Summary.
The present study examined the effect of the stimulant medication methylphenidate (MPH) on attentional functioning of adults with ADHD. Sixteen adults with a diagnosed ADHD without comorbidity were assessed twice, at baseline off MPH and following MPH treatment. The assessment battery consisted of reaction time tasks of low complexity, including measures of alertness – subdivided into tonic and phasic alertness, vigilance, divided attention, flexibility and such aspects of selective attention as including focused attention, inhibition and integration of sensory information. In addition, 16 healthy participants who were matched to adults with ADHD according to sex, age, education level and intellectual functions were also assessed twice using the same test battery. The results of the present study suggest that adults with ADHD off stimulant medication are seriously impaired in various components of attention including vigilance, divided attention, selective attention and flexibility. These impairments of attention were observed primarily in regard to reaction time and its variability. Treatment of adults with ADHD using individually tailored doses of MPH has a positive effect on measures of alertness, vigilance, selective attention, divided attention and flexibility. However, even on MPH adults with ADHD displayed considerable deficits in vigilance and integration of sensory information. The present findings indicate that adults with ADHD are not differentially impaired in attentional processes but may suffer from a more global deficit of attention. Although MPH treatment has been found to be effective in the treatment of the attention deficit of adults with ADHD, additional treatment appears to be necessary.
Similar content being viewed by others
References
E Arcia CT Gualtieri (1994) ArticleTitleNeurobehavioural performance of adults with closed-head injury, adults with attention deficit, and controls Brain Injury 8 395–404 Occurrence Handle7951202 Occurrence Handle1:STN:280:DyaK2M%2FjvVOjtw%3D%3D
RA Barkley (1977) ArticleTitleThe effects of methylphenidate on various types of activity level and attention in hyperkinetic children J Abnorm Child Psychol 5 351–369 Occurrence Handle604377 Occurrence Handle1:STN:280:DyaE1c7htVSjsA%3D%3D Occurrence Handle10.1007/BF00915084
RA Barkley (1998) Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment EditionNumber2 Guilford Press New York
RA Barkley KR Murphy (1998) Attention deficit hyperactivity disorder EditionNumber2 SeriesTitleA clinical workbook Guilford Press New York
RA Barkley KR Murphy D Kwasnik (1996) ArticleTitlePsychological adjustment and adaptive impairments in young adults with ADHD J Attent Disord 1 41–54
S Bezeau R Graves (2001) ArticleTitleStatistical power and effect sizes of clinical neuropsychology research J Clin Exp Neuropsychol 23 399–406 Occurrence Handle11419453 Occurrence Handle1:STN:280:DC%2BD3MzlvVCktQ%3D%3D
LJ Chapman JP Chapman (1987) ArticleTitleThe measurement of handedness Brain Cogn 6 175–183 Occurrence Handle3593557 Occurrence Handle1:STN:280:DyaL2s3kt1SmtA%3D%3D Occurrence Handle10.1016/0278-2626(87)90118-7
J Cohen (1988) Statistical power analysis for the behavioral sciences EditionNumber2 Erlbaum Hillsdale
NJ Cohen VI Douglas G Morgenstern (1971) ArticleTitleThe effect of methylphenidate on attentive behavior and autonomic activity in hyperactive children Psychopharmacologia 22 282–294 Occurrence Handle4943560 Occurrence Handle1:STN:280:DyaE38%2FnsFaitQ%3D%3D Occurrence Handle10.1007/BF00401790
RA Cohen (1993) The neuropsychology of attention Plenum Press New York
B Corbett DE Stanczak (1999) ArticleTitleNeuropsychological performance of adults evidencing attention-deficit hyperactivity disorder Arch Clin Neuropsychol 14 373–387 Occurrence Handle14590591 Occurrence Handle1:STN:280:DC%2BD3srht1Gkug%3D%3D Occurrence Handle10.1016/S0887-6177(98)00037-7
WM Dinn NC Robbins CL Harris (2001) ArticleTitleAdult attention-deficit/hyperactivity disorder: psychological test profiles in a clinical population Brain Cogn 46 114–121 Occurrence Handle11527308 Occurrence Handle1:STN:280:DC%2BD3MvosVeqsA%3D%3D
KK Downey FW Stelson OF Pomerleau B Giordani (1997) ArticleTitleAdult attention deficit hyperactivity disorder: psychological test profiles in a clinical population J Nerv Ment Dis 185 32–38 Occurrence Handle9040531 Occurrence Handle1:STN:280:DyaK2s7pt12guw%3D%3D
JN Epstein CK Conners G Sitarenios D Erhardt (1998) ArticleTitleContinuous performance test results of adults with attention deficit hyperactivity disorder Clin Neuropsychol 23 362–371
JN Epstein DE Johnson IM Varia CK Conners (2001) ArticleTitleNeuropsychological assessment of response inhibition in adults with ADHD J Clin Exp Neuro psychol 23 362–371 Occurrence Handle1:STN:280:DC%2BD3Mzjs1Sjug%3D%3D
SV Faraone J Biederman T Spencer T Wilens LJ Seidman E Mick AE Doyle (2000) ArticleTitleAttention-deficit/hyperactivity disorder in adults: an overview Biol Psychiatry 48 9–20 Occurrence Handle10913503 Occurrence Handle1:STN:280:DC%2BD3M%2FhvV2mtA%3D%3D Occurrence Handle10.1016/S0006-3223(00)00889-1
DA Gansler R Fucetola M Krengel S Stetson R Zimering C Makary (1998) ArticleTitleAre there cognitive subtypes in adult attention deficit/hyperactivity disorder? J Nerv Ment Dis 186 776–781 Occurrence Handle9865816 Occurrence Handle1:STN:280:DyaK1M%2FotFCitg%3D%3D Occurrence Handle10.1097/00005053-199812000-00006
LM Greenberg ID Waldman (1993) ArticleTitleDevelopmental normative data on the Test of Variables of Attention (TOVA) J Child Adolesc Psychiatry 34 1019–1030 Occurrence Handle1:STN:280:DyaK2c%2FhtlWktQ%3D%3D
CT Gualtieri MG Ondrusek C Finley (1985) ArticleTitleAttention deficit disorders in adults Clin Neuropharmacol 8 343–356 Occurrence Handle4075304 Occurrence Handle1:STN:280:DyaL28%2FnvFaitg%3D%3D
E Heiligenstein LM Conyers AR Berns MA Miller MA Smith (1998) ArticleTitlePreliminary normative data on DSM-IV attention deficit hyperactivity disorder in college students J Am College Health 46 185–188 Occurrence Handle1:STN:280:DyaK1c7otVWisw%3D%3D
JA Holdnack PJ Moberg SE Arnold RC Gur RE Gur (1995) ArticleTitleSpeed of processing and verbal learning deficits in adults diagnosed with attention deficit disorder Neuropsychiatr Neuropsychol Behav Neurol 8 282–292
DE Hollingsworth SP McAuliffe BJ Knowlton (2001) ArticleTitleTemporal allocation of visual attention in adult attention deficit hyperactivity disorder J Cogn Neurosci 13 298–305 Occurrence Handle11371308 Occurrence Handle1:STN:280:DC%2BD3M3nt1CgsA%3D%3D Occurrence Handle10.1162/08989290151137359
J Hopkins T Perlman L Hechtman G Weiss (1979) ArticleTitleCognitive style in adults originally diagnosed as hyperactives J Child Psychol Psychiatry 20 209–216 Occurrence Handle468949 Occurrence Handle1:STN:280:DyaE1M3jvFKntw%3D%3D
AM Horton (1996) ArticleTitleNeuropsychological findings in adult attention deficit disorder: a pilot study Appl Neuropsychol 3 181–185 Occurrence Handle16318511 Occurrence Handle10.1207/s15324826an0303&4_12
M Jenkins R Cohen P Malloy S Salloway EG Johnson J Penn A Marcotte (1998) ArticleTitleNeuropsychological measures which discriminate among adults with residual symptoms of attention deficit disorder and other attentional complaints Clin Neuropsychol 12 74–83
DE Johnson JN Epstein LR Waid PK Latham KE Voronin RF Anton (2001) ArticleTitleNeuropsychological performance deficits in adults with attention deficit/hyperactivity disorder Arch Clin Neuro psychol 16 587–604 Occurrence Handle1:STN:280:DC%2BD3srhtlChsQ%3D%3D Occurrence Handle10.1016/S0887-6177(00)00070-6
LJ Katz DS Wood G Goldstein RC Auchenbach M Geckle (1998) ArticleTitleThe utility of neuropsychological tests in evaluation of attention-deficit/hyperactivity disorder (ADHD) versus depression in adults Assessment 5 45–52 Occurrence Handle9458341 Occurrence Handle1:STN:280:DyaK1c7is1aksA%3D%3D
RW Keith P Engineer (1991) ArticleTitleEffects of methyl phenidate on the auditory processing abilities of children with attention deficit-hyperactivity disorder J Learn Disabil 24 630–636 Occurrence Handle1783870 Occurrence Handle1:STN:280:DyaK387kvVaksQ%3D%3D
S Kempton A Vance P Maruff E Luk J Costin C Pantelis (1999) ArticleTitleExecutive function and attention deficit hyperactivity disorder: stimulant medication and better executive function performance in children Psychol Med 29 527–538 Occurrence Handle10405075 Occurrence Handle1:STN:280:DyaK1MzjtF2lsw%3D%3D Occurrence Handle10.1017/S0033291799008338
KA Kerns K Eso J Thomson (1999) ArticleTitleInvestigation of a direct intervention for improving attention in young children with ADHD Dev Neuropsychol 16 273–295 Occurrence Handle10.1207/S15326942DN1602_9
M Kinsbourne GB DeQuiros D Tocci Ruffo (2001) Adult ADHD. Controlled medication assessment J Wasserstein LE Wolf FF Lefever (Eds) Adult attention deficit disorder SeriesTitleBrain mechanisms and life outcomes The New York Academy of Science New York 287–296
SH Klee BD Garfinkel H Beauchesne (1986) ArticleTitleAttention deficits in adults Psychiatr Ann 16 52–56
SS Kupietz (1990) ArticleTitleSustained attention in normal and in reading-disabled youngsters with and without ADDH J Abnorm Child Psychol 18 357–372 Occurrence Handle2246429 Occurrence Handle1:STN:280:DyaK3M%2FmtVyhuw%3D%3D Occurrence Handle10.1007/BF00917640
S Lehrl G Triebig B Fischer (1995) ArticleTitleMultiple choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence Acta Neurol Scand 91 335–345 Occurrence Handle7639062 Occurrence Handle1:STN:280:DyaK2Mzms1arsw%3D%3D
KA Lockwood AC Marcotte C Stern (2001) ArticleTitleDifferentiation of attention-deficit/hyperactivity disorder subtypes: application of a neuropsychological model of attention J Clin Exp Neuropsychol 23 317–330 Occurrence Handle11404810 Occurrence Handle1:STN:280:DC%2BD3Mzjs1Sjtw%3D%3D
BJ Losier PJ McGrath RM Klein (1996) ArticleTitleError patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: a meta-analytic review J Child Psychol Psychiatry 37 971–987 Occurrence Handle9119944 Occurrence Handle1:STN:280:DyaK2s7itVChsA%3D%3D
DW Lovejoy JD Ball M Keats ML Stutts EH Spain L Janda J Janusz (1999) ArticleTitleNeuropsychological performance of adults with attention deficit hyperactivity disorder (ADHD): diagnostic classification estimates for measures of frontal lobe/executive functioning J Int Neuropsychol Soc 5 222–233 Occurrence Handle10217922 Occurrence Handle1:STN:280:DyaK1M3jsVGnsA%3D%3D Occurrence Handle10.1017/S1355617799533055
S Mannuzza RG Klein A Bessler P Malloy M LaPadula (1993) ArticleTitleAdult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status Arch Gen Psychiatry 50 565–576 Occurrence Handle8317950 Occurrence Handle1:STN:280:DyaK3szgsV2qtg%3D%3D
I Manor RP Ebstein A Weizman S Tyano (2003) ArticleTitleEfficacy of single low-dose metylphenidate administration in adult ADHD patients according to psychometric assessment Dynamic Psychiatry 36 75–88
JA Matochik LL Liebenauer AC King HV Szymanski RM Cohen AJ Zametkin (1994) ArticleTitleCerebral glucose metabolism in adults with attention deficit hyperactivity disorder after chronic stimulant treatment Am J Psychiatry 151 658–664 Occurrence Handle8166305 Occurrence Handle1:STN:280:DyaK2c3hvFKnuw%3D%3D
JA Mattes L Boswell H Oliver (1984) ArticleTitleMethylphe nidate effects on symptoms of attention deficit disorder in adults Arch Gen Psychiatry 41 1059–1063 Occurrence Handle6388523 Occurrence Handle1:STN:280:DyaL2M%2FksFyltQ%3D%3D
MM Mesulam (1981) ArticleTitleA cortical network for directing attention and unilateral neglect Ann Neurol 10 309–325 Occurrence Handle7032417 Occurrence Handle1:STN:280:DyaL38%2FovF2hsA%3D%3D Occurrence Handle10.1002/ana.410100402
R Millstein T Wilens T Spencer J Biederman (1998) ArticleTitlePresenting ADHD symptoms and subtypes in clinically referred adults with ADHD J Attent Disord 2 159–165
LM Musten P Firestone S Pisterman S Bennett J Mercer (1997) ArticleTitleEffects of metylphenidate on preschool children with ADHD: cognitive and behavioral functions J Am Acad Child Adolesc Psychiatry 36 1407–1415 Occurrence Handle9334554 Occurrence Handle1:STN:280:DyaK2svnsV2gsQ%3D%3D Occurrence Handle10.1097/00004583-199710000-00025
KH Nuechterlein (1983) ArticleTitleSignal detection in vigilance tasks and behavioral attributes among offspring of schizophrenic mothers and among hyperactive children J Abnorm Child Psychol 92 4–28 Occurrence Handle1:STN:280:DyaL3s7mtF2ktA%3D%3D
LJ Rapport A VanVoorhis A Tzelepis SR Friedman (2001) ArticleTitleExecutive functioning in adult attention-deficit hyperactivity disorder Clin Neuropsychol 15 479–491 Occurrence Handle11935449 Occurrence Handle1:STN:280:DC%2BD383gtF2isg%3D%3D
MK Reid JG Borkowski (1984) ArticleTitleEffects of methyl phenidate (Ritalin) on information processing in hyperactive children J Abnorm Child Psychol 12 169–185 Occurrence Handle6715692 Occurrence Handle1:STN:280:DyaL2c7os1CrtQ%3D%3D Occurrence Handle10.1007/BF00913468
CA Riccio JJ Waldrop CR Reynolds P Lowe (2001) ArticleTitleEffects of stimulants on the continuous performance test (CPT): implications for CPT use and interpretation J Neuropsychiatr Clin Neurosci 13 326–335 Occurrence Handle1:STN:280:DC%2BD3MvmvFKmsw%3D%3D
HJ Riordan LA Flashman AJ Saykin SA Frutiger KE Carroll L Huey (1999) ArticleTitleNeuropsychological correlates of methylphenidate treatment in adult ADHD with and without depression Arch Clin Neuropsychol 14 217–233 Occurrence Handle14590604 Occurrence Handle1:STN:280:DC%2BD3srht1GltQ%3D%3D Occurrence Handle10.1016/S0887-6177(98)00015-8
HE Rosvold AF Mirsky J Sarason ED Bransome LH Beck (1956) ArticleTitleA continuous performance test of brain damage J Consult Psychol 20 343–350 Occurrence Handle13367264 Occurrence Handle10.1037/h0043220
BP Roy L Scheele J Brinkley N Ward C Wiatrak J Russo B Townes C Varley (1997) ArticleTitleAdult attention-deficit hyperactivity disorder: assessment guidelines based on clinical presentation to a specialty clinic Compr Psychiatry 38 133–140 Occurrence Handle10.1016/S0010-440X(97)90065-1
TA Sandson KJ Bachna MD Morin (2000) ArticleTitleRight hemisphere dysfunction in ADHD: visual hemispatial inattention and clinical subtype J Learn Disabil 33 83–90 Occurrence Handle15505958 Occurrence Handle1:STN:280:DC%2BD2crjsFSgsw%3D%3D
R Schachar G Logan R Wachsmuth D Chajezyk (1988) ArticleTitleAttaining and maintaining preparation: a comparison of attention in hyperactive, normal and disturbed control group J Abnorm Child Psychol 16 361–378 Occurrence Handle3221028 Occurrence Handle1:STN:280:DyaL1M7isVWntw%3D%3D Occurrence Handle10.1007/BF00914169
JB Schweitzer TL Faber ST Grafton LE Tube JM Hoffman CD Kilts (2000) ArticleTitleAlterations in the functional anatomy of working memory in adult attention deficit hyperactivity disorder Am J Psychiatry 157 278–280 Occurrence Handle10671402 Occurrence Handle1:STN:280:DC%2BD3c7jslOjtw%3D%3D Occurrence Handle10.1176/appi.ajp.157.2.278
LJ Seidman J Biederman W Weber M Hatch SV Faraone (1998) ArticleTitleNeuropsychological functions in adults with attention-deficit hyperactivity disorder Biol Psychiatry 44 260–268 Occurrence Handle9715357 Occurrence Handle1:STN:280:DyaK1czotFWntA%3D%3D Occurrence Handle10.1016/S0006-3223(97)00392-2
M Semrud-Clikeman KH Nielsen A Clinton L Sylvester N Parle RT Connor (1999) ArticleTitleAn intervention approach for children with teacher- and parent-identified attentional difficulties J Learn Disabil 32 581–590 Occurrence Handle15510444 Occurrence Handle1:STN:280:DC%2BD2crjvFertw%3D%3D
SM Silverstein PG Como DR Palumbo LL West LM Osborn (1995) ArticleTitleMultiple sources of attentional dysfunction in adults with Tourette’s syndrome: comparison with attention deficit-hyperactivity disorder Neuropsychology 9 157–164 Occurrence Handle10.1037/0894-4105.9.2.157
MM Sohlberg CA Mateer (2001) Improving attention and managing attentional problems. Adapting rehabilitation techniques to adults with ADD J Wasserstein LE Wolf FF Lefever (Eds) Adult attention deficit disorder SeriesTitleBrain mechanisms and life outcome The New York Academy of Sciences New York 359–375
T Spencer T Wilens J Biederman SV Faraone JS Ablon K Lapey (1995) ArticleTitleA double-blind, crossover comparison of methylphenidate and placebo in adults with childhood-onset attention-deficit hyperactivity disorder Arch Gen Psychiatry 52 434–443 Occurrence Handle7771913 Occurrence Handle1:STN:280:DyaK2M3ovFymuw%3D%3D
DH Sykes VI Douglas G Morgenstern (1972) ArticleTitleThe effect of methylphenidate (Ritalin) on sustained attention in hyperactive children Psychopharmacologia 25 262–274 Occurrence Handle4557941 Occurrence Handle1:STN:280:DyaE383jsFGgsg%3D%3D Occurrence Handle10.1007/BF00422506
R Tannock RJ Schachar RP Carr D Chajczyk GD Logan (1989) ArticleTitleEffects of methylphenidate on inhibitory control in hyperactive children J Abnorm Child Psychol 17 473–491 Occurrence Handle2681316 Occurrence Handle1:STN:280:DyaK3c%2Fjsl2ksQ%3D%3D Occurrence Handle10.1007/BF00916508
CJ Taylor DC Miller (1997) ArticleTitleNeuropsychological assessment of attention in ADHD adults J Attent Disord 2 77–88
BL Trommer JA Hoeppner SG Zecker (1991) ArticleTitleThe go-no go test in attention deficit disorder is sensitive to methylphenidate J Child Neurol 6 S128–S131 Occurrence Handle2002211 Occurrence Handle10.1177/088307389100600206
O Tucha KW Lange (2004) ArticleTitleHandwriting in attention deficit hyperactivity disorder Motor Control 8 461–471 Occurrence Handle15585901
CJ Vaidya G Austin G Kirkorian HW Ridlehuber JE Desmond GH Glover JD Gabrieli (1998) ArticleTitleSelective effects of methylphenidate in attention deficit hyperactivity disorder: a functional magnetic resonance study Proc Natl Acad Sci 95 14494–14499 Occurrence Handle9826728 Occurrence Handle1:CAS:528:DyaK1cXns1GlsbY%3D Occurrence Handle10.1073/pnas.95.24.14494
J Van der Meere B Gunning N Stemerdink (1999) ArticleTitleThe effect of methylphenidate and clonidine on response inhibition and state regulation in children with ADHD J Child Psychol Psychiatry 40 291–298 Occurrence Handle10188712 Occurrence Handle1:STN:280:DyaK1M3gt1Gqtw%3D%3D Occurrence Handle10.1017/S0021963098003424
J Van der Meere J Sergeant (1988) ArticleTitleControlled processing and vigilance in hyperactivity: time will tell J Abnorm Child Psychol 16 641–655 Occurrence Handle3216073 Occurrence Handle1:STN:280:DyaL1M7gvFyjsw%3D%3D Occurrence Handle10.1007/BF00913475
AH Van Zomeren WH Brouwer (1994) Clinical neuropsychology of attention Oxford University Press New York
AJ Walker EA Shores JN Trollor T Lee PS Sachdev (2000) ArticleTitleNeuropsychological functioning of adults with attention deficit hyperactivity disorder J Clin Exp Neuropsychol 22 115–124 Occurrence Handle10649550 Occurrence Handle1:STN:280:DC%2BD3c7hvFeqsg%3D%3D Occurrence Handle10.1076/1380-3395(200002)22:1;1-8;FT115
P Wender (1997) ArticleTitleAttention deficit hyperactivity disorder in adults: a wide view of a widespread condition Psychiatr Ann 27 556–562
PH Wender FW Reimherr D Wood M Ward (1985) ArticleTitleA controlled study of methylphenidate in the treatment of attention deficit disorder, residual type, in adults Am J Psychiatry 142 547–552 Occurrence Handle3885760 Occurrence Handle1:STN:280:DyaL2M7nt1artw%3D%3D
LL Weyandt JA Rice I Linterman L Mitzlaff E Emert (1998) ArticleTitleNeuropsychological performance of a sample of adults with ADHD, developmental reading disorder, and controls Dev Neuropsychol 14 643–656 Occurrence Handle10.1080/87565649809540734
TE Wilens TJ Spencer J Biederman (2001) Pharmacotherapy of adult ADHD J Wasserstein LE Wolf FF Lefever (Eds) Adult attention deficit disorder SeriesTitleBrain mechanisms and life outcomes The New York Academy of Science New York 592–606
DR Wood FW Reimherr PH Wender GE Johnson (1976) ArticleTitleDiagnosis and treatment of minimal brain dysfunction in adults: a preliminary report Arch Gen Psychiatry 33 1453–1460 Occurrence Handle793563 Occurrence Handle1:STN:280:DyaE2s%2FmsVOktg%3D%3D
SP Woods DW Lovejoy JD Ball (2002) ArticleTitleNeuropsychological characteristics of adults with ADHD: a comprehensive review of initial studies Clin Neuropsychol 16 12–34 Occurrence Handle11992223
KK Zakzanis (2001) ArticleTitleStatistics to tell the truth, the whole truth, and nothing but the truth: formulae, illustrative numerical examples, and heuristic interpretation of effect size analyses for neuropsychological researchers Arch Clin Neuropsychol 16 653–667 Occurrence Handle14589784 Occurrence Handle1:STN:280:DC%2BD3srhtlChtQ%3D%3D Occurrence Handle10.1016/S0887-6177(00)00076-7
Zimmermann P, Fimm B (1993) A computerized neuropsychological assessment of attention deficits (Manual). PsyTest, Herzogenrath, Germany
P Zimmermann B Fimm (2002) A test battery for attentional performance M Leclercq P Zimmermann (Eds) Applied neuropsychology of attention: theory, diagnosis and rehabilitation Psychology Press New York 110–151
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Tucha, O., Mecklinger, L., Laufkötter, R. et al. Methylphenidate-induced improvements of various measures of attention in adults with Attention Deficit Hyperactivity Disorder. J Neural Transm 113, 1575–1592 (2006). https://doi.org/10.1007/s00702-005-0437-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00702-005-0437-7