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D’Aiello B, Di Vara S, De Rossi P, Vicari S, Menghini D. The effect of a single dose of methylphenidate on attention in children and adolescents with ADHD and comorbid Oppositional Defiant Disorder. PLoS One 2024; 19:e0299449. [PMID: 39133690 PMCID: PMC11318934 DOI: 10.1371/journal.pone.0299449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 02/10/2024] [Indexed: 08/15/2024] Open
Abstract
The co-occurrence Oppositional Defiant Disorder (ODD) in children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has been associated to difficulties in regulating adverse states, elevated functional impairment, deficits in Executive Functions and high risk for psychopathology. Recent studies have shown that ODD is a negative predictor of a positive response to methylphenidate (MPH) treatment for ADHD symptoms in children and adolescents and that patients with a diagnosis of comorbid ADHD and ODD are less likely to respond favorably to pharmacological treatment with MPH. We conducted a naturalistic study to understand the clinical characteristics of drug-naïve children and adolescents with ADHD that influence the response to MPH by measuring the effect on attention. Specifically, we investigated whether a single dose of MPH differently affects the performance of 53 children and adolescents with ADHD with or without ODD comorbidity. In addition, participant characteristics such as symptom severity, functional impairment, and associated behavioral and emotional symptoms at baseline were examined to better understand what aspects affect the response to MPH. We found that a single dose of MPH improved the attention of children and adolescents with ADHD without ODD more than those with comorbid ADHD and ODD, resulting in reduced reaction times. Our findings indicated that children and adolescents with comorbid ADHD and ODD and those with ADHD alone did not exhibit differences in measures of attention prior to taking MPH, nor in demographic variables (age, intelligence quotient, gender), clinical characteristics related to symptom severity, and adaptive behaviors. However, we observed differences between the two groups in certain behavioral aspects, including the Dysregulation Profile and disruptive behaviors. Assessing symptoms in combination with the presence of ADHD can be beneficial in determining which individuals would derive the greatest benefits from treatment.
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Affiliation(s)
- Barbara D’Aiello
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Human Science, LUMSA University, Rome, Italy
| | - Silvia Di Vara
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Pietro De Rossi
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Department of Life Science and Public Health, Catholic University of the Sacred Heart, Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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Clark CA, Cook K, Wang R, Rueschman M, Radcliffe J, Redline S, Taylor HG. Psychometric properties of a combined go/no-go and continuous performance task across childhood. Psychol Assess 2023; 35:353-365. [PMID: 36633982 PMCID: PMC10041761 DOI: 10.1037/pas0001202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Despite the critical importance of attention for children's self-regulation and mental health, there are few task-based measures of this construct appropriate for use across a wide childhood age range including very young children. Three versions of a combined go/no-go and continuous performance task (GNG/CPT) were created with varying length and timing parameters to maximize their appropriateness for age groups spanning early to middle childhood. As part of the baseline assessment of a clinical trial, 452 children aged 3-12 years (50% male, 50% female; 52% White, non-Hispanic, 27% Black, 16% Hispanic/Latinx; 6% other ethnicity/race) completed the task. Confirmatory factor analysis indicated that all task versions assessed two latent factors, labeled response inhibition and sustained attention. Versions for older children elicited lower overall accuracy while equating levels of inhibitory demand. All versions showed limited floor and ceiling effects, as well as developmental sensitivity. Boys showed higher commission error rates and children from lower income households showed lower performance across multiple task metrics. Task metrics, especially d prime and accuracy summary scores, correlated with parent-reported executive function and externalizing behavior. Task scores show promise as valid and sensitive indicators of inhibition and sustained attention across heterogeneous pediatric age groups. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Caron A.C. Clark
- Department of Educational Psychology, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Kaitlyn Cook
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA
| | - Rui Wang
- Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep Medicine and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Michael Rueschman
- Division of Sleep Medicine and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jerilynn Radcliffe
- Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Center for Human Phenomic Science, Children′s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Susan Redline
- Division of Sleep Medicine and Circadian Disorders, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - H. Gerry Taylor
- Department of Pediatrics, Abigail Wexner Research Institute at Nationwide Children′s Hospital and The Ohio State University, Columbus, Ohio, USA
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Shannon KA, Scerif G, Raver CC. Using a multidimensional model of attention to predict low-income preschoolers' early academic skills across time. Dev Sci 2020; 24:e13025. [PMID: 32749034 DOI: 10.1111/desc.13025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 07/16/2020] [Accepted: 07/23/2020] [Indexed: 11/30/2022]
Abstract
The current study examines the organization of attention skills across the preschool year before kindergarten, and tests how distinct attention subcomponents predict early academic skills in a sample of low-income children (n = 99). Children completed well-validated attention tasks in fall at 4.5 years old and spring at 5 years old, capturing the abilities to selectively focus, sustain attention, and employ executive control. Exploratory factor analyses at both time points support a 2-factor model differentiating selective and sustained attention from attention processing speed and executive attention, suggesting that attention in low-income preschoolers may have a simpler organization than the 3-factor structure found in adulthood. Multiple regression models find children's ability to selectively focus and sustain attention serves as a robust concurrent and longitudinal predictor of academic skills. These results highlight the role of selective and sustained attention processes in supporting school readiness for economically vulnerable children.
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Affiliation(s)
| | | | - C Cybele Raver
- Applied Psychology, New York University, New York, NY, USA
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Quistberg KA, Mueller U. Prospective relations between kindergarteners’ executive function skills and their externalizing and internalizing behaviors. Clin Neuropsychol 2019; 34:845-862. [DOI: 10.1080/13854046.2019.1591510] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Kirsten A. Quistberg
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Ulrich Mueller
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Marx I, Weirich S, Berger C, Herpertz SC, Cohrs S, Wandschneider R, Höppner J, Häßler F. Living in the Fast Lane: Evidence for a Global Perceptual Timing Deficit in Childhood ADHD Caused by Distinct but Partially Overlapping Task-Dependent Cognitive Mechanisms. Front Hum Neurosci 2017; 11:122. [PMID: 28373837 PMCID: PMC5357633 DOI: 10.3389/fnhum.2017.00122] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 03/03/2017] [Indexed: 11/13/2022] Open
Abstract
Dysfunctions in perceptual timing have been reported in children with ADHD, but so far only from studies that have not used the whole set of timing paradigms available from the literature, with the diversity of findings complicating the development of a unified model of timing dysfunctions and its determinants in ADHD. Therefore, we employed a comprehensive set of paradigms (time discrimination, time estimation, time production, and time reproduction) in order to explore the perceptual timing deficit profile in our ADHD sample. Moreover, we aimed to detect predictors responsible for timing task performance deficits in children with ADHD and how the timing deficits might be positively affected by methylphenidate. Male children with ADHD and healthy control children, all aged between 8 and 13 years, participated in this longitudinal study with three experimental sessions, where children with ADHD were medicated with methylphenidate at the second session but discontinued their medication at the remaining sessions. The results of our study reveal that children with ADHD were impaired in all timing tasks, arguing for a general perceptual timing deficit in ADHD. In doing so, our predictor analyses support the notion that distinct but partially overlapping cognitive mechanisms might exist for discriminating, estimating/producing, and reproducing time intervals. In this sense, working memory deficits in terms of an abnormally fast internal counting process might be common to dysfunctions in the time estimation/time production tasks and in the time reproduction task, with attention deficits (e.g., in terms of disruptions of the counting process) additionally contributing to time estimation/time production deficits and motivational alterations additionally contributing to time reproduction deficits. Methylphenidate did not significantly alter performance of the ADHD sample, presumably due to limited statistical power of our study. The findings of our study demonstrate a pivotal role of disturbed working memory processes in perceptual timing task performance in childhood ADHD, at the same time broadening the view for additional attentional and motivational determinants of impaired task performance.
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Affiliation(s)
- Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Steffen Weirich
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, University of Heidelberg Heidelberg, Germany
| | - Stefan Cohrs
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Roland Wandschneider
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Jacqueline Höppner
- Department of Psychiatry and Psychotherapy, University Medicine Rostock Rostock, Germany
| | - Frank Häßler
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock Rostock, Germany
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Griffith SF, Arnold DH, Rolon-Arroyo B, Harvey EA. Neuropsychological Predictors of ODD Symptom Dimensions in Young Children. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2017; 48:80-92. [PMID: 28080145 DOI: 10.1080/15374416.2016.1266643] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Oppositional defiant disorder (ODD) is a commonly diagnosed childhood behavior disorder, yet knowledge of relations between ODD and early neuropsychological functions, particularly independent of attention deficit/hyperactivity disorder (ADHD), is still limited. In addition, studies have not examined neuropsy chological functioning as it relates to the different ODD symptom dimensions. Structural equation modeling was used to investigate how preschool neuropsychological functioning predicted negative affect, oppositional behavior, and antagonistic behavior symptom dimensions of ODD in 224 six-year-old children, oversampled for early behavior problems. Working memory, inhibition, and sustained attention predicted negative affect symptoms of ODD, controlling for ADHD, whereas delay aversion uniquely predicted oppositional behavior, controlling for ADHD. Delay aversion also marginally predicted antagonistic behavior, controlling for ADHD. Results demonstrate that different ODD symptom dimensions may be differentially predicted by different neuropsychological functions. The findings further underscore the importance of future research on ODD to take into account the possible heterogeneity of both symptoms and underlying neuropsychological functioning.
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Affiliation(s)
- Shayl F Griffith
- a Psychological and Brain Sciences , University of Massachusetts Amherst
| | - David H Arnold
- a Psychological and Brain Sciences , University of Massachusetts Amherst
| | | | - Elizabeth A Harvey
- a Psychological and Brain Sciences , University of Massachusetts Amherst
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