Attention Deficit/Hyperactivity Disorder and Anxiety: Implications of Comorbidity on Executive Function Deficits

Abstract

Attention Deficit with Hyperactivity Disorder (ADHD) is one of the most prevalent disorders in childhood and affects about 5% of school students. ADHD is characterized by three main symptoms: inattention, hyperactivity and impulsivity. These deficits suggest a problem in the voluntary control of behavior that is generally associated with executive functioning impairments (e.g., deficits in working memory, planning, organization, concentration, and cognitive flexibility). Moreover, ADHD is frequently accompanied by different disorders, especially anxiety, which is present in 20% to 50% of ADHD cases. This comorbidity usually has important effects on the expression of ADHD deficits in both children and adolescents. Thus, it is necessary to systematically examine the potential consequences of this association. The primary goals of this study are to firstly carry out an exhaustive review of previous research on this topic, and thereafter analyze executive function profiles in a cohort of students with ADHD and anxiety (aged 6 to 16 years). In order to clearly describe the findings and results of these goals, the present chapter comprises the following structure: 1) A brief introduction describing ADHD and executive functions deficits, with a particular focus on comorbidity between ADHD and anxiety disorders; 2) The concept of anxiety and the different classifications of this disorder is discussed in relation to the most commonly-utilized assessment methods and instruments at the present time; 3) The implications of the presence of anxiety on executive deficits in ADHD are explained, and then examined in the light of an empirical study involving a small sample of students with these very characteristics (comorbid ADHD and anxiety disorders); 4) The results from this analysis are then discussed, and some practical implications are also presented. The aspects addressed in the present chapter will provide readers with an initial insight into this problematic aspect of ADHD, and its important consequences concerning children and adolescent individuals and their future academic achievement.