The evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher-order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher-order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire-30 (MCQ-30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ-30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.

中文翻译：

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检查认知灵活性、情绪识别和元认知在成人注意力缺陷和多动障碍中的作用，主要表现为注意力不集中

评估注意力缺陷和多动障碍 (ADHD) 中的认知功能是提高治疗干预效果的基础。然而，特定的高阶认知功能在成人 ADHD 中的作用，包括认知灵活性、情绪识别和元认知，仍不清楚。因此，在目前的研究中，我们旨在检查成人 ADHD 个体中这三种不同的高阶认知功能。40 名注意力不集中的 ADHD 患者和 42 名健康对照者参与了这项研究。进行了成人注意力缺陷和多动障碍量表 (AADHDS)、威斯康星卡片分类测试 (WCST)、眼中读心测试 (RMET) 和元认知问卷 30 (MCQ-30)。结果表明，与健康对照组相比，ADHD 患者在特定子维度上的元认知评分更差。然而，各组之间的认知灵活性和情绪识别没有差异。此外，发现 MCQ-30 的认知信心亚维度是 AAHDS 注意力缺陷亚维度的唯一重要预测因子。我们的研究结果表明，尽管认知灵活性和情绪识别功能正常，但缺乏认知信心可能会导致 ADHD 症状。因此，元认知可能是减轻 ADHD 症状严重程度的合适目标。发现 MCQ-30 的认知信心子维度是 AAHDS 注意力缺陷子维度的唯一重要预测因子。我们的研究结果表明，尽管认知灵活性和情绪识别功能正常，但缺乏认知信心可能会导致 ADHD 症状。因此，元认知可能是减轻 ADHD 症状严重程度的合适目标。发现 MCQ-30 的认知信心子维度是 AAHDS 注意力缺陷子维度的唯一重要预测因子。我们的研究结果表明，尽管认知灵活性和情绪识别功能正常，但缺乏认知信心可能会导致 ADHD 症状。因此，元认知可能是减轻 ADHD 症状严重程度的合适目标。