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Objective: Diagnostic assessment of ADHD is challenging due to comorbid psychopathologies and symptoms overlapping with other psychiatric disorders. In this study, we investigate if a distinct pattern of neuromuscular dysregulation previously reported in ADHD, can help identifying ADHD in psychiatric patients with diverse and complex symptoms., Method: We explored the impact of neuromuscular dysregulation, as measured by The Motor Function Neurologic Assessment (MFNU), on the likelihood of being diagnosed with ADHD, affective disorder, anxiety disorder, or personality disorder among adults ( n  = 115) referred to a psychiatric outpatient clinic., Results: Logistic regression revealed that neuromuscular dysregulation was significantly associated with ADHD diagnosis only ( OR 1.15, p  < .01), and not with affective-, anxiety-, or personality disorders. Sensitivity and specificity for ADHD at different MFNU scores is provided., Conclusions: A test of neuromuscular dysregulation may promote diagnostic accuracy in differentiating ADHD from other psychiatric disorders in patients with an overlapping symptom picture. This may have important implications for clinical practice. More studies are needed., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The MFNU manual is edited by LLS and TS. The other authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: This study extends long-term predictive research on ADHD by including both neuropsychological and symptom measures at baseline in adolescence as predictors of diagnostic persistence 25 years later., Methods: Nineteen males with ADHD and 26 healthy controls (HC; M/F = 13/13), were assessed in adolescence and 25 years later. Measurements at baseline included a comprehensive test battery measuring eight neuropsychological domains, an IQ estimate, the Child Behavior Checklist (CBCL), and the Global Assessment Scale of Symptoms. Differences between ADHD Retainers, Remitters, and HC were calculated with ANOVAs, and potential predictions of differences in the ADHD group by linear regression analyses., Results: Eleven (58%) participants retained their ADHD diagnoses at follow-up. Motor Coordination and Visual perception at baseline predicted diagnosis at follow-up. CBCL Attention problems at baseline in the ADHD group predicted variance in diagnostic status., Conclusion: Lower-order neuropsychological functions related to motor function and perception are important long-time predictors of persistence of ADHD.

Objective: The aim of this study was to examine whether reaction time parameters in adult patients with ADHD could predict their response to methylphenidate (MPH). Method: Previously unmedicated patients ( N = 123) were administered the Conners' Continuous Performance Test II (CPT II) at baseline and after 6 weeks of treatment with immediate-release MPH. In addition to traditional CPT measures, we extracted intraindividual raw data and analyzed time series using linear and nonlinear mathematical models. Results: Clinical responders, assessed with the Clinical Global Impression-Improvement scale, showed significant normalization of target failures, reduced variability and skewness, and increased complexity of reaction time series after 6 weeks of treatment, while nonresponders showed no significant changes. Prior to treatment, responders had significantly higher variability and skewness, combined with lower complexity, compared with nonresponders. Conclusion: These results show that the CPT test is useful in the evaluation of treatment response to MPH.

Objective: The aim is to investigate the everyday executive function (EF) in children with Tourette syndrome (TS), Inattentive or Combined presentations of ADHD (ADHD-I/ADHD-C), autism spectrum disorders (ASD), and typically developing children (TDC)., Method: Nineteen TS, 33 ADHD-C, 43 ADHD-I, 34 ASD, and 50 TDC participated (8-17 years). Parents completed the Behavior Rating Inventory of Executive Function (BRIEF)., Results: TS, ADHD-C, ADHD-I, or ASD were rated with significantly more regulation problems on all scales compared with TDC. Considerable overlap of symptoms between clinical groups made differentiation difficult on individual scales. Scale configurations showed children with TS to have more problems with emotional control (EC) than cognitive flexibility in relation to children with ASD, more problems with EC than inhibitory control in relation to ADHD-C, and more problems with EC than planning/organizing in relation to ADHD-I., Conclusion: Paired BRIEF scales dissociated EF problems in children with TS from children with ADHD-C, ADHD-I, or ASD. Clinical relevance is discussed.

Objective: Little is known about cognition in preschoolers with ADHD and language delay (LD). The objective was to investigate cognitive functions in preschoolers with ADHD symptoms and LD compared with children with ADHD symptoms only and to estimate the frequency of children with ADHD symptoms, co-occurring language delay, and delays on cognitive measures., Method: Participants were recruited from the Norwegian Mother and Child Cohort Study. The teacher report of expressive language and the cognitive tests from 119 3-year-old children with parent reported ADHD symptoms and LD were compared with those of 258 children with ADHD symptoms only., Results: The ADHD + LD group performed significantly worse than the ADHD group on most language-related measures. There were no differences between the groups on most nonverbal measures. Single measures had a limited potential of differentiating between the groups., Conclusion: ADHD symptoms and co-occurring LD in preschoolers were characterized by cognitive deficits associated with both disorders, not with global neurodevelopmental delay., (© The Author(s) 2013.)

Unlabelled: Executive deficits are reported in both early onset bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD), and controversies regarding comorbidity and symptom overlap have complicated the research on executive function in BD. Reports of the negative impact of executive difficulties on academic functioning indicate a need for a greater focus on executive difficulties in early onset psychiatric disorders. Executive function and processing speed in youths with BD (n = 4), ADHD (n = 26) and BD + ADHD (n = 13) were compared with controls (n = 69). All clinical groups demonstrated executive impairment. The combined group was most impaired. There were no significant differences between the groups. Executive deficit in the BD group was associated with a history of psychotic symptoms. The BD-nonpsychotic group was impaired only with regard to processing speed. Processing speed adjustment improved working memory and normalized interference control in both BD and ADHD., Conclusion: executive deficits in BD may be determined by a history of psychotic symptoms rather than by comorbid ADHD. Some aspects of executive problems appear speed-related.

Objective: A previous factor analysis of the Conners' Continuous Performance Test (CCPT) indicates that the test measures 5 sub-functions of attention, namely focused attention, hyperactivity/impulsivity, sustained attention, vigilance, and change in control. The present study further analyzes the results from Egeland & Kowalik-Gran to test the construct- and criterion-validity of these factors., Method: Construct validity is tested by analyzing whether clinical groups known to be impaired in specified subprocesses actually differ with regard to factor scores. Comparison of CCPT factor scores from 282 individuals with ADHD, schizophrenia, affective disorders, brain injury, language disorders, and normal individuals gives validity to 4 factors, but not to the vigilance factor., Results: Other tests of controlled attention correlate only with focused attention, thus giving criterion validity to this factor and differential validity to the remaining 4 factors., Conclusion: Grouping scores on the CCPT into 4 or 5 sub-functions of attention may provide the clinician with a tool to differentiate between clinical groups.

Objective: Continuous performance tests are known to typically measure sustained attention but usually also yield parameters that potentially measure other subprocesses of attention. The aim of the present study was to test the factor structure of the Conners's Continuous Performance Test (CCPT) in a heterogeneous clinical sample consisting of subjects considered to fail in different subfunctions of attention., Method and Results: CCPT records from 376 patients were factor analyzed, yielding five factors indicating a differentiation between focused attention, hyperactivity-impulsivity, sustained attention, vigilance, and change in control., Conclusion: The study warns against reducing CCPT performance to one overall score of attention. The study further emphasizes the need to reserve the concept of sustained attention for measures of change as a function of time on task. The differentiation between sustained attention and vigilance and the concept of change in mental control during the test are possible methodological contributions of the study.

Confirmatory Factor Analyses (CFA) of the Wechsler Adult Intelligence Scale-III (WAIS-III) lend partial support to the four-factor model proposed in the test manual. However, the Arithmetic subtest has been especially difficult to allocate to one factor. Using the new Norwegian WAIS-III version, we tested factor models differing in the number of factors and in the placement of the Arithmetic subtest in a mixed clinical sample (n = 272). Only the four-factor solutions had adequate goodness-of-fit values. Allowing Arithmetic to load on both the Verbal Comprehension and Working Memory factors provided a more parsimonious solution compared to considering the subtest only as a measure of Working Memory. Effects of education were particularly high for both the Verbal Comprehension tests and Arithmetic.