ADHD diagnosis, symptom severity, and WAIS-IV working memory profiles in an adult clinical sample

Attention-deficit/hyperactivity disorder (ADHD) often persists into adult=hood, but its association with Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) profiles in clinical settings remains unclear. We examined whether ADHD diagnosis and dimensional symptom severity were associated with WAIS-IV indices and subtests in adults undergoing psychiatric evaluation. This retrospective study included 429 adults assessed at a tertiary university hospital between January 2023 and December 2025; 47 (11.0%) had ADHD. Separate linear regression models tested associations of ADHD diagnosis and standardized Adult ADHD Self-Report Scale (ASRS) scores with cognitive outcomes, adjusting for age, sex, education, depressive symptoms, and anxiety symptoms. Inference used HC3 heteroskedasticity-consistent standard errors and Holm correction within four outcome families. No index-level association was significant. At the subtest level, Digit Span Backward showed the largest and nominally significant difference (B = -1.30, 95% CI [-2.32, -0.27], unadjusted p = 0.014), although it did not remain significant after Holm correction (p = 0.095). ASRS scores were not significantly associated with outcomes. Conclusions were unchanged after excluding the 28 comparison participants with a rule-out ADHD notation. These findings do not establish an ADHD-specific WAIS-IV profile, but the Digit Span pattern, particularly the Backward difference, warrants evaluation in larger samples with performance validity assessment.