A-153: Executive Functioning Task Sensitivity in Youth With ADHD, Anxiety, and Comorbid Presentations
Abstract
Objective: Executive functioning deficits are commonly associated with attention-deficit/hyperactivity disorder (ADHD), yet less is known about how commonly used executive functioning measures differentiate ADHD from anxiety disorders and comorbid presentations in clinical settings. This looked at whether performance on executive inhibition and switching tasks varied across children and adolescents diagnosed with ADHD, anxiety, and comorbid ADHD and anxiety, and whether executive functioning tasks varied in their diagnostic sensitivity. Method/Data Selection: Participants were children and adolescents diagnosed with ADHD (n = 63), anxiety disorders (n = 26), or comorbid ADHD and anxiety (n = 23). Executive functioning was evaluated using inhibition and cognitive switching tasks, including the NEPSY-II Inhibition/Switching subtest and switching conditions from the Delis–Kaplan Executive Function System. Performance on the NEPSY-II Inhibition/Switching task was compared across diagnostic groups, with effect sizes calculated to observe the size differences in average performance. Results/Data Synthesis: NEPSY-II Inhibition/Switching performance differed significantly across diagnostic groups (F = 4.14, p = .018). Post-hoc comparisons indicated youth with anxiety performed significantly better than youth with ADHD (p = .014, d = 0.59) and youth with comorbid ADHD and anxiety (p = .007, d = 0.70). Performance did not differ between the ADHD and ADHD+anxiety groups (p = .784, d = 0.06). Other executive switching measures demonstrated weaker differentiation between groups. Conclusions: Executive inhibition and switching performance varied by diagnosis, with anxiety disorders associated with stronger performance than ADHD on developmentally sensitive measures. Comorbid anxiety did not increase inhibition/switching deficits beyond ADHD alone, highlighting task-specific differences in diagnostic sensitivity among commonly used executive functioning measures.