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Varela JL, Magnante AT, Miskey HM, Ord AS, Eldridge A, Shura RD. A systematic review of the utility of continuous performance tests among adults with ADHD. Clin Neuropsychol 2024; 38:1524-1585. [PMID: 38424025 DOI: 10.1080/13854046.2024.2315740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 12/16/2023] [Indexed: 03/02/2024]
Abstract
OBJECTIVE The clinical utility of continuous performance tests (CPTs) among adults with attention-deficit/hyperactivity disorder (ADHD) has increasingly been brought under question. Therefore, the objective of this study was to systematically review the literature to investigate the clinical utility of various commercially available CPTs, including the Conner's Continuous Performance Test (CCPT), Test of Variables of Attention (TOVA), Gordon Diagnostic System (GDS), and Integrated Visual and Auditory Continuous Performance Test (IVA) in the adult ADHD population. METHODS This systematic review followed the a priori PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Articles were gathered from PsycINFO, PsycARTICLES, Academic Search Complete, and Google Scholar on 11 April 2022. Sixty-nine articles were included in the final review. Risk of bias was assessed using the National Institute of Health Quality Assessment Took for Observational Cohort and Cross-Sectional Studies. RESULTS Most articles demonstrated high risk of bias, and there was substantial heterogeneity across studies. Overall, the reviewed CPTs appeared to have limited diagnostic utility and classification accuracy. Although many studies showed differing scores between adults with ADHD and comparison groups, findings were not consistent. Characteristics of CPT performances among adults with ADHD were mixed, with little consistency and no evidence of a clear profile of performances; however, CCPT commission errors appeared to have the most utility when used a treatment or experimental outcome measure, compared to other CCPT scores. CONCLUSION Overall, CPTs should not be used in isolation as a diagnostic test but may be beneficial when used as a component of a comprehensive assessment.
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Affiliation(s)
- Jacob L Varela
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Anna T Magnante
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Education, and Clinical Center, VA Mid-Atlantic Mental Illness Research, Durham, NC, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Holly M Miskey
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Education, and Clinical Center, VA Mid-Atlantic Mental Illness Research, Durham, NC, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Anna S Ord
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Adrienne Eldridge
- College of Health and Behavioral Sciences, Regent University, Virginia Beach, VA, USA
| | - Robert D Shura
- W. G. (Bill) Hefner VA Healthcare System, Salisbury, NC, USA
- Education, and Clinical Center, VA Mid-Atlantic Mental Illness Research, Durham, NC, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
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2
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Holland AA, Shamji JF, Clem MA, Perez R, Palka JM, Stavinoha PL. Parent ratings of executive functioning in pediatric survivors of medulloblastoma and pilocytic astrocytoma. APPLIED NEUROPSYCHOLOGY. CHILD 2024; 13:52-61. [PMID: 36111630 DOI: 10.1080/21622965.2022.2123707] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The present study compared parent-rated executive functioning in pediatric medulloblastoma (MB) and pilocytic astrocytoma (PA) survivors. Although standard care for both includes surgical resection, children with MB additionally receive chemotherapy and craniospinal irradiation. Given well-documented neurocognitive late effects associated with the latter, we anticipated poor parent-reported executive functioning in MB survivors. Parents/guardians of 36 MB survivors and 20 PA survivors completed the Behavior Rating Inventory of Executive Functioning (BRIEF). PA survivors were younger at diagnosis (t[51.97] = 3.07, p < .001, d = 0.86) and demonstrated higher IQ (t[54] = -3.51, p < .001, d = 0.95). However, relative to the MB group, the PA group was rated as having significantly more problems on all BRIEF scales (all p ≤ .05; d = 0.30 - 1.10), except the Shift scale. Additionally, all mean BRIEF scores for MB survivors were within normal limits, whereas for PA survivors, all mean BRIEF scores except for Organization of Materials were significantly discrepant from normative means. Overall, PA survivors were rated as demonstrating poorer executive function than MB survivors. Five theories are discussed as possible explanations for these surprising findings: two related to group differences, two related to potential sources of parental bias, and one related to the nature of questionnaire-based assessment. All these theories represent directions for future research. Parent questionnaires such as the BRIEF may have real-world implications for pediatric brain tumor survivors. Future research should explore factors affecting parent ratings of executive functioning in these populations, along with comparison to performance-based measures.
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Affiliation(s)
- Alice Ann Holland
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Jabeen F Shamji
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
- University of North Texas, Denton, Texas, USA
| | - Matthew A Clem
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Private practice in Dallas, Texas, USA
| | - Roger Perez
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Private practice in Mission Viejo, California, USA
| | - Jayme M Palka
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
| | - Peter L Stavinoha
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Psychiatry, Children's Medical Center Dallas, Dallas, Texas, USA
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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3
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Egeland J, Lund O, Kowalik-Gran I, Aarlien AK, Söderlund GBW. Effects of auditory white noise stimulation on sustained attention and response time variability. Front Psychol 2023; 14:1301771. [PMID: 38144987 PMCID: PMC10748431 DOI: 10.3389/fpsyg.2023.1301771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/17/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction "The moderate brain arousal model" claims that white noise improves attention by optimizing brain arousal. We analyze Conners' Continuous Performance Test-3 (CCPT-3) performance, expecting to find reduced reaction time variability with noise mediated by decrease under long event-rates and in later parts of the test, indicating that noise reverse fall in phasic and tonic arousal. Methods Sixty-five children with high or lower ADHD-symptoms from a child psychiatric unit, succeeded to complete the CCPT-3 with and without white noise. Results Noise reduced overall variability, improved performance in later parts of the test, and reduced response variability under the longest event rate particularly in the high symptoms group. No overall change in omissions and commissions, but the high symptoms group made fewer omissions during noise compared the low symptom group. Discussion The study indicates an arousal effect of noise but should be replicated with other noise variants and amplitudes to improve effect and compliance.
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Affiliation(s)
- Jens Egeland
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Olaf Lund
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
| | - Iwona Kowalik-Gran
- Divison of Mental Health & Addiction, Vestold Hospital Trust, Tønsberg, Norway
| | | | - Göran B. W. Söderlund
- Faculty of Teacher Education Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway
- Department of Education and Special Education, University of Gothenburg, Gothenburg, Sweden
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4
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Zhou Q, Luo Y. Event rate effects on children with attention-deficit/hyperactive disorder: Test predictions from the moderate brain arousal model and the neuro-energetics theory using the diffusion decision model. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 127:104262. [PMID: 35636262 DOI: 10.1016/j.ridd.2022.104262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 05/01/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Converging evidence has found that the inhibitory control of children with attention-deficit/hyperactive disorder (ADHD) is context-dependent and particularly susceptible to the event rate. The Moderate Brain Arousal (MBA) model predicts a U-shaped curve between event rate and performance as a modulation of brain arousal. The neuroenergetics theory (NeT) proposes that a smaller event rate results in neuronal fatigue and subsequent descent performance. However, previous work applied the traditional one-dimensional index of performance, such as accuracy rate and response time, which might limit the exploration of the event rate effect on the specific underlying process. AIMS We used a diffusion decision model (DDM) to study the influence of event rate on inhibition control in children with ADHD and verified the explanation of the MBA model and the NeT. METHODS AND PROCEDURES The Stop Signal Task manipulated by four event rate conditions was conducted with 24 children with ADHD (mean age=8.5, males=16) and 29 typical developmental children (TDC) (mean age=9.0, males=12). DDM was applied to compare the differences in the DDM parameters across different event rates. OUTCOMES AND RESULTS Compared with TDC, children with ADHD had a smaller drift rate, longer non-decision time, and smaller boundary separation. Although the event rate had little influence on ADHD, the drift rate of the TDC was approximately linear with an increased event rate, and the Ter had a quadratic function relationship with the event rate. CONCLUSIONS AND IMPLICATIONS The event rate effect may influence children's performance through dual mechanisms. Neuronal energy supply could regulate information processing and brain arousal to regulate the activation of primary stimuli encoding and motor control. Insight into the multi-mechanism of ADHD cognition deficits would be helpful for clinicians in making objective diagnoses and effective targeted treatments.
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Affiliation(s)
- Qian Zhou
- College of Medical Humanities, Guizhou Medical University, Guiyang 550025, PR China
| | - Yan Luo
- College of Medical Humanities, Guizhou Medical University, Guiyang 550025, PR China; Guiyang Maternity and Child Care Hospital, Guiyang 550025, PR China.
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5
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Ging-Jehli NR, Arnold LE, Roley-Roberts ME, deBeus R. Characterizing Underlying Cognitive Components of ADHD Presentations and Co-morbid Diagnoses: A Diffusion Decision Model Analysis. J Atten Disord 2022; 26:706-722. [PMID: 34085557 DOI: 10.1177/10870547211020087] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To Explore whether subtypes and comorbidities of attention-deficit hyperactivity disorder (ADHD) induce distinct biases in cognitive components involved in information processing. METHOD Performance on the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was compared between 150 children (aged 7 to 10) with ADHD, grouped by DSM-5 presentation (ADHD-C, ADHD-I) or co-morbid diagnoses (anxiety, oppositional defiant disorder [ODD], both, neither), and 60 children without ADHD. Diffusion decision modeling decomposed performance into cognitive components. RESULTS Children with ADHD had poorer information integration than controls. Children with ADHD-C were more sensitive to changes in presentation modality (auditory/visual) than those with ADHD-I and controls. Above and beyond these results, children with ADHD+anxiety+ODD had larger increases in response biases when targets became frequent than children with ADHD-only or with ADHD and one comorbidity. CONCLUSION ADHD presentations and comorbidities have distinct cognitive characteristics quantifiable using DDM and IVA-CPT. We discuss implications for tailored cognitive-behavioral therapy.
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6
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Cavicchioli M, Ogliari A, Movalli M, Maffei C. Persistent Deficits in Self-Regulation as a Mediator between Childhood Attention-Deficit/Hyperactivity Disorder Symptoms and Substance Use Disorders. Subst Use Misuse 2022; 57:1837-1853. [PMID: 36096483 DOI: 10.1080/10826084.2022.2120358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The link between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) has been largely demonstrated. Some scholars have hypothesized that self-regulation mechanisms might play a key role in explaining this association. Objective(s): The current study tested the hypothesis that retrospective childhood ADHD symptoms might lead to more severe SUDs and this association should be mediated by current self-ratings of behavioral disinhibition, inattention, and emotional dysregulation among 204 treatment-seeking adults (male: 67.3%; female: 32.7%) with a primary diagnosis of alcohol use disorder and other SUDs. Methods: The mediational model was estimated through self-report measures of childhood ADHD symptoms (independent variable; WURS), current self-regulation mechanisms (mediators)-behavioral disinhibition (BIS-11 motor subscale), difficulties with attention regulation (MAAS) and emotion regulation (DERS)-and severity of SUDs (dependent variable; SPQ alcohol, illicit and prescribed drugs). Results: The analysis showed that alterations in the self-regulation system fully mediated the association between the severity of childhood ADHD symptoms and SUDs in adulthood. Behavioral disinhibition and difficulties in attention regulation were the most representative alterations in self-regulation processes that explained this association. Conclusions: These findings suggest it is useful to implement several therapeutic approaches (e.g. behavioral, mindfulness-based, and pharmacological) to increase the self-regulation abilities of children and adolescents with ADHD in order to reduce the probability of SUD onset in adulthood. However, future longitudinal neuroimaging and neuropsychological studies are needed to further support the role of self-regulation mechanisms in explaining the prospective association between childhood ADHD symptoms and SUDs in adulthood.
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Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Anna Ogliari
- Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy.,Child in Mind Lab, University "Vita-Salute San Raffaele", Milan, Italy
| | - Mariagrazia Movalli
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Milan, Italy.,Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Milan, Italy
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7
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Jiang H, Johnstone SJ, Sun L, Zhang DW. Effect of Neurocognitive Training for Children With ADHD at Improving Academic Engagement in Two Learning Settings. J Atten Disord 2021; 25:414-431. [PMID: 30265176 DOI: 10.1177/1087054718799931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: This preliminary study investigated effectiveness of neurocognitive training on academic engagement (AET) for children with ADHD. The training approach targeted working memory, inhibitory control, and attention/relaxation (via brain electrical activity). Method: A reversal design with a 2-week follow-up was used to assess the effectiveness of the treatment on two children with diagnosed ADHD in two learning settings. Direct observation was used to collect academic-related behavior. Results: Improvements in on-task expected behavior (ONT-EX) and general AET, as well as reductions in off-task motor activity (OFF-MA) and off-task passive behavior (OFF-PB) were observed for both students over baselines and across the settings. Moreover, differences in behavioral change were found between participants and settings. Conclusion: These findings support using the treatment for improving academic performance of children with ADHD. Future studies may investigate influences of contextual differences, nontreatment variables, or adult's feedback during the training session on treatment effectiveness.
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Affiliation(s)
- Han Jiang
- School of Special Education, Zhejiang Normal University, Hangzhou, China
| | - Stuart J Johnstone
- School of Psychology, Brain & Behaviour Reseach Institute, University of Wollongong, Australia
| | - Li Sun
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders & Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Da-Wei Zhang
- School of Psychology, Brain & Behaviour Reseach Institute, University of Wollongong, Australia
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8
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Butzbach M, Fuermaier ABM, Aschenbrenner S, Weisbrod M, Tucha L, Tucha O. Metacognition in adult ADHD: subjective and objective perspectives on self-awareness of cognitive functioning. J Neural Transm (Vienna) 2021; 128:939-955. [PMID: 33464422 PMCID: PMC8295131 DOI: 10.1007/s00702-020-02293-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/17/2020] [Indexed: 02/07/2023]
Abstract
Although attention deficit hyperactivity disorder (ADHD) in adulthood is associated with marked cognitive impairment, research on metacognition in adult ADHD is scarce. Deficits in metacognition may have a negative impact on treatment adherence, functional outcomes, and everyday life. This study explores metacognition, specifically self-awareness of cognitive performance, in adults with ADHD by combining objective and subjective assessments. Forty-seven patients with ADHD and 47 control individuals completed a neuropsychological assessment battery including tests for attention, executive functions and memory (objective assessment), as well as questionnaires for cognitive functioning and symptom severity (subjective assessment; self- and informant-report). Participants evaluated their test performance of the objective assessment after test completion by selecting a percentile rank which was subtracted from their normed test result, yielding a discrepancy score. Compared to controls, adults with ADHD showed impairments in attention (medium effects) and memory (small and medium effects), but not in executive functions. The discrepancy scores between self-evaluation and cognitive performance revealed deficits in self-awareness of attentional functions (small effects), but not in executive functions and memory in patients with ADHD compared to controls. Discrepancy scores between self- and informant-reports of cognitive functioning revealed no significant differences. Adults with ADHD show impairments in metacognition in attentional functions, but may have intact metacognitive abilities in other domains. Patients with ADHD tend to overestimate their abilities, especially in attentional functions. Subjective and objective measures of metacognition may not correspond, highlighting the need for clinicians to not solely rely on patients' self-report in their assessment.
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Affiliation(s)
- Marah Butzbach
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands.
| | - Anselm B M Fuermaier
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands
| | - Steffen Aschenbrenner
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of Clinical Psychology and Neuropsychology, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany
| | - Matthias Weisbrod
- Department of Psychiatry and Psychotherapy, SRH Clinic Karlsbad-Langensteinbach, Karlsbad-Langensteinbach, Germany.,Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Lara Tucha
- Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Oliver Tucha
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, Groningen, 9712 TS Groningen, The Netherlands.,Department of Psychiatry and Psychotherapy, University Medical Center Rostock, Rostock, Germany
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9
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Skalski S, Pochwatko G, Balas R. Impact of Motivation on Selected Aspects of Attention in Children with ADHD. Child Psychiatry Hum Dev 2021; 52:586-595. [PMID: 32816140 PMCID: PMC8238702 DOI: 10.1007/s10578-020-01042-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/03/2020] [Accepted: 08/09/2020] [Indexed: 02/06/2023]
Abstract
Earlier reports showed the co-occurrence of a motivation deficit in children with ADHD. The purpose of this study was to assess the impact of extrinsic motivation on selected aspects of attention in children with ADHD, as well as to measure cortical activity and dimensions of motivation as per the self-determination theory. The study included 30 children with ADHD and 30 typically developing (TD) children aged 9-13 years. Children with ADHD exhibited a higher theta/beta power ratio (TBR) in the midline and a lower regional cerebral blood oxygenation (rCBO2) level in prefrontal areas measured using the HEG ratio compared to TD children. Children with ADHD were more likely to undertake activity under the pressure of external stimuli and exhibited attention deficits regarding vigilance, visual search and divided attention. Differences between groups regarding attention decreased in conditions of increased motivation, indicating that motivation can reduce cognitive deficits in children with ADHD.
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Affiliation(s)
- Sebastian Skalski
- Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378, Warsaw, Poland.
| | - Grzegorz Pochwatko
- grid.413454.30000 0001 1958 0162Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378 Warsaw, Poland
| | - Robert Balas
- grid.413454.30000 0001 1958 0162Institute of Psychology, Polish Academy of Sciences, 1 Jaracza Street, 00-378 Warsaw, Poland
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10
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Macdonald KT, Barnes MA, Miciak J, Roberts G, Halverson KK, Vaughn S, Cirino PT. Sustained attention and behavioral ratings of attention in struggling readers. SCIENTIFIC STUDIES OF READING : THE OFFICIAL JOURNAL OF THE SOCIETY FOR THE SCIENTIFIC STUDY OF READING 2020; 25:436-451. [PMID: 34483643 PMCID: PMC8411923 DOI: 10.1080/10888438.2020.1826950] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Attention is correlated with reading, but the extent to which behavioral ratings and sustained attention relate to reading skills is unclear. We assessed 245 4th and 5th grade struggling readers (mean age = 10.3 years) on behavioral ratings of attention, sustained attention, and reading over a school year. Contributions of behavioral ratings and sustained attention were considered cross-sectionally and longitudinally in the context of other important predictors of reading. Results suggest that sustained measures and behavioral ratings assess distinct, yet overlapping, aspects of attention. Both types of attention accounted for unique variance in comprehension, but not word reading accuracy or fluency, when evaluated cross-sectionally. Results also support the role of behavioral ratings of attention in fluency and in comprehension growth. Findings suggest that multidimensional assessment of attention is useful when considering its relation to reading, and highlights the need to integrate conceptualizations of attention that arise from different theoretical approaches.
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Affiliation(s)
- Kelly T Macdonald
- Department of Psychology, Texas Institute for Measurement, Evaluation, and Statistics, University of Houston
| | | | - Jeremy Miciak
- Department of Psychology, Texas Institute for Measurement, Evaluation, and Statistics, University of Houston
| | - Greg Roberts
- Meadows Center for Preventing Educational Risk, University of Texas at Austin
| | - Kelly K Halverson
- Department of Psychology, Texas Institute for Measurement, Evaluation, and Statistics, University of Houston
| | - Sharon Vaughn
- Meadows Center for Preventing Educational Risk, University of Texas at Austin
| | - Paul T Cirino
- Department of Psychology, Texas Institute for Measurement, Evaluation, and Statistics, University of Houston
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11
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Skalski S, Dobrakowski P. Vigilance, Inhibitory Control and Regional Cerebral Blood Oxygenation in the PFC - Differences in ADHD Types of Presentations. Adv Cogn Psychol 2020; 16:202-212. [PMID: 33062078 PMCID: PMC7540002 DOI: 10.5709/acp-0297-5] [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] [Indexed: 01/16/2023] Open
Abstract
It is commonly believed that proven abnormalities in the structure and functioning of the prefrontal lobes affect cognitive deficits in children with ADHD. The purpose of the current study was to assess vigilance, inhibitory control, and regional cerebral blood oxygenation (rCBO2) in the prefrontal cortex (PFC) of children with ADHD. The study included 150 children with ADHD and 51 typically developing (TD) children aged 9-12 years. Children with ADHD showed a deficit in vigilance (assessed by the shortened version of the Mackworth clock task), inhibitory control (the Stroop task), different rCBO2 patterns in the PFC, as well as lower cortical activation during cognitive tasks. These differences are discussed in the context of the types of ADHD presentations.
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Affiliation(s)
- Sebastian Skalski
- Polish Academy of Sciences, Institute of Psychology, Warsaw, Poland1
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12
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Peskin M, Sommerfeld E, Basford Y, Rozen S, Zalsman G, Weizman A, Manor I. Continuous Performance Test Is Sensitive to a Single Methylphenidate Challenge in Preschool Children With ADHD. J Atten Disord 2020; 24:226-234. [PMID: 27887009 DOI: 10.1177/1087054716680075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: There is a lack of evidence-based diagnostic paradigms and personalized interventions for preschoolers with ADHD. This study aimed to evaluate the performance of preschoolers diagnosed with ADHD on a continuous performance test (CPT) before and after a single methylphenidate (MPH) challenge. Method: The Test of Variables of Attention (TOVA)-a CPT-was administered to 61 preschoolers (5.64 ± 0.69 years; 74% boys) with ADHD before and after a single MPH challenge (0.3 or 0.5 mg/kg). Baseline TOVA performance was correlated with Conners' Rating Scales (CRS) and compared with post-MPH TOVA performance. Results: A high rate of omission errors and several significant correlations between TOVA values and CRS scores were found at baseline. A single MPH administration improved TOVA performance significantly and was well tolerated. Conclusion: TOVA assessment may assist in the evaluation of the effect of MPH in preschoolers with ADHD and may help in planning interventions for them.
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Affiliation(s)
- Miriam Peskin
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel
| | - Eliane Sommerfeld
- Geha Mental Health Center, Petah Tikva, Israel.,Ariel University, Israel
| | | | | | - Gil Zalsman
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel.,Columbia University, New York, NY, USA
| | - Abraham Weizman
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel.,Felsenstein Medical Research Center, Petah Tikva, Israel
| | - Iris Manor
- Geha Mental Health Center, Petah Tikva, Israel.,Tel Aviv University, Israel
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13
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Ben Amor L, Lachal J. [Impulsivity and obesity in children with Attention Deficit Hyperactivity Disorder: A clinical, neuropsychological and magnetic resonance spectroscopy exploratory study]. Encephale 2019; 45:494-500. [PMID: 31492416 DOI: 10.1016/j.encep.2019.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/15/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Relationship between Attention Deficit Hyperactivity Disorder (ADHD) and obesity in adults and children had previously been established in research studies. Brain imaging studies pointed out the important role of the prefrontal region in both ADHD and obesity. However, the underlying link between ADHD and obesity is not well understood. The hypothesis that impulsivity could play a role has been explored in clinical studies of ADHD and Binge Eating Disorders or Loss of Control Eating, with contradictory results. Our study aims to compare children with ADHD and obesity to children with ADHD and normal weight. We propose to compare these two populations with clinical, neuropsychological and brain spectroscopy investigation, focusing specifically on impulsivity items. METHOD Ten children presenting overweight or obesity were selected from a larger population of children with ADHD (5-12y) and paired with regard to gender and age with ten children with ADHD and normal weight from the same population. Conners Rating scales version parents (CPRS) and teachers (CTRS), Conners' Continuous Performance Test II (CPT-II), and Magnetic Resonance Spectroscopy (MRS) metabolites in five regions of interest (left and right prefrontal, left and right striatal and left cerebellum regions) were measured for all the children. For MRS, ratio to creatinine levels of following metabolites were measured: glycerophosphocholine+phosphocholine/creatinine (GPC+PCh/Cr), glutamate+glutamine (Glu+Gln/Cr), myoinositol (mI/Cr) et N-acétylaspartate+N-acétylaspartylglutamate (NAA+NAAG/Cr). RESULTS Hyperactivity/Impusivity and Conners Global Index (CGI) subscales of Conners rating scales showed a higher rate of impulsivity in children with ADHD and obesity as compared to children with ADHD and normal weight. Neuropsychological results were comparable in the two groups. Finally, MRS showed a higher GPC+PCh/Cr ratio in right prefrontal cortex in children with ADHD and obesity as compared to children with ADHD and normal weight. CONCLUSIONS Our results are concordant with the hypothesis that impulsivity could be the link between obesity and ADHD in a population of children with ADHD. The right prefrontal regions seem to be areas of interests that need more research in the study of the link between obesity and ADHD.
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Affiliation(s)
- L Ben Amor
- Département de psychiatrie, CHU de Sainte-Justine, 3175, chemin de la Côte-Sainte-Catherine, Montréal, QC H3T 1C5, Canada; Département de psychiatrie, université de Montréal, Montréal, QC H3T 1J4, Canada
| | - J Lachal
- Département de psychiatrie, université de Montréal, Montréal, QC H3T 1J4, Canada; APHP, hôpital Cochin, Maison de Solenn, 75014 Paris, France; Université de Paris, PCPP, Boulogne-Billancourt, France; Inserm, CESP, faculté de médecine, UVSQ, université Paris-Sud, université Paris-Saclay, 94805 Villejuif, France.
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Schmidt SL, Simões EDN, Novais Carvalho AL. Association Between Auditory and Visual Continuous Performance Tests in Students With ADHD. J Atten Disord 2019; 23:635-640. [PMID: 27864429 DOI: 10.1177/1087054716679263] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Continuous Performance Tests (CPTs) are known to measure inattention and impulsivity in students with ADHD. Many CPTs utilize a visual format. It is accepted that auditory tasks reflect attentional demand more closely in the classroom. Thus, the association between deficits found by auditory and visual CPTs needs to be studied. We hypothesized that impulsivity would be dependent on sensory modality and inattention would be a unitary cross-modal construct. METHOD Forty-four students with ADHD performed two CPTs (visual and auditory). We analyzed correlations between the variables examined by the two tasks. RESULTS There were strong correlations between variables measuring inattention. Correlations between auditory and visual measures of impulsivity were weak. CONCLUSION Inattention is partially independent of modality. In contrast, response inhibition is modality-specific. Although ADHD is defined regardless of modality, hyperactive students may exhibit deficits in the auditory modality but not in the visual modality or vice versa.
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Affiliation(s)
- Sergio Luís Schmidt
- 1 Federal University of the State of Rio de Janeiro, Brazil.,2 Federal University of Juiz de Fora, Brazil.,3 State University of Rio de Janeiro, Brazil
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Barnard H, Rao R, Xu Y, Froehlich T, Epstein J, Lanphear BP, Yolton K. Association of the Conners' Kiddie Continuous Performance Test (K-CPT) Performance and Parent-Report Measures of Behavior and Executive Functioning. J Atten Disord 2018; 22:1056-1065. [PMID: 25846228 DOI: 10.1177/1087054715578271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To explore the relationship between the Conners' Kiddie Continuous Performance Test (K-CPT) performance and parent-report measures of child behavior and executive functioning, and clarify the role of sex in K-CPT performance in preschoolers. METHOD Mothers and children recruited to the Health Outcomes and Measures of the Environment Study with complete 5-year assessment data relevant to the analyses were included ( N = 127). We examined the association between K-CPT scores and Behavior Assessment System for Children-Second Edition (BASC-2) and Behavior Rating Inventory of Executive Function (BRIEF) scores, with covariate adjustment. RESULTS We found no significant associations between K-CPT, BASC-2, and BRIEF scores in the full sample. In sex-stratified analyses, we found unusually fast reaction time on K-CPT was related to executive control difficulties in girls, whereas unusually slow reaction time was related to the same difficulties in boys. Omission errors were associated with executive difficulties only in boys. CONCLUSION The K-CPT may prove to be a useful indicator for early onset of executive control difficulties in preschool-aged children.
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Affiliation(s)
- Holly Barnard
- 1 Cincinnati Children's Hospital Medical Center, OH, USA
| | - Roshni Rao
- 2 Wright State University, Dayton, OH, USA
| | - Yingying Xu
- 1 Cincinnati Children's Hospital Medical Center, OH, USA
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Taylor NM, Enns LN. Factors predictive of a fetal alcohol spectrum disorder diagnosis: Parent and teacher ratings. Child Neuropsychol 2018; 25:507-527. [PMID: 29996711 DOI: 10.1080/09297049.2018.1495187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Diagnostic assessment in Fetal Alcohol Spectrum Disorder (FASD) is informed by multidisciplinary assessment incorporating objective (i.e., test measures) and subjective means, such as parent and teacher behavior ratings. The purpose of this study was to extend our previous neuropsychological test findings by identifying parent and teacher ratings of academic achievement, attention, executive functioning, and adaptive functioning as predictors of an FASD diagnosis. The charts of 315 children and adolescents with prenatal alcohol exposure (PAE) who underwent assessment for FASD were retrospectively reviewed. Direct logistic regressions analyzed the contribution of different ratings on the likelihood of an FASD diagnosis. The results suggest that a number of rating measures do contribute toward accurately differentiating those with FASD from within a PAE population, including teacher ratings of learning problems, inattention, and adaptive skills. The classification accuracy for each regression was clinically significant (59.1-70.8%). Children with worse ratings on these variables are approximately 1.5 to 2 times more likely to receive an FASD diagnosis. Only teacher ratings (not parent) significantly contributed to whether a diagnosis was made, suggesting that teacher observational rating scales are a critical component of an FASD assessment. Together with our previous research examining neuropsychological evaluation and FASD diagnostic assessment, this study helps to further guide decisions to streamline care in multidisciplinary assessment and intervention planning.
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Affiliation(s)
- Nicole M Taylor
- a Department of Clinical Health Psychology , University of Manitoba , Winnipeg , MB , Canada.,b Manitoba FASD Centre , SSCY Centre , Winnipeg , MB , Canada
| | - Leah N Enns
- a Department of Clinical Health Psychology , University of Manitoba , Winnipeg , MB , Canada.,b Manitoba FASD Centre , SSCY Centre , Winnipeg , MB , Canada
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Holland AA, Colaluca B, Bailey L, Stavinoha PL. Impact of attention on social functioning in pediatric medulloblastoma survivors. Pediatr Hematol Oncol 2018; 35:76-89. [PMID: 29652554 DOI: 10.1080/08880018.2018.1440333] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Parent-reported attention problems have been associated with social functioning in a broad sample of pediatric cancer survivors. OBJECTIVE The present study focused on a more homogeneous sample (pediatric medulloblastoma survivors), with the novel inclusion of self-reported attention ratings. PARTICIPANTS/METHODS Thirty-three pediatric medulloblastoma survivors, ages 7-18 years, completed a brief IQ measure and self-report of attentional and social functioning. Parents rated patients' attentional and social functioning. RESULTS Mean attention ratings were average based on both parent- and self-report, though parent ratings were significantly discrepant from normative means. No significant demographic or treatment-related predictors of self-reported attention problems were identified, whereas female gender was associated with greater parent-reported attention problems. Canonical correlation analysis revealed a significant association between parent-reported attention difficulties and social functioning in pediatric medulloblastoma survivors, but there was no association between self-reported attention problems and measures of social functioning. CONCLUSIONS Consistent with existing literature in broader samples of pediatric cancer survivors, the present study further affirms attention deficits as an underlying contributor to social deficits in pediatric medulloblastoma survivors while also finding little relationship between self-reports of attention and social performance. Notably, present findings provide additional support suggesting that attention functioning is a more significant contributor to social outcomes for pediatric medulloblastoma survivors than the level of cognitive ability.
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Affiliation(s)
- Alice Ann Holland
- a University of Texas Southwestern Medical Center , Dallas , Texas , USA.,b Children's Medical Center , Dallas , Texas , USA
| | - Beth Colaluca
- c Cook Children's Health Care System , Fort Worth , Texas , USA
| | - Laurie Bailey
- c Cook Children's Health Care System , Fort Worth , Texas , USA
| | - Peter L Stavinoha
- a University of Texas Southwestern Medical Center , Dallas , Texas , USA.,b Children's Medical Center , Dallas , Texas , USA
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Crippa A, Salvatore C, Molteni E, Mauri M, Salandi A, Trabattoni S, Agostoni C, Molteni M, Nobile M, Castiglioni I. The Utility of a Computerized Algorithm Based on a Multi-Domain Profile of Measures for the Diagnosis of Attention Deficit/Hyperactivity Disorder. Front Psychiatry 2017; 8:189. [PMID: 29042856 PMCID: PMC5632354 DOI: 10.3389/fpsyt.2017.00189] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 09/14/2017] [Indexed: 02/02/2023] Open
Abstract
The current gold standard for diagnosis of attention deficit/hyperactivity disorder (ADHD) includes subjective measures, such as clinical interview, observation, and rating scales. The significant heterogeneity of ADHD symptoms represents a challenge for this assessment and could prevent an accurate diagnosis. The aim of this work was to investigate the ability of a multi-domain profile of measures, including blood fatty acid (FA) profiles, neuropsychological measures, and functional measures from near-infrared spectroscopy (fNIRS), to correctly recognize school-aged children with ADHD. To answer this question, we elaborated a supervised machine-learning method to accurately discriminate 22 children with ADHD from 22 children with typical development by means of the proposed profile of measures. To assess the performance of our classifier, we adopted a nested 10-fold cross validation, where the original dataset was split into 10 subsets of equal size, which were used repeatedly for training and testing. Each subset was used once for performance validation. Our method reached a maximum diagnostic accuracy of 81% through the combining of the predictive models trained on neuropsychological, FA profiles, and deoxygenated-hemoglobin features. With respect to the analysis of a single-domain dataset per time, the most discriminant neuropsychological features were measures of vigilance, focused and sustained attention, and cognitive flexibility; the most discriminating blood FAs were linoleic acid and the total amount of polyunsaturated fatty acids. Finally, with respect to the fNIRS data, we found a significant advantage of the deoxygenated-hemoglobin over the oxygenated-hemoglobin data in terms of predictive accuracy. These preliminary findings show the feasibility and applicability of our machine-learning method in correctly identifying children with ADHD based on multi-domain data. The present machine-learning classification approach might be helpful for supporting the clinical practice of diagnosing ADHD, even fostering a computer-aided diagnosis perspective.
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Affiliation(s)
- Alessandro Crippa
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
- Department of Psychology, University of Milano, Milan, Italy
| | - Christian Salvatore
- Institute of Molecular Imaging and Physiology, National Research Council, Milan, Italy
| | - Erika Molteni
- Computational Biology Group, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Maddalena Mauri
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Antonio Salandi
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Sara Trabattoni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Carlo Agostoni
- Pediatric Intermediate Care Unit, Fondazione IRCCS Ca Granda—Ospedale Maggiore Policlinico, DISSCO – Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Massimo Molteni
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Maria Nobile
- Child Psychopathology Unit, Scientific Institute, IRCCS Eugenio Medea, Lecco, Italy
| | - Isabella Castiglioni
- Institute of Molecular Imaging and Physiology, National Research Council, Milan, Italy
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Mueller A, Hong DS, Shepard S, Moore T. Linking ADHD to the Neural Circuitry of Attention. Trends Cogn Sci 2017; 21:474-488. [PMID: 28483638 PMCID: PMC5497785 DOI: 10.1016/j.tics.2017.03.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 11/16/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a complex condition with a heterogeneous presentation. Current diagnosis is primarily based on subjective experience and observer reports of behavioral symptoms - an approach that has significant limitations. Many studies show that individuals with ADHD exhibit poorer performance on cognitive tasks than neurotypical controls, and at least seven main functional domains appear to be implicated in ADHD. We discuss the underlying neural mechanisms of cognitive functions associated with ADHD, with emphasis on the neural basis of selective attention, demonstrating the feasibility of basic research approaches for further understanding cognitive behavioral processes as they relate to human psychopathology. The study of circuit-level mechanisms underlying executive functions in nonhuman primates holds promise for advancing our understanding, and ultimately the treatment, of ADHD.
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Affiliation(s)
- Adrienne Mueller
- Department of Neurobiology, Stanford University, Stanford, CA 94305, USA.
| | - David S Hong
- Department of Psychiatry, Stanford University, Stanford, CA 94305, USA
| | - Steven Shepard
- Department of Neurobiology, Stanford University, Stanford, CA 94305, USA
| | - Tirin Moore
- Department of Neurobiology, Stanford University, Stanford, CA 94305, USA; Howard Hughes Medical Institute, Stanford University, Stanford, CA 94305, USA
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Pagliaccio D, Wiggins JL, Adleman NE, Curhan A, Zhang S, Towbin KE, Brotman MA, Pine DS, Leibenluft E. Behavioral and Neural Sustained Attention Deficits in Disruptive Mood Dysregulation Disorder and Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2017; 56:426-435. [PMID: 28433092 PMCID: PMC5407501 DOI: 10.1016/j.jaac.2017.02.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Revised: 02/16/2017] [Accepted: 03/01/2017] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Disruptive mood dysregulation disorder (DMDD), characterized by severe irritability, and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. This is the first study to characterize neural and behavioral similarities and differences in attentional functioning across these disorders. METHOD Twenty-seven healthy volunteers, 31 patients with DMDD, and 25 patients with ADHD (8 to 18 years old) completed a functional magnetic resonance imaging attention task. Group differences in intra-subject variability in reaction time (RT) were examined. The present functional magnetic resonance imaging analytic approach precisely quantified trial-wise associations between RT and brain activity. RESULTS Group differences manifested in the relation between RT and brain activity (all regions: p < .01, F > 2.54, partial eta-squared [ηp2] > 0.06). Patients with DMDD showed specific alterations in the right paracentral lobule, superior parietal lobule, fusiform gyrus, and cerebellar culmen. In contrast, patients with DMDD and those with ADHD exhibited blunted compensatory increases in activity on long RT trials. In addition, youth with DMDD exhibited increased activity in the postcentral gyrus, medial frontal gyrus, and cerebellar tonsil and declive (all regions: p < .05, F > 2.46, ηp2 > 0.06). Groups in the imaging sample did not differ significantly in intra-subject variability in RT (F2,79 = 2.664, p = .076, ηp2 = 0.063), although intra-subject variability in RT was significantly increased in youth with DMDD and ADHD when including those not meeting strict motion and accuracy criteria for imaging analysis (F2,96 = 4.283, p = .017, ηp2 = 0.083). CONCLUSION Patients with DMDD exhibited specific alterations in the relation between pre-stimulus brain activity and RT. Patients with DMDD and those with ADHD exhibited similar blunting of compensatory neural activity in frontal, parietal, and other regions. In addition, patients with DMDD showed increased RT variability compared with healthy youth. This work is the first to identify common and unique behavioral and neural signatures of DMDD and ADHD.
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Affiliation(s)
- David Pagliaccio
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD.
| | - Jillian Lee Wiggins
- San Diego State University and San Diego State University/University of California-San Diego Joint Doctoral Program in Clinical Psychology
| | | | - Alexa Curhan
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
| | - Susan Zhang
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
| | - Kenneth E Towbin
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
| | - Melissa A Brotman
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD
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Chu KC, Huang YS, Tseng CF, Huang HJ, Wang CH, Tai HY. Reliability and validity of DS-ADHD: A decision support system on attention deficit hyperactivity disorders. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 140:241-248. [PMID: 28254080 DOI: 10.1016/j.cmpb.2016.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 10/23/2016] [Accepted: 12/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study is to examine the reliability of the clinical use of the self-built decision support system, diagnosis-supported attention deficit hyperactivity disorder (DS-ADHD), in an effort to develop the DS-ADHD system, by probing into the development of indicating patterns of past screening support systems for ADHD. METHODS The study collected data based on 107 subjects, who were divided into two groups, non-ADHD and ADHD, based on the doctor's determination, using the DSM-IV diagnostic standards. The two groups then underwent Test of Variables of Attention (TOVA) and DS-ADHD testing. The survey and testing results underwent one-way ANOVA and split-half method statistical analysis, in order to further understand whether there were any differences between the DS-ADHD and the identification tools used in today's clinical trials. RESULTS The results of the study are as follows: 1) The ROC area between the TOVA and the clinical identification rate is 0.787 (95% confidence interval: 0.701-0.872); 2) The ROC area between the DS-ADHD and the clinical identification rate is 0.867 (95% confidence interval: 0.801-0.933). CONCLUSIONS The study results show that DS-ADHD has the characteristics of screening for ADHD, based on its reliability and validity. It does not display any statistical differences when compared with TOVA systems that are currently on the market. However, the system is more effective and the accuracy rate is better than TOVA. It is a good tool to screen ADHD not only in Chinese children, but also in western country.
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Affiliation(s)
- Kuo-Chung Chu
- Department of Information Management, National Taipei University of Nursing & Health Sciences, Taipei 112, Taiwan.
| | - Yu-Shu Huang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital at Linko, Taoyuan City 333, Taiwan; College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
| | - Chien-Fu Tseng
- Department of Information Management, National Taipei University of Nursing & Health Sciences, Taipei 112, Taiwan
| | - Hsin-Jou Huang
- Department of Information Management, National Taipei University of Nursing & Health Sciences, Taipei 112, Taiwan
| | - Chih-Huan Wang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital at Linko, Taoyuan City 333, Taiwan; Department of Psychology, Zhejiang Normal University, Zhejiang Province, 321004 China
| | - Hsin-Yi Tai
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital at Linko, Taoyuan City 333, Taiwan
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Weyandt LL, Oster DR, Gudmundsdottir BG, DuPaul GJ, Anastopoulos AD. Neuropsychological functioning in college students with and without ADHD. Neuropsychology 2017; 31:160-172. [PMID: 27831696 PMCID: PMC5280458 DOI: 10.1037/neu0000326] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Increasing numbers of students with attention-deficit/hyperactivity disorder (ADHD) are attending college; however, little empirical information is available concerning the functional impairment experienced by these students. Although preliminary studies suggest that college students with ADHD are more likely to experience a variety of psychosocial and academic difficulties compared to their peers without the disorder, findings regarding neuropsychological functioning have been inconsistent with some studies reporting that college students with ADHD perform more poorly on various cognitive and neuropsychological tasks while others report no differences compared to their peers without ADHD. METHOD The purposes of the present study, the Trajectories Related to ADHD in College project, a longitudinal study following the 4-year outcomes of college students with and without ADHD, were to (a) examine the performance of 436 first-year college students with and without ADHD (51.6% female) on measures of executive function (EF) and intelligence and (b) investigate the association of self-reported use of stimulant medication and neuropsychological performance in students with ADHD. Participant data from their first year of involvement in the study were analyzed. RESULTS Participants with ADHD performed more poorly on task-based and self-report EF measures relative to the comparison group. In contrast, no significant group differences were found with respect to intellectual performance. Within the ADHD group, use of prescription stimulant medication was associated with improved performance on some, but not all, neuropsychological tasks. Additional analyses also revealed significant group differences in EF based on clinical diagnostic status. CONCLUSION College students with ADHD demonstrated poorer EF than their peers without ADHD and psychostimulant medication was associated with improved EF performance. No group differences were found with respect to intellectual functioning, Lastly, having one or more comorbid psychiatric diagnoses in addition to ADHD was associated with poorer EF outcomes. (PsycINFO Database Record
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Affiliation(s)
| | | | | | - George J DuPaul
- Department of Education and Human Services, Lehigh University
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Sims DM, Purpura DJ, Lonigan CJ. The Relation Between Inattentive and Hyperactive/Impulsive Behaviors and Early Mathematics Skills. J Atten Disord 2016. [PMID: 23204060 DOI: 10.1177/1087054712464390] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Despite strong evidence that inattentive and hyperactive/impulsive behaviors are associated with mathematical difficulties in school-age children, little research has been conducted to examine the link between these constructs before the start of formal education. The purpose of this study was to examine how different manifestations of inattentive and hyperactive/impulsive behaviors, as measured by different assessment tools, are related to early mathematics skills in preschoolers. METHOD Eighty-two preschool children completed a measure of early mathematics and the Continuous Performance Test (CPT). Teachers rated children's behaviors using the Conners' Teacher Rating Scale-15 Item. Sixty-five of these children completed mathematics assessments 1 year later. RESULTS Teacher ratings of inattention were uniquely related to concurrent early mathematics skills, whereas CPT errors were uniquely predictive of early mathematics skills 1 year later. CONCLUSION Findings have implications for the understanding and assessment of behavior problems that are associated with early mathematics difficulties.
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Lundervold AJ, Stickert M, Hysing M, Sørensen L, Gillberg C, Posserud MB. Attention Deficits in Children With Combined Autism and ADHD: A CPT Study. J Atten Disord 2016; 20:599-609. [PMID: 22940852 DOI: 10.1177/1087054712453168] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate characteristics of attention in children with the combination of autism spectrum disorder (ASD) and ADHD. METHOD Four groups of 8- to 10-year-old children were compared on the Conners' Continuous Performance Test-Second Edition (CCPT-II): (a) ASD + ADHD (n = 11), (b) ASD only (n = 9), (c) ADHD only (n = 38), and (d) no diagnosis (n = 134). RESULTS There was an overall effect of group on the Continuous Performance Test (CPT) index and measures of hit reaction time, accuracy, response style, variability, and consistency. The ASD + ADHD group, much like the ADHD only group, had a more risky response style, a higher variability, and a lower consistency than the ASD only group. The impact of intellectual function on CCPT-II performance was considerable in children within the ASD subgroups. CONCLUSION The findings underscore the importance of including measures of attention and intellectual function when assessing children with the combination of ASD and ADHD.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Norway Uni Research, Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway
| | - Marte Stickert
- Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Mari Hysing
- Department of Biological and Medical Psychology, University of Bergen, Norway Uni Research, Bergen, Norway
| | - Lin Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Norway K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Bergen, Norway Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Christopher Gillberg
- Uni Research, Bergen, Norway Gillberg Neuropsychiatric Centre, University of Gothenburg, Sweden
| | - Maj-Britt Posserud
- Uni Research, Bergen, Norway Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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Günther T, Knospe EL, Herpertz-Dahlmann B, Konrad K. Sex Differences in Attentional Performance in a Clinical Sample With ADHD of the Combined Subtype. J Atten Disord 2015; 19:764-70. [PMID: 23093556 DOI: 10.1177/1087054712461176] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The goal of the present study was to assess whether girls with ADHD express similar deficits in various attention tasks to those described in boys. METHOD A total of 175 children with the combined subtype of ADHD (89 females) and 132 normal controls (60 females) aged 8 to 14 years participated. Five different tests were conducted: alertness, sustained attention, focused attention, divided attention, and a set-shifting task. RESULTS The children with ADHD performed worse on all aspects of attention compared with healthy control participants. Several overall general sex differences could be detected, with boys exhibiting faster reaction times and greater response variability. Controlling for ADHD symptom severity and psychiatric comorbidities, no Sex × Diagnosis interaction was found, suggesting that males and females with ADHD experience comparable attentional deficits. CONCLUSION These results indicate that deficits in various attentional domains are a robust component of ADHD in males and females.
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Affiliation(s)
| | | | | | - Kerstin Konrad
- RWTH Aachen University, Germany Research Centre Juelich, Germany
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Rogers M, Boggia J, Ogg J, Volpe R. The Ecology of ADHD in the Schools. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2015. [DOI: 10.1007/s40474-015-0038-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Rossi ASU, de Moura LM, de Mello CB, de Souza AAL, Muszkat M, Bueno OFA. Attentional Profiles and White Matter Correlates in Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type. Front Psychiatry 2015; 6:122. [PMID: 26441684 PMCID: PMC4569813 DOI: 10.3389/fpsyt.2015.00122] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/17/2015] [Indexed: 12/31/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a widely studied neurodevelopmental disorder. It is a highly heterogeneous condition, encompassing different types of expression. The predominantly inattentive type is the most prevalent and the most stable over the lifetime, yet it is the least-studied presentation. To increase understanding of its cognitive profile, 29 children with attention-deficit/hyperactivity disorder of predominantly inattentive type (ADHD-I) and 29 matched controls, aged 7-15 years, had their attentional abilities assessed through the Conners' continuous performance test. Diffusion tensor imaging data were collected for all of the participants using a 3.0-T MRI system. Fractional anisotropy (FA) values were obtained for 20 fiber tracts, and brain-behavior correlations were calculated for 42 of the children. The ADHD-I children differed significantly from the typically developing (TD) children with respect to attentional measures, such as the ability to maintain response-time consistency throughout the task (Hit RT SE and Variability), vigilance (Hit RT ISI and Hit RT ISI SE), processing speed (Hit RT), selective attention (Omissions), sustained attention (Hit RT Block Change), error profile (Response Style), and inhibitory control (Perseverations). Evidence of significant differences between the ADHD-I and the TD participants was not found with respect to the mean FA values in the fiber tracts analyzed. Moderate and strong correlations between performance on the attention indicators and the tract-average FA values were found for the ADHD-I group. Our results contribute to a better characterization of the attentional profile of ADHD-I individuals and suggest that in children and adolescents with ADHD-I, attentional performance is mainly associated with the white matter structure of the long associative fibers that connect anterior-posterior brain areas.
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Affiliation(s)
| | | | | | | | - Mauro Muszkat
- Psychobiology Department, Universidade Federal de São Paulo , São Paulo , Brazil
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Allan DM, Lonigan CJ. Relations between response trajectories on the continuous performance test and teacher-rated problem behaviors in preschoolers. Psychol Assess 2014; 27:678-88. [PMID: 25419645 DOI: 10.1037/pas0000054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Although both the continuous performance test (CPT) and behavior rating scales are used in both practice and research to assess inattentive and hyperactive/impulsive behaviors, the correlations between performance on the CPT and teachers' ratings are typically only small-to-moderate. This study examined trajectories of performance on a low target-frequency visual CPT in a sample of preschool children and how these trajectories were associated with teacher-ratings of problem behaviors (i.e., inattention, hyperactivity/impulsivity [H/I], and oppositional/defiant behavior). Participants included 399 preschool children (mean age = 56 months; 49.4% female; 73.7% White/Caucasian). An attention deficit/hyperactivity disorder (ADHD) rating scale was completed by teachers, and the CPT was completed by the preschoolers. Results showed that children's performance across 4 temporal blocks on the CPT was not stable across the duration of the task, with error rates generally increasing from initial to later blocks. The predictive relations of teacher-rated problem behaviors to performance trajectories on the CPT were examined using growth curve models. Higher rates of teacher-reported inattention and H/I were uniquely associated with higher rates of initial omission errors and initial commission errors, respectively. Higher rates of teacher-reported overall problem behaviors were associated with increasing rates of omission but not commission errors during the CPT; however, the relation was not specific to 1 type of problem behavior. The results of this study indicate that the pattern of errors on the CPT in preschool samples is complex and may be determined by multiple behavioral factors. These findings have implications for the interpretation of CPT performance in young children.
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29
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Wu YH, Gau SSF, Lo YC, Tseng WYI. White matter tract integrity of frontostriatal circuit in attention deficit hyperactivity disorder: association with attention performance and symptoms. Hum Brain Mapp 2014; 35:199-212. [PMID: 22936578 PMCID: PMC6869173 DOI: 10.1002/hbm.22169] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 07/10/2012] [Indexed: 11/12/2022] Open
Abstract
The frontostriatal circuit has been postulated to account for the core symptoms such as inattention in attention deficit/hyperactivity disorder (ADHD). This study investigated the white matter integrity of frontostriatal fiber tracts using diffusion spectrum imaging (DSI) tractography and its correlations with measures of multi-dimensional aspects of inattention based on psychiatric interview and attention tasks in 25 children with ADHD and 25 matched typically developing (TD) children. All the subjects were assessed with comprehensive psychiatric interviews and the Conner's Continuous Performance Test (CCPT). DSI data were acquired on a 3-Tesla MRI system. The frontostriatal fiber pathways were reconstructed by deterministic tractography, and generalized fractional anisotropy values were measured along individual targeted tracts to investigate alterations in microstructure integrity. Children with ADHD performed worse than TD children in the dimensions of focused attention, sustained attention, impulsivity, and vigilance of the CCPT, and showed impaired integrity in four bilateral frontostriatal tracts, namely the dorsolateral-caudate, medial prefrontal-caudate, orbitofrontal-caudate, and ventrolateral-caudate tracts, and in global white matter as well. The integrity of the left orbitofronto-caudate tract was associated with the symptom of inattention in children with ADHD, compatible with the attention deficit and motivational dysfunction theories in ADHD. The integrity of the frontostriatal tracts was associated with the attention performance only in TD children, suggestive of possible recruitment of tracts other than the frontostriatal tracts implicated in attention deficits in children with ADHD. In conclusion, our results demonstrate the functional involvement of the frontostriatal circuit with respect to clinical symptoms and attention performance.
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Affiliation(s)
- Yi-Huan Wu
- School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Egeland J, Aarlien AK, Saunes BK. Few effects of far transfer of working memory training in ADHD: a randomized controlled trial. PLoS One 2013; 8:e75660. [PMID: 24124503 PMCID: PMC3790857 DOI: 10.1371/journal.pone.0075660] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 08/14/2013] [Indexed: 11/19/2022] Open
Abstract
Objective Studies have shown that children with ADHD profit from working memory training, although few studies have investigated transfer effects comprehensively. The current Randomized Controlled Trial analyzes transfer to other neuropsychological (NP) domains, academic performance and everyday functioning at home and school. Method Sixty-seven children with ADHD were randomized into a control group or a training group. The training group underwent Cogmed’s RoboMemo program. All participants were assessed pre-training, immediately after and eight months later with a battery of NP tests, measures of mathematical and reading skills, as well as rating scales filled out by parents and teachers. Results There was a significant training effect in psychomotor speed, but not to any other NP measures. Reading and mathematics were improved. There were no training induced changes in symptom rating scales either at home or at school. The increased reading scores remained significant eight months later. Conclusion The study is the most comprehensive study of transfer effects to date, and with mixed results compared to previous research. More research is needed regarding how to improve the training program and the conditions and thresholds for successful training. Trial Registration Controlled-Trials.com ISRCTN19133620
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Affiliation(s)
- Jens Egeland
- Division of Mental Health & Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- * E-mail:
| | | | - Brit-Kari Saunes
- Division of Child and Adolescent, Telemark Hospital Trust, Skien, Norway
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Udal AH, Øygarden B, Egeland J, Malt UF, Løvdahl H, Pripp AH, Grøholt B. Executive deficits in early onset bipolar disorder versus ADHD: impact of processing speed and lifetime psychosis. Clin Child Psychol Psychiatry 2013; 18:284-99. [PMID: 22977268 DOI: 10.1177/1359104512455181] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED Executive deficits are reported in both early onset bipolar disorder (BD) and attention-deficit hyperactivity disorder (ADHD), and controversies regarding comorbidity and symptom overlap have complicated the research on executive function in BD. Reports of the negative impact of executive difficulties on academic functioning indicate a need for a greater focus on executive difficulties in early onset psychiatric disorders. Executive function and processing speed in youths with BD (n = 4), ADHD (n = 26) and BD + ADHD (n = 13) were compared with controls (n = 69). All clinical groups demonstrated executive impairment. The combined group was most impaired. There were no significant differences between the groups. Executive deficit in the BD group was associated with a history of psychotic symptoms. The BD-nonpsychotic group was impaired only with regard to processing speed. Processing speed adjustment improved working memory and normalized interference control in both BD and ADHD. CONCLUSION executive deficits in BD may be determined by a history of psychotic symptoms rather than by comorbid ADHD. Some aspects of executive problems appear speed-related.
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Sims DM, Lonigan CJ. Inattention, hyperactivity, and emergent literacy: different facets of inattention relate uniquely to preschoolers' reading-related skills. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2012. [PMID: 23186142 DOI: 10.1080/15374416.2012.738453] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Although extant studies indicate that there is a strong association between attention deficit/hyperactivity disorder and reading ability in elementary school children, knowledge regarding the relation between inattentive and hyperactive/impulsive behaviors and emergent literacy in preschool children is less established. This study examined the unique and overlapping relations between measures that assess inattention and hyperactivity/impulsivity and emergent literacy skills in preschool children. Participants included 204 preschool children (M age = 56 months, 50.9% female, 79.8% European American). Behavioral rating scales were completed by teachers, and the Continuous Performance Test (CPT) and the Test of Preschool Early Literacy were completed by the preschoolers. Across measures, inattention was a unique correlate of emergent literacy skills, whereas hyperactivity/impulsivity was not. Both rating scales and the CPT indices of inattention were uniquely associated with emergent literacy skills. These results suggest that these measures are assessing different manifestations of inattention that are both unique correlates of early reading skills.
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Affiliation(s)
- Darcey M Sims
- Department of Psychology, Florida State University, Tallahassee, FL 32306, USA.
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Shang CY, Gau SSF. Improving visual memory, attention, and school function with atomoxetine in boys with attention-deficit/hyperactivity disorder. J Child Adolesc Psychopharmacol 2012; 22:353-63. [PMID: 23083022 DOI: 10.1089/cap.2011.0149] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Atomoxetine is efficacious in reducing symptoms of attention- deficit/hyperactivity disorder (ADHD), but its effect on visual memory and attention needs more investigation. This study aimed to assess the effect of atomoxetine on visual memory, attention, and school function in boys with ADHD in Taiwan. METHOD This was an open-label 12 week atomoxetine treatment trial among 30 drug-naíve boys with ADHD, aged 8-16 years. Before administration of atomoxetine, the participants were assessed using psychiatric interviews, the Wechsler Intelligence Scale for Children, 3rd edition (WISC-III), the school function of the Chinese version of the Social Adjustment Inventory for Children and Adolescents (SAICA), the Conners' Continuous Performance Test (CPT), and the tasks of the Cambridge Neuropsychological Test Automated Battery (CANTAB) involving visual memory and attention: Pattern Recognition Memory, Spatial Recognition Memory, and Reaction Time, which were reassessed at weeks 4 and 12. RESULTS Our results showed there was significant improvement in pattern recognition memory and spatial recognition memory as measured by the CANTAB tasks, sustained attention and response inhibition as measured by the CPT, and reaction time as measured by the CANTAB after treatment with atomoxetine for 4 weeks or 12 weeks. In addition, atomoxetine significantly enhanced school functioning in children with ADHD. CONCLUSION Our findings suggested that atomoxetine was associated with significant improvement in visual memory, attention, and school functioning in boys with ADHD.
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Affiliation(s)
- Chi-Yung Shang
- Department of Psychiatry, National Taiwan University Hospital & College of Medicine, National Taiwan University, Taipei, Taiwan
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34
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Egeland J, Ueland T, Johansen S. Central processing energetic factors mediate impaired motor control in ADHD combined subtype but not in ADHD inattentive subtype. JOURNAL OF LEARNING DISABILITIES 2012; 45:361-370. [PMID: 21685345 DOI: 10.1177/0022219411407922] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Participants with attention-deficit/hyperactivity disorder (ADHD) are often impaired in visuomotor tasks. However, little is known about the contribution of modal impairment in motor function relative to central processing deficits or whether different processes underlie the impairment in ADHD combined (ADHD-C) versus ADHD inattentive (ADHD-I) subtype. The present study analyzes performance on the Visual Motor Integration Test relative to less effortful motor tests as well as on measures of energetics. Both ADHD groups showed evidence of impaired motor function on both visual-motor integration (VMI) and the less effortful motor tests. The ADHD-C group performed below the ADHD-I group on VMI, but their performance correlated highly with the measures of the energetic pools of arousal and effort. Different mechanisms may underlie impaired fine motor skills in ADHD. Central processing deficits contribute significantly to the deficit of ADHD-C but do not explain the motor impairment in ADHD-I.
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Affiliation(s)
- Jens Egeland
- Vestfold Mental Health Care Trust, Tønsberg, Norway.
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Sims DM, Lonigan CJ. Multi-Method Assessment of ADHD Characteristics in Preschool Children: Relations between Measures. EARLY CHILDHOOD RESEARCH QUARTERLY 2012; 27:329-337. [PMID: 22518069 PMCID: PMC3327380 DOI: 10.1016/j.ecresq.2011.08.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Several forms of assessment tools, including behavioral rating scales and objective tests such as the Continuous Performance Test (CPT), can be used to measure inattentive and hyperactive/impulsive behaviors associated with Attention-Deficit/Hyperactivity Disorder (ADHD). However, research with school-age children has shown that the correlations between parent ratings, teacher ratings, and scores on objective measures of ADHD-characteristic behaviors are modest at best. In this study, we examined the relations between parent and teacher ratings of ADHD and CPT scores in a sample of 65 preschoolers ranging from 50 to 72 months of age. No significant associations between teacher and parent ratings of ADHD were found. Parent-ratings of both inattention and hyperactivity/impulsivity accounted for variance in CPT omission errors but not CPT commission errors. Teacher ratings showed evidence of convergent and discriminant validity when entered simultaneously in a hierarchical regression. These tools may be measuring different aspects of inattention and hyperactivity/impulsivity.
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Memory in Early Onset Bipolar Disorder and Attention-Deficit/Hyperactivity Disorder: Similarities and Differences. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2012; 40:1179-92. [DOI: 10.1007/s10802-012-9631-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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37
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Günther T, Kahraman-Lanzerath B, Knospe EL, Herpertz-Dahlmann B, Konrad K. Modulation of attention-deficit/hyperactivity disorder symptoms by short- and long-acting methylphenidate over the course of a day. J Child Adolesc Psychopharmacol 2012; 22:131-8. [PMID: 22364402 DOI: 10.1089/cap.2010.0146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this study was to investigate whether a long-acting methylphenidate formulation (MPH-ret) is as effective as two doses of immediate-release methylphenidate (MPH-IR) in reducing attention-deficit/hyperactivity disorder (ADHD) symptoms including inattention, impulsivity, and hyperactivity during the course of the day. Two groups of children (n=18 each) with ADHD aged between 8 and 12 years completed a continuous performance test in combination with a motion-tracking system four times a day within 8 hours. Inattention (standard deviation of reaction time), impulsivity (commission error rate), and hyperactivity (path length of the headband) were simultaneously measured. We included a control group (n=20) to rule out circadian fluctuations of attentional performance and motor activity. We observed a postlunch dip in attentional performance and an increasing trend of motor activity throughout the day whereas impulsivity remained stable in controls. The MPH-ret and MPH-IR groups had comparable treatment effects on measures of hyperactivity and inattention and normalized participant performance to control levels. In contrast, MPH-IR seems to have an advantage over MPH-ret in impulsivity treatments. Thus, our data suggest that it is crucial to assess the different domains of ADHD symptoms precisely over the course of a day to determine the optimal titration and stimulant formulation for a person with ADHD.
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Affiliation(s)
- Thomas Günther
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry, University Hospital of the RWTH Aachen, Aachen, Germany.
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BARNES SA, YOUNG JW, NEILL JC. Rats tested after a washout period from sub-chronic PCP administration exhibited impaired performance in the 5-Choice Continuous Performance Test (5C-CPT) when the attentional load was increased. Neuropharmacology 2012; 62:1432-41. [PMID: 21569782 PMCID: PMC5870141 DOI: 10.1016/j.neuropharm.2011.04.024] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 04/05/2011] [Accepted: 04/20/2011] [Indexed: 02/08/2023]
Abstract
It is well documented that schizophrenia patients exhibit dysfunction in various cognitive domains, including attention/vigilance, as demonstrated by impaired performance in the myriad of Continuous Performance Tests (CPTs). NMDA receptor antagonists provide a pharmacological model in animals of the cognitive disruption presented in the disorder. We therefore examined the effects of a sub-chronic PCP treatment regimen (5.0mg/kg 7-days bi-daily) in the recently developed rodent test of vigilance, the 5-Choice Continuous Performance Test (5C-CPT). We assessed the effects of this regimen after at least a 7-day washout period on both baseline performance and when the attentional load was increased. Sub-chronic PCP treatment impaired 5C-CPT performance in a manner consistent with impaired vigilance in patients with schizophrenia, with reduced hit rate and impaired signal sensitivity. These effects were only evident when performance was challenged following parameter manipulations. These data demonstrate that attention/vigilance is sensitive to disruption following sub-chronic PCP treatment in a pre-clinical task that may demonstrate increased analogy to human vigilance tasks. Although the PCP-induced attentional deficits are not as large as those deficits observed in other domains, these data provide evidence that this pharmacological model can affect multiple cognitive domains and may be useful for assessing putative pro-cognitive therapeutics for schizophrenia.
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Affiliation(s)
- Samuel A BARNES
- The School of Pharmacy, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK
| | - Jared W YOUNG
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0804
| | - Jo C NEILL
- The School of Pharmacy, University of Bradford, Bradford, West Yorkshire, BD7 1DP, UK
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D₁ receptor activation improves vigilance in rats as measured by the 5-choice continuous performance test. Psychopharmacology (Berl) 2012; 220:129-41. [PMID: 21901319 PMCID: PMC5870138 DOI: 10.1007/s00213-011-2460-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 08/17/2011] [Indexed: 12/28/2022]
Abstract
RATIONALE Impaired attention/vigilance is putatively core to schizophrenia. The dopaminergic D(1) receptor system has been reported as one of the most promising targets for improving cognition in patients with schizophrenia, with some evidence suggesting D(1) activation may improve sustained attention. OBJECTIVES The purpose of this study was twofold: firstly assessing the applicability of using rats in the 5-Choice Continuous Performance Test (5 C-CPT), recently validated in mice. Secondly, the effect of systemic administration of a D(1) partial agonist, SKF 38393, on task performance during baseline, and a challenge session consisting of a reduced event-rate was investigated. METHODS Animals were trained to perform the 5 C-CPT with performance assessed following systemic SKF 38393 (2, 4 and 6 mg/kg) vs. vehicle administration. RESULTS Rats could discriminate between target (requiring a response) and non-target (requiring the inhibition of response) trials within the 5 C-CPT. Moreover, SKF 38393 treatment impaired performance during the baseline session reducing target detection, yet improved performance during the reduced event-rate challenge session, increasing target detection and improving signal discrimination indicating an SKF 38393-induced enhancement of vigilance. Thus, these data suggest that activation of the D(1) system affected 5 C-CPT performance in a baseline dependent manner. CONCLUSION Rats can be trained to perform the 5 C-CPT, appropriately withholding from responding to non-target trials. Systemic administration of SKF 38393 impaired performance during baseline conditions. Following a task-related challenge, which reduced the event rate, activation of the dopamine (DA) D(1) system improved performance by heightening the animals' vigilance levels, quantified using signal detection theory.
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Miranda MC, Barbosa T, Muszkat M, Rodrigues CC, Sinnes EG, Coelho LFS, Rizzuti S, Palma SMM, Bueno OFA. Performance patterns in Conners' CPT among children with attention deficit hyperactivity disorder and dyslexia. ARQUIVOS DE NEURO-PSIQUIATRIA 2012; 70:91-6. [DOI: 10.1590/s0004-282x2012000200004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2011] [Accepted: 11/09/2011] [Indexed: 11/22/2022]
Abstract
This study investigated the performance of children with attention deficit hyperactivity disorder (ADHD) and dyslexia using Conners' Continuous Performance Test (CCPT). The clinical groups were composed of 52 children with ADHD and 32 children with dyslexia. Performance in the CCPT was evaluated using ANCOVA to compare the clinical groups with the normative Brazilian sample. The ADHD group performed worse than the normative sample in almost all of the measurements, except for reaction time and response style. The dyslexia group scored higher on commissions, variability, perseverations and inconsistency in the reaction time over the six time blocks (Hit SE Block Change) than the children in the normative Brazilian sample. The ADHD and dyslexia groups differed in omission measurements, Hit RT SE, variability, perseverations, Hit RT Interstimulus Intervals (ISI) Change and Hit SE ISI Change. We thus found that the dyslexia group had specific deficit patterns, with greater response to non-target stimuli, greater perseveration and response variability, and difficulties in hit reaction time as the test progressed.
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Affiliation(s)
| | | | - Mauro Muszkat
- São Paulo Neuropsychology Center/AFIP; Federal University of São Paulo
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41
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Attentional processes and ADHD-related symptoms in pediatric patients with epilepsy. Epilepsy Res 2011; 93:53-65. [DOI: 10.1016/j.eplepsyres.2010.10.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 10/10/2010] [Accepted: 10/24/2010] [Indexed: 11/24/2022]
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