70| ADHD – A Conversation With Dr. Robb Mapou

Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, with effects on academic and occupational performance, social relationships, and other aspects of functioning. Neuropsychologists frequently work with both children and adults with ADHD, and understanding the relevant scientific literature is an important part of training and continuing education in our field. In this episode, John and Ryan talk with Robb Mapou, Ph.D., ABPP-CN, about ADHD, including conversations on developmental course, co-occurring symptoms, assessment, diagnosis, and treatment, among other topics.

A pdf of the transcript for this episode is available here.

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Topics Covered

  • ADHD as a lifespan condition
  • Problems with the constructs of “secondary ADHD” and “adult-onset ADHD”
  • ADHD as an externalizing disorder
  • Commonly co-occurring symptoms and syndromes
  • Educational, occupational, and social outcomes
  • Gender differences
  • The utility of neurocognitive testing for diagnosis and other purposes
  • The utility of self and other-reported symptom rating scales
  • Symptom and performance invalidity
  • Evidence-based interventions

About Robb

Dr. Robb Mapou is board-certified in clinical neuropsychologist.  In addition to evaluating adolescents and adults with autism spectrum disorder (ASD) for the past 25 years, he has specialized in the evaluation of adolescents and adults with learning disabilities and attention-deficit/hyperactivity disorder (ADHD).  He is senior editor of the 1995 book, Clinical Neuropsychological Assessment: A Cognitive Approach.  His second book, Adult Learning Disabilities and ADHD: Research Informed Assessment, was published by Oxford University Press in 2009.  He has published chapters on assessment of learning disabilities and ADHD in adults and regularly presents continuing professional education workshops on this topic.

Dr. Mapou holds faculty appointments in the Department of Neurology at Georgetown University School of Medicine, and the Departments of Psychiatry and Neurology at the Uniformed Services University of the Health Sciences.  He served as President of the American Academy of Clinical Neuropsychology from 2004 to 2006 and has served in other professional organization capacities.  He is the director of Oceanside Neuropsychology in Sussex County, Delaware.

Selected References

Adams, Z. W., Roberts, W. M., Milich, R., & Fillmore, M. T. (2011, Jun). Does response variability predict distractibility among adults with attention-deficit/hyperactivity disorder? Psychol Assess, 23(2), 427-436. https://doi.org/10.1037/a0022112

Alderson, R. M., Kasper, L. J., Hudec, K. L., & Patros, C. H. (2013, May). Attention-deficit/hyperactivity disorder (ADHD) and working memory in adults: a meta-analytic review. Neuropsychology, 27(3), 287-302. https://doi.org/10.1037/a0032371

Boone, K. B. (Ed.). (2007). Assessment of feigned cognitive impairment: A neuropsychological perspective. The Guilford Press.

Azeredo, A., Moreira, D., & Barbosa, F. (2018, Nov). ADHD, CD, and ODD: Systematic review of genetic and environmental risk factors. Research in Developmental Disabilities, 82, 10-19. https://doi.org/10.1016/j.ridd.2017.12.010

Barkley, R. (2019, 04/01). Neuropsychological Testing is Not Useful in the Diagnosis of ADHD: Stop It (or Prove It)! The ADHD Report, 27, 1-8. https://doi.org/10.1521/adhd.2019.27.2.1

Barkley, R. A. (2012, Nov). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology,, 121(4), 978-990. https://doi.org/10.1037/a0023961

Barkley, R. A., & Eme, R. (2019). Is Neuropsychological Testing Useful for Any Reason in the Evaluation of ADHD? A Rejoinder to Mapou. The ADHD Report, 27(5), 1-8.

Barkley, R. A., & Fischer, M. (2011). Predicting impairment in major life activities and occupational functioning in hyperactive children as adults: self-reported executive function (EF) deficits versus EF tests. Developmental Neuropsychology, 36(2), 137-161. https://doi.org/10.1080/87565641.2010.549877

Barkley, R. A., Knouse, L. E., & Murphy, K. R. (2011, Jun). Correspondence and disparity in the self- and other ratings of current and childhood ADHD symptoms and impairment in adults with ADHD. Psychological Assessment, 23(2), 437-446. https://doi.org/10.1037/a0022172

Barkley, R. A., & Murphy, K. R. (2011). The Nature of Executive Function (EF) Deficits in Daily Life Activities in Adults with ADHD and Their Relationship to Performance on EF Tests. Journal of Psychopathology and Behavioral Assessment, 33(2), 137-158. https://doi.org/10.1007/s10862-011-9217-x

Boonstra, A. M., Kooij, J. J., Oosterlaan, J., Sergeant, J. A., & Buitelaar, J. K. (2005, Apr). Does methylphenidate improve inhibition and other cognitive abilities in adults with childhood-onset ADHD? Journal of Clinical and Experimental Neuropsychology , 27(3), 278-298. https://doi.org/10.1080/13803390490515757

Boonstra, A. M., Oosterlaan, J., Sergeant, J. A., & Buitelaar, J. K. (2005, Aug). Executive functioning in adult ADHD: a meta-analytic review. Psychological Medicine, 35(8), 1097-1108. https://doi.org/10.1017/s003329170500499x

Burlison, J. D., & Dwyer, W. O. (2013, Jan). Risk screening for ADHD in a college population: is there a relationship with academic performance? Journal of Attention Disorders, 17(1), 58-63. https://doi.org/10.1177/1087054711423628

Cunill, R., Castells, X., Tobias, A., & Capella, D. (2016, Jan). Efficacy, safety and variability in pharmacotherapy for adults with attention deficit hyperactivity disorder: a meta-analysis and meta-regression in over 9000 patients. Psychopharmacology (Berlin), 233(2), 187-197. https://doi.org/10.1007/s00213-015-4099-3

De Crescenzo, F., Cortese, S., Adamo, N., & Janiri, L. (2017, Feb). Pharmacological and non-pharmacological treatment of adults with ADHD: a meta-review. Evidence Based Mental Health, 20(1), 4-11. https://doi.org/10.1136/eb-2016-102415

Delisle, J., & Braun, C. M. J. (2011). A Context for Normalizing Impulsiveness at Work for Adults with Attention Deficit/Hyperactivity Disorder (Combined Type). Archives of Clinical Neuropsychology, 26(7), 602-613. https://doi.org/10.1093/arclin/acr043

Díaz-Román, A., Mitchell, R., & Cortese, S. (2018, Jun). Sleep in adults with ADHD: Systematic review and meta-analysis of subjective and objective studies. Neuroscience & Biobehavioural Reviews, 89, 61-71. https://doi.org/10.1016/j.neubiorev.2018.02.014

Fedele, D. A., Lefler, E. K., Hartung, C. M., & Canu, W. H. (2012, Feb). Sex differences in the manifestation of ADHD in emerging adults. Journal of Attention Disorders, 16(2), 109-117. https://doi.org/10.1177/1087054710374596

Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K. P., Ramos-Quiroga, J. A., Rethelyi, J. M., Ribases, M., & Reif, A. (2018, Oct). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. Eur Neuropsychopharmacology, 28(10), 1059-1088. https://doi.org/10.1016/j.euroneuro.2018.08.001

Frazier, T. W., Youngstrom, E. A., Glutting, J. J., & Watkins, M. W. (2007, Jan-Feb). ADHD and achievement: meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. Journal of Learning Disabilities, 40(1), 49-65. https://doi.org/10.1177/00222194070400010401

Gmehlin, D., Fuermaier, A. B., Walther, S., Tucha, L., Koerts, J., Lange, K. W., Tucha, O., Weisbrod, M., & Aschenbrenner, S. (2016, Jun). Attentional Lapses of Adults with Attention Deficit Hyperactivity Disorder in Tasks of Sustained Attention. Archives of Clinical Neuropsychology, 31(4), 343-357. https://doi.org/10.1093/arclin/acw016

Huss, M., Duhan, P., Gandhi, P., Chen, C. W., Spannhuth, C., & Kumar, V. (2017). Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity. Neuropsychiatric Disease and Treatment, 13, 1741-1751. https://doi.org/10.2147/NDT.S130444

Knouse, L. E., Teller, J., & Brooks, M. A. (2017, Jul). Meta-analysis of cognitive-behavioral treatments for adult ADHD. Journal of Consulting and Clinical Psychology, 85(7), 737-750. https://doi.org/10.1037/ccp0000216

Lambez, B., Harwood-Gross, A., Golumbic, E. Z., & Rassovsky, Y. (2020, Jan). Non-pharmacological interventions for cognitive difficulties in ADHD: A systematic review and meta-analysis. Journal of Psychiatric Research, 120, 40-55. https://doi.org/10.1016/j.jpsychires.2019.10.007

Lange, K. W., Reichl, S., Lange, K. M., Tucha, L., & Tucha, O. (2010, Dec). The history of attention deficit hyperactivity disorder. ADHD Attention Deficit and Hyperactivity Disorders, 2(4), 241-255. https://doi.org/10.1007/s12402-010-0045-8

Luo, Y., Weibman, D., Halperin, J. M., & Li, X. (2019). A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD). Frontiers in Human Neuroscience, 13, 42. https://doi.org/10.3389/fnhum.2019.00042

Marshall, P. S., Hoelzle, J. B., Heyerdahl, D., & Nelson, N. W. (2016, Oct). The impact of failing to identify suspect effort in patients undergoing adult attention-deficit/hyperactivity disorder (ADHD) assessment. Psycholigcal  Assessment, 28(10), 1290-1302. https://doi.org/10.1037/pas0000247

Miller, L. A., Lewandowski, L. J., & Antshel, K. M. (2015, Aug). Effects of Extended Time for College Students With and Without ADHD. Journal of Attention Disorders, 19(8), 678-686. https://doi.org/10.1177/1087054713483308

Musso, M. W., & Gouvier, W. D. (2014, Apr). “Why is this so hard?” A review of detection of malingered ADHD in college students. Journal of Attention Disorders, 18(3), 186-201. https://doi.org/10.1177/1087054712441970

Rommelse, N., Buitelaar, J. K., & Hartman, C. A. (2017, Feb). Structural brain imaging correlates of ASD and ADHD across the lifespan: a hypothesis-generating review on developmental ASD-ADHD subtypes. Journal of Neural Transmission, (Vienna), 124(2), 259-271. https://doi.org/10.1007/s00702-016-1651-1

Staley Shumaker, B. E., & Hoyt, T. (2020). A Place for Psychological Testing in the Assessment of Adult ADHD. Journal of Health Service Psychology, 46(3), 119-131. https://doi.org/10.1007/s42843-020-00016-z

Uchida, M., Spencer, T. J., Faraone, S. V., & Biederman, J. (2018, Apr). Adult Outcome of ADHD: An Overview of Results From the MGH Longitudinal Family Studies of Pediatrically and Psychiatrically Referred Youth With and Without ADHD of Both Sexes. Journal of Attention Disorders, 22(6), 523-534. https://doi.org/10.1177/1087054715604360

Van Doren, J., Arns, M., Heinrich, H., Vollebregt, M. A., Strehl, U., & S, K. L. (2019, Mar). Sustained effects of neurofeedback in ADHD: a systematic review and meta-analysis. European Child & Adolescent Psychiatry, 28(3), 293-305. https://doi.org/10.1007/s00787-018-1121-4

Wallace, E. R., Garcia-Willingham, N. E., Walls, B. D., Bosch, C. M., Balthrop, K. C., & Berry, D. T. R. (2019, Feb). A meta-analysis of malingering detection measures for attention-deficit/hyperactivity disorder. Psychological Assessment, 31(2), 265-270. https://doi.org/10.1037/pas0000659

Weyandt, L. L., Oster, D. R., Gudmundsdottir, B. G., DuPaul, G. J., & Anastopoulos, A. D. (2017, Feb). Neuropsychological functioning in college students with and without ADHD. Neuropsychology, 31(2), 160-172. https://doi.org/10.1037/neu0000326

White, D. J., Ovsiew, G. P., Rhoads, T., Resch, Z. J., Lee, M., Oh, A. J., & Soble, J. R. (2020, Oct 21). The Divergent Roles of Symptom and Performance Validity in the Assessment of ADHD. Journal of Attention Disorders, 1087054720964575. https://doi.org/10.1177/1087054720964575

Young, Z., Moghaddam, N., & Tickle, A. (2020, Apr). The Efficacy of Cognitive Behavioral Therapy for Adults With ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Attention Disorders, 24(6), 875-888. https://doi.org/10.1177/1087054716664413

Selected Books


Robb’s YouTube Channel (Robbtheukeguy)

Queer Neuropsychological Society


One Comment

  1. Hey there, can you list the adult ADHD criteria proposed by Barkley, Murphy, and Fisher that are mentioned and that Dr. Mapou uses in his assessments? I have looked and want to be sure that I am using the correct and most updated list of symptoms.

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