Adult ADHD
Visual Abstract
High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD
How IQ Compensates for ADHD in Executive Function
Ana Luiza Vidal Milioni , Tiffany Moukbel Chaim , Mikael Cavallet , Nathalya Moleda de Oliveira , Marco Annes , Bernardo Dos Santos , Mario Louzã , Maria Aparecida da Silva , Carmen Silvia Miguel , Mauricio Henriques Serpa , Marcus V Zanetti , Geraldo Busatto , Paulo Jannuzzi Cunha
Summarized by:
August 31, 2023
study source
J Atten Disord
April 2017
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What they studied
Researchers wanted to see if intelligence can compensate for ADHD symptoms, particularly deficits in executive function.
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What they found
While most adults with ADHD showed clear deficits in executive function, high-IQ adults with ADHD performed just as well as average adults without ADHD on tests of executive function.
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What this means
These results provide a potential explanation for why ADHD often goes undiagnosed in highly intelligent individuals. Intelligence can, in some ways, compensate for ADHD symptoms.
High IQ May "Mask" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naïve Adults With ADHD
Objectives
ADHD has been shown to affect adults and children of all intellectual capacities. There are brilliant people with ADHD and there are mediocre people with ADHD as well.
ADHD doesn’t determine intelligence. But, intelligence might help someone with ADHD compensate for their symptoms.
A highly intelligent person with ADHD may still be impaired by their ADHD symptoms. But, because of their high intelligence, they would appear merely average through creative compensation.
This study wanted to test executive function in high-IQ and average-IQ adults with ADHD.
Executive function is a type of cognition known to be affected by ADHD.
What is executive function?
Study Quote
To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks.
Methods
To study this, researchers compared adults with and without ADHD. They separated the subjects into high-IQ and low-IQ adults.
They evaluated executive function with a series of neuropsychological tests.
Study Quote
We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according ...
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Results
The results showed that adults with average IQ and ADHD did significantly worse on every test, confirming that ADHD dramatically affects executive function.
However, those with high IQ and ADHD did just fine on all but one test. Despite their ADHD, they could perform just as well as ordinary people on executive function tests. This was likely because they could compensate for ADHD symptoms with higher intelligence.
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Our data show that, although ADHD adults with more elevated IQ may have EF impairments, these deficits arise more discreetly in EF tasks data than the ones presented by individuals with the disorder and standard IQ. It means that the impairment is present, but the ADHD individuals with more elevated IQ may have a wider range of intellectual strategies to compensate the deficits.
Of note, the test where both groups underperformed was the continuous performance task, one of the best cognitive tests for diagnosing ADHD.
Study Quote
The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 ( p = .000) and 3 ( p = .000), Trail Making Test (TMT) B ( p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors ( p = .022) and failures to...
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Conclusions
This study provides a good explanation for why ADHD often goes underdiagnosed in highly intelligent people. Even with ADHD, someone intelligent enough can still perform at an average level without triggering suspicion of a learning disorder.
While it is possible that highly intelligent people don’t have any executive function deficits, previous studies have shown that highly intelligent people with ADHD do underperform intelligent people without ADHD.
This means that even though someone with ADHD can compensate and keep up, they are still performing below their full capability.
Study Quote
Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a preci...
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