Hyperactivity in children, or attention deficit hyperactivity disorder (ADHD), is associated with impairments in various major life activities by adulthood, particularly occupational functioning. ADHD appears to involve deficits in executive functioning (EF). Prior studies have not examined the contribution of these deficits to adult impairment generally and occupational adjustment specifically in longitudinal studies of hyperactive/ADHD children. We did so assessing EF by both self-report and tests and using self and other-rated impairment in 10 domains of major life activities and 12 measures of occupational impairment. We studied hyperactive (H; N = 135) and community control children (C; N = 75) followed to adulthood (mean age 27 years). The H cases were subdivided into those whose ADHD did (ADHD–P) and did not persist (ADHD–NP) using modified DSM-IV criteria. Self-reported EF deficits were more severe on all five EF scales in the ADHD–P than both the ADHD–NP and C groups and on three scales in the ADHD–NP compared to C groups. Most ADHD–P cases fell in the clinically impaired range on self-reported EF as did a substantial minority of ADHD–NP cases but few were so classified on the EF tests. Impairments in occupational functioning were predicted by the EF ratings to a greater degree than by the EF tests. Most EF tests were unrelated to work history with the exception of the Five-Points Test. We conclude that EF ratings are better predictors of impairment in major life activities generally and occupational functioning specifically at adult follow-up than are EF tests. We hypothesize that this paradox arises from each method assessing different levels of a hierarchically organized EF meta-construct briefly discussed herein.

中文翻译：

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预测多动儿童成年后主要生活活动和职业功能的损害：自我报告的执行功能 (EF) 缺陷与 EF 测试

儿童多动症或注意力缺陷多动障碍 (ADHD) 与成年后各种主要生活活动的损害有关，尤其是职业功能。ADHD 似乎涉及执行功能 (EF) 的缺陷。先前的研究没有在多动症/多动症儿童的纵向研究中检查这些缺陷对成人损害的总体影响和职业调整。我们这样做是通过自我报告和测试来评估 EF，并在 10 个主要生活活动领域和 12 项职业损害措施中使用自我和其他评定的损害。我们研究了多动症 (H; N = 135) 和社区控制儿童 (C; N = 75) 直至成年（平均年龄 27 岁）。使用修改后的 DSM-IV 标准将 H 病例细分为 ADHD 有 (ADHD-P) 和未持续 (ADHD-NP) 的病例。自我报告的 EF 缺陷在 ADHD-P 的所有五个 EF 量表上都比 ADHD-NP 和 C 组更严重，在 ADHD-NP 的三个量表上与 C 组相比更严重。大多数 ADHD-P 病例在自我报告的 EF 中属于临床受损范围，少数 ADHD-NP 病例也是如此，但很少有在 EF 测试中如此归类。与 EF 测试相比，EF 评级对职业功能损害的预测程度更高。除五点测试外，大多数 EF 测试与工作经历无关。我们得出的结论是，与 EF 测试相比，EF 评级更能预测主要生活活动的损害，尤其是成人随访时的职业功能损害。