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Abstract
The diagnosis of ADHD is based on real-life attentional-executive deficits, but they are harder to detect in adults than in children and objective quantitative measures reflecting these everyday problems are lacking. We developed an online version of EPELI 3D videogame for naturalistic and scalable assessment of goal-directed action and prospective memory in adult ADHD. In EPELI, participants perform instructed everyday chores in a virtual apartment from memory. Our pre-registered hypothesis predicted weaker EPELI performances in adult ADHD compared to controls. The sample comprised 112 adults with ADHD and 255 neurotypical controls comparable in age (mean 31, SD = 8 years), gender distribution (71% females) and educational level. Using web-browser, the participants performed EPELI and other cognitive tasks, including Conner’s Continuous Performance Test (CPT). They also filled out questionnaires probing everyday executive performance and kept a 5-day diary of everyday prospective memory errors. Self-reported strategy use in the EPELI game was also examined. The ADHD participants’ self-ratings indicated clearly more everyday executive problems than in the controls. Differences in the EPELI game were mostly seen in the ADHD participants’ higher rates of task-irrelevant actions. Gender differences and a group × gender interaction was found in the number of correctly performed tasks, indicating poorer performance particularly in ADHD males. Discriminant validity of EPELI was similar to CPT. Strategy use strongly predicted EPELI performance in both groups. The results demonstrate the feasibility of EPELI for online assessment and highlight the role of impulsivity as a distinctive everyday life problem in adult ADHD.
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1 Åbo Akademi University, Department of Psychology, Turku, Finland (GRID:grid.13797.3b) (ISNI:0000 0001 2235 8415)
2 Aalto University, Department of Neuroscience and Biomedical Engineering, Helsinki, Finland (GRID:grid.5373.2) (ISNI:0000000108389418)
3 University of Helsinki, Department of Psychology and Logopedics, Helsinki, Finland (GRID:grid.7737.4) (ISNI:0000 0004 0410 2071)
4 University of Geneva, Faculty of Psychology and Educational Sciences, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2322 4988); University of Geneva, Centre for the Interdisciplinary Study of Gerontology and Vulnerability, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2322 4988)
5 University of Geneva, Centre for the Interdisciplinary Study of Gerontology and Vulnerability, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2322 4988); Swiss National Center of Competences in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, Lausanne, Geneva, Switzerland (GRID:grid.8591.5)
6 Tilburg University, School for Social and Behavioral Sciences, Department of Developmental Psychology, Tilburg, The Netherlands (GRID:grid.12295.3d) (ISNI:0000 0001 0943 3265); University of Geneva, Cognitive Aging Lab, Faculty of Psychology and Educational Sciences, Geneva, Switzerland (GRID:grid.8591.5) (ISNI:0000 0001 2322 4988)