پدانلود رایگان ترجمه مقاله عملکرد عصبی روانی در افراد مبتلا به ADHD در طول عمر (نشریه الزویر 2006)

عملکرد نوروسایکولوژی در افراد مبتلا به ADHD در سراسر طول عمرشان

Neuropsychological functioning in people with ADHD across the lifespan

Abstract

ADHD is defined by behavioral characteristics similar to neuropsychological disorders of executive dysfunction. This paper is a literature review of the neurocognitive characteristics of ADHD from early childhood through adulthood. The author addresses the development of the concept of attention and executive function (EF) deficits in ADHD, clinical neuropsychological studies of preteenage children, teenagers and adults with ADHD, gender and the role of psychiatric co-morbidity including the relationship of learning disabilities to ADHD, heterogeneity of neuropsychological dysfunctions, experimental neuropsychological studies, the relationship of brain structure to function, psychopharmacology of ADHD, and clinical neuropsychological assessment. The group data clearly supports the hypothesis that executive dysfunctions are correlates of ADHD regardless of gender and age, and these EF deficits are exacerbated by co-morbidity with learning disabilities such as dyslexia. However, there is limited data on children under the age of 5, teenagers from age 13–18, and adults with ADHD over the age of 40. Studies of individual classification of people with ADHD compared to healthy, non-psychiatric controls do not support the use of neuropsychological tests for the clinical diagnosis of ADHD, and indicate that not all persons with ADHD have EF deficits. Some persons with ADHD may have deficits in brain reward systems that are relatively independent of EF impairments. Future research should clarify the multiple sources of ADHD impairments, continue to refine neuropsychological tools optimized for assessment, and incorporate longitudinal, developmental designs to understand ADHD across the lifespan.

1 Introduction

Although most of our current knowledge about Attention-Deficit/Hyperactivity Disorder (ADHD) developed from clinical observations and research with children, understanding of the disorder in adults is growing rapidly. Children, adolescents, and adults who are diagnosed with ADHD share similar clinical features, comorbidities, and failures in major life domains (e.g., academics and work; (Biederman, Mick, & Faraone, 2000; Hechtman, 1992; Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1993), and possibly brain abnormalities (Seidman, Valera, & Bush, 2004). However, as there is much to learn from different subgroups of persons with ADHD, it is clear that a full understanding of the disorder requires research from a life span perspective — integrating what we know about how it affects both adults and children (Biederman, 1998).

Cross-sectional data suggest that neuropsychological dysfunctions are an important component of the childhood syndrome (Barkley, 1997; Faraone & Biederman, 1998), and a growing literature is suggesting the same for adults (Hervey, Epstein & Curry, 2004). However, are the neuropsychological deficits ubiquitous as suggested by the diagnostic name, “ADHD”? In this article, we review the current state of the literature pertaining to the neuropsychological dysfunctions that are found in children, teenagers and adults with ADHD, focusing particularly on executive functions. Because there is considerable interest in neuropsychological assessment as a clinical tool for persons with ADHD, the nature and validity of clinical neuropsychological assessment for this population will also be addressed.