Mechanisms of cognitive disinhibition explain individual differences in adult attention deficit hyperactivity disorder traits

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) in adults is strongly associated with psychiatric comorbidity and functional impairment. Here, we aimed to use a newly developed online cognitive battery with strong psychometric properties for measuring individual differences in three cognitive mechanisms proposed to underlie ADHD traits in adults: 1) attentional control – the ability to mobilize cognitive resources to stop a prepotent motor response; 2) information sampling/gathering – adequate sampling of information in a stimulus detection task prior to making a decision; and 3) shifting - the ability to adapt behavior in response to positive and negative contingencies. Methods: This cross-sectional and correlational study recruited 650 adults (330 males) aged 18–69 years (M = 33.06; MD = 31.00; SD = 10.50), with previously diagnosed ADHD (n = 329) and those from the general community without a history of ADHD (n = 321). Self-report measures of ADHD traits (i.e., inattention/disorganization, impulsivity, hyperactivity) and the cognitive battery were completed online. Results: Latent class analysis, exploratory structural equation modeling and factor mixture modeling revealed self-reported ADHD traits formed a unidimensional and approximately normally distributed phenotype. Bayesian structural equation modeling demonstrated that all three mechanisms measured by the cognitive battery, explained unique, incremental variance in ADHD traits, with a total of 15.9% explained in the ADHD trait factor. Conclusions: Attentional control and shifting, as well as the less researched cognitive process of information gathering, explain individual difference variance in self-reported ADHD traits with potential to yield genetic and neurobiological insights into adult ADHD.