[Cognitive conceptualization of adult attention deficit hyperactivity disorder: a systematic review]

Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent chronic neuropsychiatric disorders continuing from childhood into adulthood in 40-66% of cases. Though genetic underpinnings of the disorder are unquestionable, previous research underlie the fact that children with ADHD are faced with more adversities which might lead to maladaptive beliefs about self and world. Our aim was to provide a systematic review of ADHD studies focusing on cognitive conceptualization of the disorder.

A systematic literature search was conducted in three databases (PsychINFO, MEDLINE and Scopus) between years 2000 and 2013 with the keywords "ADHD, attention deficit hyperactivity disorder" and "core beliefs, belief system, schemas, schema therapy, dysfunctional attitude, compensatory strategies, negative automatic thoughts, case conceptualization".

We were able to identify ten original papers. According to them, adult ADHD could be characterized by maladaptive schemata including failure, impaired self-control, being different from others and a sense of inadequacy. Dysfunctional attitudes in adult ADHD were related to comorbid mood disorders. Compensatory strategies, e.g. anticipatory avoidance, brinkmanship, juggling, pseudo efficiency were described. More negative automatic thoughts were found in adult patients with ADHD, especially with comorbid mood disorder. Cognitive distortions, such as overgeneralization, magical and comparative thinking were also reported.

Though more empirical research is needed, converging results were reviewed about the cognitive characteristics of adult ADHD. Cognitive behavior therapy was showed to be effective in treatment of adult ADHD; the improvement of our knowledge about cognitive conceptualization of the disorder is a very important challenge for further research.