Investigating the Role of Sleep Problems, Emotional Impulsivity, and Hot and Cold Executive Functions in Students with Attention-Deficit/Hyperactivity Disorder Symptoms in Zanjan City, Iran

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. The condition arises due to an imbalance in neurotransmitters and abnormal activity in certain parts of the brain. In children, it typically manifests as difficulty concentrating and hyperactive behavior, while in adults, it presents as poor time management and distractibility. Objectives: The present study aimed to investigate the role of sleep problems, emotional impulsivity, and cold and warm executive functions (EFs) in explaining ADHD symptoms among students in Zanjan, Iran, in 2024. Methods: To conduct this cross-sectional study, 170 students from Islamic Azad University-Zanjan Branch were selected through convenience sampling, of which 118 completed the questionnaires. The data collection tools included the Barkley Deficits in Executive Functioning Scale (BDEFS), Adult ADHD Self-report Scale (ASRS), Pittsburgh Sleep Quality Index (PSQI), and Impulsive Behavior Scale (UPPS). After collecting the questionnaires, their raw findings were extracted and then analyzed using SPSS software (version 26). Results: The results of the present study showed that sleep problems had a significant relationship with ADHD (R = 0.46; R2 = 0.21; F = 567.49; P < 0.01). Additionally, emotional impulsivity components, including perseverance, urgency, and sensation seeking, were able to predict ADHD symptoms (R2 = 0.33; R2adj = 0.31; F = 19.04; P < 0.01). Furthermore, two components of EFs, namely "time self-management" and "emotional self-regulation", significantly explained nearly half of the variance in ADHD symptoms (R2 = 0.52; R2adj = 0.51; F = 63.22; P < 0.01). Conclusions: The findings of the study indicate that sleep problems, emotional impulsivity, and EFs play a significant role in the development of ADHD symptoms. Accordingly, it can be said that weaknesses in EFs and poor sleep quality are among the most important factors associated with the severity of the symptoms of this disorder. These results can be used in the design of psychological interventions and preventive strategies for students with ADHD symptoms.