Emotional dysfunction as a predictor of reported current, but not childhood, ADHD symptoms among adults with and...

The cardinal symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD) are highly nonspecific, and are shared with other prevalent neuropsychiatric disorders. Moreover, rates of psychopathological co-occurrence are high with ADHD. Given symptom non-specificity may confound differential diagnosis of ADHD, this study assessed the effect of elevated emotional dysfunction on endorsement of current and childhood ADHD symptoms.

Study sample included 527 adults referred for neuropsychological evaluation of suspected or known ADHD. The Clinical Assessment of Attention Deficit-Adult (CAT-A) assessed severity of self-reported childhood and current ADHD symptoms. The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) Emotional/Internalizing Dysfunction (EID) scale indexed severity of self-reported emotional dysfunction. EID T-scores ≥65 were classified as clinically elevated (n = 238), and T-scores <65 non-elevated. Childhood, current, and overall ADHD symptom endorsement was examined by EID status among those with and without ADHD.

Invariably, elevated EID significantly predicted greater current, but not childhood, ADHD symptoms with small effects (η_p² 0.021-0.045). The greatest effects of EID elevation were found among those without ADHD (η_p² 0.045-0.046). Among those without ADHD, elevated EID predicted greater overall ADHD symptoms and raised overall ADHD classification from Normal Range to Mild Clinical Risk.

Emotional dysfunction among adults presenting for differential diagnosis of ADHD predicts greater current, but not childhood, ADHD symptom endorsement, regardless of ADHD status. Results indicate that convincing ADHD complaints may emerge from nosologically unrelated conditions. Findings underscore the need to assess childhood symptom report, which was resistant to current emotional dysfunction.