Internalizing and somatic symptoms influence the discrepancy between subjective and objective cognitive difficulties in adults with ADHD who have valid and invalid test scores

IF 2.6 4区心理学 Q2 CLINICAL NEUROLOGY

Journal of the International Neuropsychological Society Pub Date : 2024-09-18 DOI:10.1017/s1355617724000365

John-Christopher A. Finley, Anthony D. Robinson, Hannah B. VanLandingham, Devin M. Ulrich, Matthew S. Phillips, Jason R. Soble

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Abstract

Objectives: This study investigated the relationship between various intrapersonal factors and the discrepancy between subjective and objective cognitive difficulties in adults with attention-deficit hyperactivity disorder (ADHD). The first aim was to examine these associations in patients with valid cognitive symptom reporting. The next aim was to investigate the same associations in patients with invalid scores on tests of cognitive symptom overreporting. Method: The sample comprised 154 adults who underwent a neuropsychological evaluation for ADHD. Patients were divided into groups based on whether they had valid cognitive symptom reporting and valid test performance (n = 117) or invalid cognitive symptom overreporting but valid test performance (n = 37). Scores from multiple symptom and performance validity tests were used to group patients. Using patients’ scores from a cognitive concerns self-report measure and composite index of objective performance tests, we created a subjective-objective discrepancy index to quantify the extent of cognitive concerns that exceeded difficulties on objective testing. Various measures were used to assess intrapersonal factors thought to influence the subjective-objective cognitive discrepancy, including demographics, estimated premorbid intellectual ability, internalizing symptoms, somatic symptoms, and perceived social support. Results: Patients reported greater cognitive difficulties on subjective measures than observed on objective testing. The discrepancy between subjective and objective scores was most strongly associated with internalizing and somatic symptoms. These associations were observed in both validity groups. Conclusions: Subjective cognitive concerns may be more indicative of the extent of internalizing and somatic symptoms than actual cognitive impairment in adults with ADHD, regardless if they have valid scores on cognitive symptom overreporting tests.

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内化症状和躯体症状对测试成绩有效和无效的成人多动症患者主观和客观认知困难之间差异的影响

研究目的本研究调查了注意力缺陷多动障碍（ADHD）成人患者的各种人际因素与主观和客观认知困难之间的差异之间的关系。研究的第一个目的是在认知症状报告有效的患者中研究这些关联。其次是研究在认知症状过度报告测试中得分无效的患者的相同关联。研究方法样本包括154名接受过多动症神经心理学评估的成年人。根据患者是否具有有效的认知症状报告和有效的测试表现（n = 117）或无效的认知症状过度报告但具有有效的测试表现（n = 37）将其分为两组。采用多种症状和表现有效性测试的得分对患者进行分组。利用患者在认知问题自我报告测量中的得分和客观表现测试的综合指数，我们创建了一个主客观差异指数，以量化认知问题超出客观测试困难的程度。我们还使用了各种测量方法来评估被认为会影响主观-客观认知差异的个人内部因素，包括人口统计学、估计的病前智力、内化症状、躯体症状和感知到的社会支持。结果显示与客观测试结果相比，患者在主观测量中报告的认知困难更大。主观评分与客观评分之间的差异与内化症状和躯体症状的关系最为密切。这些关联在两个有效性组中都能观察到。结论：与实际认知障碍相比，主观认知问题可能更能反映成人多动症患者的内化症状和躯体症状的程度，无论他们在认知症状过度报告测试中的得分是否有效。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the International Neuropsychological Society 医学-精神病学

CiteScore

5.40

自引率

3.80%

发文量

185

审稿时长

4-8 weeks

期刊介绍： The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate. To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.