • Three core executive functioning domains—verbal fluency, working memory, and planning—were evaluated using standardized neuropsychological tests.

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  • Teacher and parent ratings were collected to assess AD/HD and ODD/CD symptoms.

    • Main Results:

    • AD/HD was significantly associated with deficits in planning and working memory, irrespective of ODD/CD. Verbal fluency was not affected.
    • Teacher-reported AD/HD symptoms were predictive of EF task performance, whereas parent-reported symptoms were not.
    • No significant EF deficits were found to be associated with ODD/CD when controlling for AD/HD.

    Conclusions:

    • Executive functioning deficits appear to be specific to AD/HD, not ODD/CD.
    • The findings support a model where AD/HD is the primary driver of EF impairments, even in the presence of comorbid ODD/CD.
    • These results underscore the importance of differentiating diagnostic contributions to cognitive profiles in childhood disorders.