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Kostyrka-Allchorne K, Wass SV, Yusuf H, Rao V, Bertini C, Sonuga-Barke EJS. Inhibitory deficits and symptoms of attention-deficit hyperactivity disorder: How are they related to effortful control? BRITISH JOURNAL OF DEVELOPMENTAL PSYCHOLOGY 2023; 41:50-65. [PMID: 36127834 PMCID: PMC10087402 DOI: 10.1111/bjdp.12432] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 06/29/2022] [Accepted: 09/08/2022] [Indexed: 11/30/2022]
Abstract
Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms - inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.
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Affiliation(s)
- Katarzyna Kostyrka-Allchorne
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Sam V Wass
- School of Psychology, University of East London, London, UK
| | - Hodo Yusuf
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Vidya Rao
- School of Psychology, University of East London, London, UK
| | - Chloé Bertini
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
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2
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Gallagher R, Kessler K, Bramham J, Dechant M, Friehs MA. A proof-of-concept study exploring the effects of impulsivity on a gamified version of the stop-signal task in children. Front Psychol 2023; 14:1068229. [PMID: 36844283 PMCID: PMC9946965 DOI: 10.3389/fpsyg.2023.1068229] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
This proof-of-concept study provides an appraisal of a remotely administered gamified Stop-Signal Task (gSST) for future use in studies using child sample. Performance on the standard Stop-Signal (SST) task has been shown previously to differentiate attention-deficit-hyperactivity-disorder groups from controls. As is the case with the SST, it was envisaged that those with greater impulsivity would perform worse than those with lower levels of impulsivity in the gSST. The potential advantage of the gSST is that it could be perceived as less monotonous than the original SST and has the potential to provide higher data quality in child samples, however future research will need to be conducted to determine this. The gSST was administered remotely via video chat to 30 child participants within a community sample aged 8-12 to investigate the effect of ADHD symptoms and intrinsic motivation on gSST performance. Qualitative data was collected based on feedback from participants to gain insight into how the gSST was received by participants. A positive correlation was observed between impulsive/hyperactivity and gSST performance, however there was insufficient evidence to suggest that impulsivity predicted performance. With regards to accuracy, results suggested that impulsivity level significantly predicted the rate of go-omission errors. No relationships were observed between intrinsic motivation inventory (IMI) subscales and performance or IMI and impulsivity. Nevertheless, mean IMI scores were overarchingly high for each of the IMI subscales, suggesting that regardless of performance and/or level of impulsive behaviour, the child sample obtained in this study demonstrated high levels of intrinsic motivation, which was supported by the predominantly positive subjective feedback provided by the child participants. The present study provides some evidence based on quantitative and qualitative results for the efficacy of gSST for use with children. Future research with a larger sample of children is warranted to examine how performance on the SST and gSST compare/differ.
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Affiliation(s)
- Ruth Gallagher
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Klaus Kessler
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jessica Bramham
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Martin Dechant
- ZEISS Vision Science Lab, Institute for Ophthalmic Research, Tübingen University, Tübingen, Germany,UCLIC, University College London, London, United Kingdom
| | - Maximilian A. Friehs
- School of Psychology, University College Dublin, Dublin, Ireland,Lise-Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany,Department of Psychology of Conflict, Risk and Safety, University of Twente, Enschede, Netherlands,*Correspondence: Maximilian A. Friehs,
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3
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Davidson TL, Ramirez E, Kwarteng EA, Djan KG, Faulkner LM, Parker MN, Yang SB, Zenno A, Kelly NR, Shank LM, Tanofsky-Kraff M, Snelling A, Belson SI, Hyde A, Chen KY, Yanovski JA. Retrieval-induced forgetting in children and adolescents with and without obesity. Int J Obes (Lond) 2022; 46:851-858. [PMID: 35042933 PMCID: PMC8967761 DOI: 10.1038/s41366-021-01036-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/02/2021] [Accepted: 11/23/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND/OBJECTIVES Previous research indicates that youth with obesity exhibit deficits in executive functioning (EF), which often take the form of impaired response inhibition. One aspect of EF not previously studied in obesity is the adaptive process known as retrieval-induced forgetting (RIF), the suppression/inhibition of intrusive or non-target items by the retrieval of specific items from memory. The present study investigated if child or adolescent obesity disrupts the ability to inhibit retrieval of intrusive memories. SUBJECTS/METHODS We compared the manifestation of RIF in children (ages 8-12) and adolescents (ages 13-18) as a function of their weight status and sex. We also evaluated the effects of these variables on simple recall of items from episodic memory under conditions where competition from intrusive items was reduced. RESULTS Children with obesity did not demonstrate significant RIF, whereas RIF was exhibited by preteens without obesity and by teenage participants with- and without obesity (Weight Status × Age Group interaction p = 0.028). This pattern of results did not differ as a function of sex for either age group. No differences in episodic memory were found. Additional analyses using Age as continuous covariate (and not as a nominal group) comparing participants who exhibited RIF with those who did not, found that the no RIF group consumed fast-food meals more frequently (p = 0.024) and had higher percentages of total body adiposity and android fat compared to the RIF group (p's < 0.05). CONCLUSIONS The findings expand what is known about the effects of childhood obesity on cognitive functioning, identify impaired RIF with specific behavioral and dietary factors and increased adiposity, and suggest the possibility that impairments in the ability to inhibit intrusive memories of food and eating may contribute to poor early-life weight control.
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Affiliation(s)
- Terry L Davidson
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA.
| | - Eliana Ramirez
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Esther A Kwarteng
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Kweku G Djan
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Loie M Faulkner
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Megan N Parker
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Shanna B Yang
- Nutrition Department, Clinical Research Center, NIH, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Anna Zenno
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Nichole R Kelly
- Department of Counseling Psychology and Human Services, Prevention Science Institute, University of Oregon, Eugene, OR, 97403-5207, USA
| | - Lisa M Shank
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Metis Foundation, 300 Convent St #1330, San Antonio, TX, 78205, USA
| | - Marian Tanofsky-Kraff
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences (USU), 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Medicine, Military Cardiovascular Outcomes Research (MiCOR), USU, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
| | - Anastasia Snelling
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- Department of Health Studies, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Sarah Irvine Belson
- Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
- School of Education, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Alexia Hyde
- Department of Neuroscience, American University, 4400 Massachusetts Avenue, NW, Washington, DC, 20016, USA
| | - Kong Y Chen
- Energy Metabolism Section, Diabetes, Endocrinology, and Obesity Branch, National Institute of Digestive Diseases, Diabetes, and Kidney Disorders, National Institutes of Health (NIH), Department of Health and Human Services (DHHS), 10 Center Drive, Bethesda, MD, 20892, USA
| | - Jack A Yanovski
- Section on Growth and Obesity, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), 10 Center Drive, Bethesda, MD, 20892, USA
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4
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Albert J, Rincón-Pérez I, Sánchez-Carmona AJ, Arroyo-Lozano S, Olmos R, Hinojosa JA, Fernández-Jaén A, López-Martín S. The development of selective stopping: Qualitative and quantitative changes from childhood to early adulthood. Dev Sci 2021; 25:e13210. [PMID: 34873804 DOI: 10.1111/desc.13210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/28/2021] [Accepted: 11/30/2021] [Indexed: 11/26/2022]
Abstract
Although progress has been made in elucidating the behavioral and neural development of global stopping across the lifespan, little is known about the development of selective stopping. This more complex form of inhibitory control is required in real-world situations where ongoing responses must be inhibited to certain stimuli but not others, and can be assessed in laboratory settings using a stimulus selective stopping task. Here we used this task to investigate the qualitative and quantitative developmental changes in selective stopping in a large-scale cross-sectional study with three different age groups (children, preadolescents, and young adults). We found that the ability to stop a response selectively to some stimuli (i.e., use a selective strategy) rather than non-selectively to all presented stimuli (i.e., use a global, non-selective strategy) is fully mature by early preadolescence, and remains stable afterwards at least until young adulthood. By contrast, the efficiency or speed of stopping (indexed by a shorter stop-signal reaction time or SSRT) continues to mature throughout adolescence until young adulthood, both for global and selective implementations of stopping. We also provide some preliminary findings regarding which other task variables beyond the strategy and SSRT predicted age group status. Premature responding (an index of "waiting impulsivity") and post-ignore slowing (an index of cognitive control) were among the most relevant predictors in discriminating between developmental age groups. Although present results need to be confirmed and extended in longitudinal studies, they provide new insights into the development of a relevant form of inhibitory control.
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Affiliation(s)
- Jacobo Albert
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Alberto J Sánchez-Carmona
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain.,Centro Neuromottiva, Madrid, Spain
| | | | - Ricardo Olmos
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | - José A Hinojosa
- Instituto Pluridisciplinar, Universidad Complutense de Madrid, Madrid, Spain.,Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain.,Centro de Ciencia Cognitiva - C3, Universidad Nebrija, Madrid, Spain
| | - Alberto Fernández-Jaén
- Hospital Universitario QuirónSalud, Madrid, Spain.,School of Medicine, Universidad Europea de Madrid, Madrid, Spain
| | - Sara López-Martín
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain.,Centro Neuromottiva, Madrid, Spain
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5
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Traut HJ, Chevalier N, Guild RM, Munakata Y. Understanding and Supporting Inhibitory Control: Unique Contributions From Proactive Monitoring and Motoric Stopping to Children's Improvements With Practice. Child Dev 2021; 92:e1290-e1307. [PMID: 34339051 PMCID: PMC11230644 DOI: 10.1111/cdev.13614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Children struggle to stop inappropriate behaviors. What interventions improve inhibitory control, for whom, and why? Prior work suggested that practice proactively monitoring for relevant signals improved children's inhibitory control more than practice with motoric stopping. However, these processes were not clearly dissociated. This study tested 162 seven- to nine-year-old children (89 female, 72 male, 1 unreported; 82% White) on the stop-signal task, following monitoring or stopping-focused practice. Both methods improved inhibitory control, supported generalization, and interacted ( η p 2 = .20-.73). Practice approaches differentially impacted variability ( η p 2 = .01-.09). Only monitoring benefits showed signs of depending upon proactive control ( η p 2 = .02). These findings highlight unique contributions of attentional and stopping processes to inhibitory control, suggesting possibilities for tailored interventions.
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Affiliation(s)
- Hilary J. Traut
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Nicolas Chevalier
- School of Philosophy, Psychology, and Language Sciences, University of Edinburgh, Scotland, United Kingdom
| | - Ryan M. Guild
- Renée Crown Wellness Institute, University of Colorado Boulder, Boulder, Colorado, United States of America
| | - Yuko Munakata
- Department of Psychology and Center for Mind and Brain, University of California-Davis, Davis, California, United States of America
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6
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Maron DN, Bowe SJ, Spencer-Smith M, Mellahn OJ, Perrykkad K, Bellgrove MA, Johnson BP. Oculomotor deficits in attention deficit hyperactivity disorder (ADHD): A systematic review and comprehensive meta-analysis. Neurosci Biobehav Rev 2021; 131:1198-1213. [PMID: 34655657 DOI: 10.1016/j.neubiorev.2021.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 10/04/2021] [Accepted: 10/10/2021] [Indexed: 02/01/2023]
Abstract
Atypical motor coordination and cognitive processes, such as response inhibition and working memory, have been extensively researched in individuals with attention deficit hyperactivity disorder (ADHD). Oculomotor neural circuits overlap extensively with regions involved in motor planning and cognition, therefore studies of oculomotor function may offer unique insights into motor and cognitive control in ADHD. We performed a series of pairwise meta-analyses based on data from 26 oculomotor studies in ADHD to examine whether there were differences in performance on visually-guided saccade, gap, antisaccade, memory-guided, pursuit eye movements and fixation tasks. These analyses revealed oculomotor disturbances in ADHD, particularly for difficulties relating to saccade inhibition, memorizing visual target locations and initiating antisaccades. There was no evidence for pursuit eye movement disturbances or saccade dysmetria. Investigating oculomotor abnormalities in ADHD may provide insight into top-down cognitive control processes and motor control, and may serve as a promising biomarker in ADHD research and clinical practice.
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Affiliation(s)
- Dalia N Maron
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, VIC, 3800, Australia
| | - Steven J Bowe
- Deakin Biostatistics Unit, Faculty of Health, Deakin University, Geelong, VIC, 3220, Australia
| | - Megan Spencer-Smith
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, VIC, 3800, Australia
| | - Olivia J Mellahn
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, VIC, 3800, Australia
| | - Kelsey Perrykkad
- Cognition and Philosophy Lab, Philosophy Department, School of Philosophical, Historical and International Studies, Monash University, VIC, 3800, Australia
| | - Mark A Bellgrove
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, VIC, 3800, Australia
| | - Beth P Johnson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, 18 Innovation Walk, Monash University, VIC, 3800, Australia.
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Associations of Hyperactivity and Inattention Scores with Theta and Beta Oscillatory Dynamics of EEG in Stop-Signal Task in Healthy Children 7-10 Years Old. BIOLOGY 2021; 10:biology10100946. [PMID: 34681045 PMCID: PMC8533509 DOI: 10.3390/biology10100946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/16/2021] [Accepted: 09/17/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary Most studies on ADHD have been focused on the comparisons between healthy subjects and clinical patients. The dimensional approaches propose that the main pathological behavioral domains are distributed in the normal population and not only in individual categories of people (as assumed in traditional schemes of comparisons between patients and controls). In the current study, we used a similar approach to identify potential markers of ADHD by studying the EEG dynamics of healthy children with a natural variability in hyperactivity and inattention scores during performance of the Stop-Signal task. We found that hyperactivity/inattention scores were positively associated with RT variability. Hyperactivity/inattention scores were negatively associated with an increase in beta spectral power in the first 200 ms and positively associated with an increase in theta rhythm at about 300 ms after presentation of the Go stimulus. It has been hypothesized that such results imply insufficient vigilance in the early stages of perception and subsequent compensatory enhancing of attention to the stimulus in children with higher hyperactivity and inattention scores. Abstract In the current study, we aimed to investigate the associations between the natural variability in hyperactivity and inattention scores, as well as their combination with EEG oscillatory responses in the Stop-Signal task in a sample of healthy children. During performance, the Stop-Signal task EEGs were recorded in 94 Caucasian children (40 girls) from 7 to 10 years. Hyperactivity/inattention and inattention scores positively correlated with RT variability. Hyperactivity/inattention and inattention scores negatively correlated with an increase in beta spectral power in the first 200 ms after presentation of the Go stimulus. Such results are in line with the lack of arousal model in ADHD children and can be associated with less sensory arousal in the early stages of perception in children with symptoms of inattention. The subsequent greater increase in theta rhythm at about 300 ms after presentation of the Go stimulus in children with higher inattention scores may be associated with increased attention processes and compensation for insufficient vigilance in the early stages of perception.
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8
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The impact of maternal personality traits on behavioral problems in preschool-aged children: a population-based panel study in South Korea. Arch Womens Ment Health 2021; 24:321-328. [PMID: 32995949 DOI: 10.1007/s00737-020-01069-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 09/23/2020] [Indexed: 10/23/2022]
Abstract
The impact of maternal personality traits on offspring behavioral problems has not been well established. In our study, the association between maternal personality traits and behavioral problems in preschool-aged children was investigated. A total of 192 preschoolers with their mothers, who were part of a population-based panel study in South Korea, were included in the present study. Maternal personality traits were assessed by the Personality Assessment Inventory (PAI) when the children were 1 year old. The Child Behavior Checklist (CBCL) 1.5-5 was used to identify behavioral problems in the children at 4 and 5 years of age. Maternal personality (borderline, somatization) positively correlated with behavioral problems (externalizing, internalizing, and dysregulation) in children. Maternal paranoid personality trait correlated with children's internalizing and dysregulation behavioral problems. Multiple linear regressions showed that maternal borderline trait significantly predicted children's externalizing (B = 0.302, P = 0.001), internalizing (B = 0.211, P = 0.020), and dysregulation problems (B = 0.327, P < 0.001). Similarly, maternal somatization trait predicted children's internalizing problems (B = 0.291, P < 0.001). Maternal borderline and somatization traits showed association with children's behavioral problems. Psychological intervention and support for mothers with these personality traits may be helpful in raising children with behavioral problems.
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9
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Hot and cool response inhibition abilities develop linearly from late childhood to young adulthood. COGNITIVE DEVELOPMENT 2021. [DOI: 10.1016/j.cogdev.2021.101039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Einziger T, Ben-Shachar MS, Devor T, Shmueli M, Auerbach JG, Berger A. "My Brain Can Stop": An ERP Study of Longitudinal Prediction of Inhibitory Control in Adolescence. Brain Sci 2021; 11:100. [PMID: 33451149 PMCID: PMC7828591 DOI: 10.3390/brainsci11010100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/05/2021] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
We examined the longitudinal predictors of electrophysiological and behavioral markers of inhibitory control in adolescence. Participants were 63 adolescent boys who have been followed since birth as part of a prospective longitudinal study on the developmental pathways to attention-deficit hyperactivity disorder (ADHD). At 17 years of age, they completed the stop-signal task (SST) while electroencephalography (EEG) was continuously recorded. Inhibitory control was evaluated by the stop-signal reaction time (SSRT) as well as by the amplitude of the event-related potential (ERP) component of N2 during successful inhibition. We found that higher inattention symptoms throughout childhood predicted reduced amplitude (i.e., less negative) of the N2 in adolescence. Furthermore, the N2 amplitude was longitudinally predicted by the early precursors of child familial risk for ADHD and early childhood temperament. Specifically, father's inattention symptoms (measured in the child's early infancy) and child's effortful control at 36 months of age directly predicted the N2 amplitude in adolescence, even beyond the consistency of inattention symptoms throughout development. The SSRT was predicted by ADHD symptoms throughout childhood but not by the early precursors. Our findings emphasize the relevance of early familial and temperamental risk for ADHD to the prediction of a later dysfunction in inhibitory control.
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Affiliation(s)
- Tzlil Einziger
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Mattan S. Ben-Shachar
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
| | - Tali Devor
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Michael Shmueli
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Judith G. Auerbach
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
| | - Andrea Berger
- Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (M.S.B.-S.); (T.D.); (M.S.); (J.G.A.); (A.B.)
- Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel
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11
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Merkt J, Siniatchkin M, Petermann F. Neuropsychological Measures in the Diagnosis of ADHD in Preschool: Can Developmental Research Inform Diagnostic Practice? J Atten Disord 2020; 24:1588-1604. [PMID: 27006414 DOI: 10.1177/1087054716629741] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The diagnosis of ADHD in preschool is challenging. Behavioral ratings are less reliable, but the value of neuropsychological tests in the diagnosis of ADHD has been debated. Method: This article provides an overview of neuropsychological measures utilized in preschoolers with ADHD (3-5 years). In addition, the manuscript discusses the extent to which these measures have been tested for their diagnostic capacity. Results: The diagnostic utility of computerized continuous performance tests and working memory subtests from IQ-batteries has been demonstrated in a number of studies by assessing their psychometric properties, sensitivity, and specificity. However, findings from developmental and basic research attempting to describe risk factors that explain variance in ADHD show the most consistent associations of ADHD with measures of delay aversion. Conclusion: Results from developmental research could benefit studies that improve ADHD diagnosis at the individual level. It might be helpful to consider testing as a structured situation for behavioral observation by the clinician.
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Affiliation(s)
- Julia Merkt
- Helmut-Schmidt-University, Hamburg, Germany.,Center for Research on Individual Development and Adaptive Education of Children at Risk (IDeA), Frankfurt, Germany
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12
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Rattat AC, Chevalier N. The Different Contribution of Executive Control to Temporal Comparison and Reproduction in Children and Adults. JOURNAL OF COGNITION AND DEVELOPMENT 2020. [DOI: 10.1080/15248372.2020.1802278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Tenenbaum RB, Musser ED, Morris S, Ward AR, Raiker JS, Coles EK, Pelham WE. Response Inhibition, Response Execution, and Emotion Regulation among Children with Attention-Deficit/Hyperactivity Disorder. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:589-603. [PMID: 30112596 DOI: 10.1007/s10802-018-0466-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in response inhibition, response execution, and emotion regulation. However, the nature of the associations among these deficits remains unclear. Thus, this study examines these associations using a multi-method design. One hundred sixty-six children (aged 5-13 years; 66.3% male; 75 with ADHD) completed two conditions (i.e., neutral and fear) of an emotional go/no-go task. Parasympathetic-based regulation was indexed via respiratory sinus arrhythmia (RSA), and sympathetic-based reactivity was indexed via cardiac pre-ejection period (PEP). Overall, children exhibited more difficulty with response execution (i.e., more omission errors, fewer correct go responses) and less difficulty with response inhibition (i.e., fewer commission errors, more correct no-go responses) during the fear condition than the neutral condition. Children with ADHD displayed more difficulty with response execution during the fear condition compared to typically developing youth. Additionally, children with ADHD displayed parasympathetic-based dysregulation (i.e., RSA increase from baseline) and reduced sympathetic-based reactivity (i.e., PEP lengthening) compared to typically developing youth across task conditions. In sum, children with ADHD demonstrate greater difficulty with response execution during emotionally salient contexts, as well as parasympathetic-based emotion dysregulation. Future work should examine these associations longitudinally with the aim of predicting impairment and treatment response in youth with ADHD.
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Affiliation(s)
- Rachel B Tenenbaum
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Erica D Musser
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA.
| | - Stephanie Morris
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Anthony R Ward
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Joseph S Raiker
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - Erika K Coles
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
| | - William E Pelham
- Center for Children and Families, Department of Psychology, Florida International University, 11200 SW 8th St., AHC 4 455, Miami, FL, 33100, USA
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14
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Anticipatory oculomotor responses in parents of children with attention deficit hyperactivity disorder. Psychiatr Genet 2020; 30:65-72. [DOI: 10.1097/ypg.0000000000000252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Gómez-Tello MF, Rosetti MF, Galicia-Alvarado M, Maya C, Apiquian R. Neuropsychological screening with TOWI: Performance in 6- to 12-year-old children. APPLIED NEUROPSYCHOLOGY-CHILD 2020; 11:115-124. [PMID: 32429822 DOI: 10.1080/21622965.2020.1764357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Videogames represent an exciting development in neuropsychological assessment of cognitive function. Here, we used TOWI, a series of games based on standardized tests, to evaluate the cognitive performance of a large sample of school-age children. We compared the metrics produced by TOWI with the performance metrics reported for the standardized tests that inspired each of these tasks. We found ascending values together with age for scores reflecting correct answers and descending values together with age for scores reflecting completion times, mistakes or missed entries. Sensitivity to developmental changes, similarities with standardized tests of task metrics contribute to the validity of TOWI as a screening tool.
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Affiliation(s)
- Maria F Gómez-Tello
- Kognisi, Mexico City, Mexico.,Areté Proyectos y Administración, Mexico City, Mexico
| | - Marcos F Rosetti
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico.,Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | | | - César Maya
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Rogelio Apiquian
- Areté Proyectos y Administración, Mexico City, Mexico.,Facultad de Ciencias de la Salud, Universidad Anáhuac Campus Norte, Mexico City, Mexico
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16
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Inhibition is associated with whole-brain structural brain connectivity on network level in school-aged children born very preterm and at term. Neuroimage 2020; 218:116937. [PMID: 32416228 DOI: 10.1016/j.neuroimage.2020.116937] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/31/2020] [Accepted: 05/08/2020] [Indexed: 12/17/2022] Open
Abstract
Inhibition abilities are often impaired in children born very preterm. In typically-developing individuals, inhibition has been associated with structural brain connectivity (SC). As SC is frequently altered following preterm birth, this study investigated whether aberrant SC underlies inhibition deficits in school-aged children born very preterm. In a group of 67 very preterm participants aged 8-13 years and 69 term-born peers, inhibition abilities were assessed with two tasks. In a subgroup of 50 very preterm and 62 term-born participants, diffusion tensor imaging (DTI) data were collected. Using network-based statistics (NBS), mean fractional anisotropy (FAmean) was compared between groups. Associations of FAmean and inhibition abilities were explored through linear regression. The composite score of inhibition abilities was lower in the very preterm group (M = -0.4, SD = 0.8) than in the term-born group (M = 0.0, SD = 0.8) but group differences were not significant when adjusting for age, sex and socio-economic status (β = -0.13, 95%-CI [-0.30, 0.04], p = 0.13). In the very preterm group, FAmean was significantly lower in a network comprising thalamo-frontal, thalamo-temporal, frontal, cerebellar and intra-hemispheric connections than in the term-born group (t = 5.21, lowest p-value = 0.001). Irrespective of birth status, a network comprising parietal, cerebellar and subcortical connections was positively associated with inhibition abilities (t = 4.23, lowest p-value = 0.02). Very preterm birth results in long-term alterations of SC at network-level. As networks underlying inhibition abilities do not overlap with those differing between the groups, FAmean may not be adequate to explain inhibition problems in very preterm children. Future studies should combine complementary measures of brain connectivity to address neural correlates of inhibition abilities.
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17
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Passarotti AM, Balaban L, Colman LD, Katz LA, Trivedi N, Liu L, Langenecker SA. A Preliminary Study on the Functional Benefits of Computerized Working Memory Training in Children With Pediatric Bipolar Disorder and Attention Deficit Hyperactivity Disorder. Front Psychol 2020; 10:3060. [PMID: 32116872 PMCID: PMC7014966 DOI: 10.3389/fpsyg.2019.03060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 12/26/2019] [Indexed: 12/25/2022] Open
Abstract
Twenty-nine pediatric patients (age range, 10–16 years) with working memory (WM) deficits, including children with pediatric bipolar disorder (PBD) with and without attention-deficit hyperactivity disorder (ADHD) comorbidity and children with ADHD, underwent a Cogmed WM training program. For both patient groups, WM performance on Cogmed tasks and on the Digit Span test improved significantly after training. Moreover, the PBD group improved on Trails Making Test A and on the Inhibition Scale, the Behavior Regulation Index, and the Global Executive Composite of the Behavioral Rating Inventory of Executive Function. The ADHD group improved significantly on the Trails Making Test B, the Spatial Span Test, and the Reading Fluency Test of the Woodcock–Johnson III, as well as on depressive symptoms. The present findings suggest that working memory training is beneficial not only in youths with ADHD but also in youths with PBD. They also show evidence of near and far transfer of WM improvement in these patients, although in different ways for the two patient groups. Future studies examining the mechanisms of cognitive remediation in pediatric patients will aid in creating tailored illness-specific cognitive interventions.
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Affiliation(s)
- Alessandra M Passarotti
- Department of Psychology, The University of Illinois at Chicago, Chicago, IL, United States.,Institute for Health Research and Policy, The University of Illinois at Chicago, Chicago, IL, United States
| | - Livia Balaban
- Department of Psychology, Adler University, Chicago, IL, United States
| | - Liza D Colman
- Health Science Center, Texas Tech University, Lubbock, TX, United States
| | - Lindsay A Katz
- Department of Psychology, Roosevelt University, Chicago, IL, United States
| | - Nidhi Trivedi
- The Chicago School of Professional Psychology, Chicago, IL, United States
| | - Li Liu
- School of Public Health, The University of Illinois at Chicago, Chicago, IL, United States
| | - Scott A Langenecker
- Department of Psychiatry, College of Medicine, University of Utah, Salt Lake City, UT, United States
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18
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Śmigasiewicz K, Ambrosi S, Blaye A, Burle B. Inhibiting errors while they are produced: Direct evidence for error monitoring and inhibitory control in children. Dev Cogn Neurosci 2020; 41:100742. [PMID: 31999563 PMCID: PMC6994603 DOI: 10.1016/j.dcn.2019.100742] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 10/14/2019] [Accepted: 11/29/2019] [Indexed: 11/23/2022] Open
Abstract
The maturation of processes involved in performance monitoring, crucial for adaptive behavior, is a core aspect of developmental changes. Monitoring processes are often studied through the analysis of error processing. Previous developmental studies generally focused on post-error slowing and error-related EEG activities. Instead, the present study aims at collecting indicators of error monitoring processes occurring within trials that is, before the erroneous response is produced. Electromyographic (EMG) activity and force produced during responding were registered in 6 to 14-year-olds performing a choice-response task. As already reported in adults, force produced was weaker, EMG bursts were smaller, and motor times (interval between EMG onsets and responses) were longer during errors compared to correct responses. In contrast, the rising part of EMG burst, reflecting the initial motor command, was the same for both response outcomes. This suggests that error inhibition was applied online after the response was triggered but before the actual key was pressed. This error correction was already present in children as young as 6 years old. The effects of reduced EMG and force amplitudes remained stable across childhood. However, the prolonged motor times in young children suggests that they need more time to implement motor inhibition than their older peers.
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Affiliation(s)
- Kamila Śmigasiewicz
- Laboratoire de Neurosciences Cognitives, CNRS, Aix-Marseille Université, France.
| | - Solène Ambrosi
- Laboratoire de Psychologie Cognitive, CNRS, Aix-Marseille Université, France
| | - Agnès Blaye
- Laboratoire de Psychologie Cognitive, CNRS, Aix-Marseille Université, France
| | - Boris Burle
- Laboratoire de Neurosciences Cognitives, CNRS, Aix-Marseille Université, France.
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19
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Leontyev A, Yamauchi T. Mouse movement measures enhance the stop-signal task in adult ADHD assessment. PLoS One 2019; 14:e0225437. [PMID: 31770416 PMCID: PMC6880625 DOI: 10.1371/journal.pone.0225437] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 11/05/2019] [Indexed: 02/03/2023] Open
Abstract
The accurate detection of attention-deficit/hyperactivity disorder (ADHD) symptoms, such as inattentiveness and behavioral disinhibition, is crucial for delivering timely assistance and treatment. ADHD is commonly diagnosed and studied with specialized questionnaires and behavioral tests such as the stop-signal task. However, in cases of late-onset or mild forms of ADHD, behavioral measures often fail to gauge the deficiencies well-highlighted by questionnaires. To improve the sensitivity of behavioral tests, we propose a novel version of the stop-signal task (SST), which integrates mouse cursor tracking. In two studies, we investigated whether introducing mouse movement measures to the stop-signal task improves associations with questionnaire-based measures, as compared to the traditional (keypress-based) version of SST. We also scrutinized the influence of different parameters of stop-signal tasks, such as the method of stop-signal delay setting or definition of response inhibition failure, on these associations. Our results show that a) SSRT has weak association with impulsivity, while mouse movement measures have strong and significant association with impulsivity; b) machine learning models trained on the mouse movement data from "known" participants using nested cross-validation procedure can accurately predict impulsivity ratings of "unknown" participants; c) mouse movement features such as maximum acceleration and maximum velocity are among the most important predictors for impulsivity; d) using preset stop-signal delays prompts behavior that is more indicative of impulsivity.
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Affiliation(s)
- Anton Leontyev
- Department of Psychological and Brain Sciences, Texas
A&M University,Texas, United States of America
| | - Takashi Yamauchi
- Department of Psychological and Brain Sciences, Texas
A&M University,Texas, United States of America
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20
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Malone SA, Pritchard VE, Heron-Delaney M, Burgoyne K, Lervåg A, Hulme C. The relationship between numerosity discrimination and arithmetic skill reflects the approximate number system and cannot be explained by inhibitory control. J Exp Child Psychol 2019; 184:220-231. [DOI: 10.1016/j.jecp.2019.02.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 01/14/2019] [Accepted: 02/28/2019] [Indexed: 11/25/2022]
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21
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van Hulst BM, de Zeeuw P, Vlaskamp C, Rijks Y, Zandbelt BB, Durston S. Children with ADHD symptoms show deficits in reactive but not proactive inhibition, irrespective of their formal diagnosis. Psychol Med 2018; 48:2515-2521. [PMID: 29415788 PMCID: PMC6190063 DOI: 10.1017/s0033291718000107] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 01/05/2018] [Accepted: 01/05/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Attenuated inhibitory control is one of the most robust findings in the neuropsychology of attention-deficit/hyperactivity disorder (ADHD). However, it is unclear whether this represents a deficit in outright stopping (reactive inhibition), whether it relates to a deficit in anticipatory response slowing (proactive inhibition), or both. In addition, children with other development disorders, such as autism spectrum disorder (ASD), often have symptoms of inattention, impulsivity, and hyperactivity similar to children with ADHD. These may relate to similar underlying changes in inhibitory processing. METHODS In this study, we used a modified stop-signal task to dissociate reactive and proactive inhibition. We included not only children with ADHD, but also children primarily diagnosed with an ASD and high parent-rated levels of ADHD symptoms. RESULTS We replicated the well-documented finding of attenuated reactive inhibition in children with ADHD. In addition, we found a similar deficit in children with ASD and a similar level of ADHD symptoms. In contrast, we found no evidence for deficits in proactive inhibition in either clinical group. CONCLUSIONS These findings re-emphasize the role of reactive inhibition in children with ADHD and ADHD symptoms. Moreover, our findings stress the importance of a trans-diagnostic approach to the relationship between behavior and neuropsychology.
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Affiliation(s)
- Branko M. van Hulst
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Patrick de Zeeuw
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Chantal Vlaskamp
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yvonne Rijks
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Bram B. Zandbelt
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
| | - Sarah Durston
- NICHE Lab, Department of Psychiatry, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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22
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Gamage MWK, Hewage C, Pathirana KD. Effect of cognitive and executive functions on perception of quality of life of cognitively normal elderly people dwelling in residential aged care facilities in Sri Lanka. BMC Geriatr 2018; 18:256. [PMID: 30355292 PMCID: PMC6201633 DOI: 10.1186/s12877-018-0937-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 10/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although cognitive functions affect the health related quality of life (QoL), the relationship between perceived QoL and cognition including executive functions has not been studied adequately. Available studies show moderate to weak correlations. We evaluated the association of cognition and executive functions, namely working memory (WM) and inhibitory control (IC) with the perceived QoL of a sample of elderly people dwelling in residential aged care facilities (RACFs) in Southern Province of Sri Lanka. METHODS Cognition was assessed using Mini-Mental State Examination (MMSE), while verbal WM (VWM), visuo-spatial WM (VSWM) and IC (interference control, inhibition of pre potent and ongoing responses) were assessed using VWM, VSWM tasks, colour word Stroop (CWS), go/no-go (GNG) and stop signal (SS) tasks respectively. WHOQoL-Bref (Total score and domain scores) were used to assess QoL. The relationship was analysed using Pearson correlation and hierarchical multiple regression analysis. RESULTS Study included 237 elderly people with a mean age of 71.11 ± 6.44 years. Participants scored the highest in the domain of environment (63.48 ± 10.63) and lowest in the domain of social relationships (55.43 ± 21.84) of QoL. Psychological health domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS, SS and GNG task errors. Both physical health domain and total QoL demonstrated positive correlations with MMSE, VSWM and VWM scores, while negative correlations were observed with CWS task errors. Social relationships domain demonstrated a significant positive correlation with VSWM score. Environment domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS and SS task errors. All were significant but weak correlations. When controlled for covariates, such as educational status, physical activity and marital status, cognition was a predictor of the domain of environment of QoL, while executive functions were not predictors of total QoL and domains of QoL. CONCLUSION Cognition and executive functions weakly but significantly correlated with different domains of QoL. Only the level of cognition measured by MMSE was a predictor of the domain of environment of QoL and executive functions were not predictors of total QoL and domains of QoL in elderly people with normal cognitive functions dwelling in RACFs.
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Affiliation(s)
| | - Chandana Hewage
- Department of Physiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Gangodawila, Nugegoda, Sri Lanka
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23
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Chmielewski WX, Tiedt A, Bluschke A, Dippel G, Roessner V, Beste C. Effects of multisensory stimuli on inhibitory control in adolescent ADHD: It is the content of information that matters. NEUROIMAGE-CLINICAL 2018; 19:527-537. [PMID: 29984161 PMCID: PMC6030566 DOI: 10.1016/j.nicl.2018.05.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 02/28/2018] [Accepted: 05/15/2018] [Indexed: 01/29/2023]
Abstract
Even though deficits in inhibitory control and conflict monitoring are well-known in ADHD, factors that further modulate these functions remain to be elucidated. One factor that may be of considerable importance is how inhibitory control is modulated by multisensory information processing. We examined the influence of concurrent auditory conflicting or redundant information on visually triggered response inhibition processes in adolescent ADHD patients and healthy controls. We combined high-density event-related potential (ERP) recordings with source localization to delineate the functional neuroanatomical basis of the involved neurophysiological processes. In comparison to controls, response inhibition (RI) processes in ADHD were compromised in conflicting conditions, but showed no differences to controls when redundant or no concurrent auditory information was presented. These effects were reflected by modulations at the response selection stage (P3 ERP) in the medial frontal gyrus (BA32), but not at the attentional selection (P1, N1 ERPs) or resource allocation level (P2 ERP). Conflicting information during RI exerts its influences in adolescent ADHD via response selection mechanisms, but not via attentional selection. It is not the mere presence of concurrent information, but the presence of conflicting information during RI that may destabilize goal shielding processes in medial frontal cortical regions, by means of increasing the automaticity of response tendencies. The occurring RI deficits might relate to the increased impulsivity in adolescent ADHD and a corresponding vulnerability to react to an increased automaticity of pre-potent response tendencies. ADHD patients show a bias to a specific content of information which can modulate inhibitory control. Response inhibition (RI) performance in ADHD is modulated by multisensory information. Only incongruent/conflicting concurrent information modulates RI performance. RI deficits occur if this conflicting information braces the automaticity of response tendencies. These deficits relate to a predisposition of ADHD to engage in impulsive behavior. This may be due to deficient goal-shielding processes located in the MFG.
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Affiliation(s)
- Witold X Chmielewski
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany.
| | - Angela Tiedt
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Annet Bluschke
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Gabriel Dippel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Germany
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24
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Wang LC. Effects of Phonological Training on the Reading and Reading-Related Abilities of Hong Kong Children with Dyslexia. Front Psychol 2017; 8:1904. [PMID: 29163285 PMCID: PMC5671595 DOI: 10.3389/fpsyg.2017.01904] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 10/13/2017] [Indexed: 11/13/2022] Open
Abstract
This study aimed to investigate phonological awareness training by examining outcomes among Chinese children who learn Chinese without phonetic system training. Fifty-six Hong Kong children from the 3rd to 6th grades were recruited. Two-thirds of the children had been officially identified as dyslexic by the local government, and the remainder were considered high risk for dyslexia. The children were divided equally into a control group and an experimental group, with the groups matched as closely as possible by age and gender. Children in the experimental group were trained by onset-rime-level phonological training. The training lasted ~3 weeks, with 15 daily sessions lasting ~20 min each. Our results indicated that children in the experimental group made significant improvements in Chinese character reading, onset awareness, rime awareness, and rapid naming after training. The association between phonological awareness and Chinese character reading, especially the association between rime awareness and Chinese character reading, also changed after training. The benefits of phonological awareness training were more obvious for children younger than 10 years old. The results of the present study can be extended to provide another approach to Chinese learning for children suffering from reading difficulties who are not responding to the usual approach in their region.
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Affiliation(s)
- Li-Chih Wang
- Department of Special Education and Counselling, Education University of Hong Kong, Tai Po, Hong Kong
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25
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Karalunas SL, Gustafsson HC, Dieckmann NF, Tipsord J, Mitchell SH, Nigg JT. Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:774-792. [PMID: 28782975 PMCID: PMC5657320 DOI: 10.1037/abn0000292] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The role of cognitive mechanisms in the clinical course of neurodevelopmental disorders is poorly understood. Attention Deficit Hyperactivity Disorder (ADHD) is emblematic in that numerous alterations in cognitive development are apparent, yet how they relate to changes in symptom expression with age is unclear. To resolve the role of cognitive mechanisms in ADHD, a developmental perspective that takes into account expected within-group heterogeneity is needed. METHOD The current study uses an accelerated longitudinal design and latent trajectory growth mixture models in a sample of children ages 7-13 years carefully characterized as with (n = 437) and without (n = 297) ADHD to (a) identify heterogeneous developmental trajectories for response inhibition, visual spatial working memory maintenance, and delayed reward discounting and (b) to assess the relationships between these cognitive trajectories and ADHD symptom change. RESULTS Best-fitting models indicated multiple trajectory classes in both the ADHD and typically developing samples, as well as distinct relationships between each cognitive process and ADHD symptom change. Developmental change in response inhibition and delayed reward discounting were unrelated to ADHD symptom change, while individual differences in the rate of visual spatial working memory maintenance improvement predicted symptom remission in ADHD. CONCLUSION Characterizing heterogeneity in cognitive development will be crucial for clarifying mechanisms of symptom persistence and recovery. Results here suggest working memory maintenance may be uniquely related to ADHD symptom improvement. (PsycINFO Database Record
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Affiliation(s)
- Sarah L. Karalunas
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
| | | | | | - Jessica Tipsord
- Oregon Health & Sciences University, Department of Psychiatry
| | - Suzanne H. Mitchell
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
- Oregon Institute of Occupational Health Science
| | - Joel T. Nigg
- Oregon Health & Sciences University, Department of Psychiatry
- Oregon Health & Sciences University, Department of Beahvioral Neuroscience
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26
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Lewis FC, Reeve RA, Kelly SP, Johnson KA. Evidence of substantial development of inhibitory control and sustained attention between 6 and 8years of age on an unpredictable Go/No-Go task. J Exp Child Psychol 2017; 157:66-80. [DOI: 10.1016/j.jecp.2016.12.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 12/19/2016] [Accepted: 12/20/2016] [Indexed: 11/25/2022]
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27
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Anderson JD, Wagovich SA. Explicit and Implicit Verbal Response Inhibition in Preschool-Age Children Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:836-852. [PMID: 28384673 PMCID: PMC5548080 DOI: 10.1044/2016_jslhr-s-16-0135] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/10/2016] [Accepted: 10/08/2016] [Indexed: 05/22/2023]
Abstract
PURPOSE The purpose of this study was to examine (a) explicit and implicit verbal response inhibition in preschool children who do stutter (CWS) and do not stutter (CWNS) and (b) the relationship between response inhibition and language skills. METHOD Participants were 41 CWS and 41 CWNS between the ages of 3;1 and 6;1 (years;months). Explicit verbal response inhibition was measured using a computerized version of the grass-snow task (Carlson & Moses, 2001), and implicit verbal response inhibition was measured using the baa-meow task. Main dependent variables were reaction time and accuracy. RESULTS The CWS were significantly less accurate than the CWNS on the implicit task, but not the explicit task. The CWS also exhibited slower reaction times than the CWNS on both tasks. Between-group differences in performance could not be attributed to working memory demands. Overall, children's performance on the inhibition tasks corresponded with parents' perceptions of their children's inhibition skills in daily life. CONCLUSIONS CWS are less effective and efficient than CWNS in suppressing a dominant response while executing a conflicting response in the verbal domain.
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Affiliation(s)
- Julie D. Anderson
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| | - Stacy A. Wagovich
- Department of Communication Science and Disorders, University of Missouri, Columbia
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Réveillon M, Hüppi PS, Barisnikov K. Inhibition difficulties in preterm children: Developmental delay or persistent deficit? Child Neuropsychol 2017; 24:734-762. [DOI: 10.1080/09297049.2017.1294665] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Morgane Réveillon
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Switzerland
| | - Petra S. Hüppi
- Division of Development and Growth, Department of Pediatrics, University Hospital of Geneva, Switzerland
| | - Koviljka Barisnikov
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Switzerland
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Dekkers TJ, Agelink van Rentergem JA, Koole A, van den Wildenberg WPM, Popma A, Bexkens A, Stoffelsen R, Diekmann A, Huizenga HM. Time-on-task effects in children with and without ADHD: depletion of executive resources or depletion of motivation? Eur Child Adolesc Psychiatry 2017; 26:1471-1481. [PMID: 28536846 PMCID: PMC5701950 DOI: 10.1007/s00787-017-1006-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 05/17/2017] [Indexed: 11/25/2022]
Abstract
Children with attention-deficit/hyperactivity disorder (ADHD) are characterized by deficits in their executive functioning and motivation. In addition, these children are characterized by a decline in performance as time-on-task increases (i.e., time-on-task effects). However, it is unknown whether these time-on-task effects should be attributed to deficits in executive functioning or to deficits in motivation. Some studies in typically developing (TD) adults indicated that time-on-task effects should be interpreted as depletion of executive resources, but other studies suggested that they represent depletion of motivation. We, therefore, investigated, in children with and without ADHD, whether there were time-on-task effects on executive functions, such as inhibition and (in)attention, and whether these were best explained by depletion of executive resources or depletion of motivation. The stop-signal task (SST), which generates both indices of inhibition (stop-signal reaction time) and attention (reaction time variability and errors), was administered in 96 children (42 ADHD, 54 TD controls; aged 9-13). To differentiate between depletion of resources and depletion of motivation, the SST was administered twice. Half of the participants was reinforced during second task performance, potentially counteracting depletion of motivation. Multilevel analyses indicated that children with ADHD were more affected by time-on-task than controls on two measures of inattention, but not on inhibition. In the ADHD group, reinforcement only improved performance on one index of attention (i.e., reaction time variability). The current findings suggest that time-on-task effects in children with ADHD occur specifically in the attentional domain, and seem to originate in both depletion of executive resources and depletion of motivation. Clinical implications for diagnostics, psycho-education, and intervention are discussed.
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Affiliation(s)
- Tycho J. Dekkers
- 0000000084992262grid.7177.6Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands ,Department of Forensic Psychiatry and Complex Behavioral Disorders, Academic Center for Child and Adolescent Psychiatry, De Bascule, Rijksstraatweg 145, 1115 AP Duivendrecht, The Netherlands
| | - Joost A. Agelink van Rentergem
- 0000000084992262grid.7177.6Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands
| | - Alette Koole
- 0000000084992262grid.7177.6Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands
| | - Wery P. M. van den Wildenberg
- 0000000084992262grid.7177.6Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands ,0000000084992262grid.7177.6Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arne Popma
- Department of Forensic Psychiatry and Complex Behavioral Disorders, Academic Center for Child and Adolescent Psychiatry, De Bascule, Rijksstraatweg 145, 1115 AP Duivendrecht, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aDepartment of Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, The Netherlands ,0000 0001 2312 1970grid.5132.5Faculty of Law, Institute of Criminal Law and Criminology, Leiden University, Leiden, The Netherlands
| | - Anika Bexkens
- 0000 0001 2312 1970grid.5132.5Department of Developmental and Educational Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands ,Department of Child and Adolescent Psychiatry, GGZ Delfland, Center for Psychiatry, Amsterdam, The Netherlands
| | - Reino Stoffelsen
- Department of Forensic Psychiatry and Complex Behavioral Disorders, Academic Center for Child and Adolescent Psychiatry, De Bascule, Rijksstraatweg 145, 1115 AP Duivendrecht, The Netherlands ,0000 0004 0435 165Xgrid.16872.3aDepartment of Child and Adolescent Psychiatry, VU University Medical Center Amsterdam, Amsterdam, The Netherlands
| | - Anouk Diekmann
- Department of Forensic Psychiatry and Complex Behavioral Disorders, Academic Center for Child and Adolescent Psychiatry, De Bascule, Rijksstraatweg 145, 1115 AP Duivendrecht, The Netherlands ,Practice for Individual, Couple, and Family Therapy and Center for Training, De Kontekst, Van Breestraat 147HS, 1071 ZL Amsterdam, The Netherlands
| | - Hilde M. Huizenga
- 0000000084992262grid.7177.6Department of Psychology, University of Amsterdam, Nieuwe Achtergracht 129B, 1018 WS Amsterdam, The Netherlands ,0000000084992262grid.7177.6Amsterdam Brain and Cognition Center, University of Amsterdam, Amsterdam, The Netherlands ,0000000084992262grid.7177.6Research priority Area Yield, University of Amsterdam, Amsterdam, The Netherlands
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Poutanen M, Berg S, Kangas T, Peltomaa K, Lahti-Nuuttila P, Hokkanen L. Before and after entering school: The development of attention and executive functions from 6 to 8 years in Finnish children. Scand J Psychol 2016. [DOI: 10.1111/sjop.12264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Salla Berg
- Nekku Rehabilitation Centre; Järvenpää Finland
| | | | | | | | - Laura Hokkanen
- Institute of Behavioural Sciences; University of Helsinki; Helsinki Finland
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31
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Lee HW, Lo YH, Li KH, Sung WS, Juan CH. The relationship between the development of response inhibition and intelligence in preschool children. Front Psychol 2015; 6:802. [PMID: 26113838 PMCID: PMC4462641 DOI: 10.3389/fpsyg.2015.00802] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 05/27/2015] [Indexed: 11/13/2022] Open
Abstract
Building on the theoretical framework that intellectual behavior relies on one's ability to process both task-relevant and task-irrelevant information, this study aimed to empirically investigate the association of response inhibition with intelligence in preschool children's development. In a sample of 152 typically developing children aged between 3.6 and 6.6 years, we found evidence that suggests that inhibitory control is linked to age-related differences in intelligence. Stop-signal inhibition improved at a rate similar to the age-related changes in Verbal IQ. Components of variance analyses revealed that stop-signal reaction time predicted a larger proportion of the age-related variance in children's verbal intelligence than non-age-related variance. Results are discussed with respect to possible explanations for this intriguing relationship between response inhibition and the verbal aspects of intelligence.
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Affiliation(s)
- Hon Wah Lee
- Institute of Cognitive Neuroscience, National Central University Jhongli, Taiwan
| | - Yu-Hui Lo
- Institute of Cognitive Neuroscience, National Central University Jhongli, Taiwan
| | - Kuan-Hui Li
- Institute of Cognitive Neuroscience, National Central University Jhongli, Taiwan
| | - Wen-Shin Sung
- Institute of Cognitive Neuroscience, National Central University Jhongli, Taiwan
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University Jhongli, Taiwan ; Brain Research Center, National Central University Jhongli, Taiwan
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Poh JS, Li Y, Ratnarajah N, Fortier MV, Chong YS, Kwek K, Saw SM, Gluckman PD, Meaney MJ, Qiu A. Developmental synchrony of thalamocortical circuits in the neonatal brain. Neuroimage 2015; 116:168-76. [PMID: 25812713 DOI: 10.1016/j.neuroimage.2015.03.039] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 02/17/2015] [Accepted: 03/14/2015] [Indexed: 11/15/2022] Open
Abstract
The thalamus is a deep gray matter structure and consists of axonal fibers projecting to the entire cortex, which provide the anatomical support for its sensorimotor and higher-level cognitive functions. There is limited in vivo evidence on the normal thalamocortical development, especially in early life. In this study, we aimed to investigate the developmental patterns of the cerebral cortex, the thalamic substructures, and their connectivity with the cortex in the first few weeks of the postnatal brain. We hypothesized that there is developmental synchrony of the thalamus, its cortical projections, and corresponding target cortical structures. We employed diffusion tensor imaging (DTI) and divided the thalamus into five substructures respectively connecting to the frontal, precentral, postcentral, temporal, and parietal and occipital cortex. T2-weighted magnetic resonance imaging (MRI) was used to measure cortical thickness. We found age-related increases in cortical thickness of bilateral frontal cortex and left temporal cortex in the early postnatal brain. We also found that the development of the thalamic substructures was synchronized with that of their respective thalamocortical connectivity in the first few weeks of the postnatal life. In particular, the right thalamo-frontal substructure had the fastest growth in the early postnatal brain. Our study suggests that the distinct growth patterns of the thalamic substructures are in synchrony with those of the cortex in early life, which may be critical for the development of the cortical and subcortical functional specialization.
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Affiliation(s)
- Joann S Poh
- Department of Biomedical Engineering, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Yue Li
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Nagulan Ratnarajah
- Department of Biomedical Engineering, National University of Singapore, Singapore
| | - Marielle V Fortier
- Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital, Singapore
| | - Yap-Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Kenneth Kwek
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Seang-Mei Saw
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Peter D Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Michael J Meaney
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore; Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, McGill University, Canada; Sackler Program for Epigenetics and Psychobiology, McGill University, Canada
| | - Anqi Qiu
- Department of Biomedical Engineering, National University of Singapore, Singapore; Clinical Imaging Research Centre, National University of Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore.
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Morse AF, Benitez VL, Belpaeme T, Cangelosi A, Smith LB. Posture affects how robots and infants map words to objects. PLoS One 2015; 10:e0116012. [PMID: 25785834 PMCID: PMC4364718 DOI: 10.1371/journal.pone.0116012] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 12/03/2014] [Indexed: 11/19/2022] Open
Abstract
For infants, the first problem in learning a word is to map the word to its referent; a second problem is to remember that mapping when the word and/or referent are again encountered. Recent infant studies suggest that spatial location plays a key role in how infants solve both problems. Here we provide a new theoretical model and new empirical evidence on how the body - and its momentary posture - may be central to these processes. The present study uses a name-object mapping task in which names are either encountered in the absence of their target (experiments 1-3, 6 & 7), or when their target is present but in a location previously associated with a foil (experiments 4, 5, 8 & 9). A humanoid robot model (experiments 1-5) is used to instantiate and test the hypothesis that body-centric spatial location, and thus the bodies' momentary posture, is used to centrally bind the multimodal features of heard names and visual objects. The robot model is shown to replicate existing infant data and then to generate novel predictions, which are tested in new infant studies (experiments 6-9). Despite spatial location being task-irrelevant in this second set of experiments, infants use body-centric spatial contingency over temporal contingency to map the name to object. Both infants and the robot remember the name-object mapping even in new spatial locations. However, the robot model shows how this memory can emerge -not from separating bodily information from the word-object mapping as proposed in previous models of the role of space in word-object mapping - but through the body's momentary disposition in space.
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Affiliation(s)
- Anthony F. Morse
- Cognition Institute, Center for Robotics and Neural Systems, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, United Kingdom
| | - Viridian L. Benitez
- Department of Psychology, University of Wisconsin-Madison, 1202 W. Johnson St., Madison, WI 53706, United States of America
| | - Tony Belpaeme
- Cognition Institute, Center for Robotics and Neural Systems, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, United Kingdom
| | - Angelo Cangelosi
- Cognition Institute, Center for Robotics and Neural Systems, University of Plymouth, Drake Circus, Plymouth, PL4 8AA, United Kingdom
| | - Linda B. Smith
- Psychological and Brain Sciences, Indiana University, 1101 East Tenth Street, Bloomington, IN 47405-7007, United States of America
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34
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Inhibition of a prepotent response and response-strategy adjustments in the stop-signal paradigm: A developmental study. ANNEE PSYCHOLOGIQUE 2014. [DOI: 10.4074/s0003503314001031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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35
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Urben S, Barisnikov K, Van der Linden M. Inhibition of a prepotent response and response-strategy adjustments in the stop-signal paradigm: A developmental study. ANNEE PSYCHOLOGIQUE 2014. [DOI: 10.3917/anpsy.141.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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36
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Lo YH, Liang WK, Lee HW, Wang CH, Tzeng OJL, Hung DL, Cheng SK, Juan CH. The neural development of response inhibition in 5- and 6-year-old preschoolers: an ERP and EEG study. Dev Neuropsychol 2014; 38:301-16. [PMID: 23862634 DOI: 10.1080/87565641.2013.801980] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Many studies have used event-related potential and neural oscillations to probe the underlying neural mechanisms of inhibitory control in adults, but little has been done in typically developing preschoolers. In this study we tested healthy preschool children between the ages of 5 and 6, and observed better response inhibition in 6-year-olds compared to 5-year-olds. Importantly, this age-related difference could not be explained by the N2 component from event-related potential, but was reflected in an increase in right frontal beta power from electroencephalogram. These results suggest that frontal beta power during the preschool period may reflect neural development of inhibitory control.
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Affiliation(s)
- Yu-Hui Lo
- Institute of Cognitive Neuroscience, National Central University, Jhongli, Taiwan
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37
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Lejeune C, Catale C, Schmitz X, Quertemont E, Meulemans T. Age-related differences in perceptuomotor procedural learning in children. J Exp Child Psychol 2013; 116:157-68. [DOI: 10.1016/j.jecp.2013.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 05/06/2013] [Accepted: 05/06/2013] [Indexed: 11/17/2022]
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38
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Reaction time variability in ADHD: A meta-analytic review of 319 studies. Clin Psychol Rev 2013; 33:795-811. [PMID: 23872284 DOI: 10.1016/j.cpr.2013.06.001] [Citation(s) in RCA: 409] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Revised: 05/31/2013] [Accepted: 06/03/2013] [Indexed: 11/21/2022]
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39
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Psychometric Properties of a Test for ADHD Based on Binocular Rivalry. SPANISH JOURNAL OF PSYCHOLOGY 2013; 16:E20. [DOI: 10.1017/sjp.2013.34] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThe psychometric properties of a Binocular Rivalry (BR)-based test on a group of 159 participants (57 with attention deficit hyperactivity disorder, ADHD) aged between 6 and 15 years are presented. Two factors, which explained 56.82% of the variance, were obtained by exploratory factor analysis: (a) Alternations and Duration of exclusive dominances, and (b) Decision time. Reliability was excellent (Cronbach’s α = .834 and .884). The ADHD group showed fewer alternations and longer duration of dominances and decision time than the control group. Correlations between measures of BR, IQ, working memory, and processing speed of the WISC-IV, and ADHD symptoms, assessed by parents and teachers, ranged between low and medium.
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40
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Urben S, Van der Linden M, Barisnikov K. Emotional modulation of the ability to inhibit a prepotent response during childhood. Dev Neuropsychol 2013; 37:668-81. [PMID: 23145565 DOI: 10.1080/87565641.2012.675378] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The present study examined the bottom-up influence of emotional context on response inhibition, an issue that remains largely unstudied in children. Thus, 62 participants, aged from 6 to 13 years old, were assessed with three stop signal tasks: one with circles, one with neutral faces, and one with emotional faces (happy and sad). Results showed that emotional context altered response inhibition ability in childhood. However, no interaction between age and emotional influence on response inhibition was found. Positive emotions were recognized faster than negative emotions, but the valence did not have a significant influence on response inhibition abilities.
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Affiliation(s)
- Sébastien Urben
- Child Clinical Neuropsychology Unit, Department of Psychology, University of Geneva, Geneva, Switzerland.
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41
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Berger A, Alyagon U, Hadaya H, Atzaba-Poria N, Auerbach JG. Response Inhibition in Preschoolers at Familial Risk for Attention Deficit Hyperactivity Disorder: A Behavioral and Electrophysiological Stop-Signal Study. Child Dev 2013; 84:1616-32. [DOI: 10.1111/cdev.12072] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Aarnoudse-Moens CSH, Weisglas-Kuperus N, Duivenvoorden HJ, van Goudoever JB, Oosterlaan J. Executive function and IQ predict mathematical and attention problems in very preterm children. PLoS One 2013; 8:e55994. [PMID: 23390558 PMCID: PMC3563540 DOI: 10.1371/journal.pone.0055994] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Accepted: 01/03/2013] [Indexed: 11/19/2022] Open
Abstract
Objective of this study was to examine the impact of executive function (EF) on mathematical and attention problems in very preterm (gestational age ≤ 30 weeks) children. Participants were 200 very preterm (mean age 8.2 ± 2.5 years) and 230 term children (mean age 8.3 ± 2.3 years) without severe disabilities, born between 1996 and 2004. EFs assessed included verbal fluency, verbal working memory, visuospatial span, planning, and impulse control. Mathematics was assessed with the Dutch Pupil Monitoring System and parents and teachers rated attention problems using standardized behavior questionnaires. The impact of EF was calculated over and above processing speed indices and IQ. Interactions with group (very preterm versus term birth status) were examined. Analyses were conducted separately for two subsamples: children in preschool and children in primary school. Very preterm children performed poorer on tests for mathematics and had more parent and teacher rated attention problems than term controls (ß(s)>.11, P(s)<.01). IQ contributed unique variance to mathematics in preschool and in primary school (ß(s)>.16, P(s)<.007). A significant interaction of group with IQ (ß = -. 24, P = .02) showed that IQ contributed unique variance to attention problems as rated by teachers, but that effects were stronger for very preterm than for term infants. Over and above IQ, EF contributed unique variance to mathematics in primary school (ß = .13, P<.001), to parent rated inattention in preschool and in primary school (ß(s)>-.16, P(s)<.04), and to teacher rated inattention in primary school (ß = -.19; ß = .19, P(s)<.009). In conclusion, impaired EF is, over and above impaired IQ, an important predictor for poor mathematics and attention problems following very preterm birth.
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Shapiro HM, Wong LM, Simon TJ. A cross-sectional analysis of the development of response inhibition in children with chromosome 22q11.2 deletion syndrome. Front Psychiatry 2013; 4:81. [PMID: 23966958 PMCID: PMC3736116 DOI: 10.3389/fpsyt.2013.00081] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2012] [Accepted: 07/22/2013] [Indexed: 12/22/2022] Open
Abstract
Chromosome 22q11.2 deletion syndrome (22q11.2DS) is a neurogenetic disorder that is associated with cognitive impairments and significantly elevated risk for developing schizophrenia. While impairments in response inhibition are central to executive dysfunction in schizophrenia, the nature and development of such impairments in children with 22q11.2DS, a group at high risk for the disorder, are not clear. Here we used a classic Go/No-Go paradigm to quantify proactive (anticipatory stopping) and reactive (actual stopping) response inhibition in 47 children with 22q11.2DS and 36 typically developing (TD) children, all ages 7-14. A cross-sectional design was used to examine age-related associations with response inhibition. When compared with TD individuals, children with 22q11.2DS demonstrated typical proactive response inhibition at all ages. By contrast, reactive response inhibition was impaired in children with 22q11.2DS relative to TD children. While older age predicted better reactive response inhibition in TD children, there was no age-related association with reactive response inhibition in children with 22q11.2DS. Closer examination of individual performance data revealed a wide range of performance abilities in older children with 22q11.2DS; some typical and others highly impaired. The results of this cross-sectional analysis suggest an impaired developmental trajectory of reactive response inhibition in some children with 22q11.2DS that might be related to atypical development of neuroanatomical systems underlying this cognitive process. As part of a larger study, this investigation might help identify risk factors for conversion to schizophrenia and lead to early diagnosis and preventive intervention.
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Affiliation(s)
- Heather M Shapiro
- Department of Psychiatry and Behavioral Sciences, MIND Institute, University of California Davis , Sacramento, CA , USA
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44
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Yu C, Smith LB. Embodied attention and word learning by toddlers. Cognition 2012; 125:244-62. [PMID: 22878116 PMCID: PMC3829203 DOI: 10.1016/j.cognition.2012.06.016] [Citation(s) in RCA: 213] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2010] [Revised: 06/26/2012] [Accepted: 06/29/2012] [Indexed: 10/28/2022]
Abstract
Many theories of early word learning begin with the uncertainty inherent to learning a word from its co-occurrence with a visual scene. However, the relevant visual scene for infant word learning is neither from the adult theorist's view nor the mature partner's view, but is rather from the learner's personal view. Here we show that when 18-month old infants interacted with objects in play with their parents, they created moments in which a single object was visually dominant. If parents named the object during these moments of bottom-up selectivity, later forced-choice tests showed that infants learned the name, but did not when naming occurred during a less visually selective moment. The momentary visual input for parents and toddlers was captured via head cameras placed low on each participant's forehead as parents played with and named objects for their infant. Frame-by-frame analyses of the head camera images at and around naming moments were conducted to determine the visual properties at input that were associated with learning. The analyses indicated that learning occurred when bottom-up visual information was clean and uncluttered. The sensory-motor behaviors of infants and parents were also analyzed to determine how their actions on the objects may have created these optimal visual moments for learning. The results are discussed with respect to early word learning, embodied attention, and the social role of parents in early word learning.
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Affiliation(s)
- Chen Yu
- Department of Psychological and Brain Sciences, Cognitive Science Program, Indiana University, USA.
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Schoemaker K, Mulder H, Deković M, Matthys W. Executive Functions in Preschool Children with Externalizing Behavior Problems: A Meta-Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 41:457-71. [PMID: 23054130 DOI: 10.1007/s10802-012-9684-x] [Citation(s) in RCA: 187] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kim Schoemaker
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, the Netherlands.
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46
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Qiu A, Fortier MV, Bai J, Zhang X, Chong YS, Kwek K, Saw SM, Godfrey KM, Gluckman PD, Meaney MJ. Morphology and microstructure of subcortical structures at birth: a large-scale Asian neonatal neuroimaging study. Neuroimage 2012; 65:315-23. [PMID: 23000785 DOI: 10.1016/j.neuroimage.2012.09.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/06/2012] [Accepted: 09/11/2012] [Indexed: 11/16/2022] Open
Abstract
This paper presents the growth pattern and sexual dimorphism of the thalamus and basal ganglia in a large-scale Asian neonatal cohort using both T2-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI). Our study observed a robust growth of the thalamus and basal ganglia (caudate, putamen, globus pallidus, and anterior limb of internal capsule) beyond the overall brain growth in the early postnatal period (36-43 weeks of the gestational age). Additionally, the microstructure of the two structures was integrated as reflected by an increase in fractional anisotropy (FA) and a decrease in axial and radial water diffusivities in the first few weeks of life. Sexual dimorphism was only observed in the whole brain growth and the left thalamic volume but not in the other volumes or DTI measures of the basal ganglia and thalamus at birth. Even though the pattern of sexual dimorphism in the total brain volume is present at birth and persists throughout postnatal brain development, sexual dimorphisms of the basal ganglia and thalamus differ from those found in later stages of brain development, indicating that regionally distinct patterns of postnatal brain development between males and females arise after birth.
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Affiliation(s)
- Anqi Qiu
- Department of Bioengineering, National University of Singapore, Singapore
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Wickens JR, Hyland BI, Tripp G. Animal models to guide clinical drug development in ADHD: lost in translation? Br J Pharmacol 2012; 164:1107-28. [PMID: 21480864 DOI: 10.1111/j.1476-5381.2011.01412.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
We review strategies for developing animal models for examining and selecting compounds with potential therapeutic benefit in attention-deficit hyperactivity disorder (ADHD). ADHD is a behavioural disorder of unknown aetiology and pathophysiology. Current understanding suggests that genetic factors play an important role in the aetiology of ADHD. The involvement of dopaminergic and noradrenergic systems in the pathophysiology of ADHD is probable. We review the clinical features of ADHD including inattention, hyperactivity and impulsivity and how these are operationalized for laboratory study. Measures of temporal discounting (but not premature responding) appear to predict known drug effects well (treatment validity). Open-field measures of overactivity commonly used do not have treatment validity in human populations. A number of animal models have been proposed that simulate the symptoms of ADHD. The most commonly used are the spontaneously hypertensive rat (SHR) and the 6-hydroxydopamine-lesioned (6-OHDA) animals. To date, however, the SHR lacks treatment validity, and the effects of drugs on symptoms of impulsivity and inattention have not been studied extensively in 6-OHDA-lesioned animals. At the present stage of development, there are no in vivo models of proven effectiveness for examining and selecting compounds with potential therapeutic benefit in ADHD. However, temporal discounting is an emerging theme in theories of ADHD, and there is good evidence of increased value of delayed reward following treatment with stimulant drugs. Therefore, operant behaviour paradigms that measure the effects of drugs in situations of delayed reinforcement, whether in normal rats or selected models, show promise for the future.
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Schoemaker K, Bunte T, Wiebe SA, Espy KA, Deković M, Matthys W. Executive function deficits in preschool children with ADHD and DBD. J Child Psychol Psychiatry 2012; 53:111-9. [PMID: 22022931 DOI: 10.1111/j.1469-7610.2011.02468.x] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Impairments in executive functions (EF) are consistently associated with attention deficit hyperactivity disorder (ADHD) and to a lesser extent, with disruptive behavior disorder (DBD), that is, oppositional defiant disorder or conduct disorder, in school-aged children. Recently, larger numbers of children with these disorders are diagnosed earlier in development, yet knowledge about impairments in clinically diagnosed preschool children and the role of comorbidity is limited. Therefore, the aim of the current study was to examine EF in clinically referred preschool children with a clinical diagnosis of ADHD, DBD and ADHD + DBD. METHOD Participants were 202 children aged 3.5-5.5 years, 61 with ADHD only, 33 with DBD only, 52 with comorbid ADHD + DBD and 56 typically developing children. Five EF tasks were administered. RESULTS Confirmatory factor analysis showed that the two-factor model (inhibition and working memory) fit the data better than a one-factor model in this clinical sample. Preschoolers with ADHD displayed inhibition deficits, also after controlling for IQ. Likewise, preschoolers with DBD displayed impaired inhibition, but when IQ was controlled differences were carried mostly by the effect on the task where motivational demands were high (i.e. when tangible rewards were used). This pattern was also found in the interaction between ADHD and DBD; impaired inhibition in the comorbid group, however, was more severe than in the DBD group. Regarding working memory, few group differences were found. CONCLUSIONS Clinically diagnosed preschool children with ADHD showed robust inhibition deficits, whereas preschool children with DBD showed impaired inhibition especially where motivational incentives were prominent. Severity of inhibition impairment in the comorbid group was similar to the ADHD group.
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Affiliation(s)
- Kim Schoemaker
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands.
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Passarotti AM, Pavuluri MN. Brain functional domains inform therapeutic interventions in attention-deficit/hyperactivity disorder and pediatric bipolar disorder. Expert Rev Neurother 2011; 11:897-914. [PMID: 21651336 DOI: 10.1586/ern.11.71] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A deeper understanding of how the relationships between impulsivity, reward systems and executive function deficits may be similar or different in attention-deficit/hyperactivity disorder (ADHD) and pediatric bipolar disorder (PBD) is fundamental for better defining phenotypy in these two developmental illnesses, and moving towards improved treatment and intervention. We focus our article on recent neurocognitive and neuroimaging data examining the behavioral and neural aspects of poor behavior regulation, response inhibition and reward systems in ADHD and PBD. In light of recent research evidence, we propose that the common behavioral manifestations of impulsivity in ADHD and PBD may indeed originate from different neural mechanisms mediated by altered reward systems. In order to define and differentiate these mechanisms, unlike previous approaches, our theoretical model examines the interface of the dorsal frontostriatal circuit, involved in behavior regulation, and the ventral frontostriatal circuit, which is involved in reward-related and affect processes. Preliminary evidence suggests that the neural systems involved in impulsivity, reward systems and executive function engage differently in the two illnesses. In PBD, 'emotional impulsivity' is predominantly 'bottom-up' and emotionally/motivationally driven, and stems from ventral frontostriatal circuitry dysfunction. By contrast, in ADHD 'cognitive impulsivity' is predominantly 'top-down' and more 'cognitively driven', and stems from dorsal frontostriatal dysfunction. We discuss this evidence in view of clinically relevant questions and implications for illness-based intervention. We conclude that the reward-related mechanisms underlying the interactions between executive function, behavior regulation and impulsivity in PBD and ADHD may be differentially compromised, and in accordance differently shape the clinical symptoms of impulsivity and goal-directed behavior.
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Affiliation(s)
- Alessandra M Passarotti
- Pediatric BRAIN Center, Institute for Juvenile Research, University of Illinois at Chicago, 1747, West Roosevelt Road, M/C 747, Chicago, IL 60612, USA.
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Qiu A, Rifkin-Graboi A, Zhong J, Phua DYL, Lai YK, Meaney MJ. Birth weight and gestation influence striatal morphology and motor response in normal six-year-old boys. Neuroimage 2011; 59:1065-70. [PMID: 21963914 DOI: 10.1016/j.neuroimage.2011.09.032] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Revised: 08/27/2011] [Accepted: 09/15/2011] [Indexed: 01/21/2023] Open
Abstract
The relation between fetal growth and attention deficit hyperactivity disorder (ADHD) cuts across the normal range of birth weights suggesting that subtle variations in fetal development may influence brain and cognitive function. We investigated the relation of ADHD-related endophenotypes, such as the striatum morphology, motor response and inhibition, with birth weight and gestational age in healthy children. 157 Six-year-old boys born at term (37 to 41 weeks) within the normal range for birth weight (2500 to 4630 g) underwent magnetic resonance imaging (MRI) and performed the stop signal task. Linear regression was used to examine effects of birth weight, gestational age, and their interaction on striatal volumes and shapes as well as motor response and inhibition. Interactive effects of birth weight and gestational age, even within the normal range, predicted caudate volumes and shapes. Boys with relatively low birth weight and shorter gestation had smaller caudate volumes, reflected by shape contraction in the middle body, and in addition performed worst in motor response, reflected by mean reaction time and its variability. Our results supported the idea that prenatal influences on neurocognitive and brain development are not limited to the extreme range, but occur across the entire population. Variations in brain structure and cognitive endophenotypes associated with childhood ADHD psychopathology are sensitive to subtle prenatal influences, which provides guidance for intervention research to improve mental health of children.
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Affiliation(s)
- Anqi Qiu
- Division of Bioengineering, National University of Singapore, Singapore, Singapore.
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