A-178: Neuropsychological Distinctions Between Adult ADHD and Anxiety Disorders
Abstract
Objective: Adults frequently referred for neuropsychological evaluation report attentional difficulties, cognitive inefficiency, and executive dysfunction, complicating differential diagnosis between attention-deficit/hyperactivity disorder (ADHD) and anxiety disorders. Despite substantial symptom overlap, emerging evidence suggests these conditions are associated with distinct neuropsychological performance patterns. This narrative review examined neuropsychological distinctions between adult ADHD and anxiety disorders, with emphasis on attention, working memory, processing speed, and executive functioning. Method/Data Selection: PsycINFO was searched for peer-reviewed articles published after March 2025 using terms related to ADHD, neurological testing, anxiety, and cognitive performance. Data were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with three reviewers independently screening titles, abstracts, and full texts against predefined inclusion criteria resulting in 12 studies. Results/Data Synthesis: ADHD was consistently associated with measurable, cross-domain cognitive impairments, including sustained attention deficits, slowed processing speed, increased response variability, and executive dysfunction, reflecting relatively stable trait-like inefficiencies. In contrast, anxiety disorders more frequently demonstrate intact baseline cognitive performance, with inefficiencies emerging under heightened cognitive load, stress, or emotional context. Conclusions: Findings indicate a consistent discrepancy between subjective cognitive complaints and objective performance was observed in anxiety disorders, whereas subjective complaints in ADHD showed greater concordance with test-based impairments. These findings underscore the importance of integrating objective neuropsychological data with self-report measures when evaluating attentional complaints in adults and highlight key patterns that may enhance diagnostic accuracy and clinical decision-making.