Neuropsychological performance in adult attention-deficit hyperactivity disorder: Meta-analysis of empirical data
Claudia Schoechlin and Rolf R.Engel
Archives of Clinical Neuropsychology, Volume 20, Issue 6, August 2005, Pages 727-744

Abstract
Attention-deficit hyperactivity disorder (ADHD) is increasingly recognized not only in children but also in adults. Neuropsychological tests are important tools to quantify the attentional and/or cognitive deficits of patients compared to controls. The present meta-analysis integrates 24 empirical studies reporting results of at least one of 50 standard neuropsychological tests comparing adult ADHD patients with controls. The 50 tests were categorized into the following 10 functional domains: verbal ability, figural problem solving, abstract problem solving, executive function, fluency, simple attention, sustained attention, focused attention, verbal memory, figural memory. For each domain a pooled effect size d′ was calculated. Complex attention variables and verbal memory discriminated best between ADHD patients and controls. Effect sizes for these domains were homogeneous and of moderate size (d′ between 0.5 and 0.6). In contrast to results reported in children, executive functions were not generally reduced in adult ADHD patients.

Neuropsychological Weaknesses in Adult ADHD; Cognitive Functions as Core Deficit and Roles of Them in Persistence to Adulthood
Ozan Pazvantog ̆lu, et al.
Journal of the International Neuropsychological Society (2012), 18, 1–8. Copyright E INS. Published by Cambridge University Press, 2012. doi:10.1017/S1355617712000574
(RECEIVED July 13, 2011; FINAL REVISION March 20, 2012; ACCEPTED March 26, 2012)

Abstract
Prior investigations have shown that individuals with attention deficit hyperactivity disorder (ADHD) have impaired neuropsychological functions. This study had two aims, first to investigate weakened cognitive functions in adult ADHD (aADHD), and second, to investigate difference between persisters (those having persistently ongoing ADHD diagnosis in adulthood), and remitters (those having ADHD diagnosis only in childhood and not in adulthood), in terms of cognitive deficits. We evaluated performance on a comprehensive neuropsychological battery in three groups including 34 persisters, 35 remitters, and 35 healthy control group (absence of childhood and adulthood ADHD diagnosis).

Our findings showed that adults with ADHD have inefficient attention, interference control and set-shifting functions, which may be revealed on neuropsychological tests that require greater cognitive demand. Given the finding that interference control deficit exists across the lifespan in people with ADHD, we suggest that interference control-associated functional weakness may be a core deficit for ADHD. (JINS, 2012, 18, 1–8)

Spatial processing in adults with attention deficit hyperactivity disorder.
Kalanthroff, E., et al.
Neuropsychology, Vol 27(5), Sep, 2013. pp. 546-555.

Abstract:
Background: ‘Global processing bias’ is an automatic tendency to process the global picture prior to the local details. The right hemisphere is known to be more dominant in global processing, and some researchers have demonstrated its important role in alertness. Converging evidence implies some dysfunction in right hemisphere activation in people suffering from attention deficit hyperactivity disorder (ADHD). Global processing is yet to be understood in ADHD. Objective: We examined whether adults with ADHD show deficient global processing and whether this could be alleviated by the presence of an alerting signal. Method: Adult participants (20 ADHD, 20 typically developing controls) responded to a global–local Navon task in which they were asked to respond to the large stimulus or the small component stimuli, and to a Navon-like task with an alerting cue. Reaction time and accuracy were measured. Results: Unlike controls, adults with ADHD did not have global precedence; irrelevant global stimuli (when asked to respond to the local level) and irrelevant local stimuli (when asked to respond to the global level) produced similar interference in ADHD participants. Appearance of an alerting cue increased global processing bias (i.e., increased interference from global stimuli in the local block and reduced interference from local stimuli in the global block) for both groups, such that global processing in ADHD participants was comparable to that of controls. Conclusion: ADHD participants showed lack of a global processing bias. Most important, global processing bias was reinstated by an alerting cue. Implications for the definition of ADHD, which currently emphasizes failure to pay close attention to details, will be discussed. Moreover, the current results have important implications for social functioning of people suffering from ADHD.

Functional impairment in adults positively screened for attention-deficit hyperactivity disorder: The role of symptom presentation and executive functioning.
Szuromi, Bálint, et. al.
Comprehensive Psychiatry, Vol 54(7), Oct, 2013. pp. 974-981.

Abstract:
Background: While the number of symptoms of attention-deficit hyperactivity disorder (ADHD) decreases with age, a high proportion of adults with ADHD symptoms suffer from persistent functional impairment (Fi) linked to these symptoms. Our objective was to investigate the specific roles of two potentially important predictors of this Fi: the clinical symptom presentation and the deficit in executive functions (EFs). Methods: A total of 158 subjects from a community sample positively screened for ADHD were classified into two groups: those with and without Fi. Following a detailed diagnostic process, participants were administered a self-rating scale for ADHD symptoms as well as a neuropsychological test battery containing tests of EF and attention relevant as potential cognitive endophenotypes for ADHD. Results: The overall number as well as the number of inattentive, hyperactive and impulsive symptoms, confirmed both by examiner and self-report, were significantly higher among Fi subjects. The highest odds ratio for Fi was associated with impulsive symptoms. Additionally, self-reported complaints of problems with self-concept were significantly higher among Fi subjects. No significant relationship between Fi and neuropsychological measures of EF and attention was detected. Conclusions: This study revealed that the number of symptoms, in particular that of impulsivity, had a significant impact on Fi in adults with symptoms of ADHD. Furthermore, our results underline the importance of assessing complaints and behaviors related to self-concept, which are not included in DSM-IV diagnostic criteria of ADHD but nonetheless may be associated with functional outcome of the disorder.

Atypical left–right balance of visuomotor awareness in adult ADHD (combined type) on a test of executive function.
Braun, Claude M. J., et al.
Laterality: Asymmetries of Body, Brain and Cognition, Vol 18(4), Jul, 2013. pp. 385-406.

Abstract:
Significant left subclinical hemi-neglect or ‘hemi-unawareness’ in juvenile and adult ADHD has been reported many times. However, this literature has never been thoroughly reviewed, and is generally ignored in neuropsychological accounts of ADHD. The purposes of the present report were (1) to introduce a systematic review of this literature and (2) to prospectively test whether adults with ADHD (combined type) would present left hemi-unawareness measurable on a test of executive function commonly used with children and adults with ADHD, the Colour-Word Interference Test of the Delis-Kaplan Executive Functions System. This test requires participants to discriminate unusual stimulus characteristics by stating words aloud while visually scanning plates comprising either 50 colour patches or 50 words. A total of 28 ADHD adults (combined type) and 30 IQ-, age-, and gender-matched controls completed the task. The ADHD group manifested a significantly higher proportion of errors on the left than right sides of the plates. This atypical left-right balance was related to severity of the ADHD according to the Conners’ Adult ADHD Rating Scale (CAARS) as well as to several other indicators from the Continuous Performance Test-II.

Validating the measurement of executive functions in an occupational context for adults with attention deficit hyperactivity disorder.
Stern, Adi., et al.
American Journal of Occupational Therapy, Vol 68(6), Nov-Dec, 2014. pp. 719-728.

Abstract:
Objective: The objectives of this study were to better understand the cognitive profile of adults with attention deficit hyperactivity disorder (ADHD), their occupational performance, and their quality of life (QoL) and to examine the validity of a cognitive-functional evaluation (CFE) battery for these adults. Method: Eighty-one adults with ADHD and 58 without ADHD completed ADHD symptom ratings, the Behavior Rating Inventory of Executive Function-Adult Version, and the Adult ADHD Quality-of-Life Scale. An occupational performance interview was administered to the ADHD group. Results: A broad range ol occupational concerns were reported. We found significant differences between groups on all measures. In the ADHD group, we found medium significant correlations among the measures. Conclusion: Adults with ADHD experience cognitive and functional difficulties in their daily lives associated with QoL. The results support the use of a CFE battery that has been shown to be sensitive and specific for these adults.

Cognitive complaints of adults with attention deficit hyperactivity disorder.
Fuermaier, Anselm B. M., et al.
The Clinical Neuropsychologist, Vol 28(7), Oct, 2014. pp. 1104-1122.

Abstract:
Executive dysfunction of adults with ADHD is often associated with poor self-awareness of problems, such as in emotional competence, emotional recognition, and driving competence. However, with regard to cognitive functioning, little is known about how adults with ADHD evaluate their own cognitive performance. A total of 77 adults with ADHD and 116 healthy adults were assessed with self-report scales measuring several aspects of cognition. Significance and effect sizes as well as the proportion of patients perceiving impairments were calculated. Further analysis was carried out on the frequency of patients perceiving various types of impairments. Adults with ADHD perceived themselves to have significant and severe dysfunction in all areas of cognition assessed as a group. Furthermore, the majority of patients reported multiple impairments in attention, memory and executive functioning. The present study demonstrated that adults with ADHD are aware of problems in cognitive functioning as shown by considerable perceived neuropsychological impairment in the majority of patients. Patients with ADHD tended to report cognitive impairments in multiple domains rather than impairments in specific functions.

Examination of the influence of processing speed on the neuropsychological performance of attention deficit/hyperactivity disorder (ADHD) adults.
Creamer, Scott.
Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 75(2-B) (E), 2014.

Abstract:
To better understand how neuropsychological performance in adult attention deficit/hyperactivity disorder (ADHD) is related to symptom severity and processing speed, two studies were conducted. In study one, the relationship between the inattentive and hyperactive-impulsive symptom domains and attentional/frontal executive and processing speed measures was examined. Study two examined the influence of the WAIS Processing Speed Index (PSI) and Working Memory Index (WMI) scores on the California Verbal Learning Test (CVLT) and verbal fluency performance (COWA). Participants were 46 adults who were diagnosed with ADHD. Study 1 regression analyses revealed that tests of processing speed and executive functioning were differentially related to the two symptom domains in ADHD. More specifically, aspects of executive functioning (i.e., inhibition and sustained attention) were related to hyperactive-impulsive symptoms, whereas slower processing speed was associated with inattention. For Study 2, neither the PSI nor WMI were associated with the CVLT or COWA, suggesting that poorer verbal learning/memory and verbal fluency in ADHD adults is not largely attributable to working memory and processing speed deficits. Study 1 is consistent with the notion that poor inhibition may underpin attentional/frontal executive task performance in ADHD adults. Results from study 2 suggest that factors other than processing speed, working memory, and inhibition may be contributing to CVLT and COWA difficulties experienced by ADHD adults. Taken together, these findings are in line with suggestions that slower processing speed may represent a separate neuropsychological pathway in ADHD adults.

Cognitive heterogeneity in adult attention deficit/hyperactivity disorder: A systematic analysis of neuropsychological measurements.
Mostert, Jeanette C., et al.
European Neuropsychopharmacology, Vol 25(11), Nov, 2015. pp. 2062-2074.

Abstract:
Attention Deficit/Hyperactivity Disorder (ADHD) in childhood is associated with impaired functioning in multiple cognitive domains: executive functioning (EF), reward and timing. Similar impairments have been described for adults with persistent ADHD, but an extensive investigation of neuropsychological functioning in a large sample of adult patients is currently lacking. We systematically examined neuropsychological performance on tasks measuring EF, delay discounting, time estimation and response variability using univariate ANCOVA’s comparing patients with persistent ADHD (N = 133, 42% male, mean age 36) and healthy adults (N = 132, 40% male, mean age 36). In addition, we tested which combination of variables provided the highest accuracy in predicting ADHD diagnosis. We also estimated for each individual the severity of neuropsychological dysfunctioning. Lastly, we investigated potential effects of stimulant medication and a history of comorbid major depressive disorder (MDD) on performance. Compared to healthy adults, patients with ADHD showed impaired EF, were more impulsive, and more variable in responding. However, effect sizes were small to moderate (range: 0.05–0.70) and 11% of patients did not show neuropsychological dysfunctioning. The best fitting model predicting ADHD included measures from distinct cognitive domains (82.1% specificity, 64.9% sensitivity). Furthermore, patients receiving stimulant medication or with a history of MDD were not distinctively impaired. To conclude, while adults with ADHD as a group are impaired on several cognitive domains, the results confirm that adult ADHD is neuropsychologically heterogeneous. This provides a starting point to investigate individual differences in terms of impaired cognitive pathways.

Deficient interference control during working memory updating in adults with ADHD: An event-related potential study.
Stroux, D., et al.
Clinical Neurophysiology, Vol 127(1), Jan, 2016. pp. 452-463.

Abstract:
Objective: Little is known about the underlying mechanisms of poor working memory (WM) performance of adults with attention deficit hyperactivity disorder (ADHD). This study investigates interference and load effects during WM updating by use of event-related potentials. Method: Forty ADHD patients and 41 controls performed verbal n-back tasks under conditions of low and high WM load. Intrusion probes, i.e., lures, were implemented to challenge interference control abilities during WM processing. Results: Stimulus-dependent N200 amplitude modulation and behavioral performance in lure trials were reduced in adults with ADHD compared to healthy controls. Also, P300 amplitudes tended to be less sensitive to WM load in patients with ADHD. Conclusion: Our findings provide electrophysiological evidence for inaccurate discrimination of stimulus categories. Particularly, deficient interference control may lead to overt WM deficits in adult subjects with ADHD. Significance: The current findings contribute to a deeper understanding of the neural substrates of executive dysfunction in adult ADHD, focusing on the domain of WM.

‘Turning intentions into actions’: CBT for adult ADHD focused on implementation.
Ramsay, J. Russell
Clinical Case Studies, Vol 15(3), Jun, 2016. pp. 179-197.

Abstract:
Contemporary models of attention-deficit/hyperactivity disorder (ADHD) provide frameworks for understanding this condition that move beyond the diagnostic symptom criteria. ADHD is currently viewed as a developmental syndrome of impaired self-regulatory processes that underlie the common symptoms and functional problems. Most clinic-referred adults with ADHD report chronic difficulties executing their intended plans despite recognizing the negative consequences for not doing so. Seeing as the psychosocial treatments for adult ADHD intervene at the level of life impairments and functioning, it is important that interventions directly target these implementation problems. The goal of this article is to discuss the case of a young woman with ADHD who has difficulties engaging in the various tasks she needs to perform to pursue her post-college goals. In particular, a cognitive-behavioral therapy approach that emphasizes implementation strategies designed to help adults with ADHD follow through on their plans is illustrated.

Abnormal resting-state functional connectivity of insular subregions and disrupted correlation with working memory in adults with attention deficit/hyperactivity disorder.
Zhao, Qihua, et al.
Frontiers in Psychiatry, Vol 8, Oct 11, 2017. ArtID: 200

Abstract:
Objectives: Executive function (EF) deficits are major impairments in adults with attention deficit/hyperactivity disorder (ADHD). Previous studies have shown that the insula is involved in cognitive and EFs. However, the insula is highly heterogeneous in function, and few studies have focused on functional networks which related to specific insular subregions in adults with ADHD. We explored the functional networks of the insular subregions [anterior insula (AI), mid-insula (MI), and posterior insula (PI)]. Furthermore, their correlations with self-ratings of ecological EFs, including inhibition, shifting, and working memory were investigated. Methods: Resting-state functional magnetic resonance imaging data in 28 adults with ADHD and 30 matched healthy controls (HCs) were analyzed. The seed-based resting-state functional connectivity (RSFC) of the insular subregions was evaluated. We also investigated their associations with the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) inhibition, working memory, and shifting factor scores. results: Compared with HCs, adults with ADHD showed altered RSFC of the AI, with the precuneus, precentral gyrus, and inferior temporal gyrus extended to the middle temporal gyrus, lingual gyrus, and superior occipital gyrus, respectively. There were no significant differences in RSFC of the MI and PI between the two groups. Within the HC group, working memory scores were associated with the RSFC of AI with precuneus and temporal gyrus. However, there was no correlation between these variables in the ADHD group. conclusion: The study evaluated RSFC patterns of the insular subregions in adults with ADHD for the first time. Altered RSFC of the AI which is a crucial region of salience network (SN) and part of regions in default mode network (DMN), were detected in adults with ADHD in both results with and without global signal regression (GSR), suggesting that disrupted SN-DMN functional connectivity may be involved in EF impairments in adults with ADHD, especially with respect to working memory. Deficits of the AI which is involved in salient stimuli allocation, might be associated with the pathophysiology of ADHD. The inconsistent results of MI and PI between analyses with and without GSR need further exploration.

The structure of adult ADHD.
Adler, Lenard A., et al.
International Journal of Methods in Psychiatric Research, Vol 26(1), Mar, 2017.

Abstract:
Although DSM‐5 stipulates that symptoms of attention‐deficit hyperactivity disorder (ADHD) are the same for adults as children, clinical observations suggest that adults have more diverse deficits than children in higher‐level executive functioning and emotional control. Previous psychometric analyses to evaluate these observations have been limited in ways addressed in the current study, which analyzes the structure of an expanded set of adult ADHD symptoms in three pooled US samples: a national household sample, a sample of health plan members, and a sample of adults referred for evaluation at an adult ADHD clinic. Exploratory factor analysis found four factors representing executive dysfunction/inattention (including, but not limited to, all the DSM‐5 inattentive symptoms, with non‐DSM symptoms having factor loadings comparable to those of DSM symptoms), hyperactivity, impulsivity, and emotional dyscontrol. Empirically‐derived multivariate symptom profiles were broadly consistent with the DSM‐5 inattentive‐only, hyperactive/impulsive‐only, and combined presentations, but with inattention including executive dysfunction/inattention and hyperactivity‐only limited to hyperactivity without high symptoms of impulsivity. These results show that executive dysfunction is as central as DSM‐5 symptoms to adult ADHD, while emotional dyscontrol is more distinct but nonetheless part of the combined presentation of adult ADHD.

Delay aversion and executive functioning in adults with attention-deficit/hyperactivity disorder: Before and after stimulant treatment.
Low, Ann-Marie, et al.
International Journal of Neuropsychopharmacology, Vol 21(11), Nov, 2018. pp. 997-1006.

Abstract:
Background: Attention deficit hyperactivity disorder is a heterogeneous disorder, associated with deficits in motivation (e.g., delay aversion) and cognition. Methylphenidate is recommended as a first line treatment for attention deficit hyperactivity disorder symptoms, but little is known about its nonacute effects on motivational and cognitive deficits, particularly in adults with attention deficit hyperactivity disorder. Methods: We utilized a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 initially stimulant medication-naïve adult patients with moderate to severe attention deficit hyperactivity disorder, and 42 age- and parental education-matched healthy controls. Delay aversion and executive functioning were assessed with 2 questionnaires and 5 performance-based tests. Results: At baseline, patients and controls differed significantly on performance-based measures (moderate to large effect sizes), and self-report of delay aversion and executive functioning (very large effect sizes). Treatment with methylphenidate medication (mean dose 65.54 mg/d, SD = 10.39) was not associated with improvements in performance-based measures of delay aversion and executive functioning compared to controls, although improvements in self-report executive functioning and delay aversion were found. Self-reported delay aversion was most consistently associated with ADHD symptomatology at baseline and after medication. Conclusion: Methylphenidate treatment does not have an effect on performance-based measures of delay aversion and executive functioning, but may have significant effects on self-reported delay aversion and executive functioning. The latter finding should be interpreted cautiously, given the subjective nature of these measures and design limitations. Self-reported delay aversion is most consistently associated with attention deficit hyperactivity disorder symptomatology.

A situation-specific approach to measure attention in adults with ADHD: The Everyday Life Attention Scale (ELAS).
Groen, Yvonne, et al.
Applied Neuropsychology: Adult, Vol 26(5), Sep-Oct, 2019. pp. 411-440.

Abstract:
This study describes the development and utility of a new self-report measure of attentional capacities of adults with Attention DeficitHyperactivity Disorder (ADHD): the Everyday Life Attention Scale (ELAS). Different from previous attention scales, attentional capacities are rated for nine everyday situations. Study 1 investigated the factor structure, validity, and reliability of the ELAS in 1206 healthy participants. Confirmatory factor analysis supported a situation-specific approach which categorizes everyday attention into nine situation scales: Reading, Movie, Activity, Lecture, Conversation, Assignment, Cooking, Cleaning up, and Driving. Each scale was composed of ratings for sustained, focused, selective, and divided attention as well as motivation, and had good internal consistency. Most scales showed weak correlations with ADHD Symptoms, Executive Functioning, and Memory Efficacy. Study 2 further investigated the sensitivity of the ELAS in 80 adults with ADHD compared to matched healthy controls and a mixed clinical group of 56 patients diagnosed with other psychiatric disorders. Compared to healthy controls, patients with ADHD reported reduced attentional capacities with large effect sizes on all situation scales and had a substantially higher number of situations with impaired attention scores. The ELAS may become useful in the clinical evaluation of ADHD and related psychiatric disorders in adults. (PsycINFO Database Record

The relationship between cognitive functions and occupational performance in children, adults, and adults with Attention Deficit Hyperactivity Disorders (ADHD).
Lin, Mei-Heng.
Dissertation Abstracts International: Section B: The Sciences and Engineering, Vol 80(2-B) (E), 2019.

Abstract:
The overarching goal of this dissertation is to explore the relationship between cognitive functions and occupational performance in neurotypical children, neurotypical adults, and adults with attention-deficit/hyperactivity disorder (ADHD). Electroencephalography (EEG)/event-related potential (ERP) techniques were used to measure the neural processes while participants performed a speeded computer-based task for the three studies conducted in this dissertation. The first study examined the test-retest reliability on the amplitudes of two ERP components associated with performance monitoring, the error-related negativity (ERN) and error-positivity (Pe), in 53 neurotypical adults and 118 neurotypical children aged 8-12-year-old. The findings indicated that the test-retest reliability of these measures was moderate for children ( rERN = 0.55, rPe = 0.62), and was moderate to strong for adults (rERN = 0.69, rPe = 0.75). Moreover, the adaptive Woody filter was implemented to adjust for the trial-to-trial variation in latency (i.e., latency jitter) when measuring the ERN and Pe amplitudes. The findings showed that adjusting for the latency jitter did not improve the reliability of ERN and Pe amplitudes for both groups, suggesting that the latency variability may be a trait-like variable which systematically occurred across sessions. Furthermore, the test-retest reliability of stimulus-locked ERP components on correct trials was higher compared to the reliability of response-locked ERPs for children and adults, confirming that both children and adults generally attended to the task consistently across sessions. The second study demonstrated the feasibility of utilizing the structural equation modeling (SEM) approach to model the complicated inter-relationship between neural processes and simple task behaviors (e.g., response times) in 143 children with typical development aged 8-12 years. The findings from the latent models indicated that the brain-and-behavior relationships were significant on correct trials but were not significant on incorrect trials after controlling for trait and state factors. Moreover, both models demonstrated different patterns of relationship among latent variables to response time, yet both models yielded excellent model fit indices. This finding suggested that our conceptual models were valid in terms of detecting the distinct patterns of neural processes leading to opposite behavioral outcomes (e.g., correct and incorrect). The final model demonstrated that the post-error adjustment in the stream of neural processes provided an adaptive effect on the early neural processing of the stimulus on correct trials. To our knowledge, this is the first study demonstrating how the post-error adjustment occurs at the level of neural processing. The third study (1) compared the group differences (children, adults, and adults with ADHD) on neural and occupational performance measures, (2) examined the inter-relationship between these measures for each group, and (3) investigated which measures can best differentiate three groups. The findings suggested that adults with ADHD demonstrated significantly lower quality of occupational performance particularly on the motor aspect of the activities of daily living (ADL). Moreover, for neurotypical children, larger ERN amplitudes were associated with lower quality of social interaction. For adults with ADHD, larger N2 amplitude was associated with lower quality of social interaction. Lastly, discriminant analyses demonstrated that the combination of neural and occupational performance measures differentiated children, adults, and adults with ADHD with 93.2% classification accuracy.

A meta-analysis of mindfulness-based interventions in adults with attention-deficit hyperactivity disorder: Impact on adhd symptoms, depression, and executive functioning.
Poissant, Hélène, et al.
Mindfulness, Aug 5, 2020.

Abstract:
Objectives: Mindfulness-based interventions (MBIs) are increasingly used in adults with attention-deficit hyperactivity disorder (ADHD). The aim of the current study was to conduct a meta-analysis of the available studies on the effects of MBIs on ADHD symptoms, depression, and executive functioning in adults diagnosed with ADHD.

Methods: Screening and selection of peer-reviewed literature using PRISMA-P guidelines on PsycINFO, PubMed, SCOPUS, and ERIC databases from inception to July 2019

Results: A total of 14 studies were included in the meta-analysis, for an aggregated sample of 834 adults with ADHD. Overall, the results showed that MBIs are effective to treat ADHD symptoms in adults, as well as to reduce depression and dysexecutive problems post-intervention.

Conclusions: MBIs are useful to improve ADHD symptoms, negative affect, and cognition in adult ADHD. The results contribute to better understanding and encourage the use of non-pharmacological treatments in ADHD.