The Relationship Between Deficits in Executive Functioning and Sleep-Wake Disorders in Adults with ADHD: After Accounting for Cognitive Distortions, Depression, Anxiety, and Neuroticism

Date of Submission

2020

Degree Type

Dissertation

Degree Name

Doctor of Psychology (PsyD)

Department

Psychology

Department Chair

Stephanie Felgoise, PhD, ABPP

First Advisor

Brad Rosenfield, PsyD

Second Advisor

Robert DiTomasso, Ph.D., ABPP

Third Advisor

J. Russel Ramsay, PhD, ABPP

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that manifests in distress and a variety of cognitive and functional impairments. It is theorized that some of the symptoms experienced by adults with ADHD result from deficits in executive functioning and cognitive distortions. Although, previous studies have identified a preliminary relationship between deficits in executive functioning, cognitive distortions, neuroticism, and ADHD; these studies failed to measure the impact of sleep-wake disorders, which might explain some of the impairment, given that certain sleep-wake disorders are highly associated with ADHD, deficits in executive functioning, and cognitive distortions. Consequently, the purpose of the current study was to determine the relationship between sleep-wake disorders and deficits in executive functioning among adults with ADHD after accounting for depression, anxiety, cognitive distortions, and neuroticism. Results indicated that, in this adult ADHD sample, the relationship between deficits in executive functioning and DSM-5 sleep-wake disorders was not significant, after accounting for depression, anxiety, cognitive distortions, and neuroticism. On the other hand, a simple linear regression suggested that cognitive distortions significantly predicted insomnia symptom severity. Additionally, the combination of depression, anxiety, cognitive distortions, and deficits in executive functioning significantly predicted insomnia symptom severity in adults with ADHD. Lastly, an additional subsequent analysis revealed that pathologic sleepiness (tendency to fall asleep at inappropriate times or places) significantly predicted deficits in executive functioning. It is hoped that these findings may help to improve assessment and treatment of adults with ADHD by alerting clinicians to the need to consider sleep-wake disorders, in addition to the other variables, when treating adult ADHD.

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