An exploration of the neuropsychology and neuroelectrophysiology of university students experiencing symptoms of ADHD

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental disorders affecting approximately 5% of school-aged children and 2-5% of adults. Evidence suggests that childhood symptoms of the disorder continue into adulthood for the majority of those affected. University students with ADHD continue to struggle compared to students without the disorder, but never the less they achieve higher academic outcomes than those with ADHD who do not continue on to university and therefore they may represent a ‘better-adjusted’ subset of the ADHD population. However, little is known about the difficulties faced by this group in UK universities.

Several theoretical models of ADHD pathophysiology/psychopathology have been proposed over the years, initially focused on inhibitory control and executive functions, then reward processing and motivation, and now multiple pathways encompassing a wide range of difficulties. However, current models have not been able to account for all of the variability in the samples tested, suggesting that additional pathways may be needed. One possibility could be the entrainment of ongoing neural oscillations which is implicated in the perception and processing of stimuli, as well as neural communication within and between regions of the brain.

The aims of this research were first to investigate the neuropsychological difficulties faced by university students experiencing symptoms of ADHD, and second to explore the possibility that any such difficulties might be explained by an entrainment deficit. Across two studies, it was found that students who reported a higher level of ADHD symptoms exhibited deficits in working memory and temporal processing, but no difficulties in sustained attention, selective attention, or inhibitory control. There were also no differences between high and low symptom participants in neuro-electrophysiological measures, suggesting no underlying compensatory neural mechanisms which might explain the equivalent performance in the selective attention and inhibitory control tasks. Understanding the neuropsychological domains in which these students do and do not have difficulties allows the focusing of resources toward support strategies to aid students with ADHD symptoms through their studies.

Two paradigms for eliciting an entrainment response were tested, but neither were successful in eliciting the effect, meaning the question of whether an entrainment deficit might underlie the working memory and temporal processing difficulties remains unanswered. Being unable to elicit the entrainment of ongoing neural oscillations calls into question the ubiquity of this effect, meaning more research and the publication of null results are needed to further our understanding of this phenomenon.

In conclusion, university students with ADHD symptoms show deficits in working memory and temporal processing, but no difficulties with sustained attention, selective attention, or inhibitory control. These findings need to be replicated in larger samples to address the lack of statistical power in these studies and more research is needed to investigate the possibility that the neuropsychological deficits found here could be subserved by an entrainment deficit.

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Identifiers

ORCID for Samuele Cortese: orcid.org/0000-0001-5877-8075

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