Document Type : Research Paper

Author

• Shahrooz Nemati

Professor, Department of Education, University of Tabriz, Tabriz, Iran

Abstract

Abstract
Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition marked by significant challenges that has led to extensive research on related constructs like executive functions, with this study aiming to explore the bibliometric landscape of executive functions in ADHD through analysis of Scopus data using the PRISMA model and the keywords "Attention Deficit/Hyperactivity Disorder" and "Executive Function," revealing publications spanning 1957 to 2024 across 27 subject areas primarily in medicine, psychology, and cognitive neuroscience, where only one document appeared between 1957-1982 compared to 7,995 in 2023, demonstrating a clear upward trend despite reduced output during 2015-2016, with English, Spanish, and Chinese emerging as dominant languages and the United States, United Kingdom, Germany, Canada, and China leading in contributions while Iran ranked 22nd, consistently showing that individuals with ADHD exhibit poorer executive functioning than peers particularly in working memory and self-regulation, supported by Barkley's theoretical framework suggesting ADHD involves greater self-regulation deficits rather than pure attention problems, thereby advocating for comprehensive treatment approaches incorporating behavioral interventions, environmental modifications, and emotional regulation strategies to address these core challenges.
Keywords: attention deficit/hyperactivity disorder, executive functions, bibliometrics, systematic review
 
Extended Abstract

Introduction

Attention Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that typically emerges in childhood and frequently persists into adulthood (Farahani et al., 2024). The condition is characterized by chronic patterns of inattention and/or hyperactivity-impulsivity that significantly impair functioning or disrupt normal developmental trajectories during childhood (American Psychiatric Association, 2022).
Executive functions represent a relatively recent conceptual development in neuroscience. Luria (1966, 1973, 1980, as cited in Ardila, 2008) pioneered the theoretical framework of executive functions, proposing three functional brain units: (1) arousal-motivation (mediated by limbic and reticular systems), (2) information reception, processing, and storage (involving post-Rolandic cortical areas), and (3) activity planning, control, and verification (dependent on frontal cortex function). Luria specifically identified this third unit as possessing executive control capabilities. Baddeley (1986) subsequently organized these behavioral components into distinct cognitive domains encompassing planning deficits, behavioral disorganization, inhibitory failures, perseveration, reduced behavioral dominance, and initiation impairments - collectively termed "dysexecutive syndrome." Contemporary conceptualizations of executive function incorporate mental flexibility, distractor filtering, goal-directed behavior maintenance, and action-consequence prediction (Ardila & Surloff, 2007).
Research consistently demonstrates that individuals with ADHD perform significantly worse on executive function measures compared to neurotypical controls. Within this domain, executive dysfunction shows a strong association with inattention symptoms but no significant correlation with hyperactive-impulsive symptoms. This pattern persists in adolescent populations, where executive function deficits remain specifically linked to attention-related impairments (Martel et al., 2007).
This study sought to systematically synthesize existing evidence on the relationship between executive functions and ADHD, with the dual objectives of (1) mapping current knowledge and (2) identifying critical research gaps. The findings illuminate persistent questions, methodological limitations, and testable hypotheses that can inform future investigations. Importantly, the analysis reveals key areas where extant evidence remains inconclusive, thereby delineating priority domains for targeted research to advance understanding of ADHD-related executive dysfunction.
Method
This applied research employs a dual methodological approach combining bibliometric analysis with systematic review methodology following the PRISMA framework. Data extraction focused specifically on ADHD-related literature sourced from the Scopus database, an authoritative bibliographic platform established by Elsevier in 2004. Scopus maintains international recognition as a comprehensive repository of scientific documents across disciplines, providing robust citation indexing and bibliographic metadata for research synthesis.
Table 2: Most Cited Articles in the Field of ADHD




 


Title


Authors


Source title


Year


Cited by






1


The Unity and Diversity of Executive Functions and Their Contributions to Complex "Frontal Lobe" Tasks: A Latent Variable Analysis


A. Miyake; et al.


Cognitive Psychology


2000


10748




2


Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data


J. Kaufman; et al.


Journal of the American Academy of Child and Adolescent Psychiatry


1997


7945




3


Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD


R.A.Barkley.


Psychological Bulletin


1997


5456




4


The worldwide prevalence of ADHD: A systematic review and metaregression analysis


G.Polanczyk.; et al.


American Journal of Psychiatry


2007


4046




5


Prevalence and development of psychiatric disorders in childhood and adolescence


E.J. Costello; et al.


Archives of General Psychiatry


2003


2962




6


The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication


R.C.Kessler; et al.


American Journal of Psychiatry


2006


2952




7


A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder


Jensen P.S.


Archives of General Psychiatry


1999


2881




8


Testing the efficiency and independence of attentional networks


J. Fan.; et al.


Journal of Cognitive Neuroscience


2002


2687




9


The nature and organization of individual differences in executive functions: Four general conclusions


A. Miyake; et al..


Current Directions in Psychological Science


2012


2667




10


Working memory: Theories, models, and controversies


Baddeley A.


Annual Review of Psychology


2012


2569




11


The cerebellar cognitive affective syndrome


J.D. Schmahmann; et al..


Brain


1998


2564




12


Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents


G.V.Polanczyk; et al..


Journal of Child Psychology and Psychiatry and Allied Disciplines


2015


2468




13


Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample


E.Simonoff; et al.


Journal of the American Academy of Child and Adolescent Psychiatry


2008


2411




14


Neurocognitive deficit in schizophrenia: A quantitative review of the evidence


R.W Heinrichs.; et al..


Neuropsychology


1998


2387




15


Identification of risk loci with shared effects on five major psychiatric disorders: A genome-wide analysis


J.W. Smoller.; et al..


The Lancet


2013


2268




16


A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): A randomised controlled trial


T. Ngandu; et al.


The Lancet


2015


2204




17


The World Health Organization adult ADHD self-report scale (ASRS): A short screening scale for use in the general population


R.C. Kessler; et al.


Psychological Medicine


2005


2203




18


Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten


C. Blair.; et al..


Child Development


2007


2196




19


Frontal-Subcortical Circuits and Human Behavior


Cummings J.L.


Archives of Neurology


1993


2043




20


Altered baseline brain activity in children with ADHD revealed by resting-state functional MRI


Y.-F. Zang.; et al..


Brain and Development


2007


2029




21


Comorbidity


A. Angola; et al..


Journal of Child Psychology and Psychiatry and Allied Disciplines


1999


1958




22


Long-term cognitive impairment after critical illness


P.P.Pandharipande. et al.;


New England Journal of Medicine


2013


1916




23


Diagnostic criteria for mild cognitive impairment in Parkinson's disease: Movement Disorder Society Task Force guidelines


I, Litvan; et al..


Movement Disorders


2012


1894




24


Executive Function in Preschoolers: A Review Using an Integrative Framework


N.Garon; et al.


Psychological Bulletin


2008


1810




25


Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs


S.H. Lee.; et al.


Nature Genetics


2013


1763




26


Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019


 


The Lancet Psychiatry


2022


1642




27


Functional topography in the human cerebellum: A meta-analysis of neuroimaging studies


C.J. Stoodley; et al..


NeuroImage


2009


1614




28


Human catechol-O-methyltransferase pharmacogenetics: Description of a functional polymorphism and its potential application to neuropsychiatric disorders


H.M. Lachman; et al..


Pharmacogenetics


1996


1597




29


The spectrum of disease in chronic traumatic encephalopathy


A.C.McKee. et al.;


Brain


2013


1588




30


Development of cognitive control and executive functions from 4 to 13 years: Evidence from manipulations of memory, inhibition, and task switching


M.C. Davidson; et al..


Neuropsychologia


2006


1525




Discussion and Conclusion
This study aimed to (1) establish the bibliometric positioning of executive functions research and (2) systematically review this construct's significance and key findings within ADHD studies. Analysis of Scopus data revealed the first ADHD-related document was indexed in 1995, with publication rates showing a general upward trend. Peak productivity occurred in 2023, while the period 1957-1982 showed minimal output. Our quantitative bibliometric approach enables comprehensive analysis of: research productivity trends, leading institutions/countries, prominent authors, high-impact journals, and frequently cited works in this domain. These analyses can foster enhanced scientific collaboration by mapping the field's intellectual structure.
Barkley's (1997) behavioral inhibition theory posits that ADHD stems from a core deficit in self-regulation, where impaired behavioral inhibition disrupts executive functioning. This foundational impairment manifests as difficulties in: (1) non-verbal working memory (manipulating visual/spatial information), (2) verbal working memory (maintaining inner speech for self-guidance), (3) emotional self-regulation, and (4) goal-directed planning/problem-solving. Rather than constituting a simple attention deficit, ADHD emerges as a complex self-regulation disorder with cascading effects across cognitive and behavioral domains.
The theory's clinical implications are threefold: First, it reorients intervention focus from symptom management to addressing underlying regulatory mechanisms. Second, it advocates for multimodal strategies combining behavioral training (e.g., cognitive-behavioral techniques), environmental adaptations (e.g., structured routines), and caregiver education. Third, it underscores the condition's chronicity, necessitating longitudinal, personalized treatment plans that evolve with developmental needs.

Keywords

• Keywords: attention deficit/hyperactivity disorder
• executive functions
• bibliometrics
• systematic review