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Ben-Dor Cohen M, Nahum M, Traub Bar-Ilan R, Eldar E, Maeir A. Coping with emotional dysregulation among young adults with ADHD: A mixed-method study of self-awareness and strategies in daily life. Neuropsychol Rehabil 2024; 34:1161-1185. [PMID: 37971947 DOI: 10.1080/09602011.2023.2279181] [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: 12/28/2022] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Emotional dysregulation (ED) impacts functional outcomes among individuals with attention-deficit hyperactivity disorder (ADHD). Self-awareness and strategies may enhance coping with ED yet are rarely studied in ADHD. OBJECTIVES To explore ED-related self-awareness and strategies in daily life of adults with ADHD, and to examine the interrelations between them and their association with symptoms. METHODS Sixty young adults with ADHD participated in a mixed-method study. At baseline, self-awareness and strategies were assessed using the Self-Regulation Skills Interview (SRSI); ADHD symptoms were self-rated using the ASRS symptom checklist. Then, symptoms were rated over 5-days using ecological momentary assessment (EMA). RESULTS Significant challenges in self-awareness and strategies were demonstrated quantitatively and qualitatively. Awareness of ED was associated with variability of ADHD symptoms on EMA yet not with symptom severity. Qualitative content analysis revealed a range of self-awareness levels, which were related to noticing ED-related cues and understanding contextual factors predictive of ED. Self-awareness and strategies were significantly associated. Strategies varied regarding effort, individual preference and temporality. CONCLUSIONS Variability of ADHD symptoms was negatively associated with self-awareness of ED. Strategy selection in daily-life among adults with ADHD may be affected by self-awareness and by a possible trade-off between short-term effort and long-term effectiveness.
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Affiliation(s)
- Maayan Ben-Dor Cohen
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ruthie Traub Bar-Ilan
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eran Eldar
- Psychology Department, Faculty of Social Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Cognitive Sciences, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Adina Maeir
- School of Occupational Therapy, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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2
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Nejati V, Estaji R. The impact of transcranial direct current stimulation on attention bias modification in children with ADHD. J Neural Transm (Vienna) 2024; 131:823-832. [PMID: 38643330 DOI: 10.1007/s00702-024-02775-1] [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: 01/13/2024] [Accepted: 03/30/2024] [Indexed: 04/22/2024]
Abstract
Individuals with attention deficit-hyperactivity disorder (ADHD) struggle with the interaction of attention and emotion. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in this interaction. In the present study, we aimed to explore the effect of stimulation applied over the dlPFC and vmPFC on attention bias in individuals with ADHD. Twenty-three children with ADHD performed the emotional Stroop and dot probe tasks during transcranial direct current stimulation (tDCS) in 3 conditions: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. Findings suggest reduction of attention bias in both real conditions based on emotional Stroop task and not dot probe task. These results were independent of emotional states. The dlPFC and vmPFC are involved in attention bias in ADHD. tDCS can be used for attention bias modification in children with ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran.
| | - Reza Estaji
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran
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3
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Estaji R, Hosseinzadeh M, Arabgol F, Nejati V. Transcranial direct current stimulation (tDCS) improves emotion regulation in children with attention-deficit hyperactivity disorder (ADHD). Sci Rep 2024; 14:13889. [PMID: 38880826 PMCID: PMC11180663 DOI: 10.1038/s41598-024-64886-9] [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: 01/27/2024] [Accepted: 06/13/2024] [Indexed: 06/18/2024] Open
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) typically exhibit difficulties in emotion regulation. It has been shown that the dorsolateral prefrontal cortex (dlPFC) and ventromedial prefrontal cortex (vmPFC) are crucially involved in these deficient processes. In this study, we aimed to explore the impact of electrical stimulation over the left dlPFC and right vmPFC on emotion regulation in children with ADHD. Twenty-four children with ADHD completed the Emotional Go/No-Go and Emotional 1-Back tasks while undergoing transcranial direct current stimulation (tDCS) in three separate sessions, each with a different electrode placement: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. During both real tDCS conditions, the accuracy of pre-potent inhibitory control and working memory performance improved, but not speed. This study provides evidence that the left dlPFC and the right vmPFC are involved in emotion regulation in ADHD.
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Affiliation(s)
- Reza Estaji
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mariam Hosseinzadeh
- Department of Psychiatry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Arabgol
- Department of Psychiatry, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran.
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4
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Smith JN, Jusko ML, Fosco WD, Musser ED, Raiker JS. A critical review of hot executive functioning in youth attention-deficit/hyperactivity disorder: Methodological limitations, conceptual considerations, and future directions. Dev Psychopathol 2024; 36:601-615. [PMID: 36734223 DOI: 10.1017/s0954579422001432] [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: 02/04/2023]
Abstract
Hot executive functioning (EF) - EF under emotionally or motivationally salient conditions - is a putative etiology of attention-deficit/hyperactivity disorder (ADHD), disruptive behavior problems (DBPs), and their related impairments. Despite two decades of research, the present study is the first review of the construct in youth ADHD, with a particular focus on the role of task design, age, and DBPs, as well as relevant conceptual and methodological considerations. While certain hot EF tasks have been investigated extensively (e.g., choice impulsivity), substantial inconsistency in measurement of the broader construct remains, severely limiting conclusions. Future research should a) consider the extent to which various hot EF tasks relate to one another, a higher order factor, and other related constructs; b) further investigate task design, particularly the elicitation of emotion or motivation and its anticipated effect on EF; and c) incorporate multiple levels of analysis to validate similarities and differences among tasks with regard to the affective experiences and cognitive demands they elicit. With improved measurement and conceptual clarity, hot EF has potential to advance the literature on etiological pathways to ADHD, DBPs and associated impairments and, more broadly, may represent a useful tool for understanding the influence of emotion and motivation on cognition.
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Affiliation(s)
| | | | | | - Erica D Musser
- Florida International University (FIU), USA
- FIU Center for Children and Families, USA
- FIU Embrace, USA
| | - Joseph S Raiker
- Florida International University (FIU), USA
- FIU Center for Children and Families, USA
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5
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Yeung MK, Wan JCH, Chan MMK, Cheung SHY, Sze SCY, Siu WWY. Motivation and emotional distraction interact and affect executive functions. BMC Psychol 2024; 12:188. [PMID: 38581067 PMCID: PMC10998358 DOI: 10.1186/s40359-024-01695-9] [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: 09/21/2023] [Accepted: 03/28/2024] [Indexed: 04/07/2024] Open
Abstract
Previous research on cool-hot executive function (EF) interactions has examined the effects of motivation and emotional distraction on cool EF separately, focusing on one EF component at a time. Although both incentives and emotional distractors have been shown to modulate attention, how they interact and affect cool EF processes is still unclear. Here, we used an experimental paradigm that manipulated updating, inhibition, and shifting demands to determine the interactions of motivation and emotional distraction in the context of cool EF. Forty-five young adults (16 males, 29 females) completed the go/no-go (inhibition), two-back (updating), and task-switching (shifting) tasks. Monetary incentives were implemented to manipulate motivation, and task-irrelevant threatening or neutral faces were presented before the target stimulus to manipulate emotional distraction. We found that incentives significantly improved no-go accuracy, two-back accuracy, and reaction time (RT) switch cost. While emotional distractors had no significant effects on overall task performance, they abolished the incentive effects on no-go accuracy and RT switch cost. Altogether, these findings suggest that motivation and emotional distraction interact in the context of cool EF. Specifically, transient emotional distraction disrupts the upregulation of control activated by incentives. The present investigation has advanced knowledge about the relationship between cool and hot EF and highlights the importance of considering motivation-emotion interactions for a fuller understanding of control.
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Affiliation(s)
- Michael K Yeung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong, China.
| | - Jaden Cheuk-Hei Wan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Michelle Mei-Ka Chan
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Sam Ho-Yu Cheung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Steven Chun-Yui Sze
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
| | - Winnie Wing-Yi Siu
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China
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6
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Zhang J, Guan W, Lipp OV. The effect of emotion counter-regulation to anger on working memory updating. Psychophysiology 2023; 60:e14366. [PMID: 37334924 DOI: 10.1111/psyp.14366] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/06/2023] [Accepted: 05/17/2023] [Indexed: 06/21/2023]
Abstract
Emotion counter-regulation has been suggested as the core cognitive mechanism of automatic emotion regulation. Emotion counter-regulation not only induces an unintentional transfer of attention from the current emotional state to stimuli with the opposite valence but also prompts approach to stimuli of the opposite valence and increases response inhibition to stimuli of the same valence. Working memory (WM) updating has been shown to be related to attention selection and response inhibition. However, it remains unclear whether emotion counter-regulation would affect WM updating with emotional stimuli. In the present study, 48 participants were recruited and randomly assigned to the angry-priming group that watched highly arousing angry video clips, or the control group that watched neutral video clips. Then participants performed a two-back face identity matching task with happy and angry face pictures. Behavioral results showed higher accuracy for identity recognition of happy than of angry faces. The event-related potential (ERP) results revealed smaller P2 to angry faces than to happy faces in the control group. In the angry-priming group, there was no difference in P2 amplitude between angry and happy trials. Between groups, P2 to angry faces was larger in the priming group than in the control group. Late positive potential (LPP) was smaller for happy faces than for angry faces in the priming group, but not in the control group. These findings suggest that emotion counter-regulation affects the onset updating and maintenance of emotional face stimuli in WM.
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Affiliation(s)
- Jing Zhang
- Department of Psychology, Renmin University of China, Beijing, China
| | - Wanyao Guan
- Department of Psychology, Renmin University of China, Beijing, China
| | - Ottmar V Lipp
- School of Psychology & Counselling, Queensland University of Technology, Brisbane, Queensland, Australia
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7
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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: 3] [Impact Index Per Article: 1.0] [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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8
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Mestre-Bach G, Steward T, Potenza MN, Granero R, Fernández-Aranda F, Mena-Moreno T, Magaña P, Vintró-Alcaraz C, Del Pino-Gutiérrez A, Menchón JM, Jiménez-Murcia S. The Role of ADHD Symptomatology and Emotion Dysregulation in Gambling Disorder. J Atten Disord 2021; 25:1230-1239. [PMID: 31884864 DOI: 10.1177/1087054719894378] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: Although emotion regulation deficits have been implicated in gambling disorder and ADHD, the interplay between these factors has yet to be systematically studied. We examined relationships between ADHD symptoms, emotion regulation, and gambling disorder severity in a sample of treatment-seeking gambling disorder patients (n = 98). We also examined clinical differences between patients with and without ADHD symptomatology. Method: Structural equation modeling (SEM) evaluated direct and indirect effects of ADHD and emotion regulation on gambling disorder severity. Results: Significant correlations between ADHD symptomatology and emotion regulation and between emotion regulation and gambling disorder severity were identified. Differences in emotion regulation were found between gambling disorder patients with and without ADHD symptomatology. Path analysis revealed emotion regulation to be a mediator between ADHD and gambling disorder. Conclusion: Our findings indicate the presence of ADHD symptomatology to be associated with greater severity of gambling disorder and greater emotional dysregulation.
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Affiliation(s)
- Gemma Mestre-Bach
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Yale School of Medicine, New Haven, CT, USA
| | - Trevor Steward
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,The University of Melbourne, Parkville, Victoria, Australia
| | - Marc N Potenza
- Yale School of Medicine, New Haven, CT, USA.,Connecticut Council on Problem Gambling, Wethersfield, USA.,Connecticut Mental Health Center, New Haven, USA
| | - Roser Granero
- Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,Universitat Autònoma de Barcelona, Spain
| | - Fernando Fernández-Aranda
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
| | - Teresa Mena-Moreno
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | - Pablo Magaña
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
| | - Cristina Vintró-Alcaraz
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
| | | | - José M Menchón
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,University of Barcelona, Spain.,CIBER Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Jiménez-Murcia
- Bellvitge University Hospital-IDIBELL, Barcelona, Spain.,Ciber Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain.,University of Barcelona, Spain
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9
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Leroy A, Spotorno S, Faure S. Emotional scene processing in children and adolescents with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 2021; 30:331-346. [PMID: 32034554 DOI: 10.1007/s00787-020-01480-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
"Impairments in emotional information processing are frequently reported in attention deficit hyperactivity disorder (ADHD) at a voluntary, explicit level (e.g., emotion recognition) and at an involuntary, implicit level (e.g., emotional interference). Most of previous studies have used faces with emotional expressions, rarely examining other important sources of information usually co-occurring with faces in our every day experience. Here, we examined how the emotional content of an entire visual scene depicting real-world environments and situations is processed in ADHD. We systematically reviewed in PubMed, SCOPUS and ScienceDirect, using the PRISMA guidelines, empirical studies published in English until March 2019, about processing of visual scenes, with or without emotional content, in children and adolescents with ADHD. We included 17 studies among the 154 initially identified. Fifteen used scenes with emotional content (which was task-relevant in seven and irrelevant in eight studies) and two used scenes without emotional content. Even though the interpretation of the results differed according to the theoretical model of emotions of the study and the presence of comorbidity, differences in scene information processing between ADHD and typically developing children and adolescents were reported in all but one study. ADHD children and adolescents show difficulties in the processing of emotional information conveyed by visual scenes, which may stem from a stronger bottom-up impact of emotional stimuli in ADHD, increasing the emotional experience, and from core deficits of the disorder, decreasing the overall processing of the scene".
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Affiliation(s)
- Anaïs Leroy
- Laboratoire D'Anthropologie Et de Psychologie Cliniques, Cognitives Et Sociales (LAPCOS), MSHS Sud Est, Université Côte D'Azur, Pôle Universitaire Saint Jean D'Angely, 24 avenue des Diables Bleus, 06357, Nice Cédex 4, France. .,CERTA, Reference Centre for Learning Disabilities, Fondation Lenval, Hôpitaux Pédiatriques de Nice CHU-Lenval, Nice, France.
| | | | - Sylvane Faure
- Laboratoire D'Anthropologie Et de Psychologie Cliniques, Cognitives Et Sociales (LAPCOS), MSHS Sud Est, Université Côte D'Azur, Pôle Universitaire Saint Jean D'Angely, 24 avenue des Diables Bleus, 06357, Nice Cédex 4, France
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10
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Zhang J, Yang L, Zhang Y, Su H, Zhang Y, Yang Y. Updating Emotional Stimuli in Heroin Abstainers' Working Memory: An Event-Related Potential Investigation. Subst Use Misuse 2021; 56:801-807. [PMID: 33754934 DOI: 10.1080/10826084.2021.1899223] [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: 10/21/2022]
Abstract
BACKGROUND It is well-documented that heroin users demonstrate aberrant emotion-processing abilities. However, the mechanism by which heroin users process emotional information after it has captured their attention and entered their working memory is unclear. OBJECTIVES A modified emotional 2-back task was used to examine whether heroin abstainers demonstrate specific bias patterns in updating emotional stimuli in their working memory. METHODS In total, 26 male heroin abstainers and 29 healthy controls were asked to identify whether the current picture was the same as a picture that had appeared two trials earlier, while behavioral data and electroencephalogram data were collected. RESULTS Contrary to predictions, the heroin abstainers and healthy controls demonstrated a similar pattern of P300 activity in response to emotional stimuli with no between-group differences in accuracy or reaction time. More specifically, the P300 amplitudes were larger for negative pictures than for positive and neutral pictures. Surprisingly, we found larger P300 amplitudes at Fz electrodes than at Cz and Pz electrodes in the control group, whereas there was no significant difference at midline electrodes in the heroin abstainers. CONCLUSIONS/IMPORTANCE Although subtle differences may exist in attentional engagement toward incoming emotional stimulus between two groups, the similar P300 pattern may indicate partial preservation of emotional working memory capacity associated with adaptive emotion regulation in heroin abstainers. These results deepen our understanding of the emotion regulation impairments associated with chronic drug use.
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Affiliation(s)
- Jianxun Zhang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Ling Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Yang Zhang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Hongting Su
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Yinyan Zhang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
| | - Yanhui Yang
- Key Laboratory of Behavioral and Mental Health of Gansu Province, School of Psychology, Northwest Normal University, Lanzhou, People's Republic of China
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11
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Muñoz-Suazo MD, Navarro-Muñoz J, Díaz-Román A, Porcel-Gálvez AM, Gil-García E. Sex differences in neuropsychological functioning among children with attention-deficit/hyperactivity disorder. Psychiatry Res 2019; 278:289-293. [PMID: 31254878 DOI: 10.1016/j.psychres.2019.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/19/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022]
Abstract
Cognitive impairments are often reported in research on children with attention-deficit/hyperactivity disorder (ADHD). However, studies analyzing sex differences in this context are still sparse. This study aimed to compare the neuropsychological performance of boys and girls with ADHD across several cognitive domains. Verbal comprehension, perceptual reasoning, working memory, processing speed, and general cognitive performance were assessed in 240 children aged 6-17 years: 120 children (65 boys) with a clinical diagnosis of ADHD and 120 typically developing children (60 boys). Underperformance of children with ADHD compared to controls was observed in all the evaluated cognitive domains, except for verbal comprehension. Significantly lower scores in perceptual reasoning, with a medium effect size, were found in girls with ADHD relative to boys, although the sexes did not significantly differ in terms of the remaining variables. Children's ADHD subtypes did not correlate significantly with any performance measure, and no significant interaction effects between children's age and sex were noted in the results. The performance commonalities found between boys and girls with ADHD outweighed the differences, which highlights the importance of further research on cognitive dysfunction in girls with ADHD, regardless of sex differences in the prevalence of the disorder.
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Affiliation(s)
| | | | - Amparo Díaz-Román
- Mind, Brain and Behavior Research Center, CIMCYC, University of Granada, Granada, Spain.
| | - Ana María Porcel-Gálvez
- Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, University of Seville, Seville, Spain
| | - Eugenia Gil-García
- Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry, University of Seville, Seville, Spain
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12
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Kim SY, Shin JE, Lee YI, Kim H, Jo HJ, Choi SH. Neural evidence for persistent attentional bias to threats in patients with social anxiety disorder. Soc Cogn Affect Neurosci 2019; 13:1327-1336. [PMID: 30445473 PMCID: PMC6277744 DOI: 10.1093/scan/nsy101] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 11/07/2018] [Indexed: 12/21/2022] Open
Abstract
Does the biased attention toward social threats dwells on or disappears in patients with social anxiety disorder (SAD)? We investigated the neural mechanism of attentional bias in terms of attentional capture and holding in SAD. A total of 31 SAD patients and 30 healthy controls performed a continuous performance task detecting the orientation of a red letter 'T' while angry or neutral face distractors appeared or disappeared at the center of the screen. Behaviorally, typical attentional capture effects were found in response to abruptly appearing distractors in both groups. The patient group showed significant attentional dwelling effects in response to the angry face distractor only. Patients showed increased neural activity in the amygdala, insula/inferior frontal gyrus (IFG) and temporo-parietal junction (TPJ) compared with those of controls for the abruptly appearing angry distractor. Patients also maintained increased activities in brain regions related to attentional reorienting to distractor, namely the TPJ and IFG in line with their behavioral results of attentional holding effects. Our results indicate that patients with SAD showed prolonged attentional bias to task-irrelevant social threats. The underlying mechanism of prolonged attentional bias in SAD was indicated with amygdala hyperactivity and continued activity of the bottom-up attention network including the TPJ and IFG.
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Affiliation(s)
- So-Yeon Kim
- Department of Psychology, Duksung Women's University, Seoul, Republic of Korea
| | - Jung Eun Shin
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Yoonji Irene Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Haena Kim
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, USA
| | - Hang Joon Jo
- Department of Neurology, Mayo Clinic, Rochester, MN, USA.,Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
| | - Soo-Hee Choi
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine and Institute of Human Behavioral Medicine, SNU-MRC, Seoul 03080, Republic of Korea
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13
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Abstract
PURPOSE OF REVIEW Emotional symptoms are common and persistent in youth and adults with attention-deficit/hyperactivity disorder (ADHD) and cause clinically significant impairments. We review recent neuropsychological, neurophysiological, and peripheral psychophysiological evidence for emotion and emotion regulation deficits in ADHD across youth and adults. RECENT FINDINGS Central and autonomous nervous system correlates argue in favor of more general self-regulation deficits and also specific emotional deficits in ADHD. These include general performance deficits in executive functions, and structural as well as functional impairments in neuronal networks associated with top-down self-regulation. Specific deficits with bottom-up emotional activation in the amygdala and emotion evaluation associated with the orbitofrontal cortex have also been described. Furthermore, vagally mediated, high-frequency heart rate variability is associated with emotional self-regulation deficits throughout the life span. The current evidence is based on multilevel studies that assess associations of emotion regulation. However, further studies that adequately consider the processual recursive character of emotion generation and regulation may give important new insights into emotional regulation of ADHD. Emotion regulation deficits in ADHD are associated with specific as well as general self-regulation deficits traceable on the level of neuropsychological, neurophysiological, and psychophysiological assessments. The temporal dynamics of the interplay of those different systems need further study in order to optimize and personalize treatment of emotion regulation difficulties, including emotional reactivity, in patients with ADHD.
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14
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Janus M, Bialystok E. Working Memory With Emotional Distraction in Monolingual and Bilingual Children. Front Psychol 2018; 9:1582. [PMID: 30210408 PMCID: PMC6120977 DOI: 10.3389/fpsyg.2018.01582] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 08/08/2018] [Indexed: 12/21/2022] Open
Abstract
Extensive work has demonstrated the benefits of bilingualism on executive functioning (EF) across the lifespan. Concurrently, other research has shown that EF is related to emotion regulation (ER), an ability that is integral to healthy socio-emotional development. However, no research to date has investigated whether bilingualism-related advantages in EF can also be found in emotional contexts. The current study examined the performance of 93 children who were 9-years old, about half of whom were bilingual, on the Emotional Face N-Back Task, an ER task used to assess the interference effect of emotional processing on working memory. Bilingual children were more accurate than monolingual children in both 1-back and 2-back conditions but were significantly slower than monolingual children on the 2-back condition. There were significant effects of emotional valence on reaction time, but these did not differ across language groups. These results confirm previous research showing better EF performance by bilinguals, but no differences in ER were found between language groups. Findings are discussed in the context of our current understanding of the ER literature with potential implications for previously unexplored differences between monolingual and bilingual children.
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Affiliation(s)
| | - Ellen Bialystok
- Department of Psychology, York University, Toronto, ON, Canada
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15
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Electrophysiological evidence of an attentional bias towards appetitive and aversive words in adults with attention-deficit/hyperactivity disorder. Clin Neurophysiol 2018; 129:1937-1946. [PMID: 30007893 DOI: 10.1016/j.clinph.2018.06.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/15/2018] [Accepted: 06/23/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Emotional dysregulation has emerged as a core symptom domain in adults with Attention-Deficit/Hyperactivity Disorder (ADHD). However, the pathophysiological underpinnings remain poorly understood. This study investigated attentional biases to positive and negative emotional words as possible contributing mechanisms. METHODS Event-related potentials (ERPSs) and behavioral attention bias indices were recorded from 39 adult patients with ADHD and 41 healthy controls during a verbal dot-probe task with positive-neutral, negative-neutral, and neutral-neutral word pairs. RESULTS Cue-locked N2pc amplitudes indicated a significant attentional bias towards emotional words in patients with ADHD and healthy controls. In healthy controls, the bias was only significant in positive trials. In patients, the bias was associated with ADHD severity and self-reported poor emotion regulation skills. ADHD patients also exhibited reduced target-locked P1 amplitudes and inferior behavioral performance compared with healthy controls. CONCLUSIONS Our findings provide evidence of an attention bias to positive and negative emotional stimuli in adult patients with ADHD and adverse effects of emotional stimuli on task performance. SIGNIFICANCE An attentional bias to emotional stimuli might contribute to emotional reactivity and dysregulation in adult patients with ADHD.
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16
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Vetter NC, Buse J, Backhausen LL, Rubia K, Smolka MN, Roessner V. Anterior insula hyperactivation in ADHD when faced with distracting negative stimuli. Hum Brain Mapp 2018; 39:2972-2986. [PMID: 29569801 PMCID: PMC6866282 DOI: 10.1002/hbm.24053] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/08/2018] [Accepted: 03/12/2018] [Indexed: 01/30/2023] Open
Abstract
Patients with attention deficit hyperactivity disorder (ADHD) suffer from poor emotion regulation that might arise from problems in the distribution of attentional resources when confronted with emotional distractors. Previous studies investigating the neurocognitive basis of these problems remain inconclusive. Moreover, most of these studies did not exclude participants with comorbidity, particularly of conduct or oppositional defiant disorder. The aim of this study was to assess alterations in fronto-limbic activation in ADHD adolescents specifically during negative distractors in an emotional attention task. For this purpose, we used functional magnetic resonance imaging to assess 25 boys with noncomorbid ADHD and 25 typically developing (TD) boys while they performed an emotional attention task with positive, negative, and neutral emotional distractors. Boys with ADHD had increased activation relative to TD boys specifically during the negative valenced stimuli in an emotional processing network comprising left anterior insula reaching into the inferior frontal gyrus. The findings suggest altered salience processing in ADHD of negative valenced emotional stimuli that may lead to higher distractibility in ADHD specifically when faced with negative emotional distractors.
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Affiliation(s)
- Nora C. Vetter
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the TU DresdenDresdenGermany
| | - Judith Buse
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the TU DresdenDresdenGermany
| | - Lea L. Backhausen
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the TU DresdenDresdenGermany
| | - Katya Rubia
- Department of Child & Adolescent PsychiatryInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUnited Kingdom
| | - Michael N. Smolka
- Department of Psychiatry and Neuroimaging CenterTechnische Universität DresdenDresdenGermany
| | - Veit Roessner
- Department of Child and Adolescent PsychiatryFaculty of Medicine of the TU DresdenDresdenGermany
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