DEVELOPMENTAL NEUROPSYCHOLOGY

Interactive Associations of Youth Executive Function and Negative Emotionality: Prospective Predictions of Adolescent Psychopathology
MacNaughton GA and Lee SS
To characterize the developmental origins of youth attention-deficit/hyperactivity disorder (ADHD), we examined independent and interactive associations of childhood-negative emotionality (NE) and executive functioning (EF; set shifting, inhibitory control, working memory) as predictors of adolescent externalizing and internalizing problems. Participants were children with and without ADHD ( = 230; ages 5-11 at baseline) followed for 6-7 years. Parent-reported NE predicted later psychopathology, and performance-based set shifting moderated this association. Unexpectedly, set shifting predicted internalizing symptoms. Findings highlight NE and EF as key transdiagnostic risk factors informing developmental models of ADHD and underscoring priorities for prevention and intervention.
Deliberate and Affective Driven Decision-Making. A 10-Year Longitudinal Study of Decision-Making in Autism
Skogli EW, Andersen PN, Fossum IN, Øverland E, Kjørren E, Hovik KT, Øie MG and Orm S
We investigated the developmental trajectory of decision-making in autistic individuals from childhood into emerging adulthood and examined the impact of internalizing symptoms on decision-making strategies. Thirty-eight autistic and 50 non-autistic individuals were assessed at baseline (Mage = 11.8 years, 72.7% boys), at 2-year, and 10-year follow-up. Autistic and non-autistic individuals showed similar improvements in decision-making performance over time. However, the autistic participants exhibited a more risk-averse decision-making style compared to the non-autistic participants. The pattern of risk-averse decision-making in the autistic individuals reflected a more deliberate thinking style in advantageous situations and the influence of internalizing symptoms in disadvantageous situations.
Is Cognitive Disengagement Syndrome a Risk Factor for Obese Children? A Case-Control Study
Gümüş Ü, Kılıçaslan F, Altıncık SA and Başay Ö
The aim of this study is to investigate whether there are differences in terms of cognitive disengagement syndrome (CDS) symptoms and some psychiatric symptoms between obese children and healthy controls. Participants were 60 cases diagnosed with obesity and 60 healthy children who were not obese/overweight aged 6-12 years. The obese group had significantly higher CDS symptom scores comparing to the control group. In the obese group, there were statistically significant associations found between the symptoms of CDS and attention, conduct issues, emotional instability, and excessive daytime sleepiness. Clinicians who work with obese children should also be aware of CDS symptoms.
Age-Related Effects on Facial Emotion Recognition in Schoolchildren: An ERP Study
Ramos-Loyo J, Espinosa-Denenea SE, Sanz-Martin A and Llamas-Alonso LA
The ability to recognize emotions in others is crucial for social interaction and develops during childhood. We studied the effects of age on emotional facial recognition in schoolchildren using ERP components. Children aged 6, 8, and 10 completed identity, sex, and emotion recognition (happiness, anger, sadness) tasks. The oldest group had the highest accuracy and fastest reaction times. Only the LPP component showed age-related differences, with lower amplitudes in older children. LPP showed higher amplitude during emotion recognition, which may be associated with motivational evaluation. ERP accounted for the temporal dynamics of facial processing, which involve cognitive and emotional processes.
Confirmatory Factor Analysis and Concurrent Validity of the Concussion Clinical Profiles Screening Tool (CP Screen)
Preszler J, Manderino L, Elbin RJ, Eagle SR, Brunner MN, Gomes D, Collins MW and Kontos AP
The factor structure of the Concussion Clinical Profiles Screen (CP Screen) has not been empirically evaluated. In this study, 323 patients (59% male; 74% sport-related) completed CP Screen, ImPACT, and Vestibular/Ocular-Motor Screening (VOMS) at initial clinical visit within 30 days of concussion (±/-6.10 days). A second-order model best fit the data, with cognitive-fatigue, migraine, and ocular factors comprising a second-order factor. Loadings were all significant/substantial. Vestibular, ocular, and cognitive-fatigue factors all significantly (βs = .15-.44 ps ≤ .01) predicted assessments in similar domains, supporting concurrent validity. This study provides initial psychometric support for the structure of the CP-screen.
Comparison of Cold and Cool Cognition in Children With and Without Attention Deficit-Hyperactivity Disorder (ADHD)
Nejati V, Jamshidifar A, Borhani K and Fathabadi J
Children with ADHD suffer from impaired attentional, executive, and emotional processing. This study aimed to compare attentional and executive processing using (non)emotional stimuli in children with and without ADHD. Eighty-five children with ADHD and 72 matched typically developing children performed the Stroop, continuous performance, and Go/No-Go tasks using (non)emotional stimuli. Greater performance in selective attention, inhibitory control, and sustained attention was found in emotional stimuli compared to non-emotional stimuli in both groups. Emotional stimuli facilitated attentional and executive functions in children with and without ADHD. Impaired attentional and executive functions in children with ADHD are not valence-sensitive.
Reading Disability in Children: Exploring the N400 and its Associations with Set-For-Variability
Basma B, Savage R, Luk G and Bertone A
The N400 event-related potential (ERP), a marker of lexical-semantic processing, can assess the neural basis of reading difficulties. This study examines 1) semantic processes in typically developing (TD) children and children with reading disabilities (RD) using N400 and Set-for-Variability (SfV) profiles and 2) correlations between N400 and SfV. Fifty-one children read congruent and incongruent sentences during EEG. Results showed RD children lacked an N400 effect and had delayed SfV. A negative correlation between SfV and N400 latency in the RD group indicated distinct semantic processing delays in these children.
Cross-Sectional Study on the Effect of Bilingualism, Age, Gender, and Family Income on Executive Function Development in a Sample of Lebanese School-Aged Children
Tayar VG, Saad J, El Sheikh WG and Roukoz C
This study investigates executive functions (EFs) and selected developmental factors in 120 children aged 6-11 years. By examining inhibition, working memory, and cognitive flexibility, the research evaluates the potential influences of age, gender, bilingualism, and family income on these EF skills. Tests adapted to Lebanese Arabic were used to assess EFs. Results indicate a linear development of inhibition, working memory, and flexibility with age. Gender differences were observed, affecting verbal and visuospatial working memory as well as flexibility. Bilingualism positively impacts EFs, with early bilinguals outperforming late bilinguals. Family income, however, shows no significant effect on EFs.
Self-Reported Traumatic Brain Injury and Its Biopsychosocial Risk Factors in Siblings of Individuals with Neurodevelopmental Conditions
Wolff B, Glasson EJ, Babikian T and Pestell CF
Siblings of individuals with neurodevelopmental conditions (NDCs) are situated within a complex system of risk and resilience factors for poor outcomes, many of which overlap with the risk of traumatic brain injury (TBI) and correlate with poorer recovery trajectories. This study used Bayesian analyses to characterize and compare TBI and biopsychosocial risk factors among 632 siblings (207 NDC, 425 controls; mean age 20.54 years, range 10-30, 78.48% female). NDC siblings had a higher self-reported lifetime history of TBI compared to controls (14.98% versus 6.35%), with most reporting more than one TBI, and at an earlier age. TBI history was associated with psychiatric diagnoses and subclinical NDC features. Family and structural factors related to TBI included poorer parent-child relationship, NDC diagnoses of autism or fetal alcohol spectrum disorder, minority ethnicity, and lower income. Findings have implications for health literacy, TBI education and screening, and implementation of family support.
Visuospatial Perception in Prematurely Born Children Without Cerebral Palsy or Retinopathy but With Scholar Complaints
Drissi H, Mosquera J, Plaisant F, Vuillerot C, Gonzalez-Monge S and Pisella L
In the absence of any complaints in early childhood, preterm children remain more at risk of encountering academic difficulties, but their clinical picture remains not well characterized. We screened visuospatial perception in 70 children born preterm consulting for scholar complaints. Developmental Coordination Disorder (with or without comorbidities) was associated with high prevalence (27%) of impaired perception of spatial relationship. Prematurely born children who obtained no diagnosis of Neuro-Developmental Disorder exhibited a high prevalence (31%) of impaired perception of object magnitude. Regression revealed that low gestational age and fetal growth restriction significantly predicted the magnitude but not the spatial relationship perception.
Attention Deficit/Hyperactivity Disorder in Individuals with Non-Syndromic Craniosynostosis: A Systematic Review and Meta-Analysis
Osborn AJ, Lange O and Roberts RM
It is not yet understood whether, and to what extent, craniosynostosis impacts the development of Attention Deficit/Hyperactivity Disorder (ADHD). This PRISMA compliant and PROSPERO pre-registered (ID: CRD42023458640) systematic review and meta-analysis examines the association of single-suture, non-syndromic craniosynostosis with ADHD and inattention/hyperactivity symptoms. Data from 17 independent studies ( = 2,389;  = 7.3 years) were analyzed, taking into consideration suture location, surgical status, age, and measures administered, where feasible. Few differences were found between cases and controls, but some studies reported high symptom levels. Additional research is required utilizing larger sample sizes and more comprehensive assessment of ADHD.
Neurocognition in Pediatric Temporal Lobe Tumor-Related Epilepsy
Turner EM, Olsen E and Duvall S
Tumor-related epilepsy is a common and understudied neurological comorbidity among pediatric temporal lobe tumor patients that poses risk for neurocognitive impairment (NCI). Forty-one youth with either TLT+ ( = 23) or nonneoplastic temporal lobe epilepsy ( = 18) ages 6-20 years completed routine neuropsychological evaluations. Rates of NCI were similar across groups; however, NCI was more common in nonneoplastic participants on a task of phonemic fluency,  = .047. Younger age of seizure onset and greater number of antiseizure medications were associated with NCI among TLT+ participants only. Preliminary findings suggest separate prognostic models of cognitive outcomes between TLT+ and nonneoplastic epilepsy populations may be needed.
Adaptive, Externalizing, and Internalizing Behavior of Children with Prenatal Alcohol Exposure: A Comparison of Three Parent-Report Questionnaires
Sobolewski CM, Courchesne-Krak NS, Hyland MT, Bernes GA, Veziris CR, Wozniak JR, Mattson SN and
This study compared the Behavior Assessment System for Children-Third Edition (BASC-3) to the Child Behavior Checklist (CBCL) and the Vineland Adaptive Behavior Scales-Third Edition (VABS-3) in children with and without histories of prenatal alcohol exposure. Data were collected from Collaborative Initiative on Fetal Alcohol Spectrum Disorders Phase 4 sites. Caregivers rated their child's behavior using three questionnaires: BASC-3, CBCL, and VABS-3. BASC-3 Adaptive Skills, Externalizing Problems, and Internalizing Problems scores were correlated with comparable scores from the CBCL (Externalizing and Internalizing Problems) and VABS-3 (Adaptive Skills) both within and across groups. Sensitivity, specificity, and positive and negative predictive values were calculated for the BASC-3. BASC-3 sensitivity rates were 78.1%, 80.5%, and 47.0% and specificity rates were 79.4%, 80.4%, and 81.5% for Adaptive Skills, Externalizing Problems, and Internalizing Problems, respectively. Positive predictive values were 87.1%, 88.0%, and 81.9% and negative predictive values were 67.0%, 69.8%, and 46.3% for Adaptive Skills, Externalizing Problems, and Internalizing Problems, respectively. Results replicated previous reports of behavioral and adaptive difficulties in children with prenatal alcohol exposure. These findings provide support for using the BASC-3 in this population.
Autistic Traits Associated with the Fragile X Premutation Allele: The Neurodevelopmental Profile
Zucker A and Hinton VJ
Although most individuals who carry the Fragile X premutation allele, defined as 55-200 CGG repeats on the X-linked gene ( gene), do not meet diagnostic criteria for autism spectrum disorder, there is a suggestion of increased behaviors associated with subtle autistic traits. More autism associated characteristics have been reported among adults than children. This may highlight a possible worsening developmental trajectory, variable findings due to research quality or differences in number of studies done in adults vs children, rather than true developmental changes. This review is designed to examine the neurodevelopmental profile associated with the premutation allele from a developmental perspective, focused on autistic traits.
Preliminary Evidence for a Positive Relation Between the COMT rs4680 Met/Met Genotype and Math Achievement
Chamorro Y, Mendizabal-Ruiz AP, Abreu-Mendoza RA, Morales JA, de Lourdes Ramírez-Dueñas M and Matute E
To identify if polymorphisms interact with executive functions as predictors of math skills, we assessed 38 adolescents (mean age = 16.4 ± 0.80 years, IQ > 80) from a larger study of high-school students screened for their mathematical abilities. Adolescents were genotyped for the Val158Met polymorphism (grouped as Met/Met or Val-carriers) and completed the WRAT math achievement test, working-memory, inhibitory-control, and shifting tasks. Met/Met-carriers achieved higher WRAT scores than the Val-carriers ( = 229,  = .009). Genotype group was a moderate-to-strong predictor of WRAT scores ( 0.56 to 0.74). No genotype/executive-function interaction was detected. Our findings suggest that the rs4680 Met/Met genotype is positively associated with math achievement.
Decoders are Less Efficient in RAN Objects than Children using Lexical Processing
Fromont M, Vanderauwera J and Van Reybroeck M
While rapid automatized naming (RAN) is recognized as a predictor of reading, it is unclear whether RAN is related to a particular reading route. This study aims to better understand the relationship between RAN and both reading processes (phonological decoding or lexical processing). One hundred and twenty-six children ( = 8.89 years) were separated into two groups based on their performance in irregular word reading. Children from the phonological decoding group obtained significantly lower scores for RAN objects than children from the lexical processing group, but the scores of the two groups were equivalent for the other RAN matrices. Correlations showed a stronger relationship between RAN objects and irregular word reading than pseudoword reading.
Toward Inclusive Social Cognition Assessment: Validating a Unified Battery for Hearing and Deaf Children
Mejia C, Rocha L, Quimbaya J and Cardona JF
The Social Cognition Battery (SCB) was validated as an inclusive tool for assessing social cognition (SC) in hearing and deaf children, addressing cross-cultural gaps. Participants included 154 hearing (M age = 8.10, SD = 1.56) and 30 deaf children (M age = 9.80, SD = 1.97) from Latin America. Exploratory Factor Analysis revealed a unifactorial SC structure (RMSEA = 0.069, CFI = 0.962) with high reliability (ω = 0.753). Age predicted SC in hearing children, while school year better explained SC in deaf children. ROC analysis (AUC = 0.8126) confirmed strong discriminative ability. The SCB is a reliable, culturally adapted tool for diverse populations.
Latent Profile Analysis of Creativity: Its Relation to Intelligence and Executive Functions
Pasarin-Lavin T, García T, Rodríguez C and Núñez JC
This study used Latent Profile Analysis (LPA) to identify different creativity profiles among 182 secondary school students (Mage = 13.34), based on verbal and figural creative dimensions (PIC-J) which were related to Executive functions measured using Nesplora Ice Cream (VR-based), and intelligence with the WISC-V. Three profiles emerged showed a similar levels of figural creativity, but differed in verbal creativity (low, medium, high). IQ differed between low and medium verbal groups, while EF did not significantly differ across profiles. Although no overall gender differences were found, boys were slightly more represented in the high-verbal group. Findings highlight implications for educational and cognitive interventions.
Motor Skills in Intellectually Gifted Children: A Neuropsychological Investigation
Bucaille A, Jarry C, Laurent A, Allard J, Brosseau-Beauvir A, Ropars J, Brochard S, Peudenier S and Roy A
Researches on motor skills in intellectually gifted children (IGC) are Insufficient to establish a clear profile of their motor functioning and understanding their potential needs. This study aimed to characterize motor skills in 30 IGC (Intelligence Quotient ≥130) compared with 35 typically developing children (TDC) with an intelligence level in the average range, aged from 6 to 16 years. A thorough theory-driven exploratory examination of motor skills was carried out to explore distinct components described in the cognitive models of apraxia. Results of IGC were compared with those of TDC for neuropsychological performance-based and rating measures, and the presence of neurological soft signs (NSS). IGC did not differ from TDC on most of neuropsychological measures, except those of handwriting skills (at school age) where they demonstrated a weaker performance in quality. For the IGC concerned, these are generally associated with more NSS and motor complaints in daily life than the TDC. Superior performances were evidenced in measures requiring planning ability. This study did not find clear evidence for differences in motor skills between IGC and TDC. While a few IGC may develop handwriting problems as a group, they do not seem to be at risk for motor/praxis difficulties.
Age-Related Changes in Theory of Mind in Middle Childhood: A Cross-Cultural Comparison Between Australian and Chinese Children
Wang S, Andrews G, Pendergast D, Neumann DL, Liang X, Cao Y, Li D and Shum DHK
Theory of mind (ToM) is centrally important in everyday social communication and interactions, and a growing number of studies have focused on this social-cognitive construct in school-aged children. This study explored age-related changes in ToM abilities and cross-cultural differences between children from China and Australia. We recruited 126 children from China and 83 children from Australia. The children's cognitive and affective ToM were measured by four tests. The findings showed that although there were no cultural differences in Interpretive ToM and Faux Pas performances, Chinese children performed poorer in Reading Mind in the Eyes and Strange Stories than Australian children.
Beyond Clinical Signs: The Interplay Between Vagal Tone and Lethargic Behavior in Preterm Infants
Aldrete-Cortez V, Catano-Cedillo L and Rendón-Macías ME
In this cross-sectional, observational study, the association between lethargy and vagal tone was analyzed in thirteen low-risk preterm infants. Infants underwent behavioral assessment and vagal tone measurement indexed by high-frequency heart-rate variability (HF-HRV). A lower vagal tone cluster was associated with greater lethargy ( = .05), reduced handling ( = .003), excitability ( = .006), higher skin stress indicators ( = .13), and central nervous system stress indicators ( = .10) than cluster with a higher vagal tone cluster. A lower vagal tone could indicate autonomic nervous system dysregulation or immaturity, leading to neurobehavioral challenges, such as lethargy and further neurodevelopmental difficulties.
Relations Between Family Environment, the Rate of Externalizing Problems and Cognitive Functioning of Primary Students with ADHD
Walenista W, Izydorczyk B, Lipowska M and Sitnik-Warchulska K
This study explored how socioeconomic status and family structure predict aggressive and impulsive behaviors in children with ADHD and whether cognitive functioning moderates these effects. We assessed 190 Polish children with ADHD for cognitive functions and parent-reported behavior and socioeconomic data. In girls, attentional selectivity and phonological loop functioning moderated the effects of financial situation and family structure on behaviors. In boys, single parenthood predicted aggression, moderated by phonological loop functioning. Findings show sex-specific patterns and highlight the complex interplay between cognitive, environmental, and family factors in ADHD-related behaviors, underscoring the need for further targeted research.
A Systematic Review on Visual-Processing Deficits in Neurofibromatosis Type 1: What Possible Impact on Learning to Read?
Vernet M, Ducrot S and Chaix Y
This systematic review aimed to examine the possible implication of visual-perceptual, visuo-attentional and oculomotor processing in the reading deficits frequently experienced by children with Neurofibromatosis type 1 (NF1), as previously shown in dyslexia. Using PRISMA methodological guidelines, we examined 49 studies; most of these reported visual-processing deficits in this population, raising the importance of directly studying the visuo-perceptual and visuo-attentional processes and eye-movement control involved in the learning-to-read process in NF1. The discussion provides a reflection for a better understanding of how visual-processing skills interact with reading deficits in NF1, as well as new avenues for their screening and care.
Contributions of Working Memory, Inhibition, and Processing Speed to Writing Composition in Attention-Deficit/hyperactivity Disorder
Trane FE, Paulich KN, Dokuru DR and Willcutt EG
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often struggle with writing composition, possibly due to deficits in executive functions and processing speed. This study examined 518 children with ADHD and 851 controls to assess these effects. Multiple mediation tested whether executive functions (i.e., working memory, inhibition) and processing speed partially mediated the association between inattention and writing composition, controlling for transcription. Results showed inattention negatively predicted writing composition. Executive function accounted for nearly 10%, and processing speed nearly 17%, of the variance in this association. Findings highlight the contributions of executive functions and processing speed to writing difficulties in ADHD.
The Effect of Psychological Distress and Intimate Partner Violence on Treatment Adherence in the Mothers of Children with Attention Deficit Hyperactivity Disorder
Kocaman O, Tekin U, Yılmaz S and Saygılı Ok S
This study examines the effects of maternal psychological distress and the Intimate partner violence (IPV) to which mothers are exposed on treatment adherence. 55 mothers of children diagnosed with ADHD and 51 mothers of healthy children were included in the study. Psychological distress and IPV were greater in the mothers of children with ADHD than in those of healthy children. Greater IPV was determined in the low treatment adherence group among the mothers of children with ADHD than in the moderate-high adherence. Holistic approaches in ADHD in which the mother's mental health is included can increase adherence to treatment.
Executive Functioning Measures from Early Childhood to School Age: Exploring Prospective Associations
Houde-Labrecque C, Côté MP, Beauchamp MH and Bernier A
This study aimed to identify tasks targeting early executive functioning (EF) that are predictive of EF performance at early school age (kindergarten and Grade 1). Using data from 202 participants, we examined the associations between EF performance at 2, 3, or 4 years of age and performance on commonly used EF tasks at early school age. The results show that some but not all early childhood tasks predicted EF in kindergarten and Grade 1. The results point to the potential of some early EF tasks while highlighting the challenge of calibrating task difficulty at an early age.
Are Communication Skills, Emotion Regulation and Theory of Mind Skills Impaired in Adolescents with Developmental Dyslexia?
Özyurt G, Öztürk Y, Turan S, Çıray RO, Tanıgör EK, Ermiş Ç, Tufan AE and Akay A
This study investigates pragmatic language impairment, Theory of Mind (ToM), and emotion regulation in adolescents with Developmental Dyslexia(DD). The Social Responsiveness Scale-2(SRS) and Children's Communication Checklist-2(CCC-2) scores were found to be statistically significantly higher in the DD group than in healthy controls. DD group had lower performance in ToM skills and they have more difficulties in emotion regulation. We also found that CCC-2 and ToM scores were significantly correlated in adolescents with DD. These results may be important in understanding the difficulties experienced in social functioning and interpersonal relationships in adolescents with DD.
Neurobiological Contributions to Speech and Language Interventions: Applications to Developmental Populations
Curtis M, Alfano AR, Murphy D, Pruden SM, Bayat M, Graziano PA and Dick AS
Although our understanding of the neural bases of speech and language has advanced considerably in recent decades, a disconnect persists between this knowledge and early interventions currently used in clinical practice. Insights into how neurobiological data may be incorporated into identification, differential diagnosis, and targeted treatment offer valuable lessons for early developmental intervention. Neurobiologically-informed methods already incorporated into the treatment of speech and language disorders show promise for improving treatment strategies, but these approaches are not yet widely adopted. Bridging the gap between neuroscience and clinical care could initiate a paradigm shift from symptom-based management to proactive, neurobiologically-informed care.
The Association of Speech/Language Risk With Phonological Awareness, Rapid Naming, and Reading Ability in Children With Cleft Lip and/or Palate
Kapp-Simon KA, Crilly Bellucci C, Albert M, O'Gara M, Richards S and Morgan A
Children with cleft lip and/or palate were assessed for speech, language, phonological awareness (PA), rapid naming (RN) and reading ability using standardized instruments at baseline (T1; = 142, M = 6.14 years, 51% males) and 2-year follow-up (T2; 89% retention, M = 8.38). Children with no speech or language risk scored higher for T1 and T2 PA, RN, and reading than children with both speech and language risk [Adjusted Mean Difference (AMD) ranged from 11.79 to 21.25]; language risk (AMD 8.37 to 13.58); and speech risk (0.51 to 6.87). No significant differences by cleft type or child sex.
The Meaning of Irritability in ADHD: Systematic Review
Silva Santos RM, de Andrade JN, Soares da Silva A, Coelho Martins T, Martins Rezende VH, Maia Gomes PG, Alvim-Soares Júnior AM, Romano-Silva MA and Marques de Miranda D
To investigate the role of irritability in the psychopathology and functioning of children with ADHD. This review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA, a protocol that standardizes the collection of evidence, and was registered at the International Prospective Register of Systematic Review - PROSPERO. Of the 3,902 studies returned from the databases, duplicates and studies that met the exclusion criteria were removed, leaving 24 articles in the review. In children with ADHD, higher levels of irritability were strongly associated with more severe ADHD symptoms and a greater presence of psychiatric comorbidities, including depression, anxiety, and mood disorders, such as bipolar disorder. Irritability showed a positive correlation with Oppositional Defiant Disorder and both internalizing and externalizing behaviors. Cognitive functioning was notably affected, with irritability linked to poorer language skills and lower accuracy in emotion recognition. Children with chronic irritability demonstrated poorer inhibitory control, reduced social skills, and an increased tendency to abandon tasks. Furthermore, irritability was associated with faster reaction times but also lower task accuracy, and it was significantly correlated with suicidality. Irritability appears to exacerbate symptoms in patients with ADHD and increase psychiatric comorbidities. It is essential to consider irritability in the assessment and treatment of ADHD to improve mental health outcomes and the overall prognosis for these individuals.