1
|
Zhou H, Cai S, Zhang X, Chen Y, Wang A. Cross-modal conflict deficit in children with attention-deficit/hyperactivity disorder. J Exp Child Psychol 2024; 243:105917. [PMID: 38579588 DOI: 10.1016/j.jecp.2024.105917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 02/19/2024] [Accepted: 03/13/2024] [Indexed: 04/07/2024]
Abstract
The difference between the audiovisual incongruent condition and the audiovisual congruent condition is known as cross-modal conflict, which is an important behavioral index to measure the conflict control function. Previous studies have found conflict control deficits in children with attention-deficit/hyperactivity disorder (ADHD), but it is not clear whether and how cross-modal conflict occurs in children with ADHD at different processing levels. The current study adopted the cross-modal matching paradigm to recruit 25 children with ADHD (19 boys and 6 girls) and 24 TD children (17 boys and 7 girls), aiming to investigate the cross-modal conflict effect at the perception and response levels of children with ADHD. The results showed that both groups of children showed significant cross-modal conflict, and there was no significant difference between the ADHD and TD groups in the number of error trials and mean response time. However, the cross-modal conflict effect caused by auditory distractors was different between the ADHD and TD groups; the TD group had stronger auditory conflict at the response level, whereas the ADHD group had weaker auditory conflict. This indicates that the ADHD group had a deficit of auditory conflict at the response level.
Collapse
Affiliation(s)
- Heng Zhou
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou 215123, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing 101408, China; Chinese Institute for Brain Research, Beijing 102206, China
| | - Shizhong Cai
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Xianghui Zhang
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou 215123, China
| | - Yan Chen
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou 215025, China.
| | - Aijun Wang
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou 215123, China.
| |
Collapse
|
2
|
Li X, Cai S, Chen Y, Tian X, Wang A. Enhancement of visual dominance effects at the response level in children with attention-deficit/hyperactivity disorder. J Exp Child Psychol 2024; 242:105897. [PMID: 38461557 DOI: 10.1016/j.jecp.2024.105897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/16/2024] [Accepted: 02/16/2024] [Indexed: 03/12/2024]
Abstract
Previous studies have widely demonstrated that individuals with attention-deficit/hyperactivity disorder (ADHD) exhibit deficits in conflict control tasks. However, there is limited evidence regarding the performance of children with ADHD in cross-modal conflict processing tasks. The current study aimed to investigate whether children with ADHD have poor conflict control, which has an impact on sensory dominance effects at different levels of information processing under the influence of visual similarity. A total of 82 children aged 7 to 14 years, including 41 children with ADHD and 41 age- and sex-matched typically developing (TD) children, were recruited. We used the 2:1 mapping paradigm to separate levels of conflict, and the congruency of the audiovisual stimuli was divided into three conditions. In C trials, the target stimulus and the distractor stimulus were identical, and the bimodal stimuli corresponded to the same response keys. In PRIC trials, the distractor stimulus differed from the target stimulus and did not correspond to any response keys. In RIC trials, the distractor stimulus differed from the target stimulus, and the bimodal stimuli corresponded to different response keys. Therefore, we explicitly differentiated cross-modal conflict into a preresponse level (PRIC > C), corresponding to the encoding process, and a response level (RIC > PRIC), corresponding to the response selection process. Our results suggested that auditory distractors caused more interference during visual processing than visual distractors caused during auditory processing (i.e., typical auditory dominance) at the preresponse level regardless of group. However, visual dominance effects were observed in the ADHD group, whereas no visual dominance effects were observed in the TD group at the response level. A possible explanation is that the increased interference effects due to visual similarity and children with ADHD made it more difficult to control conflict when simultaneously confronted with incongruent visual and auditory inputs. The current study highlights how children with ADHD process cross-modal conflicts at multiple levels of information processing, thereby shedding light on the mechanisms underlying ADHD.
Collapse
Affiliation(s)
- Xin Li
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou 215123, China
| | - Shizhong Cai
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou 215025, China
| | - Yan Chen
- Department of Child and Adolescent Healthcare, Children's Hospital of Soochow University, Suzhou 215025, China.
| | - Xiaoming Tian
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Suzhou University of Science and Technology, Suzhou 215011, China.
| | - Aijun Wang
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou 215123, China.
| |
Collapse
|
3
|
Abed M, Mansureh HH, Masoud GAL, Elaheh H, Mohammad-Hossein NHK, Yamin BD, Abdol-Hossein V. Construction of Meta-Thinking Educational Program Based on Mental-Brain Simulation ( MTMBS) and Evaluating its Effectiveness on Executive Functions, Emotion Regulation, and Impulsivity in Children With ADHD: A Resting-State Functional MRI Study. J Atten Disord 2023; 27:1223-1251. [PMID: 36843348 DOI: 10.1177/10870547231155436] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVE The aim of present research was to make a Meta-Thinking educational program based on mental-brain simulation and to evaluate its effectiveness on executive functions, emotion regulation and impulsivity in children with ADHD. METHODS The research method was Embedded Design: Embedded Experimental Model. The research sample included 32 children with ADHD who were randomly assigned to two experimental and control groups. The intervention was implemented for eight sessions of 1.5 hr for the experimental group, and fMRI images were taken from them, while the control group didn't receive any treatment. Finally, using semi-structured interviews, coherent information was collected from the parents of the experimental group about the changes made. Data were analyzed with SPSS-24, MAXQDA, fMRIprep, and FSL software. RESULTS The Meta-Thinking Educational Program had effect on performance of ADHD children and suppressed brain regions related to DMN. CONCLUSION The Implementation of this educational program plays a vital role in improving psychological problems of children with ADHD.
Collapse
|
4
|
Griffiths KR, Aparício L, Braund TA, Yang J, Harvie G, Harris A, Hay PJ, Touyz S, Kohn MR. Impulsivity and Its Relationship With Lisdexamfetamine Dimesylate Treatment in Binge Eating Disorder. Front Psychol 2021; 12:716010. [PMID: 34531798 PMCID: PMC8439192 DOI: 10.3389/fpsyg.2021.716010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/27/2021] [Indexed: 11/13/2022] Open
Abstract
High trait impulsivity is thought to contribute to the sense of loss of control over eating and impulses to binge eat experienced by those with binge eating disorder (BED). Lisdexamfetamine dimesylate (LDX), a drug approved for treatment of moderate to severe BED, has been shown to decrease impulsive features of BED. However, the relationship between LDX-related reductions of binge eating (BE) episodes and impulsivity has not yet been explored. Forty-one adults aged 18-40years with moderate to severe BED completed questionnaires and tasks assessing impulsivity at baseline and after 8weeks of 50-70mg of LDX. Twenty age-matched healthy controls were also assessed at two timepoints for normative comparison. Data were analysed using linear mixed models. BED participants exhibited increased self-reported motor, non-planning, cognitive and food-related impulsivity relative to controls but no differences in objective task-based measures of impulsivity. Food-related and non-planning impulsivity was significantly reduced by LDX, but not to normative levels. Individuals with higher baseline levels of motor and non-planning impulsivity, and loss of control over eating scores experienced the greatest reduction in BE frequency after 8weeks of LDX. Further, there were significant associations between the degree to which subjective loss of control over eating, non-planning impulsivity and BE frequency reduced after 8weeks of LDX. These data suggest that specific subjective measures of impulsivity may be able to predict who will have the greatest benefit from LDX treatment and that reductions in BE frequency may be moderated by concurrent reductions in non-planning impulsivity.
Collapse
Affiliation(s)
- Kristi R Griffiths
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
| | - Leonor Aparício
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia.,Faculty of Medicine, University of Porto, Porto, Portugal
| | - Taylor A Braund
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia.,BlackDog Institute, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Jenny Yang
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
| | - Grace Harvie
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia
| | - Anthony Harris
- Brain Dynamics Centre, Westmead Institute for Medical Research, University of Sydney, Westmead, NSW, Australia.,Discipline of Psychiatry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Phillipa J Hay
- School of Medicine, Translational Health Research Institute, Western Sydney University, Sydney, NSW, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, School of Psychology, University of Sydney, Sydney, NSW, Australia.,InsideOut Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Michael R Kohn
- Centre for Research into Adolescents' Health (CRASH), University of Sydney, Sydney, NSW, Australia.,Adolescent and Young Adult Medicine, Westmead Hospital, Sydney, NSW, Australia
| |
Collapse
|
5
|
Rostami M, Khosrowabadi R, Albrecht B, Rothenberger A, Pouretemad H. Classifying ADHD subtypes/presentations considering the joint effect of three levels of investigation. Nord J Psychiatry 2021; 75:31-37. [PMID: 33393425 DOI: 10.1080/08039488.2020.1787512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM Discriminant validity of the Attention Deficits/Hyperactive Disorders (ADHD) subtypes/presentations is not yet clear. The purpose of this study was to investigate joint contribution of the strongest factors of the three dimensions, namely psychopathology, neuropsychology and electrophysiology for subtyping of presentations. METHOD A sample of 104 boys aged 7-12 years was subdivided into three groups with ADHD combined (n = 22), inattentive (n = 25) and hyperactive/impulsive subtype (n = 14), and 43 typically developing controls (TDC). Children were investigated regarding the Child Behavior Checklist (CBCL), the Integrated Visual and Auditory Test (IVA), and EEG spectral power during eyes closed resting state. Subsequently, statistical analysis included discriminant functional analysis and principle component analysis. RESULTS Neuropsychological parameters had the highest contribution in classifying of the groups. EEG parameters had no effect on differentiation of the groups, and among the psychopathological parameters, only the oppositional behavioral disorder score contributed to correctly classify 74.3% of the groups. Furthermore, we found four factors with eigenvalues higher than 1 in the ADHD and typical groups, with one factor characterized by four CBCL scales, another one by auditory and visual vigilance, speed and beta band power, the third by auditory and visual prudence, and forth by theta band power. CONCLUSIONS Our results demonstrated that ADHD subtypes/presentations can be differentiated from each other at different levels of investigation despite some clinical symptoms overlap. The results suggested that not only psychopathology but also the impairment of sensory processing should be assessed in children with ADHD in order to use this additional information for a jointly multilevel clinical intervention, which may improve treatment success.
Collapse
Affiliation(s)
- Mohammad Rostami
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Reza Khosrowabadi
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Björn Albrecht
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Göttingen, Germany
| | - Aribert Rothenberger
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University Medical Center of Göttingen, Germany
| | - Hamidreza Pouretemad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| |
Collapse
|
6
|
İpÇİ M, İncİ İzmİr SB, TÜrkÇapar MH, Özdel K, ArdiÇ ÜA, Ercan ES. Psychiatric Comorbidity in the Subtypes of ADHD in Children and Adolescents with ADHD According to DSM-IV. ACTA ACUST UNITED AC 2020; 57:283-289. [PMID: 33354119 DOI: 10.29399/npa.24807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 05/13/2020] [Indexed: 11/07/2022]
Abstract
Introduction The prevalence rate of psychiatric comorbidity in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) was 60-80%. The objective of this study was to examine comorbid disorders associated with ADHD and the subtypes of ADHD in children and adolescents with the diagnosis of ADHD. Method The study included 326 children and adolescents aged between 8-15 years who were diagnosed with ADHD for the first time as a result of an interview by psychiatry, in a child adolescent psychiatry clinic in İzmir. Sociodemographic form, Turgay DSM-IV Disruptive Behavior Disorders Rating Scale and Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children Present and Lifetime version were used to assess psychiatric comorbidity. Results The comorbidities accompanied ADHD were disruptive behavior disorder (28.8%), depressive disorder (13.2%), obsessive-compulsive disorder (9.5%) and anxiety disorder (6.1%). When the subtypes of ADHD were assessed according to psychiatric comorbidity, oppositional defiant disorder and conduct disorder were frequently seen with ADHD combined type, whereas anxiety disorder was more frequent with ADHD inattentive type. Discussion Comorbidity in ADHD Combined type increases the severity of disease, delays treatment response and exacerbates prognosis. Therefore, it is very important to determine which psychiatric diagnosis accompany with ADHD.
Collapse
Affiliation(s)
- Melis İpÇİ
- Hasan Kalyoncu University, Institute of Social Sciences, Department of Clinical Psychology, Gaziantep, Turkey
| | - Sevim Berrin İncİ İzmİr
- Ege University Substance Addiction Toxicology and Pharmaceutical Sciences Institute, İzmir, Turkey
| | - Mehmet Hakan TÜrkÇapar
- Social Sciences University of Ankara, Faculty of Humanities and Social Sciences Department of Psychology, Ankara, Turkey
| | - Kadir Özdel
- Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Ülkü Akyol ArdiÇ
- Denizli State Hospital, Child and Adolescent Psychiatry, Denizli, Turkey
| | | |
Collapse
|
7
|
Picken C, Clarke AR, Barry RJ, McCarthy R, Selikowitz M. The Theta/Beta Ratio as an Index of Cognitive Processing in Adults With the Combined Type of Attention Deficit Hyperactivity Disorder. Clin EEG Neurosci 2020; 51:167-173. [PMID: 31875684 DOI: 10.1177/1550059419895142] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
An elevated theta/beta ratio in the EEG has long been observed among individuals with Attention Deficit Hyperactivity Disorder (ADHD). The theta/beta ratio was previously hypothesised to be an index of arousal, but a number of studies failed to find any association between the ratio and indices of arousal, instead proposing that the theta/beta ratio may actually be indicative of cognitive processing. This hypothesis was tested by Clarke et al using a sample of healthy adults, with results indicating that the theta/beta ratio correlated with a marker of cognitive processing (P300 latency in an auditory oddball task), while P300 amplitude correlated with an arousal marker (alpha power). The aim of this study was to test whether similar results could be found in a sample of 41 adults with the combined type of ADHD. EEGs were recorded during an eyes-closed resting condition and an auditory oddball task. Results demonstrated that the theta/beta ratio correlated significantly with P300 latency. Absolute alpha power did not correlate significantly with P300 amplitude or P300 latency. These results support the hypotheses that the theta/beta ratio is a marker of cognitive processing capacity in both the general population and in participants with ADHD, and that the alpha/arousal linkage is anomalous in ADHD.
Collapse
Affiliation(s)
- Christie Picken
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Adam R Clarke
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Robert J Barry
- Brain & Behaviour Research Institute and School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Rory McCarthy
- Sydney Developmental Clinic, Sydney, New South Wales, Australia
| | - Mark Selikowitz
- The Children's Clinic, Bondi Junction, New South Wales, Australia
| |
Collapse
|
8
|
Dallmer-Zerbe I, Popp F, Lam AP, Philipsen A, Herrmann CS. Transcranial Alternating Current Stimulation (tACS) as a Tool to Modulate P300 Amplitude in Attention Deficit Hyperactivity Disorder (ADHD): Preliminary Findings. Brain Topogr 2020; 33:191-207. [PMID: 31974733 PMCID: PMC7066286 DOI: 10.1007/s10548-020-00752-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 01/04/2020] [Indexed: 12/22/2022]
Abstract
Studies examining event-related potentials (ERP) in patients affected by attention deficit/hyperactivity disorder (ADHD) have found considerable evidence of reduced target P300 amplitude across different perceptual modalities. P300 amplitude has been related to attention-driven context comparison and resource allocation processes. Altered P300 amplitude in ADHD can be reasonably assumed to be related to ADHD typical cognitive performance deficits. Transcranial alternating current stimulation (tACS) can increase the amplitude of endogenous brain oscillations. Because ERP components can be viewed as event-related oscillations (EROs), with P300 translating into the delta (0–4 Hz) and theta (4–8 Hz) frequency range, an increase of delta and theta ERO amplitudes by tACS should result in an increase of P300 amplitudes in ADHD patients. In this pilot study, 18 adult ADHD patients (7 female) performed three consecutive blocks of a visual oddball task while the electroencephalogram (EEG) was recorded. Patients received either 20 min of tACS or sham stimulation at a stimulation intensity of 1 mA. Individual stimulation frequency was determined using a time–frequency decomposition of the P300. Our preliminary results demonstrate a significant increase in P300 amplitude in the stimulation group which was accompanied by a decrease in omission errors pre-to-post tACS. However, studies including larger sample sizes are advised.
Collapse
Affiliation(s)
- Isa Dallmer-Zerbe
- Department of Complex Systems, Institute of Computer Science, Czech Academy of Sciences, Prague, Czech Republic.,Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster for Excellence "Hearing for All", Carl Von Ossietzky University Oldenburg, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany
| | - Fabian Popp
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster for Excellence "Hearing for All", Carl Von Ossietzky University Oldenburg, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany
| | - Alexandra Philomena Lam
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy - University Hospital, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany.,Medical Campus University of Oldenburg, School of Medicine and Health Sciences, Psychiatry and Psychotherapy - University Hospital, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Christoph Siegfried Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster for Excellence "Hearing for All", Carl Von Ossietzky University Oldenburg, Ammerländer Heerstr. 114-118, 26129, Oldenburg, Germany. .,Research Center Neurosensory Science, Carl Von Ossietzky University, Oldenburg, Germany.
| |
Collapse
|
9
|
Hadar Y, Hocherman S, Lamm O, Tirosh E. Auditory and Visual Executive Functions in Children and Response to Methylphenidate: A Randomized Controlled Trial. J Atten Disord 2020; 24:235-245. [PMID: 28388850 DOI: 10.1177/1087054717700978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: The aim of the study was to assess auditory and visually based executive functions (EFs) and the effect of methylphenidate (MPH) in children with ADHD. Methods: Thirty-six boys between the ages of 8.3 and 9.7 years with ADHD and 36 matched controls were included. The study group was randomized into MPH and placebo for 7 days each in a crossover design. A Cued Choice Reaction Time (CCRT) test that included incongruent cuing was administered at baseline and following 1 and 2 weeks. Results: The difference between the study and control groups was more evident with visual cues and incongruent cuing. Increased gains by children with predominantly hyperactive-impulsive\combined (HI\C) type of ADHD were observed under MPH. Conclusions: The differences between children with ADHD and typical children are more pronounce under incongruent auditory cuing . The gains attributable to MPH are more specific to tasks involving auditory and visual EFs and in children with HI\C type ADHDs.
Collapse
|
10
|
Park J, Choi HW, Yum MS, Ko TS, Shon SH, Kim HW. Relationship Between Aggravation of Seizures and Methylphenidate Treatment in Subjects with Attention-Deficit/Hyperactivity Disorder and Epilepsy. J Child Adolesc Psychopharmacol 2018; 28:537-546. [PMID: 30089215 DOI: 10.1089/cap.2017.0070] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES We aimed to investigate the effectiveness and safety of methylphenidate (MPH), and especially its influence on seizures, in subjects with attention-deficit/hyperactivity disorder (ADHD) and epilepsy through a retrospective chart review of subjects treated with MPH in a clinical setting. We also evaluated factors that could affect seizure aggravation during MPH treatment. METHODS From April 2004 to July 2011, MPH was prescribed to 105 subjects with ADHD and epilepsy. The demographic characteristics, psychiatric and medical history, and electroencephalography (EEG) results were reviewed. Two pediatric neurologists reviewed seizure type, epilepsy diagnosis, changes in seizure frequency, and EEG parameters during MPH treatment. Pediatric neurologists and psychiatrists determined the temporal relationship between seizure aggravation and MPH treatment. RESULTS The mean age of the subjects was 14.8 ± 3.4 years (range: 7-24 years). Sixty-five (61.9%) of the subjects were male. The mean duration of MPH treatment was 22 months (range: 2 weeks to 89 months) and the mean dose of MPH was 0.84 mg/kg/day. MPH was effective in controlling ADHD symptoms in both the seizure aggravation and nonaggravation groups. However, 21 (20%) subjects had aggravated seizures and 32 (32.3%) subjects had worsened EEG findings. Subjects with uncontrolled seizure or anxiety disorders at baseline were more likely to show aggravated seizures. Subjects who had epileptiform discharges, anxiety disorders, or were free of antiepileptic drug use at baseline experienced EEG worsening more frequently. The median duration of MPH treatment was significantly longer in subjects who did not show seizure aggravation than in those who did (p < 0.001). CONCLUSIONS MPH treatment may be related to aggravation of seizures or significant worsening of EEG findings in subjects with ADHD and epilepsy. Thus, clinicians should closely monitor seizure aggravation after MPH administration, especially for high-risk subjects with uncontrolled seizures or anxiety disorders at baseline.
Collapse
Affiliation(s)
- Jangho Park
- 1 Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine , Ulsan, Korea
| | - Hae-Won Choi
- 2 Department of Pediatrics, Kangdong Miz Women's Hospital , Seoul, Korea
| | - Mi-Sun Yum
- 3 Department of Pediatric Neurology, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Tae-Sung Ko
- 3 Department of Pediatric Neurology, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Seung-Hyun Shon
- 4 Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| | - Hyo-Won Kim
- 4 Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine , Seoul, Korea
| |
Collapse
|
11
|
Mesrobian SK, Villa AEP, Bader M, Götte L, Lintas A. Event-Related Potentials during a Gambling Task in Young Adults with Attention-Deficit/Hyperactivity Disorder. Front Hum Neurosci 2018; 12:79. [PMID: 29535621 PMCID: PMC5835343 DOI: 10.3389/fnhum.2018.00079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 02/12/2018] [Indexed: 01/20/2023] Open
Abstract
Attention-deficit hyperactivity disorder (ADHD) is characterized by deficits in executive functions and decision making during childhood and adolescence. Contradictory results exist whether altered event-related potentials (ERPs) in adults are associated with the tendency of ADHD patients toward risky behavior. Clinically diagnosed ADHD patients (n = 18) and healthy controls (n = 18), aged between 18 and 29 (median 22 Yo), were screened with the Conners' Adult ADHD Rating Scales and assessed by the Mini-International Neuropsychiatric Interview, adult ADHD Self-Report Scale, and by the 60-item HEXACO Personality Inventory. The characteristic personality traits of ADHD patients were the high level of impulsiveness associated with lower values of agreeableness. All participants performed a probability gambling task (PGT) with two frequencies of the feedback information of the outcome. For each trial, ERPs were triggered by the self-paced trial onset and by the gamble selection. After trial onset, N2-P3a ERP component associated with the attentional load peaked earlier in the ADHD group than in controls. An N500 component related to the feedback frequency condition after trial onset and an N400-like component after gamble selection suggest a large affective stake of the decision making and an emphasized post-decisional evaluation of the choice made by the ADHD participants. By combining ERPs, related to the emotions associated with the feedback frequency condition, and behavioral analyses during completion of PGT, this study provides new findings on the neural dynamics that differentiate controls and young ADHD adults. In the patients' group, we raise the hypothesis that the activity of frontocentral and centroparietal neural circuits drive the decision-making processes dictated by an impaired cognitive workload followed by the build-up of large emotional feelings generated by the conflict toward the outcome of the gambling choice. Our results can be used for new investigations aimed at studying the fine spatiotemporal distribution of cortical activity, and the neural circuits that underly the generation of that activity, associated with the behavioral deficits characteristic of ADHD.
Collapse
Affiliation(s)
- Sarah K. Mesrobian
- Neuroheuristic Research Group, University of Lausanne, Lausanne, Switzerland
| | - Alessandro E. P. Villa
- Neuroheuristic Research Group, University of Lausanne, Lausanne, Switzerland
- LABEX, Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| | - Michel Bader
- Research Unit of the University Department of Child and Adolescent Psychiatry (SUPEA), CHUV University Hospital and Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lorenz Götte
- Institute for Applied Microeconomics and Bonn Graduate School of Economics of the University Bonn, Bonn, Germany
| | - Alessandra Lintas
- Neuroheuristic Research Group, University of Lausanne, Lausanne, Switzerland
- LABEX, Faculty of Business and Economics, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
12
|
Cue-dependent inhibition in posttraumatic stress disorder and attention-deficit/hyperactivity disorder. J Anxiety Disord 2017; 51:1-6. [PMID: 28818658 DOI: 10.1016/j.janxdis.2017.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/18/2017] [Accepted: 08/01/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are common among military veterans, but the comorbidity of these two psychiatric disorders remains largely unstudied. Evaluating response inhibition and cue-dependent learning as behavioral and neurocognitive mechanisms underlying ADHD/PTSD can inform etiological models and development of tailored interventions. METHOD A cued go/no-go task evaluated response inhibition in 160 adult males. Participants were recruited from the community and a Veterans Administration medical center. Four diagnostic groups were identified: ADHD-only, PTSD-only, ADHD+PTSD, controls. RESULTS Group differences were observed across most indices of inhibitory functioning, reaction time, and reaction time variability, whereby PTSD-only and ADHD+PTSD participants demonstrated deficits relative to controls. No cue dependency effects were observed. CONCLUSION Finding complement prior work on neurocognitive mechanisms underlying ADHD, PTSD, and ADHD+PTSD. Lack of expected group differences for the ADHD-only group may be due to limited power. Additional work is needed to better characterize distinctions among clinical groups, as well as to test effects among women and youth.
Collapse
|
13
|
Abstract
OBJECTIVE Children with ADHD have heterogeneous behavioral and neuropsychological profiles. The aim of this study was to examine the possible utility of executive function (EF) subtypes within ADHD. METHOD Participants were 357 children aged 6 through 13 with a diagnosis of ADHD. Children completed a brief laboratory battery measuring EF, including response inhibition, response variability, speed, and set-shifting. Children also completed standardized intelligence and achievement testing. RESULTS Two-way cluster analysis of EF profiles of children with ADHD produced a three-cluster solution, labeled poor inhibitory control, poor set-shifting/speed, and intact task performance. Clusters significantly differed in measures of intelligence, academic achievement, and other disruptive behavior and anxiety/mood symptoms. CONCLUSION These findings further support the idea that children with ADHD have heterogeneous EF profiles and suggest that the theory of ADHD should consider these individual differences in EF profiles within the ADHD diagnostic category.
Collapse
Affiliation(s)
| | | | - Joel T. Nigg
- Psychiatry Department, Oregon Health and Sciences University
| |
Collapse
|
14
|
Jarrett MA, Meter AV, Youngstrom EA, Hilton DC, Ollendick TH. Evidence-Based Assessment of ADHD in Youth Using a Receiver Operating Characteristic Approach. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2016; 47:808-820. [PMID: 27775429 DOI: 10.1080/15374416.2016.1225502] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Guidelines exist for the assessment of attention deficit/hyperactivity disorder (ADHD), but they are often unclear as to how a clinician should consider multiple informants, methods, and co-occurring symptoms to reach an overall diagnostic probability for an individual patient. The current study used receiver operating characteristic analyses and evidence-based medicine methods to evaluate the Achenbach System of Empirically Based Assessment measures and the Conners' Continuous Performance Test for ADHD diagnosis in youth. Children (n = 379) and their parent(s) presented at an outpatient clinic for a psychoeducational assessment. Analyses examined the diagnostic efficiency and utility of study measures for predicting a best-estimate ADHD diagnosis. The Child Behavior Checklist Attention Problems construct, Teacher Report Form Attention Problems construct, and Hit Reaction Time Standard Error showed adequate diagnostic efficiency and unique contributions to the prediction of ADHD, Combined Type diagnosis. None of these measures showed good diagnostic efficiency or utility for the prediction of ADHD, Predominantly Inattentive Type. Child anxiety did not moderate the relations between predictors and ADHD diagnosis. Both the Child Behavior Checklist and Teacher Report Form Attention Problems constructs can discriminate youth with ADHD, Combined Type from other clinic-referred youth. Although Hit Reaction Time Standard Error also showed diagnostic utility, the decision to include a computerized measure should consider time and expense and be utilized in cases where diagnostic probability is unclear. Finally, anxiety may be associated with elevated attention problems, but it does not appear that anxiety affects diagnostic cutoffs for ADHD.
Collapse
Affiliation(s)
| | - Anna Van Meter
- b Ferkauf Graduate School of Psychology , Yeshiva University
| | - Eric A Youngstrom
- c Department of Psychology , University of North Carolina at Chapel Hill
| | | | - Thomas H Ollendick
- d Department of Psychology , Virginia Polytechnic Institute and State University
| |
Collapse
|
15
|
Roberts W, Milich R, Fillmore MT. The Effects of Preresponse Cues on Inhibitory Control and Response Time in Adults With ADHD. J Atten Disord 2016; 20:317-24. [PMID: 23881558 PMCID: PMC4026333 DOI: 10.1177/1087054713495737] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of preresponse cues on behavioral control in adults with ADHD. METHOD Eighty-eight adults with ADHD and 67 adults with no history of ADHD completed a cued go/no-go task. This task requires participants to respond or inhibit a response to go and no-go targets, respectively, and preresponse cues provide participants with predictive information about the upcoming target. RESULTS Overall, participants with ADHD made more inhibitory failures and responded more slowly than controls. These group differences were only present in the valid-cue condition, and there were no significant group differences in the invalid-cue conditions. CONCLUSION These findings suggest that adults with ADHD are less able to utilize predictive environmental information to facilitate behavioral control.
Collapse
|
16
|
Ercan ES, Suren S, Bacanlı A, Yazici KU, Callı C, Ozyurt O, Aygunes D, Kosova B, Franco AR, Rohde LA. Decreasing ADHD phenotypic heterogeneity: searching for neurobiological underpinnings of the restrictive inattentive phenotype. Eur Child Adolesc Psychiatry 2016; 25:273-82. [PMID: 26058607 DOI: 10.1007/s00787-015-0731-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 05/30/2015] [Indexed: 11/25/2022]
Abstract
During the process of developing the DSM-5, a new phenotype of ADHD was proposed-the ADHD restrictive inattentive presentation (ADHD-RI), describing subjects with high endorsement of inattentive symptoms and a low level of hyperactivity. However, this phenotype was not included in the DSM-5 because of the lack of robust neurobiological data. We aimed to assess the specific neurobiological underpinnings of individuals presenting ADHD-RI. We compared a sample of 301 subjects (101 ADHD-Combined; 50 ADHD-RI; 50 ADHD predominantly inattentive type and 100 typically developing subjects) aged 8-15 years, using a complete neuropsychological battery, molecular genetic data (DRD4 and DAT1 most studied polymorphisms) and functional MRI during a Go-No/Go task. Subjects with ADHD-RI had a significantly different neuropsychological profile compared with the other groups, including lower psychomotor speeds, longer reaction times and the worst overall performance in the global neurocognitive index. The proportion of subjects with the presence of DRD4-7 repeat allele was significantly higher in ADHD-RI. The fMRI data suggested that more attention-related posterior brain regions (especially temporo-occipital areas) are activated in ADHD-RI during both Go and No-Go cues compared to TD controls and ADHD predominantly inattentive type. ADHD-RI may represent a different phenotype than other types of ADHD. In addition, our results suggest that reducing the phenotypic heterogeneity may aid in the search for the neurobiological underpinnings of ADHD.
Collapse
Affiliation(s)
- Eyup Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey.
| | | | | | - Kemal Utku Yazici
- Child and Adolescent Psychiatry Department, Medical Faculty, Fırat University, Elazig, Turkey
| | - Cem Callı
- Radiology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Onur Ozyurt
- Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey
| | - Duygu Aygunes
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Buket Kosova
- Medical Biology Department, Medical Faculty, Ege University, Izmir, Turkey
| | - Alexandre Rosa Franco
- Brain Institute of Rio Grande do Sul (InsCer), PUCRS, Porto Alegre, Brazil.,School of Engineering, PUCRS, Porto Alegre, Brazil
| | - Luis Augusto Rohde
- Department of Psychiatry, ADHD Outpatient Program, Hospital de Clinicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,National Institute of Developmental Psychiatry for Children and Adolescents, São Paulo, Brazil
| |
Collapse
|
17
|
Araujo Jiménez EA, Jané Ballabriga MC, Bonillo Martin A, Arrufat FJ, Serra Giacobo R. Executive functioning in children and adolescents with symptoms of sluggish cognitive tempo and ADHD. J Atten Disord 2015; 19:507-14. [PMID: 23887861 DOI: 10.1177/1087054713495442] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of this study was to observe whether the independent presence of Sluggish Cognitive Tempo (SCT) directly impacts on the Executive Function (EF), and to determine whether there are deficits in EF that are unique to ADHD predominantly inattentive (ADHD-I) or SCT. METHOD Seventy-six participants aged 6 to 17 years and their parents were assessed using a diagnostic interview, an instrument that assesses the EF, and another instrument that assesses the SCT. Two hierarchical linear regression models were performed. The first one analyzed the independent relationship between SCT and EF, and the second model added the symptomatology of ADHD-I. RESULTS The SCT has a statistically significant direct relation on the EF deficits and remains in the second model even with the inclusion of the ADHD-I. CONCLUSION The SCT and ADHD-I symptoms independently promote executive deficits. Children with ADHD-I symptoms showed deficits in most areas of the EF. Deficits in inhibition and initiative are unique to inattention.
Collapse
|
18
|
Moussa MN, Simpson SL, Mayhugh RE, Grata ME, Burdette JH, Porrino LJ, Laurienti PJ. Long-term moderate alcohol consumption does not exacerbate age-related cognitive decline in healthy, community-dwelling older adults. Front Aging Neurosci 2015; 6:341. [PMID: 25601835 PMCID: PMC4283638 DOI: 10.3389/fnagi.2014.00341] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 12/06/2014] [Indexed: 11/13/2022] Open
Abstract
Recent census data has found that roughly 40% of adults 65 years and older not only consume alcohol but also drink more of it than previous generations. Older drinkers are more vulnerable than younger counterparts to the psychoactive effects of alcohol due to natural biological changes that occur with aging. This study was specifically designed to measure the effect of long-term moderate alcohol consumption on cognitive health in older adult drinkers. An extensive battery of validated tests commonly used in aging and substance use literature was used to measure performance in specific cognitive domains, including working memory and attention. An age (young, old) (*) alcohol consumption (light, moderate) factorial study design was used to evaluate the main effects of age and alcohol consumption on cognitive performance. The focus of the study was then limited to light and moderate older drinkers, and whether or not long-term moderate alcohol consumption exacerbated age-related cognitive decline. No evidence was found to support the idea that long-term moderate alcohol consumption in older adults exacerbates age-related cognitive decline. Findings were specific to healthy community dwelling social drinkers in older age and they should not be generalized to individuals with other consumption patterns, like heavy drinkers, binge drinkers or ex-drinkers.
Collapse
Affiliation(s)
- Malaak N. Moussa
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Neuroscience Program, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Sean L. Simpson
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Biostatistical Sciences, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Rhiannon E. Mayhugh
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Neuroscience Program, Wake Forest School of MedicineWinston-Salem, NC, USA
| | | | - Jonathan H. Burdette
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Linda J. Porrino
- Department of Physiology and Pharmacology, Wake Forest School of MedicineWinston-Salem, NC, USA
| | - Paul J. Laurienti
- Laboratory for Complex Brain Networks, Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
- Department of Radiology, Wake Forest School of MedicineWinston-Salem, NC, USA
| |
Collapse
|
19
|
Nagashima M, Monden Y, Dan I, Dan H, Tsuzuki D, Mizutani T, Kyutoku Y, Gunji Y, Hirano D, Taniguchi T, Shimoizumi H, Momoi MY, Watanabe E, Yamagata T. Acute neuropharmacological effects of atomoxetine on inhibitory control in ADHD children: a fNIRS study. NEUROIMAGE-CLINICAL 2014; 6:192-201. [PMID: 25379431 PMCID: PMC4215398 DOI: 10.1016/j.nicl.2014.09.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 11/28/2022]
Abstract
The object of the current study is to explore the neural substrate for effects of atomoxetine (ATX) on inhibitory control in school-aged children with attention deficit hyperactivity disorder (ADHD) using functional near-infrared spectroscopy (fNIRS). We monitored the oxy-hemoglobin signal changes of sixteen ADHD children (6–14 years old) performing a go/no-go task before and 1.5 h after ATX or placebo administration, in a randomized, double-blind, placebo-controlled, crossover design. Sixteen age- and gender-matched normal controls without ATX administration were also monitored. In the control subjects, the go/no-go task recruited the right inferior and middle prefrontal gyri (IFG/MFG), and this activation was absent in pre-medicated ADHD children. The reduction of right IFG/MFG activation was acutely normalized after ATX administration but not placebo administration in ADHD children. These results are reminiscent of the neuropharmacological effects of methylphenidate to up-regulate reduced right IFG/MFG function in ADHD children during inhibitory tasks. As with methylphenidate, activation in the IFG/MFG could serve as an objective neuro-functional biomarker to indicate the effects of ATX on inhibitory control in ADHD children. This promising technique will enhance early clinical diagnosis and treatment of ADHD in children, especially in those with a hyperactivity/impulsivity phenotype. We assessed the effects of atomoxetine administration to ADHD children using fNIRS. Normal healthy control subjects recruited the right IFG/MFG during go/no-go tasks. Pre-medicated ADHD children exhibited reduced right IFG/MFG activation. The activation was acutely normalized by atomoxetine, but not by placebo. The right IFG/MFG activation may serve as an objective neuro-functional biomarker.
Collapse
Affiliation(s)
| | | | - Ippeita Dan
- Department of Neurosurgery, Shimotsuke, Japan ; Applied Cognitive Neuroscience Laboratory, Chuo University, 1-13-27 Kasuga, Bunkyo, Tokyo 112-8551, Japan
| | - Haruka Dan
- Department of Neurosurgery, Shimotsuke, Japan
| | - Daisuke Tsuzuki
- Applied Cognitive Neuroscience Laboratory, Chuo University, 1-13-27 Kasuga, Bunkyo, Tokyo 112-8551, Japan
| | - Tsutomu Mizutani
- Department of Pediatrics, Shimotsuke, Japan ; Functional Brain Science Laboratory, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan
| | - Yasushi Kyutoku
- Applied Cognitive Neuroscience Laboratory, Chuo University, 1-13-27 Kasuga, Bunkyo, Tokyo 112-8551, Japan
| | - Yuji Gunji
- Department of Pediatrics, Shimotsuke, Japan ; Department of Pediatrics, International University of Health and Welfare, 537-3 Iguchi, Nasushiobara, Tochigi 329-2763, Japan
| | - Daisuke Hirano
- International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, Japan
| | - Takamichi Taniguchi
- International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, Japan
| | - Hideo Shimoizumi
- Rehabilitation Center, International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi 324-8501, Japan
| | - Mariko Y Momoi
- Department of Pediatrics, Shimotsuke, Japan ; International University of Health and Welfare, 2600-1 Kitakanemaru, Otawara, Tochigi, Japan
| | | | | |
Collapse
|
20
|
Mazaheri A, Fassbender C, Coffey-Corina S, Hartanto TA, Schweitzer JB, Mangun GR. Differential oscillatory electroencephalogram between attention-deficit/hyperactivity disorder subtypes and typically developing adolescents. Biol Psychiatry 2014; 76:422-9. [PMID: 24120092 PMCID: PMC3972379 DOI: 10.1016/j.biopsych.2013.08.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 08/15/2013] [Accepted: 08/22/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND A neurobiological-based classification of attention-deficit/hyperactivity disorder (ADHD) subtypes has thus far remained elusive. The aim of this study was to use oscillatory changes in the electroencephalogram (EEG) related to informative cue processing, motor preparation, and top-down control to investigate neurophysiological differences between typically developing (TD) adolescents, and those diagnosed with predominantly inattentive (IA) or combined (CB) (associated with symptoms of inattention as well as impulsivity/hyperactivity) subtypes of ADHD. METHODS The EEG was recorded from 57 rigorously screened adolescents (12 to 17 years of age; 23 TD, 17 IA, and 17 CB), while they performed a cued flanker task. We examined the oscillatory changes in theta (3-5 Hz), alpha (8-12 Hz), and beta (22-25 Hz) EEG bands after cues that informed participants with which hand they would subsequently be required to respond. RESULTS Relative to TD adolescents, the IA group showed significantly less postcue alpha suppression, suggesting diminished processing of the cue in the visual cortex, whereas the CB group showed significantly less beta suppression at the electrode contralateral to the cued response hand, suggesting poor motor planning. Finally, both ADHD subtypes showed weak functional connectivity between frontal theta and posterior alpha, suggesting common top-down control impairment. CONCLUSIONS We found both distinct and common task-related neurophysiological impairments in ADHD subtypes. Our results suggest that task-induced changes in EEG oscillations provide an objective measure, which in conjunction with other sources of information might help distinguish between ADHD subtypes and therefore aid in diagnoses and evaluation of treatment.
Collapse
Affiliation(s)
- Ali Mazaheri
- Academic Medical Center, Department of Psychiatry, University of Amsterdam, The Netherlands.
| | - Catherine Fassbender
- M.I.N.D. Institute, University of California, Davis, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA,Imaging Research Center, University of California, Davis, CA, USA,Center for Mind and Brain, University of California, Davis, CA, USA
| | | | | | - Julie B. Schweitzer
- M.I.N.D. Institute, University of California, Davis, CA, USA,Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - George R. Mangun
- Center for Mind and Brain, University of California, Davis, CA, USA,Department of Psychology, University of California, Davis, CA, USA,Department of Neurology, University of California, Davis, CA, USA
| |
Collapse
|
21
|
Durak S, Ercan ES, Ardic UA, Yuce D, Ercan E, Ipci M. Effect of methylphenidate on neurocognitive test battery: an evaluation according to the diagnostic and statistical manual of mental disorders, fourth edition, subtypes. J Clin Psychopharmacol 2014; 34:467-74. [PMID: 24875071 DOI: 10.1097/jcp.0000000000000128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aims of this study were to evaluate the neuropsychological characteristics of the restrictive (R) subtype according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the attention-deficit/hyperactivity disorder (ADHD) combined (CB) type and predominantly inattentive (PI) type subtypes and to evaluate whether methylphenidate (MPH) affects neurocognitive test battery scores according to these subtypes. This study included 360 children and adolescents (277 boys, 83 girls) between 7 and 15 years of age who had been diagnosed with ADHD and compared the neuropsychological characteristics and MPH treatment responses of patients with the R subtype-which has been suggested for inclusion among the ADHD subtypes in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-with those of patients with the PI and CB subtypes. They did not differ from the control subjects in the complex attention domain, which includes Continuous Performance Test, Stroop test, and Shifting Attention Test, which suggests that the R subtype displayed a lower level of deterioration in these domains compared with the PI and CB subtypes. The patients with the CB and PI subtypes did not differ from the control subjects in the Continuous Performance Test correct response domain, whereas those with the R subtype presented a poorer performance than the control subjects. The R subtype requires a more detailed evaluation because it presented similar results in the remaining neuropsychological evaluations and MPH responses.
Collapse
Affiliation(s)
- Sibel Durak
- From the *Behcet Uz State Hospital and †Department of Child and Adolescent Psychiatry, Ege University Faculty of Medicine, Izmir; ‡Department of Preventive Oncology, Hacettepe University Cancer Institute, Ankara; and §Department of Psychological Counseling and Guidance, Ege University Faculty of Education; ∥Department of Psychology, Ege University Faculty of Literature, Izmir, Turkey
| | | | | | | | | | | |
Collapse
|
22
|
Horschig JM, Zumer JM, Bahramisharif A. Hypothesis-driven methods to augment human cognition by optimizing cortical oscillations. Front Syst Neurosci 2014; 8:119. [PMID: 25018706 PMCID: PMC4072086 DOI: 10.3389/fnsys.2014.00119] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 06/03/2014] [Indexed: 01/08/2023] Open
Abstract
Cortical oscillations have been shown to represent fundamental functions of a working brain, e.g., communication, stimulus binding, error monitoring, and inhibition, and are directly linked to behavior. Recent studies intervening with these oscillations have demonstrated effective modulation of both the oscillations and behavior. In this review, we collect evidence in favor of how hypothesis-driven methods can be used to augment cognition by optimizing cortical oscillations. We elaborate their potential usefulness for three target groups: healthy elderly, patients with attention deficit/hyperactivity disorder, and healthy young adults. We discuss the relevance of neuronal oscillations in each group and show how each of them can benefit from the manipulation of functionally-related oscillations. Further, we describe methods for manipulation of neuronal oscillations including direct brain stimulation as well as indirect task alterations. We also discuss practical considerations about the proposed techniques. In conclusion, we propose that insights from neuroscience should guide techniques to augment human cognition, which in turn can provide a better understanding of how the human brain works.
Collapse
Affiliation(s)
- Jörn M. Horschig
- Radboud University Nijmegen, Donders Institute for Brain, Behaviour and CognitionNijmegen, Netherlands
| | - Johanna M. Zumer
- Radboud University Nijmegen, Donders Institute for Brain, Behaviour and CognitionNijmegen, Netherlands
- School of Psychology, University of BirminghamBirmingham, UK
| | - Ali Bahramisharif
- Radboud University Nijmegen, Donders Institute for Brain, Behaviour and CognitionNijmegen, Netherlands
| |
Collapse
|
23
|
Dovis S, Van der Oord S, Wiers RW, Prins PJM. ADHD Subtype Differences in Reinforcement Sensitivity and Visuospatial Working Memory. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2014; 44:859-74. [PMID: 24766106 DOI: 10.1080/15374416.2014.895940] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Both cognitive and motivational deficits are thought to give rise to the problems in the combined (ADHD-C) and inattentive subtype (ADHD-I) of attention-deficit hyperactivity disorder (ADHD). In both subtypes one of the most prominent cognitive weaknesses appears to be in visuospatial working memory (WM), which is composed of short-term memory (STM) and a central executive (CE). In children with ADHD-C, both STM and the CE seem impaired, and together with motivational impairments, give rise to their deficits in visuospatial WM. In children with ADHD-I, no studies investigated these WM components and their interplay with motivational impairments. Effects of a standard (feedback only) and a high level of reinforcement (feedback + 10 euros) on visuospatial WM-, STM-, and CE performance were examined in 27 children with ADHD-I (restrictive-subtype), 70 children with ADHD-C, and 40 typically developing controls (aged 9-12). In both ADHD-subtypes CE and WM performance was worse than in controls. STM performance of children with ADHD-I was, in contrast to that of children with ADHD-C, not different from controls. STM and WM performance was worse in ADHD-C than in ADHD-I, whereas CE-related performance did not differ. High reinforcement improved STM and WM performance in both subtypes but not in controls. This improvement was equally pronounced in both subtypes. High reinforcement did not improve CE-related performance. Both subtypes have equally pronounced motivational deficits, which have detrimental effects on their visuospatial STM and WM performance. In contrast to children with ADHD-C, children with ADHD-I seem unimpaired on visuospatial STM; only an impaired CE and motivational impairments give rise to their deficits in visuospatial WM.
Collapse
Affiliation(s)
- Sebastiaan Dovis
- a Department of Developmental Psychology , University of Amsterdam
| | | | | | | |
Collapse
|
24
|
Atomoxetine response in the inattentive and combined subtypes of attention deficit hyperactivity disorder: a retrospective chart review. ACTA ACUST UNITED AC 2013; 5:377-85. [PMID: 23737214 DOI: 10.1007/s12402-013-0111-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Accepted: 05/23/2013] [Indexed: 10/26/2022]
Abstract
The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 1994, American Psychiatric Association) describes attention deficit hyperactivity disorder (ADHD) as a heterogeneous disorder; providing diagnostic criteria for three subtypes: hyperactive/impulsive (ADHD/HI), inattentive (ADHD/I), and combined type (ADHD/C). Differences among the subtypes are well defined, but there may be also differences in terms of treatment responses. The aim of this study is to assess the responses of ADHD/I and ADHD/C to atomoxetine treatment. The medical records of the January-June 2012 term, first time referrals to outpatient clinic, were reviewed, and 37 ADHD diagnosed primary school age children (18 ADHD/I, 19 ADHD/C) that were treated with atomoxetine were determined. Thirty-five of them who completed 8 weeks of treatment duration were recruited for the study. The children with an ADHD medication use history in 2 months time prior to onset of treatment and/or the children receiving additional psychopharmacologic treatment to atomoxetine were excluded. Baseline and eighth week assessment, records were evaluated. Efficacy assessments included Turgay DSM-IV ADHD Screening and Rating Scale parent and teacher forms (T-DSM-IV) and Clinical Global Impression Scale-Severity and Improvement subscales. Safety assessments included laboratory and body weight assessments, ECG, heart rate, and blood pressure evaluations (baseline and eighth week) along a scale filled by the parents at the eighth week to review side effects. Atomoxetine was found to be effective in both ADHD/I and ADHD/C groups. Atomoxetine also decreased the opposition defiance subscale scores of T-DSM-IV (both parent and teacher forms), whereas it was not found to make statistically significant difference in the conduct disorder subscale scores. Mean difference in 8-week time in T-DSM-IV hyperactivity subscale and total scores of parent and teacher forms; inattention subscale scores of only parent forms and the CGI- severity subscale scores; differed significantly among the ADHD/I and ADHD/C groups; that ADHD/C types responded better to medication. Results of this study revealed that atomoxetine is effective both in ADHD/I and ADHD/C subtypes. ADHD/C types may be responding better to atomoxetine treatment than the ADHD/I subtypes.
Collapse
|
25
|
Cao J, Wang S, Ren Y, Zhang Y, Cai J, Tu W, Shen H, Dong X, Xia Y. Interference control in 6–11 year‐old children with and without ADHD: behavioral and ERP study. Int J Dev Neurosci 2013; 31:342-9. [DOI: 10.1016/j.ijdevneu.2013.04.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2012] [Revised: 04/10/2013] [Accepted: 04/26/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- Jian Cao
- The Third Affiliated Hospital of SoochowChangzhouChina
- The Fourth Centeral Hospital of Tian JinTianjinChina
| | - Suhong Wang
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Yanling Ren
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Yili Zhang
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Jing Cai
- The Third Affiliated Hospital of SoochowChangzhouChina
| | - Wenjuan Tu
- The Children Hospital of ChangzhouChangzhouChina
| | - Huijuan Shen
- The Children Hospital of ChangzhouChangzhouChina
| | - Xuan Dong
- The Children Hospital of ChangzhouChangzhouChina
| | - Ying Xia
- The University of Texas Medical School at HoustonTXUSA
| |
Collapse
|
26
|
Barkley RA. Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012; 42:161-73. [PMID: 23094604 DOI: 10.1080/15374416.2012.734259] [Citation(s) in RCA: 215] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Controversy continues as to whether sluggish cognitive tempo (SCT) is a subtype of attention-deficit/hyperactivity disorder (ADHD) or a distinct disorder. This study examined differences between these disorders in demographics, executive functioning (EF), impairment, and prior professional diagnoses to address the issue. There were 1,800 children 6 to 17 years of age of both sexes from various U.S. ethnic backgrounds who were divided into four groups: (a) high SCT but not ADHD (N = 41), (b) high ADHD but not SCT (N = 95), (c) high in both SCT and ADHD (N = 61), and (d) the control group (N = 1,603). Besides providing demographics, parents completed scales assessing ADHD and SCT symptoms, EF deficits, and psychosocial impairment and reported their child's history of professional diagnoses. SCT symptoms formed two distinct but interrelated factors separate from those for ADHD. SCT differed from ADHD in demographics (age, sex ratio, parental education, income). ADHD was associated with more severe and pervasive EF deficits than SCT, whereas SCT was chiefly associated with mild deficits in Self-Organization. ADHD contributed far more variance to EF deficits than did SCT. Both disorders were impairing, but ADHD was more severely and pervasively so than SCT, especially in Home-School domains; SCT was most impairing in Community-Leisure domains. Different patterns of comorbidity were evident between SCT and ADHD. SCT showed less comorbidity and was particularly associated with depression. SCT may comprise a distinct disorder from ADHD but both may coexist in 39% to 59% of cases each.
Collapse
Affiliation(s)
- Russell A Barkley
- Department of Psychiatry, Medical University of South Carolina, Mt. Pleasant, SC 29466, USA.
| |
Collapse
|
27
|
Right prefrontal activation as a neuro-functional biomarker for monitoring acute effects of methylphenidate in ADHD children: An fNIRS study. NEUROIMAGE-CLINICAL 2012; 1:131-40. [PMID: 24179746 PMCID: PMC3757725 DOI: 10.1016/j.nicl.2012.10.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 10/01/2012] [Accepted: 10/03/2012] [Indexed: 12/04/2022]
Abstract
An objective biomarker is a compelling need for the early diagnosis of attention deficit hyperactivity disorder (ADHD), as well as for the monitoring of pharmacological treatment effectiveness. The advent of fNIRS, which is relatively robust to the body movements of ADHD children, raised the possibility of introducing functional neuroimaging diagnosis in younger ADHD children. Using fNIRS, we monitored the oxy-hemoglobin signal changes of 16 ADHD children (6 to 13 years old) performing a go/no-go task before and 1.5 h after MPH or placebo administration, in a randomized, double-blind, placebo-controlled, crossover design. 16 age- and gender-matched normal controls without MPH administration were also monitored. Relative to control subjects, unmedicated ADHD children exhibited reduced activation in the right inferior frontal gyrus (IFG) and middle frontal gyrus (MFG) during go/no-go tasks. The reduced right IFG/MFG activation was acutely normalized after MPH administration, but not after placebo administration. The MPH-induced right IFG/MFG activation was significantly larger than the placebo-induced activation. Post-scan exclusion rate was 0% among 16 right-handed ADHD children with IQ > 70. We revealed that the right IFG/MFG activation could serve as a neuro-functional biomarker for monitoring the acute effects of methylphenidate in ADHD children. fNIRS-based examinations were applicable to ADHD children as young as 6 years old, and thus would contribute to early clinical diagnosis and treatment of ADHD children.
Collapse
|
28
|
Smith LC, Tamm L, Hughes CW, Bernstein IH. Separate and overlapping relationships of inattention and hyperactivity/impulsivity in children and adolescents with attention-deficit/hyperactivity disorder. ACTA ACUST UNITED AC 2012; 5:9-20. [PMID: 22996914 DOI: 10.1007/s12402-012-0091-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Accepted: 08/30/2012] [Indexed: 11/24/2022]
Abstract
There is debate regarding the dimensional versus categorical nature of attention-deficit/hyperactivity disorder (ADHD). This study utilized confirmatory factor analysis to examine this issue. ADHD symptoms rated on interviews and rating scales from a large sample of individuals (ages 3-17, 74 % male, 75 % Caucasian) with ADHD were examined (n = 242). Four potential factor structures were tested to replicate prior findings in a sample with a wide age range and included only participants who met DSM-IV-TR diagnostic criteria for ADHD. Correlations with executive function measures were performed to further assess the separability and validity of the derived factors. The data support a bifactor model with a general ADHD factor and two specific factors, inattention and hyperactivity/impulsivity. Importantly, the individual factors were also differentially correlated with executive functioning measures. This study adds to a growing literature suggesting both a general component to ADHD, as well as dimensional traits of inattention and hyperactivity/impulsivity, associated with distinct executive functioning profiles. The presence of a general underlying factor contraindicates separating the inattentive and combined subtypes of ADHD into distinct disorders.
Collapse
Affiliation(s)
- Lauren C Smith
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX 75390-8589, USA
| | | | | | | |
Collapse
|
29
|
Meinzer MC, Pettit JW, Leventhal AM, Hill RM. Explaining the covariance between attention-deficit hyperactivity disorder symptoms and depressive symptoms: the role of hedonic responsivity. J Clin Psychol 2012; 68:1111-21. [PMID: 22777931 DOI: 10.1002/jclp.21884] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to examine low hedonic responsivity, a facet of hedonic capacity, as a potential explanatory variable in the relationship between attention deficit/hyperactivity disorder (ADHD) symptoms and depressive symptoms. METHOD One hundred ninety-eight undergraduate students (mean age = 21.3, standard deviation = 4.6; 59.6% women) from a large, public university completed self-report measures for this cross-sectional study. RESULTS Results indicated that ADHD symptoms were significantly associated with depressive symptoms, and that low hedonic responsivity partially accounted for this association. This effect was statistically significant for total ADHD symptoms and inattentive symptoms, but not for hyperactive-impulsive symptoms. CONCLUSIONS Findings are consistent with the possibility that impaired hedonic responsiveness may be a common endophenotype for depression and the inattentive symptoms of ADHD. Implications for future research and clinical work are discussed.
Collapse
Affiliation(s)
- Michael C Meinzer
- Department of Psychology, Florida International University, Miami, FL 33199, USA.
| | | | | | | |
Collapse
|
30
|
Bernfeld J. ADHD and Factor Analysis: Are There Really Three Distinct Subtypes of ADHD? APPLIED NEUROPSYCHOLOGY-CHILD 2012; 1:100-4. [DOI: 10.1080/21622965.2012.699421] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
31
|
Frick PJ, Nigg JT. Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annu Rev Clin Psychol 2011; 8:77-107. [PMID: 22035245 PMCID: PMC4318653 DOI: 10.1146/annurev-clinpsy-032511-143150] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This review evaluates the diagnostic criteria for three of the most common disorders for which children and adolescents are referred for mental health treatment: attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Although research supports the validity and clinical utility of these disorders, several issues are highlighted that could enhance the current diagnostic criteria. For ADHD, defining the core features of the disorder and its fit with other disorders, enhancing the validity of the criteria through the lifespan, considering alternative ways to form subtypes of the disorder, and modifying the age-of-onset criterion are discussed relative to the current diagnostic criteria. For ODD, eliminating the exclusionary criteria of CD, recognizing important symptom domains within the disorder, and using the cross-situational pervasiveness of the disorder as an index of severity are highlighted as important issues for improving classification. Finally, for CD, enhancing the current subtypes related to age of onset and integrating callous-unemotional traits into the diagnostic criteria are identified as key issues for improving classification.
Collapse
Affiliation(s)
- Paul J Frick
- Department of Psychology, University of New Orleans, New Orleans, Louisiana 70148, USA.
| | | |
Collapse
|
32
|
Bauermeister JJ, Barkley RA, Bauermeister JA, Martínez JV, McBurnett K. Validity of the Sluggish Cognitive Tempo, Inattention, and Hyperactivity Symptom Dimensions: Neuropsychological and Psychosocial Correlates. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 40:683-97. [PMID: 22179974 DOI: 10.1007/s10802-011-9602-7] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
33
|
Hepler J, Albarracin D, McCulloch KC, Noguchi K. Being Active and Impulsive: The Role of Goals for Action and Inaction in Self-Control. MOTIVATION AND EMOTION 2011; 36:416-424. [PMID: 23766548 DOI: 10.1007/s11031-011-9263-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Although self-control often requires behavioral inaction (i.e., not eating a piece of cake), the process of inhibiting impulsive behavior is commonly characterized as cognitively active (i.e., actively exerting self-control). Two experiments examined whether motivation for action or inaction facilitates self-control behavior in the presence of tempting stimuli. Experiment 1 used a delay discounting task to assess the ability to delay gratification with respect to money. Experiment 2 used a Go/No-Go task to assess the ability to inhibit a dominant but incorrect motor response to the words "condom" and "sex". The results demonstrate that goals for inaction promote self-control, whereas goals for action promote impulsive behavior. These findings are discussed in light of recent evidence suggesting that goals for action and inaction modulate physiological resources that promote behavioral execution.
Collapse
|
34
|
Adams ZW, Roberts WM, Milich R, Fillmore MT. Does response variability predict distractibility among adults with attention-deficit/hyperactivity disorder? Psychol Assess 2011; 23:427-36. [PMID: 21443365 DOI: 10.1037/a0022112] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Increased intraindividual variability in response time (RTSD) has been observed reliably in attention-deficit/hyperactivity disorder (ADHD) and has often been used as a measure of inattention. RTSD is assumed to reflect attentional lapses and distractibility, though evidence for the validity of this connection is lacking. We assessed whether RTSD is an indicator of inattention by comparing RTSD on the stop-signal task (SST) with performance on the delayed oculomotor response (DOR) task, a measure of distractibility. Participants included 30 adults with ADHD and 28 controls. Participants completed the SST and the DOR task, which measured subjects' ability to maintain attention and avoid distraction by inhibiting reflexive saccades toward distractors. On the SST, the ADHD group was slower to inhibit than were controls, indicating poorer inhibitory control in ADHD. The ADHD group also displayed slower reaction times (RTs), greater RTSD, and more omission errors. On the DOR task, the ADHD group displayed more premature saccades (i.e., greater distractibility) than did controls. Greater variability in RT was associated with increased distraction on the DOR task, but only in ADHD participants. Results suggest that RTSD is linked to distractibility among adults with ADHD and support the use of RTSD as a valid measure of inattention in ADHD.
Collapse
Affiliation(s)
- Zachary W Adams
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506-0044, USA.
| | | | | | | |
Collapse
|
35
|
Kooistra L, Crawford S, Gibbard B, Kaplan BJ, Fan J. Comparing Attentional Networks in fetal alcohol spectrum disorder and the inattentive and combined subtypes of attention deficit hyperactivity disorder. Dev Neuropsychol 2011; 36:566-77. [PMID: 21667361 DOI: 10.1080/87565641.2010.549978] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Attention Network Test (ANT) was used to examine alerting, orienting, and executive control in fetal alcohol spectrum disorder (FASD) versus attention deficit hyperactivity disorder (ADHD). Participants were 113 children aged 7 to 10 years (31 ADHD-Combined, 16 ADHD-Primarily Inattentive, 28 FASD, 38 controls). Incongruent flanker trials triggered slower responses in both the ADHD-Combined and the FASD groups. Abnormal conflict scores in these same two groups provided additional evidence for the presence of executive function deficits. The ADHD-Primarily Inattentive group was indistinguishable from the controls on all three ANT indices, which highlights the possibility that this group constitutes a pathologically distinct entity.
Collapse
|
36
|
Tamm L, Adinoff B, Nakonezny PA, Winhusen T, Riggs P. Attention-deficit/hyperactivity disorder subtypes in adolescents with comorbid substance-use disorder. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2011; 38:93-100. [PMID: 21834613 DOI: 10.3109/00952990.2011.600395] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Little is known about the relationship between attention-deficit/hyperactivity disorder (ADHD) subtypes and substance-use disorder (SUD). As there is literature suggesting different subtype phenotypes, there may be subtype differences in regard to the risk for developing SUD and substance treatment response. OBJECTIVES To characterize the sample in a Clinical Trials Network (CTN) study according to ADHD subtypes and baseline psychosocial and substance-use characteristics and to compare subtypes on response to treatment. METHODS Secondary analyses on data collected from adolescents (n = 276) diagnosed with ADHD and SUD (non-nicotine) and treated with stimulant medication or placebo and cognitive behavioral therapy (CBT) for substance use. Participants were characterized as inattentive or combined ADHD subtype and compared on baseline characteristics and treatment outcome. RESULTS The combined subtype presented with more severe SUDs and higher rates of conduct disorder. There were a greater proportion of boys with inattentive subtype. The inattentive subtype appeared less ready for treatment (greater University of Rhode Island Change Assessment precontemplation scores) with poorer coping skills (poorer problem-solving and abstinence focused coping) at baseline. However, the two subtypes responded equally to treatment even after controlling for baseline differences. CONCLUSIONS Findings from this large community sample indicate that there were no subtype differences in treatment response, although there were differences in terms of substance use, antisocial behavior, readiness for treatment, and gender prior to treatment. SCIENTIFIC SIGNIFICANCE This study is the first to report on subtype differences for treatment response for non-nicotine SUD in a comorbid ADHD-SUD population. Despite some baseline differences, both subtypes responded equally to treatment, suggesting limited relevance for subtype designation on treatment planning.
Collapse
Affiliation(s)
- Leanne Tamm
- Department of Pediatrics, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, OH 45229-3039, USA.
| | | | | | | | | |
Collapse
|
37
|
Roberts W, Fillmore MT, Milich R. Separating automatic and intentional inhibitory mechanisms of attention in adults with attention-deficit/hyperactivity disorder. JOURNAL OF ABNORMAL PSYCHOLOGY 2011; 120:223-33. [PMID: 21058752 DOI: 10.1037/a0021408] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Researchers in the cognitive sciences recognize a fundamental distinction between automatic and intentional mechanisms of inhibitory control. The use of eye-tracking tasks to assess selective attention has led to a better understanding of this distinction in specific populations, such as children with attention-deficit/hyperactivity disorder (ADHD). This study examined automatic and intentional inhibitory control mechanisms in adults with ADHD using a saccadic interference task and a delayed ocular response task. Thirty adults with ADHD were evaluated against 27 comparison adults on measures of inhibitory control. The delayed ocular response task showed that adults with ADHD were less able than comparison adults to inhibit a reflexive saccade toward the sudden appearance of a stimulus in the periphery. However, saccadic interference task performance showed that the ADHD group did not differ significantly from the comparison group on a measure of automatic inhibitory control. These findings suggest a dissociation between automatic and intentional inhibitory deficits in adults with ADHD.
Collapse
Affiliation(s)
- Walter Roberts
- Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA
| | | | | |
Collapse
|
38
|
Skirbekk B, Hansen BH, Oerbeck B, Kristensen H. The Relationship Between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 39:513-25. [PMID: 21331639 DOI: 10.1007/s10802-011-9488-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Benedicte Skirbekk
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Nydalen, Oslo, Norway.
| | | | | | | |
Collapse
|
39
|
Adams ZW, Milich R, Fillmore MT. Examining manual and visual response inhibition among ADHD subtypes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2011; 38:971-83. [PMID: 20449644 DOI: 10.1007/s10802-010-9420-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study compared inhibitory functioning among ADHD subtype groups on manual and visual versions of the stop task. Seventy-six children, identified as ADHD/I (n=17), ADHD/C (n=43), and comparison (n=20) completed both tasks. Results indicated that both ADHD groups were slower to inhibit responses than the comparison group on both tasks. Comparison children were faster to inhibit than activate responses on both tasks. Children in the ADHD groups also demonstrated this robust pattern on the manual task. However, on the visual task, the ADHD groups evidenced slowed inhibition comparable to the time required to activate responding. This implies that the visual task is more sensitive than the manual task to inhibitory deficits associated with ADHD. The ADHD/I and the ADHD/C groups did not differ on most measures, suggesting that neither stop task is effective in differentiating the subtypes. These findings extend work highlighting the role of disinhibition in ADHD, and contrast recent work suggesting divergence between ADHD subtypes.
Collapse
Affiliation(s)
- Zachary W Adams
- Department of Psychology, University of Kentucky, 202A Kastle Hall, Lexington, KY 40506-0044, USA
| | | | | |
Collapse
|
40
|
Weafer J, Milich R, Fillmore MT. Behavioral components of impulsivity predict alcohol consumption in adults with ADHD and healthy controls. Drug Alcohol Depend 2011; 113:139-46. [PMID: 20863628 PMCID: PMC3010339 DOI: 10.1016/j.drugalcdep.2010.07.027] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 07/09/2010] [Accepted: 07/09/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND The degree to which distinct behavioral components of impulsivity predict alcohol consumption is as yet not well-understood. Further, the possibility that this relation might be more pronounced in groups characterized by heightened impulsivity (i.e., individuals with ADHD) has not been tested. METHODS The current study examined the degree to which three specific behavioral components of impulsivity (i.e., poor response inhibition, poor attentional inhibition, and increased risk-taking) were associated with quantity and frequency of alcohol consumption in a group of young adult social drinkers with ADHD (n = 33) and in a comparison control group (n = 21). Participants performed the delayed ocular return task (attentional inhibition), the cued go/no-go task (behavioral inhibition), and the balloon analogue risk task (risk-taking). RESULTS Both poor behavioral inhibition and greater risk-taking were related to greater quantity of consumption in the entire sample, whereas poor attentional inhibition was related to greater quantity specifically among those with ADHD. By contrast, only risk-taking was associated with frequency of consumption, and this was found specifically in the control group. CONCLUSIONS These findings provide important information regarding the potential role of distinct behavioral components of impulsivity in drinking behavior, and highlight unique relevance of attentional impairments to drinking behavior in those with ADHD.
Collapse
|
41
|
Rucklidge J, Taylor M, Whitehead K. Effect of micronutrients on behavior and mood in adults With ADHD: evidence from an 8-week open label trial with natural extension. J Atten Disord 2011; 15:79-91. [PMID: 20071638 DOI: 10.1177/1087054709356173] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To investigate the effect of a 36-ingredient micronutrient formula consisting mainly of minerals and vitamins in the treatment of adults with both ADHD and severe mood dysregulation (SMD). METHOD 14 medication-free adults (9 men, 5 women; 18-55 years) with ADHD and SMD completed an 8-week open-label trial. RESULTS A minority reported transitory mild side effects. Significant improvements were noted across informants (self, observer, clinician) on measures of inattention and hyperactivity/impulsivity, mood, quality of life, anxiety, and stress all with medium to very large effect sizes (all ps < .01); however, the mean of inattention remained in a clinical range whereas the means on measures of mood and hyperactivity/impulsivity were normalized. Follow-up data showed maintenance of changes or further improvement for those who stayed on the micronutrients. CONCLUSIONS Although this study, as an open trial, does not in itself prove efficacy, it provides preliminary evidence supporting the need for a randomized clinical trial of micronutrients as treatment for the more complex presentations of ADHD.
Collapse
Affiliation(s)
- Julia Rucklidge
- Department of Psychology, University of Canterbury, Christchurch, New Zealand.
| | | | | |
Collapse
|
42
|
Semrud-Clikeman M. The role of inattention and social perception and performance in two subtypes of ADHD. Arch Clin Neuropsychol 2010; 25:771-80. [PMID: 20926493 DOI: 10.1093/arclin/acq074] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study evaluated the social perception and social functioning of children with Attention Deficit Hyperactivity Disorder-Combined (ADHD-C), ADHD-predominately inattentive (ADHD-PI), and controls. Two-hundred and seventy children with ADHD-C, ADHD-PI, or controls were evaluated using direct and indirect measures of social functioning. The ADHD-C and ADHD-PI groups showed significant differences in interpretation of emotional and nonverbal cues on a direct measure of social perception compared with controls. The number of inattentive symptoms was significantly related to poor performance for interpretation of both emotional and nonverbal cues, whereas hyperactivity and impulsivity symptoms showed a less robust relation. Children with ADHD-C were rated by parents and teachers as showing significant problems with social performance and problem behaviors compared with those with ADHD-PI or with controls. These findings show a link between inattention and social perception that is separate from impulsivity difficulties. These findings have important implications for treatment.
Collapse
|
43
|
Smith TF. Meta-analysis of the heterogeneity in association of DRD4 7-repeat allele and AD/HD: stronger association with AD/HD combined type. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:1189-99. [PMID: 20468072 DOI: 10.1002/ajmg.b.31090] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The purpose of this meta-analysis was to examine whether association studies between attention deficit/hyperactivity disorder (AD/HD) and the dopamine receptor 4 gene 7-repeat (DRD4 7R) allele vary systematically based on study characteristics. A total of 27 empirical studies with 28 distinct samples using either case-control or family-based association analyses were included. Consistent with previous meta-analytic work [Gizer et al. (2009), Hum Genet 126:51-90], the DRD4 7R allele was associated with AD/HD across studies (OR = 1.33; 95% CI = 1.16-1.53, z = 4.04, P = 0.00005) and there was significant systematic variability among studies (Q = 54.24; P = 0.001; I(2) = 50.22). To account for the variability among studies, sample and study level covariates were examined. No differences in overall effect size emerged between family-based and case-control studies. However, the risk allele frequency in the control population accounted for a significant portion of the variance in overall effect size within case-control studies. In addition, evidence for the association between the DRD4 7R allele and distinct AD/HD subtypes emerged across family-based and case-control studies. The proportion of AD/HD, combined type individuals within the AD/HD sample was associated with a significant increase in the magnitude of association between the DRD4 7R allele and AD/HD. Conversely, an increase in the proportion of AD/HD, predominantly inattentive type individuals within the AD/HD sample was associated with a decrease in study effect size. Implications regarding AD/HD etiological and phenotypic heterogeneity are discussed.
Collapse
Affiliation(s)
- Taylor F Smith
- Department of Psychology, University of North Carolina at Greensboro, 1100 W. Market Street, Greensboro, NC 27402, USA.
| |
Collapse
|
44
|
Goth-Owens TL, Martinez-Torteya C, Martel MM, Nigg JT. Processing speed weakness in children and adolescents with non-hyperactive but inattentive ADHD (ADD). Child Neuropsychol 2010; 16:577-91. [PMID: 20560083 DOI: 10.1080/09297049.2010.485126] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
DSM-IV-TR defines ADHD-Predominantly Inattentive as allowing up to five symptoms of hyperactivity/impulsivity, while theories of the inattentive type usually assume a group that is hypoactive and characterized by processing speed and cognitive interference deficits. In a community-recruited sample of 572 children and adolescents, a pure inattentive subtype of ADHD (ADD) was defined as those who met DSM-IV-TR criteria for ADHD-PI but had two or fewer hyperactive/impulsive symptoms. Processing and output speeds of those with ADD were compared to those identified with DSM-IV-TR ADHD combined type and non-ADHD controls. These results were then contrasted with those found when DSM-IV-TR defined ADHD-PI was compared with ADHD-C and controls. Processing and output speed were assessed with the Trailmaking A and B and the Stroop Naming Tests. Cognitive interference control was assessed with the interference score from the Stroop Task. Slower cognitive interference speed was found in the ADD vs. ADHD-C and controls comparisons, but not the ADHD-PI versus ADHD-C and controls comparisons. On output speed measures, ADD exhibited the slowest performance, significantly different from controls and the effect size for the set-shifting speed contrast (Trailmaking B) was double that of the ADHD-PI vs. control comparison. ADHD-Inattentive type as defined by the DSM-IV-TR is a heterogeneous condition with a meaningful proportion of those affected exhibiting virtually no hyperactive/impulsive symptoms. This subgroup may represent a distinct inattentive condition characterized by poor cognitive interference control and slow processing or output speed.
Collapse
|
45
|
Adams ZW, Milich R, Fillmore MT. A Case for the Return of Attention-Deficit Disorder in DSM-5. ACTA ACUST UNITED AC 2010. [DOI: 10.1521/adhd.2010.18.3.1] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
46
|
Carr L, Henderson J, Nigg JT. Cognitive control and attentional selection in adolescents with ADHD versus ADD. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2010; 39:726-40. [PMID: 21058121 PMCID: PMC3059559 DOI: 10.1080/15374416.2010.517168] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
An important research question is whether Attention Deficit Hyperactivity Disorder (ADHD) is related to early- or late-stage attentional control mechanisms and whether this differentiates a nonhyperactive subtype (ADD). This question was addressed in a sample of 145 ADD/ADHD and typically developing comparison adolescents (aged 13-17). Attentional blink and antisaccade tasks were used to assay early- and late-stage control, respectively. ADD was defined using normative cutoffs to ensure low activity level in children who otherwise met full criteria for ADHD. The ADD group had an attenuated attentional blink versus controls and ADHD-combined. The effect was not produced using DSM--IV definition of ADHD-primarily inattentive type or DSM symptom counts. ADHD-combined showed greater weakness in response inhibition, as manifest in the antisaccade task. Combining tasks yielded an interaction differentiating group performance on the two tasks.
Collapse
Affiliation(s)
- Laurie Carr
- Department of Psychology, Michigan State University, USA.
| | | | | |
Collapse
|
47
|
Miller DJ, Derefinko KJ, Lynam DR, Milich R, Fillmore MT. Impulsivity and Attention Deficit-Hyperactivity Disorder: Subtype Classification Using the UPPS Impulsive Behavior Scale. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2009; 32:323-332. [PMID: 21765593 DOI: 10.1007/s10862-009-9155-z] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This study examined the classification accuracy of the UPPS Impulsive Behavior Scale (UPPS) in discriminating several attention deficit/hyperactivity disorder (ADHD) subtypes, including predominantly inattentive type (ADHD/I), combined type (ADHD/C), and combined type with behavioral problems (ADHD/ODD), between each other and a non-ADHD control group using logistic regression analyses. The sample consisted of 88 children ranging in age from 9.0 years to 12.8 years, with a mean of 10.9 years. Children were predominantly male (74%) and Caucasian (86%) and in grades 3-7. Results indicated that the UPPS performed well in classifying ADHD subtypes relative to traditional diagnostic measures. In addition, analyses indicated that differences in symptoms between subtypes can be explained by specific pathways to impulsivity. Implications for the assessment of ADHD and conceptual issues are discussed.
Collapse
Affiliation(s)
- Drew J Miller
- Department of Psychological Sciences, Purdue University, West Lafayette, IN 47907, USA
| | | | | | | | | |
Collapse
|
48
|
Weafer J, Fillmore MT, Milich R. Increased sensitivity to the disinhibiting effects of alcohol in adults with ADHD. Exp Clin Psychopharmacol 2009; 17:113-21. [PMID: 19331488 PMCID: PMC2787090 DOI: 10.1037/a0015418] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The acute impairing effects of alcohol on inhibitory control have been well documented in healthy drinkers. By contrast, little is known about alcohol effects in individuals with disorders characterized by poor impulse control, such as those with attention-deficit/hyperactivity disorder (ADHD). Alcohol could produce greater inhibitory impairment in these individuals. The present study tested this hypothesis in adults with ADHD (n=10) and controls (n=12) using the cued go/no-go task. The task requires quick responses to go targets and suppression of responses to no-go targets following the presentation of cues. Prior research on healthy adults has shown that valid cues can protect against alcohol impairment (Marczinski & Fillmore, 2003). Performance was tested under 3 doses of alcohol: 0.65 g/kg, 0.45 g/kg, and 0.0 g/kg (placebo). Alcohol dose-dependently increased inhibitory failures in controls in the invalid, but not the valid, cue condition. By contrast, those with ADHD displayed significant alcohol impairment regardless of cue condition. Thus, unlike controls, valid cues offered little protection from the disinhibiting effects of alcohol in drinkers with ADHD, suggesting an increased sensitivity to alcohol impairment of inhibitory control.
Collapse
Affiliation(s)
- Jessica Weafer
- Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA
| | | | | |
Collapse
|
49
|
Adams ZW, Derefinko KJ, Milich R, Fillmore MT. Inhibitory functioning across ADHD subtypes: recent findings, clinical implications, and future directions. ACTA ACUST UNITED AC 2009; 14:268-75. [PMID: 19072751 DOI: 10.1002/ddrr.37] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Although growing consensus supports the role of deficient behavioral inhibition as a central feature of the combined subtype of ADHD (ADHD/C; Barkley 1997 Psychol Bull 121:65-94; Nigg 2001 Psychol Bull 127:571-598), little research has focused on how this finding generalizes to the primarily inattentive subtype (ADHD/I). This question holds particular relevance in light of recent work suggesting that ADHD/I might be better characterized as a disorder separate from ADHD/C (Diamond 2005 Dev Psychopathol 17:807-825; Milich et al. 2001 Clin Psychol Sci Pract 8:463-488). This article describes major findings in the area of inhibitory performance in ADHD and highlights recent research suggesting important areas of divergence between the subtypes. In particular, preliminary findings point to potential differences between the subtypes with respect to how children process important contextual information from the environment, such as preparatory cues that precede responses and rewarding or punishing feedback following behavior. These suggestive findings are discussed in the context of treatment implications, which could involve differential intervention approaches for each subtype targeted to the specific deficit profiles that characterize each group of children. Future research avenues aimed toward building a sound theoretical model of ADHD/I and a better understanding of its relation to ADHD/C are also presented. Specifically, investigators are encouraged to continue studying the complex interplay between inhibitory and attentional processes, as this area seems particularly promising in its ability to improve our understanding of the potentially distinct pathologies underlying the ADHD subtypes.
Collapse
Affiliation(s)
- Zachary W Adams
- Department of Psychology, University of Kentucky, Lexington, Kentucky 40506-0044, USA
| | | | | | | |
Collapse
|
50
|
Vaurio RG, Simmonds DJ, Mostofsky SH. Increased intra-individual reaction time variability in attention-deficit/hyperactivity disorder across response inhibition tasks with different cognitive demands. Neuropsychologia 2009; 47:2389-96. [PMID: 19552927 DOI: 10.1016/j.neuropsychologia.2009.01.022] [Citation(s) in RCA: 180] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2008] [Revised: 12/12/2008] [Accepted: 01/02/2009] [Indexed: 10/21/2022]
Abstract
One of the most consistent findings in children with ADHD is increased moment-to-moment variability in reaction time (RT). The source of increased RT variability can be examined using ex-Gaussian analyses that divide variability into normal and exponential components and Fast Fourier transform (FFT) that allow for detailed examination of the frequency of responses in the exponential distribution. Prior studies of ADHD using these methods have produced variable results, potentially related to differences in task demand. The present study sought to examine the profile of RT variability in ADHD using two Go/No-go tasks with differing levels of cognitive demand. A total of 140 children (57 with ADHD and 83 typically developing controls), ages 8-13 years, completed both a "simple" Go/No-go task and a more "complex" Go/No-go task with increased working memory load. Repeated measures ANOVA of ex-Gaussian functions revealed for both tasks children with ADHD demonstrated increased variability in both the normal/Gaussian (significantly elevated sigma) and the exponential (significantly elevated tau) components. In contrast, FFT analysis of the exponential component revealed a significant task x diagnosis interaction, such that infrequent slow responses in ADHD differed depending on task demand (i.e., for the simple task, increased power in the 0.027-0.074 Hz frequency band; for the complex task, decreased power in the 0.074-0.202 Hz band). The ex-Gaussian findings revealing increased variability in both the normal (sigma) and exponential (tau) components for the ADHD group, suggest that both impaired response preparation and infrequent "lapses in attention" contribute to increased variability in ADHD. FFT analyses reveal that the periodicity of intermittent lapses of attention in ADHD varies with task demand. The findings provide further support for intra-individual variability as a candidate intermediate endophenotype of ADHD.
Collapse
Affiliation(s)
- Rebecca G Vaurio
- Kennedy Krieger Institute, Department of Neuropsychology, Baltimore, MD 21211, USA.
| | | | | |
Collapse
|