Skip to main content
SpringerLink
Log in

Adult Attention Deficit Hyperactivity Disorder (ADHD) in ASD

  • Chapter
  • First Online:
Psychopathology in Adolescents and Adults with Autism Spectrum Disorders

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by core symptoms of inattention, impulsivity, and hyperactivity. ADHD has been considered for a long time as a childhood condition, fading as children grew up. Instead, ADHD changes its clinical presentation over the lifespan, but persists in most cases in adulthood with its associated impairment.

It is only since 2013, with the release of DSM-5, that it is possible to diagnose ADHD in the presence of ASD. This change was based on studies performed in children, adolescents, and adults that found high comorbidity rates between ASD and ADHD.

Studies investigating the co-occurrence of such disorders at a genetic, at structural and functional neuroimaging levels indicate that they share common genetic risk factors, involve similar biological mechanisms, and affect the same brain regions.

The co-existence of both disorders causes a significant burden. Individuals with ASD presenting ADHD symptomatology exhibit a more severe phenotype, with more autistic traits, greater impairment in adaptive behavior, and increased risk for developing additional psychiatric conditions.

Pharmacotherapeutic treatments for ADHD, such as methylphenidate and atomoxetine, have been studied in individuals with ADHD+ASD, demonstrating efficacy in decreasing the severity of ADHD symptoms, although with lower effect sizes than in people with only ADHD.

The diagnosis of ADHD is established clinically and requires the use of rating scales as well as clinical interviews for avoiding the risk of misdiagnosis.

The stigma surrounding individuals with ADHD is huge, therefore it is necessary to increase awareness about this disorder among both the public and healthcare professionals, in order to reduce the barriers that patients face to get access to proper diagnosis and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Still GF. Some abnormal psychical conditions in children: the Goulstonian lectures. Lancet. 1902;1:1008–12.

    Google Scholar 

  2. Kramer F, Pollnow H. Über eine hyperkinetische Erkrankung im Kindesalter. Monatsschr Psychiatr Neurol. 1932;82:1–40.

    Article  Google Scholar 

  3. Ross DM, Ross SA. Hyperactivity: research, theory and action. New York: Wiley; 1976.

    Google Scholar 

  4. APA. Diagnostic and statistical manual of mental disorders (DSM-III-R). 3rd Rev ed. Washington, DC: American Psychiatric Association; 1987.

    Google Scholar 

  5. APA. Diagnostic and statistical manual of mental disorders—DSM 5. In: APAD-T, editor. Force. 5th ed. Washington, DC: American Psychiatric Publishing; 2013.

    Google Scholar 

  6. Philipsen A, Hesslinger B, Tebartz van Elst L. Attention deficit hyperactivity disorder in adulthood: diagnosis, etiology and therapy. Dtsch Arztebl Int. 2008;105(17):311–7.

    Google Scholar 

  7. Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J. Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry. 2019;56:14–34. https://doi.org/10.1016/j.eurpsy.2018.11.001.

    Article  Google Scholar 

  8. Kooij JJS. Adult ADHD. Diagnostic assessment and treatment. 3rd ed. London: Springer-Verlag; 2013. ISBN 978-1-4471-4138-9. https://doi.org/10.1007/978-1-4471-4138-9.

    Book  Google Scholar 

  9. Skirrow C, McLoughlin G, Kuntsi J, Asherson P. Behavioral, neurocognitive and treatment overlap between attention-deficit/hyperactivity disorder and mood instability. Expert Rev Neurother. 2009;9:489–503. https://doi.org/10.1586/ern.09.2.

    Article  Google Scholar 

  10. Skirrow C, Asherson P. Emotional lability, comorbidity and impairment in adults with attention-deficit hyperactivity disorder. J Affect Disord. 2013;147(1-3):80–6.

    Article  Google Scholar 

  11. Fayyad J, Sampson NA, Hwang I, Adamowski T, Aguilar-Gaxiola S, Al-Hamzawi A, Andrade LH, Borges G, de Girolamo G, Florescu S, Gureje O, Haro JM, Hu C, Karam EG, Lee S, Navarro-Mateu F, O’Neill S, Pennell BE, Piazza M, Posada-Villa J, Ten Have M, Torres Y, Xavier M, Zaslavsky AM, Kessler RC, WHO World Mental Health Survey Collaborators. The descriptive epidemiology of DSM-IV Adult ADHD in the World Health Organization World Mental Health Surveys. Atten Defic Hyperact Disord. 2017;9(1):47–65.

    Article  Google Scholar 

  12. de Graaf R, Kessler RC, Fayyad J, ten Have M, Alonso J, Angermeyer M, et al. The prevalence and effects of adult attention-deficit/hyperactivity disorder (ADHD) on the performance of workers: results from the WHO World Mental Health Survey Initiative. Occup Environ Med. 2008;65(12):835–42.

    Article  Google Scholar 

  13. Ginsberg Y, Hirvikoski T, Lindefors N. Attention deficit hyperactivity disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder. BMC Psychiatry. 2010;10:112. https://doi.org/10.1186/1471-244X-10-112.

    Article  Google Scholar 

  14. Østergaard SD, Dalsgaard S, Faraone SV, Munk-Olsen T, Laursen TM. Teenage parenthood and birth rates for individuals with and without attention-deficit/hyperactivity disorder: a nationwide cohort study. J Am Acad Child Adolesc Psychiatry. 2017;56(7):578–584.e3. https://doi.org/10.1016/j.jaac.2017.05.003. Epub 2017 May 11.

    Article  Google Scholar 

  15. Wymbs BT, Dawson AE, Egan TE, Sacchetti GM. Rates of intimate partner violence perpetration and victimization among adults with ADHD. J Atten Disord. 2016;23:949–58. pii: 1087054716653215.

    Article  Google Scholar 

  16. Young S, Gudjonsson G, Asherson P, Theobald J, Oliver B, Scott C, et al. Attention deficit hyperactivity disorder and critical incidents in a Scottish prison population. Personal Individ Differ. 2009;46:265–9.

    Article  Google Scholar 

  17. Manor I, Gutnik I, Ben-Dor DH, Apter A, Sever J, Tyano S, Weizman A, Zalsman G. Possible association between attention deficit hyperactivity disorder and attempted suicide in adolescents - a pilot study. Eur Psychiatry. 2010;25(3):146–50.

    Article  Google Scholar 

  18. Dalsgaard S, Østergaard SD, Leckman JF, Mortensen PB, Pedersen MG. Mortality in children, adolescents, and adults with attention deficit hyperactivity disorder: a nationwide cohort study. Lancet. 2015;385(9983):2190–6. https://doi.org/10.1016/S0140-6736(14)61684-6.

    Article  Google Scholar 

  19. Torgersen T, Gjervan B, Rasmussen K. ADHD in adults: a study of clinical characteristics, impairment and comorbidity. Nord J Psychiatry. 2006;60(1):38–43.

    Article  Google Scholar 

  20. Cortese S, Moreira-Maia CR, St Fleur D, Morcillo-Peñalver C, Rohde LA, Faraone SV. Association between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry. 2016;173(1):34–43.

    Article  Google Scholar 

  21. Bijlenga D, van der Heijden KB, Breuk M, van Someren EJ, Lie ME, Boonstra AM, et al. Associations between sleep characteristics, seasonal depressive symptoms, lifestyle, and ADHD symptoms in adults. J Atten Disord. 2013;17(3):261–74.

    Article  Google Scholar 

  22. Spencer TJ, Faraone SV, Tarko L, McDermott K, Biederman J. Attention-deficit/ hyperactivity disorder and adverse health outcomes in adults. J Nerv Ment Dis. 2014;202(10):725–31.

    Article  Google Scholar 

  23. Stickley A, Koyanagi A, Takahashi H, Ruchkin V, Inoue Y, Kamio Y. Attention- deficit/hyperactivity disorder and physical multimorbidity: a population-based study. Eur Psychiatry. 2017;45:227–34.

    Article  Google Scholar 

  24. Instanes JT, Klungsoyr K, Halmoy A, Fasmer OB, Adult ADHD, Haavik J. Comorbid somatic disease: a systematic literature review. J Atten Disord. 2018;22(3):203–28.

    Article  Google Scholar 

  25. Kooij JJ, Bijlenga D. The circadian rhythm in adult attention-deficit/hyperactivity disorder: current state of affairs. Expert Rev Neurother. 2013;13(10):1107–16.

    Article  Google Scholar 

  26. Kirono E, Imagawa H, Goto T, Montgomery W. Sociodemographics, comorbidities, healthcare utilization and work productivity in Japanese patients with adult ADHD. PLoS One. 2015;10(7):e0132233. https://doi.org/10.1371/journal.pone.0132233.

    Article  Google Scholar 

  27. Jacob CP, Romanos J, Dempfle A, Heine M, Windemuth-Kieselbach C, Kruse A, et al. Co-morbidity of adult attention-deficit/hyperactivity disorder with focus on personality traits and related disorders in a tertiary referral center. Eur Arch Psychiatry Clin Neurosci. 2007;257(6):309–17. Epub 2007 Apr 1.

    Article  Google Scholar 

  28. Van Veen MM, Kooij JJ, Boonstra AM, Gordijn MC, Van Someren EJ. Delayed circadian rhythm in adults with attention-deficit/hyperactivity disorder and chronic sleep-onset insomnia. Biol Psychiatry. 2010;67(11):1091–6.

    Article  Google Scholar 

  29. Vogel SWN, Bijlenga D, Benjamins JS, Beekman ATF, Kooij JJS, Van Someren EJW. Attention deficit hyperactivity disorder symptom severity and sleep problems in adult participants of the Netherlands sleep registry. Sleep Med. 2017;40:94–102.

    Article  Google Scholar 

  30. Martinez-Raga J, Szerman N, Knecht C, de Alvaro R. Attention deficit hyperactivity disorder and dual disorders. Educational needs for an underdiagnosed condition. Int J Adolesc Med Health. 2013;25(3):231–43. https://doi.org/10.1515/ijamh-2013-0057.

    Article  Google Scholar 

  31. Katzman MA, Bilkey TS, Chokka PR, Fallu A, Klassen LJ. Adult ADHD and comorbid disorders: clinical implications of a dimensional approach. BMC Psychiatry. 2017;17:1–15. https://doi.org/10.1186/s12888-017-1463-3.

    Article  Google Scholar 

  32. Chang Z, Quinn PD, Hur K, Gibbons RD, Sjölander A, Larsson H, D’Onofrio BM. Association between medication use for attention-deficit/hyperactivity disorder and risk of motor vehicle crashes. JAMA Psychiat. 2017;74(6):597–603. https://doi.org/10.1001/jamapsychiatry.2017.0659.

    Article  Google Scholar 

  33. Liang SH, Yang YH, Kuo TY, Liao YT, Lin TC, Lee Y, McIntyre RS, Kelsen BA, Wang TN, Chen VC. Suicide risk reduction in youths with attention-deficit/hyperactivity disorder prescribed methylphenidate: a Taiwan nationwide population-based cohort study. Res Dev Disabil. 2018;72:96–105. https://doi.org/10.1016/j.ridd.2017.10.023.

    Article  Google Scholar 

  34. Lichtenstein P, Halldner L, Zetterqvist J, Sjölander A, Serlachius E, Fazel S, Långström N, Larsson H. Medication for attention deficit-hyperactivity disorder and criminality. N Engl J Med. 2012;367(21):2006–14. https://doi.org/10.1056/NEJMoa1203241.

    Article  Google Scholar 

  35. Joshi G, Faraone SV, Wozniak J, Petty C, Fried R, Galdo M, Furtak SL, McDermott K, Epstien C, Walker R, Caron A, Feinberg L, Biederman J. Examining the clinical correlates of autism spectrum disorder in youth by ascertainment source. J Autism Dev Disord. 2014;44(9):2117–26.

    Article  Google Scholar 

  36. Salazar F, Baird G, Chandler S, Tseng E, O’sullivan T, Howlin P, Pickles A, Simonoff E. Co-occurring psychiatric disorders in preschool and elementary school-aged children with autism spectrum disorder. J Autism Dev Disord. 2015;45(8):2283–94.

    Article  Google Scholar 

  37. Kaat AJ, Gadow KD, Lecavalier L. Psychiatric symptom impairment in children with autism spectrum disorders. J Abnorm Child Psychol. 2013;41(6):959–69.

    Article  Google Scholar 

  38. Antshel KM, Zhang-James Y, Wagner KE, Ledesma A, Faraone SV. An update on the comorbidity of ADHD and ASD: a focus on clinical management. Expert Rev Neurother. 2016;16:279–93. https://doi.org/10.1586/14737175.2016.1146591.

    Article  Google Scholar 

  39. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample [Article]. J Am Acad Child Adolesc Psychiatry. 2008;47:921–9. https://doi.org/10.1097/CHI.0b013e318179964f.

    Article  Google Scholar 

  40. Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA. ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. 2014;43(2):434–42.

    Article  Google Scholar 

  41. Taurines R, Schwenck C, Westerwald E, Sachse M, Siniatchkin M, Freitag C. ADHD and autism: differential diagnosis or overlapping traits? A selective review. Atten Defic Hyperact Disord. 2012;4(3):115–39.

    Article  Google Scholar 

  42. Lai M-C, Lombardo MV, Baron-Cohen S. Autism. Lancet. 2014;383:896–910.

    Article  Google Scholar 

  43. Kotte A, Joshi G, Fried R, Uchida M, Spencer A, Woodworth KY, Kenworthy T, Faraone SV, Biederman J. Autistic traits in children with and without ADHD. Pediatrics. 2013;132(3):e612–22.

    Article  Google Scholar 

  44. Cooper M, Martin J, Langley K, Hamshere M, Thapar A. Autistic traits in children with ADHD index clinical and cognitive problems. Eur Child Adolesc Psychiatry. 2014;23(1):23–34.

    Article  Google Scholar 

  45. Miller M, Musser ED, Young GS, Olson B, Steiner RD, Nigg JT. Sibling recurrence risk and cross-aggregation of attention-deficit/hyperactivity disorder and autism spectrum disorder. JAMA Pediatr. 2019;173:147–52.

    Article  Google Scholar 

  46. Boyle CA, Boulet S, Schieve LA, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, et al. Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics. 2011;127(6):1034–42.

    Article  Google Scholar 

  47. Yoo HJ. Recent increase in autism and ADHD: true or inflated? J Korean Med Sci. 2013;28(7):974–5.

    Article  Google Scholar 

  48. Kern JK, Geier DA, Sykes LK, Geier MR, Deth RC. Are ASD and ADHD a continuum? A comparison of pathophysiological similarities between the disorders. J Atten Disord. 2015;19:805–27. https://doi.org/10.1177/1087054712459886.

    Article  Google Scholar 

  49. Banaschewski T, Poustka L, Holtmann M. Autism and ADHD across the life span. Differential diagnoses or comorbidity? Nervenarzt. 2011;82:573–80.

    Article  Google Scholar 

  50. Grzadzinski R, Di Martino A, Brady E, Mairena MA, O’Neale M, Petkova E, Castellanos FX. Exam- ining autistic traits in children with ADHD: does the autism spectrum extend to ADHD? J Autism Dev Disord. 2011;41:1178–91.

    Article  Google Scholar 

  51. Ronald A, Hoekstra RA. Autism spectrum disorders and autistic traits: a decade of new twin studies. Am J Med Genet Pt B Neuropsychiatr Genet. 2011;156B:255–74.

    Article  Google Scholar 

  52. Nikolas MA, Burt SA. Genetic and environmental influences on ADHD symptom dimensions of inattention and hyperactivity: a meta-analysis. J Abnorm Psychol. 2010;119:1–17.

    Article  Google Scholar 

  53. Hoekstra RA, Bartels M, Verweij CJH, Boomsma DI. Heritability of autistic traits in the general population. Arch Pediatr Adolesc Med. 2007;161:372–7.

    Article  Google Scholar 

  54. Boomsma DI, Saviouk V, Hottenga J-J, Distel MA, de Moor MHM, Vink JM, et al. Genetic epidemiology of attention deficit hyperactivity disorder (ADHD index) in adults. PLoS One. 2010;12:e10621.

    Article  Google Scholar 

  55. Larsson H, Asherson P, Chang Z, Ljung T, Friedrichs B, Larsson J-O, et al. Genetic and environmental influences on adult attention deficit hyperactivity disorde symptoms: a large Swedish population-based study of twins. Psychol Med. 2013;43:197–207.

    Article  Google Scholar 

  56. Chen MH, Wei HT, Chen LC, Su TP, Bai YM, Hsu JW, et al. Autistic spectrum disorder, attention deficit hyperactivity disorder, and psychiatric comorbidities: a nationwide study. Res Autism Spectr Disord. 2015;10:1–6.

    Article  Google Scholar 

  57. Martin J, Cooper M, Hamshere ML, Pocklington A, Scherer SW, Kent L, et al. Biological overlap of attention-deficit/hyperactivity disorder and autism spectrum disorder: evidence from copy number variants. J Am Acad Child Adolesc Psychiatry. 2014;53:761–770, e726.

    Article  Google Scholar 

  58. Williams NM, Franke B, Mick E, Anney RJ, Freitag CM, Gill M, et al. Genome-wide analysis of copy number variants in attention deficit hyperactivity disorder: the role of rare variants and duplications at 15q13. 3. Am J Psychiatry. 2012;169:195–204.

    Article  Google Scholar 

  59. Williams NM, Zaharieva I, Martin A, Langley K, Mantripragada K, Fossdal R, et al. Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder: a genome-wide analysis. Lancet. 2010;376:1401–8.

    Article  Google Scholar 

  60. Davis NO, Kollins SH. Treatment for co-occurring attention deficit/hyperactivity disorder and autism spectrum disorder. Neurotherapeutics. 2012;9:518–30. https://doi.org/10.1007/s13311-012-0126-9.

    Article  Google Scholar 

  61. Ghirardi L, Brikell I, Kuja-Halkola R, Freitag CM, Franke B, Asherson P, et al. The familial co-aggregation of ASD and ADHD: a register-based cohort study. Mol Psychiatry. 2017;23:257–62.

    Article  Google Scholar 

  62. Mason J, Scior K. ‘Diagnostic Overshadowing’ amongst clinicians working with people with intellectual disabilities in the UK. JARID. 2004;17:85–90. https://doi.org/10.1111/j.1360-2322.2004.00184.x.

    Article  Google Scholar 

  63. Thapar A, Cooper M, Eyre O, Langley K. What have we learnt about the causes of ADHD? J Child Psychol Psychiatry. 2013;54:3–16.

    Article  Google Scholar 

  64. Oerlemans AM, Burmanje MJ, Franke B, Buitelaar JK, Hartman CA, Rommelse NN. Identifying unique versus shared pre- and perinatal risk factors for ASD and ADHD using a simplex-multiplex stratification. J Abnorm Child Psychol. 2015;44(5):923–35.

    Article  Google Scholar 

  65. Hoogman M, Bralten J, Hibar DP, Mennes M, Zwiers MP, Schweren LSJ, van Hulzen KJE, Medland SE, Shumskaya E, Jahanshad N, Zeeuw P, Szekely E, Sudre G, Wolfers T, Onnink AMH, Dammers JT, Mostert JC, Vives-Gilabert Y, Kohls G, Oberwelland E, Seitz J, Schulte-Rüther M, Ambrosino S, Doyle AE, Høvik MF, Dramsdahl M, Tamm L, van Erp TGM, Dale A, Schork A, Conzelmann A, Zierhut K, Baur R, McCarthy H, Yoncheva YN, Cubillo A, Chantiluke K, Mehta MA, Paloyelis Y, Hohmann S, Baumeister S, Bramati I, Mattos P, Tovar-Moll F, Douglas P, Banaschewski T, Brandeis D, Kuntsi J, Asherson P, Rubia K, Kelly C, Martino AD, Milham MP, Castellanos FX, Frodl T, Zentis M, Lesch KP, Reif A, Pauli P, Jernigan TL, Haavik J, Plessen KJ, Lundervold AJ, Hugdahl K, Seidman LJ, Biederman J, Rommelse N, Heslenfeld DJ, Hartman CA, Hoekstra PJ, Oosterlaan J, Polier GV, Konrad K, Vilarroya O, Ramos-Quiroga JA, Soliva JC, Durston S, Buitelaar JK, Faraone SV, Shaw P, Thompson PM, Franke B. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry. 2017;4(4):310–9.

    Article  Google Scholar 

  66. Antshel KM, Zhang-James Y, Faraone SV. The comorbidity of ADHD and autism spectrum disorder. Expert Rev Neurother. 2013;13(10):1117–28.

    Article  Google Scholar 

  67. Sudre G, Szekely E, Sharp W, Kasparek S, Shaw P. Multimodal mapping of the brain’s functional connectivity and the adult outcome of attention deficit hyperactivity disorder. Proc Natl Acad Sci U S A. 2017;114(44):11787–92.

    Article  Google Scholar 

  68. Shaw P, Eckstrand K, Sharp W, Blumenthal J, Lerch JP, Greenstein D, et al. Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proc Natl Acad Sci U S A. 2007;104:19649–54. https://doi.org/10.1073/pnas.0707741104.

    Article  Google Scholar 

  69. Shaw P, Malek M, Watson B, Sharp W, Evans A, Greenstein D. Development of cortical surface area and gyrification in attention-deficit/hyperactivity disorder. Biol Psychiatry. 2012;72:191–7. https://doi.org/10.1016/j.biopsych.2012.01.031.

    Article  Google Scholar 

  70. Adamo N, Huo L, Adelsberg S, Petkova E, Castellanos FX, Di Martino A. Response time intra-subject variability: commonalities between children with autism spectrum disorders and children with ADHD. Eur Child Adolesc Psychiatry. 2014b;23(2):69–79.

    Article  Google Scholar 

  71. Flehming HC, Steinborn M, Langner R, Scholz A, Westhoff K. Assessing intraindividual variability in sustained attention: reliability, relation to speed and accuracy, and practice effects. Psychol Sci. 2007;49(2):132–49.

    Google Scholar 

  72. Johnson KA, Robertson IH, Kelly SP, Silk TJ, Barry E, et al. Dissociation in performance of children with ADHD and high-functioning autism on a task of sustained attention. Neuropsychologia. 2007;45:2234–45.

    Article  Google Scholar 

  73. Saville CWN, Pawling R, Trullinger M, Daley D, Intriligator J, Klein C. On the stability of instability: optimising the reliability of intra-subject variability of reaction times. Personal Individ Differ. 2011;51(2):148–53.

    Article  Google Scholar 

  74. Kuntsi J, Stevenson J. Psychological mechanisms in hyperactivity: II. The role of genetic factors. J Child Psychol Psychiatry. 2001;42(2):211–9.

    Article  Google Scholar 

  75. Wood AC, Asherson P, van der Meere JJ, Kuntsi J. Separation of genetic influences on attention deficit hyperactivity disorder symptoms and reaction time performance from those in IQ. Psychol Med. 2010;40(6):1027–37.

    Article  Google Scholar 

  76. Kuntsi J, Wood AC, Rijsdijk F, Johnson KA, Andreou P, Albrecht B, Arias- Vasquez A, et al. Separation of cognitive impairments in attention-deficit/hyperactivity disorder into 2 familial factors. Arch Gen Psychiatry. 2010;67(11):1159–67.

    Article  Google Scholar 

  77. Rommelse NN, Altink ME, Oosterlaan J, Beem L, Buschgens CJ, Buitelaar J, Sergeant JA. Speed, variability, and timing of motor output in ADHD: which measures are useful for endophenotypic research? Behav Genet. 2008;38(2):121–32.

    Article  Google Scholar 

  78. Kofler MJ, Alderson RM, Raiker JS, Bolden J, Sarver DE, Rapport MD. Working memory and intraindividual variability as neurocognitive indicators in ADHD: examining competing model predictions. Neuropsychology. 2014;28(3):459–71.

    Article  Google Scholar 

  79. Castellanos FX, Sonuga-Barke EJ, Scheres A, Di Martino A, Hyde C, Walters JR. Varieties of attention-deficit/hyperactivity disorder-related intra-individual variability. Biol Psychiatry. 2005;57:1416–23.

    Article  Google Scholar 

  80. Epstein JN, Langberg JM, Rosen PJ, Graham A, Narad ME, Antonini TN, et al. Evidence for higher reaction time variability for children with ADHD on a range of cognitive tasks including reward and event rate manipulations. [Research Support, N.I.H., Extramural]. Neuropsychology. 2011;25:427–41. https://doi.org/10.1037/a0022155.

    Article  Google Scholar 

  81. Adamo N, Di Martino A, Esu L, Petkova E, Johnson K, Kelly S, Castellanos FX, Zuddas A. Increased response-time variability across different cognitive tasks in children with ADHD. J Atten Disord. 2014a;18(5):434–46. https://doi.org/10.1177/1087054712439419. Epub 2012 Apr 16.

    Article  Google Scholar 

  82. Lundervold AJ, et al. Attention deficits in children with combined autism and ADHD: a CPT study. J Atten Disord. 2016;20:599–609.

    Article  Google Scholar 

  83. Tye C, Asherson P, Ashwood KL, Azadi B, Bolton P, McLoughlin G. Attention and inhibition in children with ASD, ADHD and co-morbid ASD + ADHD: an event- related potential study. Psychol Med. 2013;44(5):1101–16.

    Article  Google Scholar 

  84. Anholt GE, Cath DC, van Oppen P, Eikelenboom M, Smit JH, van Megen H, van Balkom AJ. Autism and ADHD symptoms in patients with OCD: are they associated with specific OC symptom dimensions or OC symptom severity? J Autism Dev Disord. 2010;40(5):580–9.

    Article  Google Scholar 

  85. Craig F, Lamanna AL, Margari F, Matera E, Simone M, Margari L. Overlap between autism spectrum disorders and attention deficit hyperactivity disorder: searching for distinctive/common clinical features. Autism Res. 2015;8(3):328–37. https://doi.org/10.1002/aur.1449.

    Article  Google Scholar 

  86. Sinzig J, Morsch D, Bruning N, Schmidt MH, Lehmkuhl G. Inhibition, flexibility, working memory and planning in autism spectrum disorders with and without comorbid ADHD-symptoms. Child Adolesc Psychiatry Ment Health. 2008;2:4.

    Article  Google Scholar 

  87. Lawson RA, Papadakis AA, Higginson CI, Barnett JE, Wills MC, Strang JF, Wallace GL, Kenworthy L. Everyday executive function impairments predict comorbid psychopathology in autism spectrum and attention deficit hyperactivity disorders. Neuropsychology. 2015;29(3):445–53.

    Article  Google Scholar 

  88. Kerekes N, Brandstrom S, Lundstrom S, Rastam M, Nilsson T, Anckarsater H. ADHD, autism spectrum disorder, temperament, and character: phenotypical associations and etiology in a Swedish childhood twin study. Compr Psychiatry. 2013;54:1140–7. https://doi.org/10.1016/j.comppsych.2013.05.009.

    Article  Google Scholar 

  89. Yerys BE, Wallace GL, Sokoloff JL, Shook DA, James JD, Kenworthy L. Attention deficit/hyperactivity disorder symptoms moderate cogni tion and behavior in children with autism spectrum disorders. Autism Res. 2009;2:322–33. https://doi.org/10.1002/aur.103.

    Article  Google Scholar 

  90. Wilens TE, Upadhyaya HP. Impact of substance use disorder on ADHD and its treatment. J Clin Psychiatry. 2007;68(8):e20.

    Article  Google Scholar 

  91. van Emmerik van Oortmerssen K, Van de Glind G, Van den Brink B, Smit F, Crunelle CL, Swetsa M, Schoevers RA. Prevalence of attention-deficit hyperactivity disorder in substance use disorder patients: a meta-analysis and meta-regression analysis. Drug Alcohol Depend. 2012;122:11–9.

    Article  Google Scholar 

  92. Rengit AC, McKowen JW, O’Brien J, Howe YJ, McDougle CJ. Brief report: autism spectrum disorder and substance use disorder: a review and case study. J Autism Dev Disord. 2016;46(7):2514–9.

    Article  Google Scholar 

  93. Hofvander B, Delorme R, Chaste P, Agneta Nydén A, Wentz E, Stahlberg O, Herbrecht E, Stopin A, Anckarsäter H, Gillberg C, Rastam M, Leboyer M. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry. 2009;9:35.

    Article  Google Scholar 

  94. Lugnegard T, Hallerback MU, Gillberg C. Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Res Dev Disabil. 2011;32:1910–7.

    Article  Google Scholar 

  95. Sizoo B, Van den Brink W, Koeter M, Gorissen van Eenigee M, Van Wijngaarden-Cremers P, Van der Gaag RJ. Treatment seeking adults with autism or ADHD and co-morbid substance use disorder: prevalence, risk factors and functional disability. Drug Alcohol Depend. 2010;107:44–50.

    Article  Google Scholar 

  96. De Alwis D, Agrawal A, Reiersen AM, Constantino JN, Henders A, Martin NG, Lynskey MT. ADHD symptoms, autistic traits, and substance use and misuse in adult Australian twins. J Stud Alcohol Drugs. 2014;75(2):211–21.

    Article  Google Scholar 

  97. Antshel KM, Polacek C, McMahon M, Dygert K, Spenceley L, Dygert L, Miller L, Faisal F. Comorbid ADHD and anxiety affect social skills group intervention treatment efficacy in children with autism spectrum disorders. J Dev Behav Pediatr. 2011;32(6):439–46.

    Article  Google Scholar 

  98. Zablotsky B, Bradshaw CP, Anderson C, Law PA. The association between bullying and the psychological functioning of children with autism spectrum disorders. J Dev Behav Pediatr. 2013;34(1):1–8.

    Article  Google Scholar 

  99. Sterzing PR, Shattuck PT, Narendorf SC, Wagner M, Cooper BP. Bullying involvement and autism spectrum disorders: prevalence and correlates of bullying involvement among adolescents with an autism spectrum disorder. Arch Pediatr Adolesc Med. 2012;166(11):1058–64.

    Article  Google Scholar 

  100. Goodheart CD. A primer for ICD-10-CM users: psychological and behavioural conditions. Washington, DC: American Psychological Association; 2014.

    Book  Google Scholar 

  101. Goodman D. ADHD in adults: update for clinicians on diagnosis and assessment. Prim Psychiatry. 2009;16(11):38–47.

    Google Scholar 

  102. Kooij JJS, Francken MH. Diagnostic interview of ADHD in Adults. Version 2.0 (DIVA). Hague: DIVA Foundation; 2010.

    Google Scholar 

  103. Pettersson R, Soderstrom S, Nilsson KW. Diagnosing ADHD in adults: an examination of the discriminative validity of neuropsychological tests and diagnostic assessment instruments. J Atten Disord. 2018;22:1019–31.

    Article  Google Scholar 

  104. Ramos-Quiroga JA, Bosch R, Richarte V, Valero S, Gomez-Barros N, Nogueira M, et al. Criterion and concurrent validity of Conners Adult ADHD Diagnostic Interview for DSM-IV (CAADID) Spanish version. [Spanish] Validez de criterio y concurrente de la version espanola de la Conners Adult ADHD Diagnostic Interview for DSM-IV. Rev Psiquiatr Salud Ment. 2012;5(4):229–35.

    Article  Google Scholar 

  105. Adler LA, Kessler RC, Spencer T. Adult Self Report Scale. ASRS-V1.1. New York: World Health Organization; 2003.

    Google Scholar 

  106. Barkley RA. Barkley Adult ADHD Rating Scale-IV (BAARS-IV). New York: Guilford Press; 2011.

    Google Scholar 

  107. Conners CK, Erhardt D, Sparrow E. Conners’ Adult ADHD Rating Scales: technical manual. North Tonawanda: Multi-Health Systems; 1999.

    Google Scholar 

  108. Brown TE. Brown attention-deficit disorder scales. San Antonio: The Psychological Corporation; 1996.

    Google Scholar 

  109. Epstein J, Johnson DE, Conners CK. Conners’ adult ADHD diagnostic interview for DSM-IV. North Tonawanda: Multi-Health Systems; 2001.

    Google Scholar 

  110. Wasserman T, Wasserman LD. The sensitivity and specificity of neuropsychological tests in the diagnosis of attention deficit hyperactivity disorder. Appl Neuropsychol Child. 2012;1(2):90–9. https://doi.org/10.1080/21622965.2012.702025. Epub 2012 Jul 10.

    Article  Google Scholar 

  111. Kooij JJS, Boonstra MA, Swinkels SHN, Bekker EM, de Noord I, Buitelaar JK. Reliability, validity, and utility of instruments for self-report and informant report concerning symptoms of ADHD in adult patients. J Atten Disord. 2008;11(4):445–58. https://doi.org/10.1177/1087054707299367.

    Article  Google Scholar 

  112. De Crescenzo F, Cortese S, Adamo N, et al. Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review. Evid Based Ment Health. 2017;20:4–11.

    Article  Google Scholar 

  113. Faraone SV, Glatt SJ. A comparison of the efficacy of medications for adult attention-deficit/ hyperactivity disorder using meta-analysis of effect sizes. J Clin Psychiatry. 2010;71:754–63.

    Article  Google Scholar 

  114. Cortese S, Adamo N, Del Giovane C, Mohr-Jensen C, Hayes AJ, Carucci S, Atkinson LZ, Tessari L, Banaschewski T, Coghill D, Hollis C, Simonoff E, Zuddas A, Barbui C, Purgato M, Steinhausen HC, Shokraneh F, Xia J, Cipriani A. Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysis. Lancet Psychiatry. 2018;5(9):727–38.

    Article  Google Scholar 

  115. Wietecha LA, Clemow DB, Buchanan AS, Young JL, Sarkis EH, Findling RL. Atomoxetine increased effect over time in adults with attention-deficit/hyperactivity disorder treated for up to 6 months: pooled analysis of two double-blind, placebo-controlled, randomized trials. CNS Neurosci Ther. 2016;22(7):546–57.

    Article  Google Scholar 

  116. Maneeton N, Maneeton B, Intaprasert S, Woottiluk P. A systematic review of randomized controlled trials of bupropion versus methylphenidate in the treatment of attention-deficit/hyperactivity disorder. Neuropsychiatr Dis Treat. 2014;10:1439–49.

    Article  Google Scholar 

  117. Hamedi M, Mohammdi M, Ghaleiha A, Keshavarzi Z, Jafarnia M, Keramatfar R, et al. Bupropion in adults with attention-deficit/hyperactivity disorder: a randomized, double-blind study. Acta Med Iran. 2014;52(9):675–80.

    Google Scholar 

  118. Turner D. A review of the use of modafinil for attention-deficit hyperactivity disorder. Expert Rev Neurother. 2006;6(4):455–68.

    Article  Google Scholar 

  119. Arnold VK, Feifel D, Earl CQ, Yang R, Adler LA. A 9-week, randomized, double-blind, placebo-controlled, parallel-group, dose-finding study to evaluate the efficacy and safety of modafinil as treatment for adults with ADHD. J Atten Disord. 2014;18(2):133–44.

    Article  Google Scholar 

  120. Wernicke JF, Faries D, Girod D, et al. Cardiovascular effects of atomoxetine in children, adolescents, and adults. Drug Saf. 2003;26(10):729–40.

    Article  Google Scholar 

  121. Dean L. Atomoxetine therapy and CYP2D6 genotype. In: Pratt V, McLeod H, Rubinstein W, et al., editors. Medical genetics summaries [Internet]. Bethesda, MD: National Center for Biotechnology Information (US); 2015. https://www.ncbi.nlm.nih.gov/books/NBK315951/.

    Google Scholar 

  122. Mészáros A, Czobor P, Bálint S, Komlósi S, Simon V, Bitter I. Pharmacotherapy of adult attention deficit hyperactivity disorder (ADHD): a meta-analysis. Int J Neuropsychopharmacol. 2009;12(8):1137–47. https://doi.org/10.1017/S1461145709990198.

    Article  Google Scholar 

  123. Hirvikoski T, Waaler E, Alfredsson J, Pihlgren C, Holmstrom A, Johnson A, et al. Reduced ADHD symptoms in adults with ADHD after structured skills training group: results from a randomized controlled trial. Behav Res Ther. 2011;49(3):175–85.

    Article  Google Scholar 

  124. Mongia M, Hechtman L. Cognitive behavior therapy for adults with attention deficit/hyperactivity disorder: a review of recent randomized controlled trials. Curr Psychiatry Rep. 2012;14(5):561–7.

    Article  Google Scholar 

  125. Emilsson B, Gudjonsson G, Sigurdsson JF, Baldursson G, Einarsson E, Olafsdottir H, et al. Cognitive behaviour therapy in medication-treated adults with ADHD and persistent Symptoms: a randomized controlled trial. BMC Psychiatry. 2011;11:116.

    Article  Google Scholar 

  126. Seixas M, Weiss M, Muller U. Systematic review of national and international guidelines on attention-deficit hyperactivity disorder. J Psychopharmacol (Oxf). 2012;26(6):753–65.

    Article  Google Scholar 

  127. Arnold LE, Hodgkins P, Caci H, Kahle J, Young S. Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: a systematic review. PLoS One. 2015;10(2):e0116407. https://doi.org/10.1371/journal.pone.eCollection.2015.

    Article  Google Scholar 

  128. Philipsen A. Psychotherapy in adult attention deficit hyperactivity disorder: implications for treatment and research. Expert Rev. 2012;12(10):1217–25.

    Google Scholar 

  129. Young S, Bramham J. Cognitive-behavioural therapy for ADHD in adolescents and adults: a psychological guide to practice. 2nd ed. Chichester: Wiley; 2012.

    Book  Google Scholar 

  130. Kubik JA. Efficacy of ADHD coaching for adults with ADHD. J Atten Disord. 2010;13(5):442–53. https://doi.org/10.1177/1087054708329960.

    Article  Google Scholar 

  131. Prevatt F, Yelland S. An empirical evaluation of ADHD coaching in college students. J Atten Disord. 2015;19(8):666–77. https://doi.org/10.1177/1087054713480036.

    Article  Google Scholar 

  132. Pearson DA, Santos CW, Aman MG, Arnold LE, Casat CD, Mansour R, Lane DM, Loveland KA, Bukstein OG, Jerger SW, Factor P, Vanwoerden S, Perez E, et al. Effects of extended release methylphenidate treatment on ratings of attention-deficit/hyperactivity disorder (ADHD) and associated behavior in children with autism spectrum disorders and ADHD symptoms. J Child Adolesc Psychopharmacol. 2013;23(5):337–51.

    Article  Google Scholar 

  133. Reichow B, Volkmar FR, Bloch MH. Systematic review and meta-analysis of pharmacological treatment of the symptoms of attention-deficit/hyperactivity disorder in children with pervasive developmental disorders. J Autism Dev Disord. 2013;43(10):2435–41.

    Article  Google Scholar 

  134. Kilincaslan A, Mutluer TD, Pasabeyoglu B, Tutkunkardas MD, Mukaddes NM. Effects of atomoxetine in individuals with attention-deficit/hyperactivity disorder and low-functioning autism spectrum disorder. J Child Adolesc Psychopharmacol. 2016;26(9):798–806.

    Article  Google Scholar 

  135. Ghanizadeh A. Atomoxetine for treating ADHD symptoms in autism: a systematic review. J Atten Disord. 2013;17(8):635–40. https://doi.org/10.1177/1087054712443154. Epub 2012 Apr 27.

    Article  Google Scholar 

  136. Gajria K, Lu M, Sikirica V, Greven P, Zhong Y, Qin P, Xie J. Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder - a systematic literature review. Neuropsychiatr Dis Treat. 2014;10:1543–69. https://doi.org/10.2147/NDT.S65721.

    Article  Google Scholar 

  137. Barkley RA, Guevremont DC, Anastopoulos AD, DuPaul GJ, Shelton TL. Driving-related risks and outcomes of attention deficit/hyper-activity disorder in adolescents and young adults: a 3-5 year follow-up survey. Pediatrics. 1993;92:212–8.

    Article  Google Scholar 

  138. Baeyens D, Moniquet A, Danckaerts M, van der Oord S. A comparative study of the structural stigmatisation of ADHD and autism spectrum disorder in Flemish newspapers. Tijdschr Psychiatr. 2017;59(5):269–77.

    Google Scholar 

  139. Mueller AK, Fuermaier ABM, Koerts J, Tucha L. Stigma in attention deficit hyperactivity disorder. Atten Defic Hyperact Disord. 2012;4(3):101–14.

    Article  Google Scholar 

  140. Geffen J, Forster K. Treatment of adult ADHD: a clinical perspective. Ther Adv Psychopharmacol. 2018;8:25–32.

    Article  Google Scholar 

  141. Gargaro BA, Rinehart NJ, Bradshaw JL, Tonge BJ, Sheppard DM. Autism and ADHD: how far have we come in the comorbidity debate? Neurosci Biobehav Rev. 2011;35(5):1081–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. INS—Institute of Neuroscience, Florence, Italy

    Luana Salerno

  2. Amsterdam University Medical Center, VUMc, Amsterdam, The Netherlands

    J. J. Sandra Kooij

  3. Expertise Center Adult ADHD, PsyQ, The Hague, The Netherlands

    J. J. Sandra Kooij

Authors
  1. Luana Salerno
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. J. Sandra Kooij
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Adult Autism Centre, Mental Health Department, Local Health Unit ASL Città di Torino, Turin, Italy

    Roberto Keller

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Salerno, L., Sandra Kooij, J.J. (2019). Adult Attention Deficit Hyperactivity Disorder (ADHD) in ASD. In: Keller, R. (eds) Psychopathology in Adolescents and Adults with Autism Spectrum Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-26276-1_11

Download citation

Publish with us

Policies and ethics

Search

Navigation