Executive Functions and Overt/Covert Patterns of Conduct Disorder Symptoms in Children With ADHD

Abstract

There are inconsistencies in findings exploring the relationship between executive functions (EF), attention-deficit/hyperactivity disorder (ADHD), and conduct disorder (CD) symptoms in children in adolescents. In order to reconcile conflicting results in the existing literature, it is necessary to consider more carefully how these constructs are measured and the theory underlying any expected associations. The proposed study examined the EF correlates of overt and covert CD symptoms in a high-risk sample of 6-14 year old children with ADHD and varying levels of conduct problems. Several aspects of EF were examined, including shifting, working memory, behavioral inhibition, and interference control, to examine their relationship to both ADHD and overt and covert conduct problems. It was expected, after ADHD was accounted for, that deficits in behavioral inhibition and working memory would be related to both overt and covert CD symptoms, whereas deficits in shifting and interference control would be uniquely related to overt CD symptoms. Set shifting abilities were found to be significantly lower in children with co-occurring ADHD and CD in comparison to children with ADHD-only. Results failed to find consistent evidence for differential relationships between individual overt and covert behaviors and domains of EF, but an interaction between set shifting and interference control did significantly predict overt, but not covert symptoms. Potential reasons for these findings, as well as future directions for research are discussed.