Clinical correlates of mind wandering in adults with ADHD

Clinical correlates of mind wandering in adults with ADHD

Biederman J, Lanier J, DiSalvo M, Noyes E, Fried R, Woodworth KY, Biederman I, Faraone SV.

J Psychiatr Res. 2019 Jun 18;117:15-23.

doi: 10.1016/j.jpsychires.2019.06.012.

Commentary* by Dr. Margaret Weiss: Mind wandering has become a clinically meaningful concept in understanding ADHD which has been shown in multiple research studies to be a strong predictor of multiple outcomes.

ABSTRACT

The objective of this study was to investigate the prevalence and clinical correlates of ADHD patients with mind wandering. 255 consecutively referred 18- to 55-year-old adults of both sexes with ADHD were assessed. Subjects completed a demographic interview, the Mind Wandering Questionnaire (MWQ), the ADHD Rating Scale (ADHD RS), the Behavior Rating Inventory of Executive Function – Adult Version (BRIEF-A), the Social Responsiveness Scale – Second Edition (SRS-2) Adult Self-Report Form, the Adult Self-Report (ASR), the Barkley Emotional Dysregulation Scale, and the Quality of Life Enjoyment & Satisfaction Questionnaire (Q-LES-Q).

We used receiver operator characteristic (ROC) curves to identify the optimal cut-off on the MWQ to categorize patients as having high-versus low-level mind wandering and compared demographic and clinical characteristics between the two groups.

Participants were categorized by ROC analysis as having high- (N = 127) and low-level (N = 128) mind wandering based on an MWQ total score ≥ or < than 24, respectively. Compared with low-level mind wandering participants, those with high-level mind wandering had significantly more Inattentive and Hyperactive symptoms (all p < 0001), worse executive functioning as measured by the BRIEF-A, more impaired mean (all p ≤ 0.001) and dichotomized scores (t-score ≥65) (all p < 0.005) on subscales and composite ASR scales, more impaired scores on the Barkley Emotional Dysregulation Scale (p < 0.001), and more impaired quality of life scores.

High-level mind wandering is prevalent in adults with ADHD and is associated with more severe ADHD symptoms, more executive function deficits, more emotional dysregulation, higher levels of associated psychopathology, and more impaired quality of life.

* Abstracts are selected for their clinical relevance by Dr. Margaret Weiss, Director of Clinical Research, Child Psychiatry, Cambridge Health Alliance, Harvard University. Her commentary reflects her own opinion, is not approved, or necessarily representative, of the opinion of the CADDRA board.