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Wagner D, Mason SG, Eastwood JD. The experience of effort in ADHD: a scoping review. Front Psychol 2024; 15:1349440. [PMID: 38895497 PMCID: PMC11184226 DOI: 10.3389/fpsyg.2024.1349440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/29/2024] [Indexed: 06/21/2024] Open
Abstract
Background Mental effort plays a critical role in regulating cognition. However, the experience of mental effort may differ for individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), a disorder for which sustained mental effort 'avoidance' or 'dislike' is a criterion in the DSM. We conducted a scoping review to characterize the literature on the experiences of effort in ADHD. Methods This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology. PsycINFO (OVID), PsycINFO (ProQuest) and PubMed were searched for studies published in English before February 14, 2023. Studies must have included an ADHD population or a measure of ADHD symptomatology, in addition to a self-report measure of the experience of effort or the use of an effort preference paradigm. Two researchers reviewed all abstracts, and one researcher reviewed full-text articles. Results Only 12 studies met the inclusion criteria. Several gaps and inconsistencies in the research were identified in terms of method, definitions of effort, measurements of ADHD, and sample characteristics. Moreover, the pattern of results on the experience of effort was mixed. Conclusion Despite its diagnostic and conceptual significance, the experience of mental effort in ADHD is not well studied. Critical gaps were identified in the existing literature. A three-facet conceptualization of effort is proposed-specifically, task-elicited effort, volitionally exerted effort, and the affect associated with engaging in effort - to guide future explorations of the experience of effort in ADHD.
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Affiliation(s)
- Danika Wagner
- The Boredom Lab, Department of Psychology, York University, Toronto, ON, Canada
| | - Samantha G. Mason
- The Boredom Lab, Department of Psychology, York University, Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Research Institute, Toronto, ON, Canada
| | - John D. Eastwood
- The Boredom Lab, Department of Psychology, York University, Toronto, ON, Canada
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Inci Izmir SB, Aktan ZD, Ercan ES. Assessing the mediating relationships between psychological factors in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome. APPLIED NEUROPSYCHOLOGY. CHILD 2024:1-17. [PMID: 38615909 DOI: 10.1080/21622965.2024.2341251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
This study aims to investigate the predictive and mediating relationships between emotion dysregulation, internalizing disorders, family functionality, loneliness preference, and executive functions (EF) in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome (ADHD + CDS). This study included 176 children and adolescents (92 boys, 84 girls) who were diagnosed with ADHD + CDS according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist, between ages 8 -12 (M = 10, SD = 1.52) with a convenience sampling method. The solitude scale for children, difficulties in emotion dysregulation scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, Family assessment device, and CNS Vital Signs test were used. The results showed that difficulty in emotion regulation, preference for loneliness, internalizing disorders and CDS symptom severity did not have a mediating effect between family functionality and EF. Still, emotion dysregulation mediates the relationship between EF and internalizing disorders by itself and through loneliness preference. Also, preference for loneliness and emotion dysregulation had a mediating effect between family functionality and internalizing disorders. Finally, it was found that the effect of emotion regulation difficulty, loneliness preference, and internalizing disorders had a mediating role between CDS symptom severity and family functionality. In conclusion, the information obtained from this study on the etiology of CDS may guide future studies.
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Affiliation(s)
| | - Z Deniz Aktan
- Child and Adolescent Clinical Psychology Department, Isik University, Istanbul, Turkey
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey
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Alacha HF, Rosen PJ, Bufferd SJ. Children's emotional reactivity and negative affect predict future ADHD symptom severity beyond initial ADHD symptom severity. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02403-z. [PMID: 38502319 DOI: 10.1007/s00787-024-02403-z] [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] [Received: 08/18/2023] [Accepted: 02/18/2024] [Indexed: 03/21/2024]
Abstract
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) often experience significant emotion dysregulation. However, there is limited longitudinal data on associations between multiple aspects of emotion dysregulation and ADHD symptoms. Additionally, given substantial evidence that increased levels and variability of negative affect (NA) are identified in children with ADHD, it is important to examine the role of NA in this relationship. The present study used momentary and longitudinal data to examine the relation between two aspects of emotion dysregulation (emotional lability and emotional reactivity), the two ADHD symptom clusters separately (inattentive and hyperactive/impulsive), total ADHD symptom severity, and NA variability over a period of six months. Participants (N = 68) were parents of children aged 7-12 years old (M = 9.80, SD = 1.34) who completed baseline and 6-month follow-up reports of children's ADHD symptoms and emotion dysregulation as well as ecological momentary assessments (EMA) of their children's NA for one week. Results were threefold: (1) children's emotional reactivity predicted inattentive, hyperactive/impulsive, and total ADHD symptom severity above and beyond initial ADHD symptom severity, but emotional lability did not significantly predict severity of any ADHD symptom cluster; (2) NA variability predicted hyperactive/impulsive and total ADHD symptom severity, but not inattentive severity; and (3) initial ADHD symptom severity did not predict emotion dysregulation at follow-up. The current study provides novel insight regarding the longitudinal influence of specific aspects of emotion dysregulation and NA on ADHD symptom severity in children and suggests that targeting emotional reactivity could minimize ADHD symptom severity.
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Affiliation(s)
- Helena F Alacha
- Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences Building, Louisville, KY, 40292, USA.
| | - Paul J Rosen
- Department of Pediatrics, University of Louisville School of Medicine, 571 S Floyd St, Louisville, KY, 40202, USA
- Norton Children's Behavioral and Mental Health, 200 E Chestnut St #200, Louisville, KY, 40202, USA
| | - Sara J Bufferd
- Department of Psychological and Brain Sciences, University of Louisville, 317 Life Sciences Building, Louisville, KY, 40292, USA
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Ojha A, Jones NP, Henry T, Versace A, Gnagy EM, Joseph HM, Molina BSG, Ladouceur CD. Altered Lateral Prefrontal Cortex Functioning During Emotional Interference Resistance Is Associated With Affect Lability in Adults With Persisting Symptoms of Attention-Deficit/Hyperactivity Disorder From Childhood. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00054-5. [PMID: 38378127 DOI: 10.1016/j.bpsc.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 01/09/2024] [Accepted: 02/12/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention and/or impulsivity/hyperactivity. ADHD, especially when persisting into adulthood, often includes emotional dysregulation, such as affect lability; however, the neural correlates of emotionality in adults with heterogeneous ADHD symptom persistence remain unclear. METHODS The present study sought to determine shared and distinct functional neuroanatomical profiles of neural circuitry during emotional interference resistance using the emotional face n-back task in adult participants with persisting (n = 47), desisting (n = 93), or no (n = 42) childhood ADHD symptoms while undergoing functional magnetic resonance imaging. RESULTS Participants without any lifetime ADHD diagnosis performed significantly better (faster and more accurately) than participants with ADHD diagnoses on trials with high cognitive loads (2-back) that included task-irrelevant emotional distractors, tapping into executive functioning and emotion regulatory processes. In participants with persisting ADHD symptoms, more severe emotional symptoms were related to worse task performance. Heightened dorsolateral and ventrolateral prefrontal cortex activation was associated with more accurate and faster performance on 2-back emotional faces trials, respectively. Reduced activation was associated with greater affect lability in adults with persisting ADHD, and dorsolateral prefrontal cortex activation mediated the relationship between affect lability and task accuracy. CONCLUSIONS These findings suggest that alterations in dorsolateral prefrontal cortex function associated with greater interference in cognitive processes from emotion could represent a marker of risk for problems with emotional dysregulation in individuals with persisting ADHD and thus represent a potential therapeutic target for those with greater emotional symptoms of ADHD.
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Affiliation(s)
- Amar Ojha
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Neil P Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Teague Henry
- Department of Psychology, University of Virginia, Charlottesville, Virginia; School of Data Science, University of Virginia, Charlottesville, Virginia
| | - Amelia Versace
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Elizabeth M Gnagy
- Department of Psychology, Florida International University, Miami, Florida
| | - Heather M Joseph
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Brooke S G Molina
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Cecile D Ladouceur
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
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5
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Sells RC, Liversedge SP, Chronaki G. Vocal emotion recognition in attention-deficit hyperactivity disorder: a meta-analysis. Cogn Emot 2024; 38:23-43. [PMID: 37715528 DOI: 10.1080/02699931.2023.2258590] [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: 03/10/2023] [Revised: 06/06/2023] [Accepted: 06/28/2023] [Indexed: 09/17/2023]
Abstract
There is debate within the literature as to whether emotion dysregulation (ED) in Attention-Deficit Hyperactivity Disorder (ADHD) reflects deviant attentional mechanisms or atypical perceptual emotion processing. Previous reviews have reliably examined the nature of facial, but not vocal, emotion recognition accuracy in ADHD. The present meta-analysis quantified vocal emotion recognition (VER) accuracy scores in ADHD and controls using robust variance estimation, gathered from 21 published and unpublished papers. Additional moderator analyses were carried out to determine whether the nature of VER accuracy in ADHD varied depending on emotion type. Findings revealed a medium effect size for the presence of VER deficits in ADHD, and moderator analyses showed VER accuracy in ADHD did not differ due to emotion type. These results support the theories which implicate the role of attentional mechanisms in driving VER deficits in ADHD. However, there is insufficient data within the behavioural VER literature to support the presence of emotion processing atypicalities in ADHD. Future neuro-imaging research could explore the interaction between attention and emotion processing in ADHD, taking into consideration ADHD subtypes and comorbidities.
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Affiliation(s)
- Rohanna C Sells
- School of Psychology and Computer Science, University of Central Lancashire, UK
| | - Simon P Liversedge
- School of Psychology and Computer Science, University of Central Lancashire, UK
| | - Georgia Chronaki
- School of Psychology and Computer Science, University of Central Lancashire, UK
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Eichorn N, Hall J, Marton K. Complex working memory in adults with and without stuttering disorders: Performance patterns and predictive relationships. JOURNAL OF FLUENCY DISORDERS 2023; 77:105993. [PMID: 37406551 DOI: 10.1016/j.jfludis.2023.105993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/13/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023]
Abstract
PURPOSE Available studies of working memory (WM) in speakers who stutter tend to rely on parent report, focus on phonological WM, or measure WM in combination with other processes. The present research aimed to: (1) compare complex WM in adults who stutter (AWS) and adults who do not stutter (AWNS); (2) characterize group performance patterns; and (2) determine whether WM predicts stuttering severity. METHODS Eighteen AWS and 20 AWNS completed parallel verbal and spatial span tasks in which to-be-remembered items were interleaved with a distracting task across varying set sizes. Dependent variables included the number of correctly recalled items, accuracy on distraction tasks, and detailed analyses of item-level responses. We further examined whether span scores predicted subjective and objective measures of stuttering severity. RESULTS Relative to AWNS, AWS showed poorer recall, specifically on short set sizes in the spatial task. Groups performed similarly on distraction tasks and showed comparable error patterns. Predictive relationships differed by span task and severity measure. Lower verbal span scores predicted greater stuttering impact and more overt stuttering behaviors; lower spatial span scores predicted lower impact and was unrelated to overt behaviors. CONCLUSIONS Findings suggest that AWS differ subtly from AWNS in WM performance. Group differences became more apparent under certain task conditions but could not be attributed to specific underlying processes. Data further indicated a complex relationship between WM and stuttering severity. Overall, results corroborate previous studies linking stuttering to domain-general weaknesses, but highlight the need for additional research to clarify the nature of this relationship.
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Affiliation(s)
- Naomi Eichorn
- The University of Memphis, 4055 N. Park Loop, Memphis, TN, 38152, USA.
| | - Jessica Hall
- The University of Memphis, 4055 N. Park Loop, Memphis, TN, 38152, USA
| | - Klara Marton
- Graduate Center, City University of New York, 365 Fifth Ave, New York, NY 10016, USA; Brooklyn College, City University of New York, 2900 Bedford Ave, Brooklyn, NY 11210, USA; MTA-ELTE Language-Learning Disorders Research Group, Bárczi Gusztáv College of Special Needs Education, Eötvös Loránd University, Egyetem tér 1-3, Budapest 1053, Hungary
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Yaacoby-Vakrat R, Pade M, Bar-Shalita T. Exploring Co-Regulation-Related Factors in the Mothers of ADHD Children-Proof of Concept Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1286. [PMID: 37628285 PMCID: PMC10453235 DOI: 10.3390/children10081286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a complex neurological condition interfering with family relationships and co-regulation capabilities. Therefore, exploring factors underpinning parental co-regulation ability is crucial for future fostering relationships in families of children with ADHD. OBJECTIVE This preliminary study aims to characterize and compare the executive-functions, anxiety, self-efficacy, and sensory modulation in mothers of children with and without ADHD. METHOD Mothers of children with (study group) and without (control-comparison, group) ADHD completed online self-reports, measuring executive-functions; parental self-efficacy; anxiety; and sensory modulation. RESULTS The study group (N = 40) had lower self-efficacy compared to the control group (N = 27; p = 0.018), and the control group had lower sensory responsiveness (p = 0.025). Within both groups the Behavior Rating Inventory of Executive Function-Adult (BRIEF-A) Global Executive Function Composite score (GEC) and the Beck Anxiety Inventory (BAI) were moderately correlated. Further, within the study group correlations were found between the BRIEF-A-GEC and the Sensory Responsiveness Questionnaire (SRQ)-Aversive scores (r = 0.37, p ≤ 0.01), and between the BRIEF-A Behavioral-Rating-Index and the parental self-efficacy scores (r = 0.31, p ≤ 0.05). Within the control group, negative correlations were found between the BRIEF-A-GEC and SRQ-Hedonic scores (r= -0.44, p < 0.05). CONCLUSION Self-efficacy, executive-functions, high sensory responsiveness and anxiety traits are interwoven and may impact parental co-regulation ability.
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Affiliation(s)
| | | | - Tami Bar-Shalita
- Department of Occupational Therapy, The Stanley Steyer School of Health Professions, Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Tel-Aviv 6997801, Israel; (R.Y.-V.); (M.P.)
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Leib SI, Miller SA, Chin E. Latent structure of working memory and emotion regulation in pediatric ADHD. Child Neuropsychol 2023; 29:644-665. [PMID: 35975287 DOI: 10.1080/09297049.2022.2107626] [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] [Indexed: 10/15/2022]
Abstract
Working memory is a key cognitive function that is often implicated in ADHD and may represent an underlying cognitive endophenotype of the disorder. Working memory is related to emotion regulation, which is a common area of impairment in children with ADHD. Given the high rate of comorbid diagnoses with ADHD, children with comorbid internalizing, externalizing, and developmental disorders may present with variable working memory profiles and subsequent emotion regulation deficits. This study aimed to adequately characterize the latent structure of working memory impairments and emotional regulation outcomes in a clinical sample of children ages 6-16 with ADHD. This study also examined the interplay between the identified working memory/emotion regulation patterns, demographic characteristics, and the role of comorbid diagnoses. Results highlighted two distinct, invariant, unrestricted classes of working memory/emotion regulation. Class 1 (Average; 62% of the sample) had significantly lower digit-span scores, and generally persevered emotion regulation functioning per parent/teacher report. Class 2 (Emotionally Dysregulated) had average working memory scores, and elevated emotion regulation problems. The working memory indicators had small correlations with parents (and not teacher) measures of emotion regulation. Finally, latent class membership did not differ by comorbid diagnosis, age, gender, or verbal IQ. Findings elucidate heterogeneity in common domains affected by ADHD and suggest that this heterogeneity may not be due to demographic/comorbidity factors. The role of varying information reports is discussed, and potential assessment and treatment implications are highlighted.
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Affiliation(s)
- Sophie I Leib
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Steven A Miller
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Esther Chin
- Ascension Alexian Brothers Neurosciences Institute, IL, USA
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Robison MK, Ralph KJ, Gondoli DM, Torres A, Campbell S, Brewer GA, Gibson BS. Testing locus coeruleus-norepinephrine accounts of working memory, attention control, and fluid intelligence. COGNITIVE, AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2023:10.3758/s13415-023-01096-2. [PMID: 37081225 PMCID: PMC10118234 DOI: 10.3758/s13415-023-01096-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2023] [Indexed: 04/22/2023]
Abstract
The current set of studies examined the relationship among working memory capacity, attention control, fluid intelligence, and pupillary correlates of tonic arousal regulation and phasic responsiveness in a combined sample of more than 1,000 participants in two different age ranges (young adults and adolescents). Each study was designed to test predictions made by two recent theories regarding the role of the locus coeruleus-norepinephrine (LC-NE) system in determining individual differences in cognitive ability. The first theory, proposed by Unsworth and Robison (2017a), posits two important individual differences: the moment-to-moment regulation of tonic arousal, and the phasic responsiveness of the system to goal-relevant stimuli. The second theory, proposed by Tsukahara and Engle (2021a), argues that people with higher cognitive abilities have greater functional connectivity between the LC-NE system and cortical networks at rest. These two theories are not mutually exclusive, but they make different predictions. Overall, we found no evidence consistent with a resting-state theory. However, phasic responsiveness was consistently correlated with working memory capacity, attention control, and fluid intelligence, supporting a prediction made by Unsworth and Robison (2017a). Tonic arousal regulation was not correlated with working memory or fluid intelligence and was inconsistently correlated with attention control, which offers only partial support for Unsworth and Robison's (2017a) second prediction.
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Affiliation(s)
- Matthew K Robison
- Department of Psychology, University of Texas at Arlington, Arlington, TX, USA.
| | - Kathryn J Ralph
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Dawn M Gondoli
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Alexis Torres
- Department of Psychology, Arizona State University, Phoenix, AZ, USA
| | - Stephen Campbell
- Department of Psychology, University of Texas at Arlington, Arlington, TX, USA
| | - Gene A Brewer
- Department of Psychology, Arizona State University, Phoenix, AZ, USA
| | - Bradley S Gibson
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
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Soler-Gutiérrez AM, Pérez-González JC, Mayas J. Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLoS One 2023; 18:e0280131. [PMID: 36608036 PMCID: PMC9821724 DOI: 10.1371/journal.pone.0280131] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.
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Affiliation(s)
- Ana-María Soler-Gutiérrez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Julia Mayas
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- * E-mail:
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Grossman A, Avital A. Emotional and sensory dysregulation as a possible missing link in attention deficit hyperactivity disorder: A review. Front Behav Neurosci 2023; 17:1118937. [PMID: 36935890 PMCID: PMC10017514 DOI: 10.3389/fnbeh.2023.1118937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a common developmental disorder affecting 5-7% of adults and children. We surveyed the literature to examine ADHD through three pillars: developmental characteristics, symptomatology, and treatment strategies. Firstly, in terms of developmental characterstics, early life stress may increase the risk of developing ADHD symptoms according to animal models' research. Secondly, the current core symptoms of ADHD are comprised of inattention, hyperactivity, and impulsivity. However, the up-to-date literature indicates individuals with ADHD experience emotional and sensory dysregulation as well, which early-life stress may also increase the risk of. Finally, we discuss the therapeutic benefits of methylphenidate on both the current core ADHD symptoms and the sensory and emotional dysregulation found in those with ADHD. In summation, we surveyed the recent literature to analyze (i) the potential role of early-life stress in ADHD development, (ii) the involvement of emotional and sensory dysregulation in ADHD symptomatology and finally, (iii) the therapeutic intervention with methylphenidate, aiming to reduce the potential effect of early life stress in ADHD, and mainly emotional and sensory dysregulation. The apparent but currently less recognized additional symptoms of emotional and sensory dysregulation in ADHD call for further investigation of these possible causes and thus increasing treatments efficacy in individuals with ADHD.
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12
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Wang S. YOGA FOR EMOTIONAL CONTROL IN CHILDREN WITH ADHD. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
ABSTRACT Introduction: Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders, with several negative social and behavioral consequences. Yoga shows appropriate efficacy in different conditions but is poorly explored during childhood. Objective: Analyze the efficacy of yoga in regulating emotions and symptoms in children with ADHD. Methods: This experimental study followed up on a control group of 30 children with ADHD. They were randomly allocated group into control (N=15) and experimental (N=15) through the block randomization method. Participants completed the emotion regulation and Conner scale (CBRS) before, after, and 60 days after yoga exercise (20 sessions twice a week). Results: After 8 weeks of training, participants’ emotion regulation and ADHD symptoms improved significantly. The improvement in emotion regulation and ADHD symptoms was maintained at follow-up. Conclusion: Yoga training proved to be an easy and inexpensive method to improve the mental and physical condition of children with ADHD. Level of evidence II; Therapeutic studies - investigating treatment outcomes.
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Affiliation(s)
- Sheng Wang
- Yangtze University College of Arts and Sciences, China
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13
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Jaisle EM, Groves NB, Black KE, Kofler MJ. Linking ADHD and ASD Symptomatology with Social Impairment: The Role of Emotion Dysregulation. Res Child Adolesc Psychopathol 2023; 51:3-16. [PMID: 36326970 PMCID: PMC9913618 DOI: 10.1007/s10802-022-00982-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often experience social impairments. These children also frequently struggle with emotion regulation, and extant literature suggests that emotion dysregulation predicts social impairment in both clinical and neurotypical populations. However, the evidence base linking ADHD/ASD with social impairment comes primarily from samples meeting full diagnostic criteria for ADHD and/or ASD despite evidence that both syndromes reflect extreme ends of natural continuums that are normally distributed across the general population. To our knowledge, the present study is the first to concurrently examine unique and overlapping relations among ADHD/ASD symptoms, emotion regulation, and social difficulties using multi-informant measures (parent, teacher) with a clinically-evaluated sample of 108 children ages 8-13 (40 girls; 66% White/Non-Hispanic) with and without clinically-elevated ASD and ADHD symptoms and other common clinical disorders. Bias-corrected, bootstrapped conditional effects modeling revealed that ADHD-inattentive (β=-0.23) and ASD-social communication (β=-0.20) symptoms predicted social impairment directly, whereas ADHD-hyperactive/impulsive (β=-0.06) and ASD-restricted/repetitive behavior/interests (β=-0.06) symptoms predicted social impairment only via their shared associations with emotion dysregulation. Sensitivity analyses revealed that most relations were robust to control for item overlap across measures. In contrast, only the ADHD-inattention/social impairment link was robust to control for mono-informant bias, highlighting the importance of multi-informant methods and the potential for different determinants of social functioning across settings. Overall, this study implicates emotion regulation skills and all four ADHD/ASD symptom clusters as potential influences on children's social functioning, albeit with a more nuanced and potentially setting-specific pattern than suggested by prior work.
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Panah MT, Taremian F, Dolatshahi B, Seddigh SH, Raeisian FS, Panah E. A comparison of Barkley's behavioral inhibition model (1997) with Barkley's updated executive functioning model in predicting adult ADHD symptoms: A preliminary report using structural equation modeling. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-13. [PMID: 36576870 DOI: 10.1080/23279095.2022.2158441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
One of the most comprehensive approaches to explaining attention-deficit/hyperactivity disorder (ADHD) symptoms is Barkley's behavioral inhibition model (BBIM) (1997), in which behavioral inhibition (BI) plays a primary role. Due to the substantial role of working memory (WM) in explaining ADHD symptoms, Barkley recently updated his model and elevated WM from a mediator variable (in BBIM) to a primary position as an exogenous variable alongside BI, and titled his new model as Barkley's updated executive functioning model (BUEFM). However, since the information about the explanatory power of the new model is sparse, this study aims to investigate the impact of this change in WM role by comparing these two models to explain ADHD symptoms. The study involved a sample of 184 (96 females and 88 males) undergraduate students with high ADHD symptoms who were selected using the purposive sampling method. For assessing models, we have utilized four tools that include: CNS-Vital Sign Test Battery; Barkley Deficit in Executive Functioning Scale; self-verbalization questionnaire (SVQ); and trail making test. We analyzed the data by running structural equation modeling (SEM) analysis using IBM AMOS software version 22. The results show that Model Comparison Measurement (e.g. AIC was 197.583 and 144.614 for BBIM and BUEFM, respectively) and Model Fit Indices (e.g. root mean square error of approximation (RMSEA) obtained 0.076 and 0.067 for BBIM and BUEFM, respectively) representing that BUEFM had a better value than BBIM, which means that the BUEFM was considered better fitting to the data. The findings of this study show that BUEFM has more Predictive power than BBIM to predict symptoms of ADHD through the motor control fluency (MOT) variable.
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Affiliation(s)
- Mohammad Taher Panah
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farhad Taremian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Behrouz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyyed Hamzeh Seddigh
- Department of Psychiatry, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Fatemeh Sadat Raeisian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ebrahim Panah
- Modern Language Department, University College of Yayasan Pahang, Kuantan Pahang, Malaysia
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15
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The relationships between attachment styles, reflective functioning, and emotion regulation in mothers of children diagnosed with ADHD. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03706-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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16
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Zainal NH, Newman MG. Life Satisfaction Prevents Decline in Working Memory, Spatial Cognition, and Processing Speed: Latent Change Score Analyses Across 23 Years. Eur Psychiatry 2022; 65:1-55. [PMID: 35437134 PMCID: PMC9121850 DOI: 10.1192/j.eurpsy.2022.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/01/2022] Open
Abstract
Background Within-person growth in life satisfaction (LS) can protect against declines in cognitive functioning, and, conversely, over time. However, most studies have been cross-sectional, thereby precluding causal inferences. Thus, we used bivariate dual latent change score modeling to test within-person change-to-future change relations between LS and cognition. Method Community adults completed in-person tests of verbal working memory (WM), processing speed, spatial cognition, and an LS self-report. Five waves of assessment occurred across 23 years. Results Reduction in LS predicted future decreases in spatial cognition, processing speed, and verbal WM (|d | = 0.150–0.354). Additionally, depletion in processing speed and verbal WM predicted a future decrease in LS (d = 0.142–0.269). However, change in spatial cognition did not predict change in LS (|d | = 0.085). Discussion LS and verbal WM and processing speed predicted one another across long durations. Evidence-based therapies can be augmented to target LS and cognition.
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Affiliation(s)
- Nur Hani Zainal
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
- National University of Singapore, Singapore
| | - Michelle G. Newman
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
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17
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High working memory load impairs reappraisal but facilitates distraction – an Event-Related Potential investigation. Biol Psychol 2022; 171:108327. [DOI: 10.1016/j.biopsycho.2022.108327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 03/31/2022] [Accepted: 04/01/2022] [Indexed: 12/23/2022]
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18
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Groves NB, Chan ESM, Marsh CL, Gaye F, Jaisle EM, Kofler MJ. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front Psychiatry 2022; 13:1034722. [PMID: 36561637 PMCID: PMC9763728 DOI: 10.3389/fpsyt.2022.1034722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Approximately 48-54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation. METHODS This preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8-13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls). RESULTS Results of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1-2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2-4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings. DISCUSSION To determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03324464].
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Emma M Jaisle
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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19
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Targeting working memory to modify emotional reactivity in adult attention deficit hyperactivity disorder: a functional magnetic resonance imaging study. Brain Imaging Behav 2021; 16:680-691. [PMID: 34524649 PMCID: PMC9010388 DOI: 10.1007/s11682-021-00532-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 11/10/2022]
Abstract
Understanding the neural mechanisms of emotional reactivity in Attention-Deficit/Hyperactivity Disorder (ADHD) may help develop more effective treatments that target emotion dysregulation. In adult ADHD, emotion regulation problems cover a range of dimensions, including emotional reactivity (ER). One important process that could underlie an impaired ER in ADHD might be impaired working memory (WM) processing. We recently demonstrated that taxing WM prior to the exposure of emotionally salient stimuli reduced physiological and subjective reactivity to such cues in heavy drinkers, suggesting lasting effects of WM activation on ER. Here, we investigated neural mechanisms that could underlie the interaction between WM and ER in adult ADHD participants. We included 30 male ADHD participants and 30 matched controls. Participants performed a novel functional magnetic resonance imaging paradigm in which active WM-blocks were alternated with passive blocks of negative and neutral images. We demonstrated group-independent significant main effects of negative emotional images on amygdala activation, and WM-load on paracingulate gyrus and dorsolateral prefrontal cortex activation. Contrary to earlier reports in adolescent ADHD, no impairments were found in neural correlates of WM or ER. Moreover, taxing WM did not alter the neural correlates of ER in either ADHD or control participants. While we did find effects on the amygdala, paCG, and dlPFC activation, we did not find interactions between WM and ER, possibly due to the relatively unimpaired ADHD population and a well-matched control group. Whether targeting WM might be effective in participants with ADHD with severe ER impairments remains to be investigated.
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20
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Working memory training for adult glioma patients: a proof-of-concept study. J Neurooncol 2021; 155:25-34. [PMID: 34491526 DOI: 10.1007/s11060-021-03839-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND CogMed Working Memory Training (CWMT) is a computer-based program shown to improve working memory (WM) among those with cognitive impairments. No study to date has investigated its feasibility, acceptability, and satisfaction in adult patients with glioma, despite the well-documented incidence of WM impairment in this population. METHODS Twenty patients with glioma and objective and/or perceived WM deficits enrolled in the study: 52% high-grade, 60% female, Mage = 47 (range = 21-72 years). Adverse events were monitored to determine safety. Feasibility and acceptability were assessed based on established metrics. Satisfaction was explored by exit-interviews. Neurocognitive tests and psychological symptoms were analyzed at baseline and post-CWMT to estimate effect sizes. RESULTS Of 20 enrolled patients, 16 completed the intervention (80% retention rate). Reasons for withdrawal included time burden (n = 2); tumor-related fatigue (n = 1) or loss to follow-up (n = 1). No adverse events were determined to be study-related. Adherence was 69% with reasons for nonadherence similar to those for study withdrawal. The perceived degree of benefit was only moderate. Baseline to post-CWMT assessments showed medium to large effects on neurocognitive tasks. Psychological symptoms remained stable throughout the study period. CONCLUSIONS CWMT was found to be safe and acceptable in adult patients with glioma. Enrollment, retention rates, and treatment adherence were all adequate and comparable to studies recruiting similar populations. Only moderate perceived benefit was reported despite demonstrated improvements in objectively-assessed WM. This may indicate that the time commitment and intervention intensity (5 weeks of 50-min training sessions on 5 days/week) outweighed the perceived benefits of the program. (Trial Registration Number: NCT03323450 registered on 10/27/2017).
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21
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Gårdvik KS, Rygg M, Torgersen T, Wallander JL, Lydersen S, Indredavik MS. Association of treatment procedures and resilience to symptom load three-years later in a clinical sample of adolescent psychiatric patients. BMC Psychiatry 2021; 21:411. [PMID: 34412609 PMCID: PMC8377856 DOI: 10.1186/s12888-021-03417-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We aimed to examine symptom load in a clinical adolescent population at three-year follow-up and explore associations with standard care treatment procedures and resilience factors upon first presenting at Child and Adolescent Mental Health Services. METHODS This study is part of a prospective longitudinal cohort study: The Health Survey in Department of Children and Youth, St. Olavs hospital, Norway. A clinical population of 717 (43.5% of eligible) adolescents aged 13-18 years participated in the first study visit (T1, 2009-2011). Of these, 447 adolescents with psychiatric disorders, with treatment history from medical records and self-reported resilience factors (Resilience Scale for Adolescents; READ) at T1, reported symptom load (Achenbach System of Empirically Based Assessment - Youth Self Report; YSR) three years later aged 16-21 years (T2). RESULT At T1, 93.0% received individual treatment. The frequency of psychotherapy and medication varied by disorder group and between genders. Overall, psychotherapy was more frequent among girls, whereas medication was more common among boys. Total READ mean value (overall 3.5, SD 0.8), ranged from patients with mood disorders (3.0, SD 0.7) to patients with Attention Deficit Hyperactivity disorder (3.7, SD 0.7), and was lower for girls than boys in all diagnostic groups. At T2, the YSR Total Problem mean T-score ranged across the diagnostic groups (48.7, SD 24.0 to 62.7, SD 30.2), with highest symptom scores for those with mood disorders at T1, of whom 48.6% had T-scores in the borderline/clinical range (≥60) three years later. Number of psychotherapy sessions was positively associated and Total READ score was negatively associated with the YSR Total Problems T-score (regression coefficient β = 0.5, CI (0.3 to 0.7), p < 0.001 and β = - 15.7, CI (- 19.2 to - 12.1), p < 0.001, respectively). The subscale Personal Competence was associated with the lowest Total Problem score for both genders. CONCLUSIONS Self-reported symptom load was substantial after three years, despite comprehensive treatment procedures. Higher self-reported resilience characteristics were associated with lower symptom load after three years. These results highlight the burden of adolescent psychiatric disorders, the need for extensive interventions and the importance of resilience factors for a positive outcome.
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Affiliation(s)
- Kari Skulstad Gårdvik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Children and Youth, Clinic of Mental Health Care, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Marite Rygg
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,grid.52522.320000 0004 0627 3560Department of Pediatrics, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Terje Torgersen
- grid.52522.320000 0004 0627 3560Orkdal District Psychiatric Centre, Clinic of Mental Health Care, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jan Lance Wallander
- grid.5947.f0000 0001 1516 2393Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,grid.266096.d0000 0001 0049 1282Psychological Sciences and Health Sciences Research Institute, University of California, Merced, USA
| | - Stian Lydersen
- grid.5947.f0000 0001 1516 2393Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Sæbø Indredavik
- grid.5947.f0000 0001 1516 2393Department of Clinical and Molecular Medicine (IKOM), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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22
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Bauer R, Jost L, Jansen P. The effect of mindfulness and stereotype threat in mental rotation: a pupillometry study. JOURNAL OF COGNITIVE PSYCHOLOGY 2021. [DOI: 10.1080/20445911.2021.1967366] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Robert Bauer
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Leonardo Jost
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
| | - Petra Jansen
- Faculty of Human Sciences, University of Regensburg, Regensburg, Germany
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23
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Mukherjee P, Hartanto T, Iosif AM, Dixon JF, Hinshaw SP, Pakyurek M, van den Bos W, Guyer AE, McClure SM, Schweitzer JB, Fassbender C. Neural basis of working memory in ADHD: Load versus complexity. NEUROIMAGE-CLINICAL 2021; 30:102662. [PMID: 34215140 PMCID: PMC8175567 DOI: 10.1016/j.nicl.2021.102662] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/29/2021] [Accepted: 04/01/2021] [Indexed: 11/15/2022]
Abstract
Working memory (WM). Load versus Complexity. ADHD. FMRI. Working Memory Striatum and Cerebellum.
Working memory (WM) deficits are key in attention deficit hyperactivity disorder (ADHD). Nevertheless, WM is not universally impaired in ADHD. Additionally, the neural basis for WM deficits in ADHD has not been conclusively established, with regions including the prefrontal cortex, cerebellum, and caudate being implicated. These contradictions may be related to conceptualizations of WM capacity, such as load (amount of information) versus operational-complexity (maintenance-recall or manipulation). For instance, relative to neurotypical (NT) individuals, complex WM operations could be impaired in ADHD, while simpler operations are spared. Alternatively, all operations may be impaired at higher loads. Here, we compared the impact of these two components of WM capacity: load and operational-complexity, between ADHD and NT, behaviorally and neurally. We hypothesized that the impact of WM load would be greater in ADHD, and the neural activation would be altered. Participants (age-range 12–23 years; 50 ADHD (18 females); 82 NT (41 females)) recalled three or four objects (load) in forward or backward order (operational-complexity) during functional magnetic resonance imaging scanning. The effects of diagnosis and task were compared on performance and neural engagement. Behaviorally, we found significant interactions between diagnosis and load, and between diagnosis, load, and complexity. Neurally, we found an interaction between diagnosis and load in the right striatum, and between diagnosis and complexity in the right cerebellum and left occipital gyrus. The ADHD group displayed hypo-activation compared to NT group during higher load and greater complexity. This informs mechanisms of functional problems related to WM in adolescents and young adults with ADHD (e.g., academic performance) and remedial interventions (e.g., WM-training).
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Affiliation(s)
- Prerona Mukherjee
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA.
| | - Tadeus Hartanto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis, Davis, CA 95616, USA
| | - J Faye Dixon
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley, 3rd Floor, Berkeley Way West Building, 2121 Berkeley Way West, Berkeley, CA 94720, USA
| | - Murat Pakyurek
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Wouter van den Bos
- Department of Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS Amsterdam, Netherlands
| | - Amanda E Guyer
- Department of Human Ecology, University of California, Davis, 1 Shields Ave, Davis, CA 95616, USA; Center for Mind and Brain, University of California, Davis, 267 Cousteau Pl, Davis, CA 95618, USA
| | - Samuel M McClure
- Department of Psychology, Arizona State University, Tempe, AZ 85287, USA
| | - Julie B Schweitzer
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA
| | - Catherine Fassbender
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California, Davis, 2825 50th St., Sacramento, CA 95817, USA; School of Psychology, Dublin City University, DCU Glasnevin Campus, Dublin 9, Ireland
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Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots? JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-020-09859-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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25
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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Soto EF, Kofler MJ, Singh LJ, Wells EL, Irwin LN, Groves NB, Miller CE. Executive functioning rating scales: Ecologically valid or construct invalid? Neuropsychology 2020; 34:605-619. [PMID: 32730048 PMCID: PMC7483691 DOI: 10.1037/neu0000681] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE Executive functions are commonly measured using rating scales and performance tests. However, replicated evidence indicates weak/nonsignificant cross-method associations that suggest divergent rather than convergent validity. The current study is the first to investigate the relative concurrent and predictive validities of executive function tests and ratings using (a) multiple gold-standard performance tests, (b) multiple standardized rating scales completed by multiple informants, and (c) both performance-based and ratings-based assessment of academic achievement-a key functional outcome with strong theoretical links to executive function. METHOD A well-characterized sample of 136 children oversampled for ADHD and other forms of child psychopathology associated with executive dysfunction (ages 8-13; 68% Caucasian/non-Hispanic) completed a counterbalanced series of executive function and academic tests. Parents/teachers completed executive function ratings; teachers also rated children's academic performance. RESULTS The executive function tests/ratings association was modest (r = .30) and significantly lower than the academic tests/ratings association (r = .63). Relative to ratings, executive function tests showed significantly higher cross-method predictive validity and significantly better within-method prediction; executive function ratings failed to demonstrate improved within-method prediction. Both methods uniquely predicted academic tests and ratings. CONCLUSION These findings replicate prior evidence that executive function tests and ratings cannot be used interchangeably as executive function measures in research and clinical applications, while suggesting that executive function tests may have superior validity for predicting academic behavior/achievement. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Elia F. Soto
- Florida State University, Department of Psychology
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27
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England-Mason G. Emotion Regulation as a Transdiagnostic Feature in Children with Neurodevelopmental Disorders. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2020. [DOI: 10.1007/s40474-020-00200-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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