Executive and Non-Executive Functions in Attention Deficit Hyperactivity Disorder of the Inattentive Type (ADHD-I): A Cognitive Profile


Objective: This study examined the hypothesis that individuals with attention deficit hyperactivity disorder, predominantly inattentive type (ADHD-I), show both executive function (EF) deficits and non-EF deficits. Method: A group with ADHD-I (n = 16) and a paired control group (n = 21) completed a battery of tasks covering the major domains of EF (planning, working memory, flexibility and inhibition) and non-EF (alertness, divided attention, flexibility, sustained attention, visual field and visual scanning). Results: EF impairments in planning, spatial working memory, flexibility, and inhibition as well as non-EF impairments in divided attention, flexibility, sustained attention and visual scanning were observed in the ADHD-I group. Conclusion: Our results do not support the traditional model of ADHD. Given that neither EF nor non-EF tests typically distinguish ADHD-I from ADHD-C, alternative methodologies are required to confirm the validity of ADHD subtypes in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition.

Share and Cite:

Y. Song and Y. Hakoda, "Executive and Non-Executive Functions in Attention Deficit Hyperactivity Disorder of the Inattentive Type (ADHD-I): A Cognitive Profile," Journal of Behavioral and Brain Science, Vol. 4 No. 1, 2014, pp. 1-10. doi: 10.4236/jbbs.2014.41001.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] R. C. K. Chan, D. Shum, T. Toulopoulou, et al., “Assessment of Executive Functions: Review of Instruments and Identification of Critical Issues,” Archives of Clinical Neuropsychology, Vol. 23, No. 2, 2008, pp. 201-216.
[2] C. Hughes, “Executive Function in Preschoolers: Links with Theory of Mind and Verbal Ability,” British Journal of Developmental Psychology, Vol. 16, No. 2, 1998, pp. 233-253.
[3] A. Miyake, N. P. Friedman, M. J. Emerson, et al., “The Unity and Diversity of Executive Functions and Their Contributions to Complex Frontal Lobe Tasks: A Latent Variable Analysis,” Cognitive psychology, Vol. 41, No. 1, 2000, pp. 49-100.
[4] S. Ozonoff, “Components of Executive Function in Autism and Other Disorders,” In: J. Russell, Ed., Autism as an Executive Disorder, Oxford University Press, New York, 1997.
[5] T. W. Robbins, D. Weinberger, J. G. Taylor, et al., “Dissociating Executive Functions of the Prefrontal Cortex,” Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, Vol. 351, No. 1346, 1996, pp. 1463-1471.
[6] M. C. Welsh, B. F. Pennington and D. B. Groisser, “A Normative-Developmental Study of Executive Function: A Window on Prefrontal Function in Children,” Developmental Neuropsychology, Vol. 7, No. 2, 1991, pp. 131-149. http://dx.doi.org/10.1080/87565649109540483
[7] M. C. Welsh and B. F. Pennington, “Assessing Frontal Lobe Functioning in Children: Views from Developmental Psychology,” Developmental Neuropsychology, Vol. 4, No. 3, 1988, pp. 199-230.
[8] E. G. Willcutt, A. E. Doyle, J. T. Nigg, et al., “Validity of the Executive Function Theory of Attention-Deficit/ Hyperactivity Disorder: A Meta-Analytic Review,” Biological Psychiatry, Vol. 57, No. 11, 2005, pp. 1336-1346.
[9] L. L. Boucugnani and R. W. Jones, “Behaviors Analogous to Frontal Lobe Dysfunction in Children with Attention Deficit Hyperactivity Disorder,” Archives of Clinical Neuropsychology, Vol. 4, No. 2, 1989, pp. 161-173.
[10] F. X. Castellanos and R. Tannock, “Neuroscience of Attention-Deficit/Hyperactivity Disorder: The Search for Endophenotypes,” Nature Reviews Neuroscience, Vol. 3, No. 8, 2002, pp. 617-628.
[11] P. M, Levin, “Restlessness in Children,” Archives of Neurology and Psychiatry, Vol. 39, No. 4, 1938, pp. 764-770.
[12] B. F. Pennington and S. Ozonoff, “Executive Functions and Developmental Psychopathology,” Journal of Child Psychology and Psychiatry, Vol. 37, No. 1, 1996, pp. 51-87. http://dx.doi.org/10.1111/j.1469-7610.1996.tb01380.x
[13] D. A. Pineda, M. A. Restrepo, R. J. Sarmiento, et al., “Statistical Analyses of Structural Magnetic Resonance Imaging of the Head of the Caudate Nucleus in Colombian Children with Attention-Deficit Hyperactivity Disorder,” Journal of Child Neurology, Vol. 17, No. 2, 2002, pp. 97-105.
[14] K. L. Shue and V. I. Douglas, “Attention Deficit Hyperactivity Disorder and the Frontal Lobe Syndrome,” Brain and Cognition, Vol. 20, No. 1, 1992, pp. 104-124.
[15] American Psychiatric Association (APA), “Diagnostic and Statistical Manual of Mental Disorders,” 4th Edition, Text Revision, Author, Washington DC, 2000.
[16] R. A. Barkley, “Behavioral Inhibition, Sustained Attention, and Executive Functions: Constructing a Unifying Theory of ADHD,” Psychological Bulletin, Vol. 121, No. 1, 1997, p. 65.
[17] C. L. Carlson and M. Mann, “Attention-Deficit/Hyperactivity Disorder, Predominately Inattentive Subtype,” Child and Adolescent Psychiatric Clinics of North America, Vol. 19, No. 9, 2000, pp. 499-510.
[18] R. Milich, A. C. Balentine and D. R. Lynam, “ADHD Combined Type and ADHD Predominantly Inattentive Type Are Distinct and Unrelated Disorders,” Clinical Psychology: Science and Practice, Vol. 8, No. 4, 2001, pp. 463-488. http://dx.doi.org/10.1093/clipsy.8.4.463
[19] J. T. Nigg, “Neuropsychologic Theory and Findings in Attention-Deficit/Hyperactivity Disorder: The State of the Field and Salient Challenges for the Coming Decade,” Biological Psychiatry, Vol. 57, No. 11, 2005, pp. 1424-1435. http://dx.doi.org/10.1016/j.biopsych.2004.11.011
[20] J. T. Nigg, L. G. Blaskey, C. L. Huang-Pollock, et al., “Neuropsychological Executive Functions and DSM-IV ADHD Subtypes,” Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 41, No. 1, 2002, pp. 59-66.
[21] A. C. Bedard, A. Ickowicz, G. D. Logan, et al., “Selective Inhibition in Children with Attention-Deficit Hyperactivity Disorder off and on Stimulant Medication,” Journal of Abnormal Child Psychology, Vol. 31, No. 3, 2003, pp. 315-327. http://dx.doi.org/10.1023/A:1023285614844
[22] N. Chhabildas, B. F and Pennington, E. G. Willcutt, “A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD,” Journal of Abnormal Child Psychology, Vol. 29, No. 6, 2001, pp. 529-540.
[23] M. Schmitz, L. Cadore, M. Paczko, et al., “Neuropsychological Performance in DSM-IV ADHD Subtypes: An Exploratory Study with Untreated Adolescents,” Canadian Journal of Psychiatry, Vol. 47, 2002, pp. 863-869.
[24] A. Angold, M. Prendergast, A. Cox, et al., “The Child and Adolescent Psychiatric Assessment (CAPA),” Psychological Medicine, Vol. 25, No. 4, 1995, pp. 739-754.
[25] C. K. Conners, “Rating Scales in Attention-Deficit/Hyperactivity Disorder: Use in Assessment and Treatment Monitoring,” The Journal of Clinical Psychiatry, Vol. 59, No. 9, 1997, pp. 24-30.
[26] C. K. Conners, “The Conners Rating Scales: Instruments for the Assessment of Childhood Psychopathology,” Duke University, Durham, 1995.
[27] American Psychiatric Association, “Diagnostic and Statistical Manual of Mental Disorders: DSM-IV,” American Psychiatric Pub Inc., Arlington, 1994.
[28] Y. Hakoda and M Sasaki, “Group Version of the Stroop and Reverse-Stroop Test: The Effects of Reaction Mode, Order and Practice,” Kyoiku Shinrigaku Kenkyu (Japanese Journal of Educational Psychology), Vol. 38, No. 1, 1990, pp. 389-394.
[29] Y. Hakoda and M. Sasaki, “Two Interferences Based on New Stroop Test and Reaction Model (Report No. 3),” Kyushu University, Department of Information Systems, Fukuoka, 1991, pp. 12-15.
[30] M. Luciana and C. A. Nelson, “Neurodevelopmental Assessment of Cognitive Function Using the Cambridge Neuropsychological Testing Automated Battery (CAN-TAB): Validation and Future Goals,” Functional Neuroimaging in Child Psychiatry, Cambridge University Press, Cambridge, 2000, pp. 379-397.
[31] B. J. Sahakian and A. M. Owen, “Computerized Assessment in Neuropsychiatry Using CANTAB: Discussion Paper,” Journal of the Royal Society of Medicine, Vol. 85, No. 7, 1992, p. 399.
[32] M. C. Goldberg, S. H. Mostofsky, L. E. Cutting, et al., “Subtle Executive Impairment in Children with Autism and Children with ADHD,” Journal of Autism and Developmental Disorders, Vol. 35, No. 3, 2005, pp. 279-293.
[33] S. Kempton, A. Vance, P. Maruff, et al., “Executive Function and Attention Deficit Hyperactivity Disorder: Stimulant Medication and Better Executive Function Performance in Children,” Psychological Medicine, Vol. 29, No. 3, 1999, pp. 527-538.
[34] E. Joyce, S. Blumenthal and S. Wessely, “Memory, Attention, and Executive Function in Chronic Fatigue Syndrome,” Journal of Neurology, Neurosurgery & Psychiatry, Vol. 60, No. 5, 1996, pp. 495-503.
[35] T. Shallice, “Specific Impairments of Planning,” Philosophical Transactions of the Royal Society of London, Biological Sciences, Vol. 298, No. 1089, 1982, pp. 199-209. http://dx.doi.org/10.1098/rstb.1982.0082
[36] M. Luciana, “Practitioner Review: Computerized Assessment of Neuropsychological Function in Children: Clinical and Research Applications of the Cambridge Neuropsychological Testing Automated Battery (CANTAB),” Journal of Child Psychology and Psychiatry, Vol. 44, No. 5, 2003, pp. 649-663.
[37] D. A. Grant and E. Berg, “A Behavioral Analysis of Degree of Reinforcement and Ease of Shifting to New Responses in a Weigl-Type Card-Sorting Problem,” Journal of Experimental Psychology, Vol. 38, No. 4, 1948, pp. 404-411. http://dx.doi.org/10.1037/h0059831
[38] R. K. Heaton, “A Manual for the Wisconsin Card Sorting Test,” Western Psycological Services, 1981.
[39] R. K. Heaton, “Wisconsin Card Sorting Test: Computer Version 2,” Psychological Assessment Resources, Odessa, 1993.
[40] Y. Song and Y. Hakoda, “An Asymmetric Stroop/ReverseStroop Interference Phenomenon in ADHD,” Journal of Attention Disorders, Vol. 15, No. 6, 2011, pp. 499-505.
[41] P. Goodyear and G. W. Hynd, “Attention-Deficit Disorder with (ADD/H) and without (ADD/WO) Hyperactivity: Behavioral and Neuropsychological Differentiation,” Journal of Clinical Child Psychology, Vol. 21, No. 3, 1992, pp. 273-305.
[42] B. B. Lahey and C. L. Carlson, “Validity of the Diagnostic Category of Attention Deficit Disorder without Hyperactivity A Review of the Literature,” Journal of Learning Disabilities, Vol. 24, No. 2, 1991, pp. 110-120.
[43] P. Zimmermann and B. Fimm, “A Test Battery for Attentional Performance,” Applied Neuropsychology of Attention, Vol. 20, No. 2, 2002, pp. 110-151.
[44] B. A. Corbett, L. J. Constantine, R. Hendren, D. Rocke and S. Ozonoff, “Examining Executive Functioning in Children with Autism Spectrum Disorder, Attention Deficit Hyperactivity Disorder and Typical Development,” Psychiatry Research, Vol. 166, No. 2, 2009, pp. 210-222.
[45] R. Martinussen, J. Hayden, S. Hogg-Johnson and R. Tannock, “A Meta-Analysis of Working Memory Impairments in Children with Attention-Deficit/Hyperactivity Disorder,” Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 44, No. 4, 2005, pp. 377-384.
[46] H. M. Geurts, S. Verté, J. Oosterlaan, H. Roeyers and J. A. Sergean, “How Specific Are Executive Functioning Deficits in Attention Deficit Hyperactivity Disorder and Autism?” Journal of Child Psychology and Psychiatry, Vol. 45, No. 4, 2004, pp. 836-854.
[47] H. M. Geurts, S. Verté, J. Oosterlaan, H. Roeyers and J. A. Sergean, “ADHD Subtypes: Do They Differ in Their Executive Functioning Profile?” Archives of Clinical Neuropsychology, Vol. 20, No. 4, 2005, pp. 457-477.
[48] B. F. Pennington, D. Groisser and M. C. Welsh, “Contrasting Cognitive Deficits in Attention Deficit Hyperactivity Disorder versus Reading Disability,” Developmental Psychology, Vol. 29, No. 3, 1993, pp. 511-523.
[49] L. L. Weyandt and W. G. Willis, “Executive Functions in School—Aged Children: Potential Efficacy of Tasks in Discriminating Clinical Groups,” Developmental Neuropsychology, Vol. 10, No. 1, 1994, pp. 27-38.
[50] A. H. Amaral and M. M. Guerreiro, “Attention Deficit Hyperactivity Disorder: Proposal of Neuropsychological Assessment,” Arquivos de Neuro-Psiquiatria, Vol. 59, No. 4, 2001, pp. 884-888.
[51] W. V. Reeve and S. L. Schandler, “Frontal Lobe Functioning in Adolescents with Attention Deficit Hyperactivity Disorder,” Adolescence, Vol. 36, No. 144, 2001, pp. 749-765.
[52] M. Semrud-Clikeman, R. J. Steingard, P. Filipek, J. Biederman, K. Bekken and P. F. Renshaw, “Using MRI to Examine Brain-Behavior Relationships in Males with Attention Deficit Disorder with Hyperactivity,” Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 39, No. 4, 2000, pp. 477-484.
[53] G. Tripp, J. Ryan and K. Peace, “Neuropsychological Functioning in Children with DSM-IV Combined Type Attention Deficit Hyperactivity Disorder,” Australian and New Zealand Journal of Psychiatry, Vol. 36, No. 6, 2002, pp. 771-779.
[54] S. Houghton, G. Douglas, J. West, et al., “Differential Patterns of Executive Function in Children with AttentionDeficit Hyperactivity Disorder According to gender and Subtype,” Journal of Child Neurology, Vol. 14, No. 12, 1999, pp. 801-805.
[55] R. Van Mourik, J. Oosterlaan and J. A. Sergeant, “The Stroop Revisited: A Meta Analysis of Interference Control in AD/HD,” Journal of Child Psychology and Psychiatry, Vol. 46, No. 2, 2005, pp. 150-165.
[56] M. M. Lansbergen, J. L. Kenemans and H. van Engeland, “Stroop Interference and Attention-Deficit/Hyperactivity Disorder: A Review and Meta-Analysis,” Neuropsychology, Vol. 21, No. 2, 2007, pp. 251-262.
[57] J. R. Stroop, “Studies of Interference in Serial Verbal Reactions,” Journal of Experimental Psychology, Vol. 18, No. 6, 1935, pp. 643-662.
[58] C. A. Riccio, S. Homack, K. P. Jarratt and M. E. Wolfe, “Differences in Academic and Executive Function Domains among Children with ADHD Predominantly Inattentive and Combined Types,” Archives of Clinical Neuropsychology, Vol. 21, No. 7, 2006, pp. 657-667.
[59] P. G. Aaron, R. M. Joshi and J. Phipps, “A Cognitive Tool to Diagnose Predominantly Inattentive ADHD Behavior,” Journal of Attention Disorders, Vol. 7, No. 3, 2004, pp. 125-135.
[60] K. D. Gadow, J. Sprafkin and E. E. Nolan, “DSM-IV Symptoms in Community and Clinic Preschool Children,” Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 40, No. 12, 2001, pp. 1383-1392.
[61] B. W. Graetz, M. G. Sawyer, P. L. Hazell, F. Arney and P. Baghurst, “Validity of DSM-IV ADHD Subtypes in a Nationally Representative Sample of Australian Children and Adolescents,” Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 40, No. 12, 2001, pp. 1410-1417.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.