Differential diagnosis of adults with ADHD: the role of executive function and self-regulation.

Adult ADHD is conceptualized as a disorder of age-inappropriate behavior that occurs because of maldevelopment of 2 related neuropsychological domains. The neuropsychological symptoms seen in adults with ADHD may be explained by deficits in executive function, which can be broadly defined as a set of neurocognitive processes that allow for the organization of behavior across time so as to attain future goals. Executive function is comprised of 2 broad domains: inhibition and metacognition. Inhibition encompasses the ability to inhibit motor, verbal, cognitive, and emotional activities. In turn, deficits in inhibition contribute to deficits in the development of 4 aspects of executive function in the domain of metacognition, which include nonverbal working memory, verbal working memory, planning and problem-solving, and emotional self-regulation. Understanding the ways in which deficits in executive function contribute to the symptoms of ADHD can help in differentiating ADHD from disorders that share similar characteristics. (c) Copyright 2010 Physicians Postgraduate Press, Inc.