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Chan WWY, Shum KKM, Downs J, Liu NT, Sonuga-Barke EJS. Attention-deficit/hyperactivity disorder (ADHD) in cultural context II: a comparison of the links between ADHD symptoms and waiting-related responses in Hong Kong and UK. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02506-7. [PMID: 38935132 DOI: 10.1007/s00787-024-02506-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
The concept of attention-deficit/hyperactivity disorder (ADHD) is considered to have cross-cultural validity, but direct comparisons of its psychological characteristics across cultures are limited. This study investigates whether preschool children's ADHD symptoms expressed in two cultures with different views about child behaviour and parenting, Hong Kong and the UK, show the same pattern of associations with their waiting-related abilities and reactions, an important marker of early self-regulation. A community sample of 112 preschoolers (mean age = 46.22 months; 55 from UK, 57 from HK) completed three tasks measuring different waiting elements - waiting for rewards, choosing the amount of time to wait, and having to wait unexpectedly when a task is interrupted. Participants' waiting-related behavioural and emotional reactions were coded. Parents rated their children's ADHD symptoms and delay aversion. Our findings revealed that the associations between ADHD symptoms and waiting-related responses were comparable in both UK and HK samples. This suggests that the core psychological characteristics of ADHD, particularly in relation to waiting behaviours, may exhibit similarity across cultural contexts. Future research can extend this cross-cultural analysis to other ADHD-related psychological domains and explore additional cultural settings.
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Affiliation(s)
- Wendy W Y Chan
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | | | - Johnny Downs
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ngai Tsit Liu
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Edmund J S Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- Department of Child & Adolescent Psychiatry, Aarhus University, Aarhus, Denmark.
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, DeCrespigny Park, SE5 8AF, UK.
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White E, Dalley JW. Brain mechanisms of temporal processing in impulsivity: Relevance to attention-deficit hyperactivity disorder. Brain Neurosci Adv 2024; 8:23982128241272234. [PMID: 39148691 PMCID: PMC11325328 DOI: 10.1177/23982128241272234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/25/2024] [Indexed: 08/17/2024] Open
Abstract
In this article, we critique the hypothesis that different varieties of impulsivity, including impulsiveness present in attention-deficit hyperactivity disorder, encompass an accelerated perception of time. This conceptualisation provides insights into how individuals with attention-deficit hyperactivity disorder have the capacity to maximise cognitive capabilities by more closely aligning themselves with appropriate environmental contexts (e.g. fast paced tasks that prevent boredom). We discuss the evidence for altered time perception in attention-deficit hyperactivity disorder alongside putative underlying neurobiological substrates, including a distributed brain network mediating time perception over multiple timescales. In particular, we explore the importance of temporal representations across the brain for time perception and symptom manifestation in attention-deficit hyperactivity disorder, including a prominent role of the hippocampus and other temporal lobe regions. We also reflect on how abnormalities in the perception of time may be relevant for understanding the aetiology of attention-deficit hyperactivity disorder and mechanism of action of existing medications.
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Affiliation(s)
- Eleanor White
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - Jeffrey W Dalley
- Department of Psychology, University of Cambridge, Cambridge, UK
- Department of Psychiatry, Herschel Smith Building for Brain and Mind Sciences, Cambridge, UK
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Chan WWY, Shum KKM, Downs J, Sonuga-Barke EJS. An experimental task to measure preschool children's frustration induced by having to wait unexpectedly: The role of sensitivity to delay and culture. J Exp Child Psychol 2024; 237:105763. [PMID: 37647841 DOI: 10.1016/j.jecp.2023.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/26/2023] [Accepted: 08/07/2023] [Indexed: 09/01/2023]
Abstract
The ability to manage frustration induced by having to wait for valued outcomes emerges across childhood and is an important marker of self-regulatory capacity. However, approaches to measure this capacity in preschool children are lacking. In this study, we introduced a new task, the Preschool Delay Frustration Task (P-DeFT), designed specifically to identify children's behavioral and emotional markers of waiting-induced frustration during the imposed wait period and after the release from waiting. We then explored how waiting-induced frustration relates to individual differences in delay sensitivity and whether it differs between two cultural groups thought to have different attitudes toward children's conduct and performance: Hong Kong (HK) and the United Kingdom (UK). A total of 112 preschool children (mean age = 46.22 months) completed the P-DeFT in a quiet laboratory. Each trial had two stages; first, a button press elicited a Go signal; second, this Go signal allowed children to go to a "supermarket" to pick a target toy. On most trials, the Go signal occurred immediately on the first press. On 6 trials, an unexpected/unsignaled 5- or 10-s pre-Go-signal period was imposed. Frustration was indexed by performance (button presses and press duration), behavioral agitation, and negative affect during the pre-Go-signal wait period and the post-Go-signal shopping task. Parents rated their children's delay sensitivity. Waiting-related frustration expressed during both the pre-Go-signal wait period and the post-Go-signal task varied with (a) the length of wait and (b) individual differences in parent-rated delay sensitivity. UK children displayed more negative affect during delay than their HK counterparts, although the relationship between delay sensitivity and frustration was culturally invariant.
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Affiliation(s)
- Wendy Wing-Ying Chan
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Department of Psychology, The University of Hong Kong, Hong Kong
| | | | - Johnny Downs
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK
| | - Edmund J S Sonuga-Barke
- School of Academic Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, UK; Department of Child and Adolescent Psychiatry, Aarhus University, 8000 Aarhus C, Denmark.
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Sonuga‐Barke EJS. ‘If it don't fit, don't force it?’
If real‐world, complex clinical decisions are intrinsically categorical can dimensional systems add value? Reflections on Lahey, Tiemeier & Krueger (2022). JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Van Dessel J, Sonuga-Barke E, Moerkerke M, Van der Oord S, Lemiere J, Morsink S, Danckaerts M. The amygdala in adolescents with attention-deficit/hyperactivity disorder: Structural and functional correlates of delay aversion. World J Biol Psychiatry 2020; 21:673-684. [PMID: 30945592 DOI: 10.1080/15622975.2019.1585946] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Recent magnetic resonance imaging (MRI) studies implicate structural alterations of amygdala, a brain region responsible for processing and experiencing negative emotions, in adolescents with attention-deficit/hyperactivity disorder (ADHD). Here we examined ADHD-related structural correlates of amygdala functional activity elicited during a functional MRI task designed to test behavioural and brain responses to the imposition of delay - an event known to both elicit amygdala hyperactivation and aversity in ADHD. METHODS Structural MRI scans from 28 right-handed male adolescents with combined type ADHD and 32 age-matched controls were analysed. Regional grey matter volumes of ADHD and control participants (P[FWE] < 0.05) were correlated with delay aversion self-ratings and neural activity in response to delay-related cues on the Escape Delay Incentive fMRI task. RESULTS ADHD was associated with significantly reduced volumes in bilateral amygdala, parahippocampal and temporal gyrus (P[FWE] < 0.05), greater basolateral amygdala activation to delay-related cues (P[FWE] < 0.05) and higher delay aversion self-ratings. Amygdala volume reductions were significantly correlated with, and statistically mediated the pathway from ADHD to, delay-cue-related amygdala hyperactivity (P < 0.01) and self-reported delay aversion (P < 0.01). CONCLUSIONS We provide the first evidence of the functional significance of reduced amygdala volumes in adolescents with ADHD by highlighting its relation to delay-induced brain activity that is linked to delay aversion.
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Affiliation(s)
- Jeroen Van Dessel
- Center for Developmental Psychiatry, Department of Neurosciences, UPC - KU Leuven, Leuven, Belgium
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Matthijs Moerkerke
- Center for Developmental Psychiatry, Department of Neurosciences, UPC - KU Leuven, Leuven, Belgium
| | - Saskia Van der Oord
- Clinical Psychology, KU Leuven, Leuven, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Jurgen Lemiere
- Center for Developmental Psychiatry, Department of Neurosciences, UPC - KU Leuven, Leuven, Belgium
| | - Sarah Morsink
- Center for Developmental Psychiatry, Department of Neurosciences, UPC - KU Leuven, Leuven, Belgium
| | - Marina Danckaerts
- Center for Developmental Psychiatry, Department of Neurosciences, UPC - KU Leuven, Leuven, Belgium
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Hwang-Gu SL, Chen YC, Liang SHY, Ni HC, Lin HY, Lin CF, Gau SSF. Exploring the Variability in Reaction Times of Preschoolers at Risk of Attention-Deficit/Hyperactivity Disorder: an ex-Gaussian Analysis. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:1315-1326. [PMID: 30706251 DOI: 10.1007/s10802-018-00508-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Reaction times (RTs) are typically slower and more variable in individuals with attention-deficit/hyperactivity disorder (ADHD). Analysis of the ex-Gaussian RT distribution, which is described by mu, sigma (mean and standard deviation, respectively, of the normal distribution) and tau (that of exponential distribution), reveals that individuals with ADHD do not display overall slower RTs but have a high proportion of extremely slow RTs, represented by a high tau value. Although this is a vital component for describing ADHD-related RT variability in school-aged children, adolescents, and adults, it has not been thoroughly studied at the preschool age. We assessed 65 preschoolers at risk of ADHD and 98 typically developing preschoolers with the Conners' Kiddie Continuous Performance Test (K-CPT) and parental and teacher reports of ADHD symptoms. We found that preschoolers at risk of ADHD had greater values for RT standard deviation, sigma, and tau than typically developing preschoolers at long inter-stimulus intervals (ISIs) (3 s), but not at short ISIs (1.5 s). This suggests that attention problems in preschool children may only be apparent in the tasks with a relatively slow event rate. Our study demonstrates that the ex-Gaussian tau value is essential for describing the inattentive component of task performance in preschoolers with heightened ADHD symptoms. Furthermore, the fact that the tau effect was modulated by ISI suggests that the longer duration (3 s vs. 1.5 s) is a non-optimal energetic state in preschoolers at risk of ADHD, and that this might account for the subtle attentional flaw in task performance.
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Affiliation(s)
- Shoou-Lian Hwang-Gu
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Yu-Chi Chen
- Division of Clinical Psychology, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Sophie Hsin-Yi Liang
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsing-Chang Ni
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Hsiang-Yuan Lin
- Department of Psychiatry, National Taiwan University Hospital, and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Chiao-Fan Lin
- Department of Child Psychiatry, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Susan Shur-Fen Gau
- Department of Psychiatry, National Taiwan University Hospital, and College of Medicine, No. 7, Chung-Shan South Road, Taipei, 10002, Taiwan.
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Chronaki G, Benikos N, Soltesz F, Sonuga-Barke EJS. The reinforcing value of delay escape in attention deficit/hyperactivity disorder: An electrophysiological study. NEUROIMAGE-CLINICAL 2019; 23:101917. [PMID: 31491823 PMCID: PMC6614592 DOI: 10.1016/j.nicl.2019.101917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/15/2019] [Accepted: 06/29/2019] [Indexed: 12/03/2022]
Abstract
The delay aversion hypothesis argues that the tendency for impulsive choice (preference for smaller sooner over larger later rewards) is motivated by the escape of negative affective states associated with delay. This model predicts that individuals with ADHD find the imposition of delay before an outcome or event especially aversive and its escape reinforcing. Consistent with this, fMRI studies show that ADHD is associated with amygdala hyper-sensitivity to cues of delay. However, evidence that delay escape is reinforcing is lacking. Here we extend fMRI research by using electrophysiological methods to study the reinforcing properties of delay-escape in ADHD. Thirty controls and 25 adolescents with ADHD aged 10–15 years performed the Escape Delay Incentive (EDI) task- in which pre-target cues indicated three conditions: i) CERTAIN DELAY: delay would follow a response irrespective of response speed ii) CONDITIONAL DELAY: delay would only follow if the response was too slow and iii) NO DELAY: delay would follow the response whatever the speed. We focused on the Contingent Negative Variation (CNV), a cue-evoked marker of motivated response preparation, across two time windows (CNV1 and CNV2). We took measures of parent, teacher and self-rated ADHD symptoms, task performance (RT) and self-rated delay aversion. We isolated CNV components and compared these between ADHD and controls. Adolescents with ADHD displayed a larger CNV2 to the CONDITIONAL DELAY than the CERTAIN DELAY cues compared to controls. However, this effect was not mirrored at the performance level and was unrelated to self-reported delay aversion. Our study provides the first ERP evidence that delay escape differentially reinforcers neural activation of attention preparation in ADHD cases. Future studies should examine the impact of varying cognitive load on task EDI performance. Individuals with ADHD find cues predicting the imposition of delay aversive but evidence that delay escape is reinforcing is lacking We used the Escape-Delay Incentive Task to isolate the CNV, reflecting motivated attention preparation to escape delay cues Adolescents with ADHD displayed larger CNV2 to cues signalling the possibility to escape delay Results provide the first ERP evidence of the reinforcing value of delay escape in ADHD
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Affiliation(s)
- Georgia Chronaki
- Developmental Cognitive Neuroscience (DCN) Laboratory, School of Psychology, University of Central Lancashire, UK; Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK; Division of Neuroscience & Experimental Psychology, University of Manchester, UK.
| | - Nicholas Benikos
- Department of Cognitive Science, Macquarie University, Australia
| | - Fruzsina Soltesz
- Developmental Brain-Behaviour Laboratory, Psychology, University of Southampton, UK
| | - Edmund J S Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Denmark.
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Abstract
Development of the frontal lobe is critical to acquisition, execution, and control of a wide range of functions, from basic motor response to complex decision-making. These functions are influenced by contingency-based (e.g., reward and response-cost/punishment) feedback that is mediated through the adaptive integration of fronto-subcortical neural circuitry. The frontal lobe manages incoming information and chooses the appropriate action based on one's goals in a particular context. This aspect of frontal function, while only one component, is crucial to development and maintenance of approach and avoidance behavior central to all human (and animal) behavior. Furthermore, disruptions in fronto-subcortical circuitry governing motivated behavior appear to contribute to a range of developmental disorders, including attention-deficit/hyperactivity disorder (ADHD), and confer vulnerability for psychopathology more broadly. The particular deficits that manifest in altered behavior depend upon the specific circuitry that is compromised due to the functional specificity of distinct regions of the frontal lobe and its interconnections with subcortical structures. Neurobiologic models of motivated behavior provide a valuable framework for characterizing developmental disorders from a transdiagnostic dimensional systems perspective. Improved characterization of approach and avoidance motivation across neurodevelopmental disorders has the potential to inform the development of novel interventions and personalized medicine.
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Affiliation(s)
- Keri Shiels Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States.
| | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, United States
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Rosch KS, Mostofsky SH, Nebel MB. ADHD-related sex differences in fronto-subcortical intrinsic functional connectivity and associations with delay discounting. J Neurodev Disord 2018; 10:34. [PMID: 30541434 PMCID: PMC6292003 DOI: 10.1186/s11689-018-9254-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 11/14/2018] [Indexed: 01/12/2023] Open
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is associated with atypical fronto-subcortical neural circuitry and heightened delay discounting, or a stronger preference for smaller, immediate rewards over larger, delayed rewards. Recent evidence of ADHD-related sex differences in brain structure and function suggests anomalies in fronto-subcortical circuitry may differ among girls and boys with ADHD. The current study examined whether the functional connectivity (FC) within fronto-subcortical neural circuitry differs among girls and boys with ADHD compared to same-sex typically developing (TD) controls and relates to delay discounting. Methods Participants include 8–12-year-old children with ADHD (n = 72, 20 girls) and TD controls (n = 75, 21 girls). Fronto-subcortical regions of interest were functionally defined by applying independent component analysis to resting-state fMRI data. Intrinsic FC between subcortical components, including the striatum and amygdala, and prefrontal components, including ventromedial prefrontal cortex (vmPFC), anterior cingulate cortex (ACC), and anterior dorsolateral prefrontal cortex (dlPFC), was compared across diagnostic groups overall and within sex. Correlations between intrinsic FC of the six fronto-subcortical pairs and delay discounting were also examined. Results Both girls and boys with ADHD show atypical FC between vmPFC and subcortical regions including the striatum (stronger positive FC in ADHD) and amygdala (weaker negative FC in ADHD), with the greatest diagnostic effects among girls. In addition, girls with ADHD show atypical intrinsic FC between the striatum and dlPFC components, including stronger positive FC with ACC and stronger negative FC with dlPFC. Further, girls but not boys, with ADHD, show heightened real-time delay discounting. Brain–behavior correlations suggest (1) stronger negative FC between the striatal and dlPFC components correlated with greater money delay discounting across all participants and (2) stronger FC between the amygdala with both the dlPFC and ACC components was differentially related to heightened real-time discounting among girls and boys with and without ADHD. Conclusions Our findings suggest fronto-subcortical functional networks are affected in children with ADHD, particularly girls, and relate to delay discounting. These results also provide preliminary evidence of greater disruptions in fronto-subcortical FC among girls with ADHD that is not due to elevated inattention symptom severity, intellectual reasoning ability, age, or head motion. Electronic supplementary material The online version of this article (10.1186/s11689-018-9254-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA. .,Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, 21205, USA. .,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary Beth Nebel
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, Baltimore, MD, 21205, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Low AM, le Sommer J, Vangkilde S, Fagerlund B, Glenthøj B, Sonuga-Barke E, Habekost T, Jepsen JRM. Delay Aversion and Executive Functioning in Adults With Attention-Deficit/Hyperactivity Disorder: Before and After Stimulant Treatment. Int J Neuropsychopharmacol 2018; 21:997-1006. [PMID: 30124878 PMCID: PMC6209856 DOI: 10.1093/ijnp/pyy070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 08/14/2018] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder is a heterogeneous disorder, associated with deficits in motivation (e.g., delay aversion) and cognition. Methylphenidate is recommended as a first line treatment for attention deficit hyperactivity disorder symptoms, but little is known about its nonacute effects on motivational and cognitive deficits, particularly in adults with attention deficit hyperactivity disorder. METHODS We utilized a prospective, non-randomized, non-blinded, 6-week follow-up design with 42 initially stimulant medication-naïve adult patients with moderate to severe attention deficit hyperactivity disorder, and 42 age- and parental education-matched healthy controls. Delay aversion and executive functioning were assessed with 2 questionnaires and 5 performance-based tests. RESULTS At baseline, patients and controls differed significantly on performance-based measures (moderate to large effect sizes), and self-report of delay aversion and executive functioning (very large effect sizes). Treatment with methylphenidate medication (mean dose 65.54 mg/d, SD=10.39) was not associated with improvements in performance-based measures of delay aversion and executive functioning compared to controls, although improvements in self-report executive functioning and delay aversion were found. Self-reported delay aversion was most consistently associated with ADHD symptomatology at baseline and after medication. CONCLUSION Methylphenidate treatment does not have an effect on performance-based measures of delay aversion and executive functioning, but may have significant effects on self-reported delay aversion and executive functioning. The latter finding should be interpreted cautiously, given the subjective nature of these measures and design limitations. Self-reported delay aversion is most consistently associated with attention deficit hyperactivity disorder symptomatology.
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Affiliation(s)
- Ann-Marie Low
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Correspondence: Ann-Marie Low, Department of Psychology, University of Copenhagen, Østre Farimagsgade 2A, 1353 Copenhagen K, Denmark ()
| | - Julijana le Sommer
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Signe Vangkilde
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Birgitte Fagerlund
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark,Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Faculty of Health and Medical Sciences, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College, London, United Kingdom
| | - Thomas Habekost
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Jens Richardt Møllegaard Jepsen
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, University of Copenhagen, Copenhagen, Denmark,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark
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Van Dessel J, Sonuga-Barke E, Mies G, Lemiere J, Van der Oord S, Morsink S, Danckaerts M. Delay aversion in attention deficit/hyperactivity disorder is mediated by amygdala and prefrontal cortex hyper-activation. J Child Psychol Psychiatry 2018; 59:888-899. [PMID: 29427289 DOI: 10.1111/jcpp.12868] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND Experimental research supports delay aversion as a motivational feature of attention deficit/hyperactivity disorder (ADHD). To investigate the neurobiology of delay aversion in ADHD, this study examined whether adolescents with ADHD display an unusually strong activation in affective brain regions in response to cues predicting forthcoming delay and whether these effects are (a) delay-dose dependent and (b) statistically mediate the association between ADHD and self-reported delay aversion. METHODS Twenty-nine right-handed male adolescents with combined type ADHD and 32 typically developing controls (ages 10-18 years) performed a reaction time task in an MRI scanner. Pretarget cues indicated delay-related response consequences. One indicated that delay would follow the response irrespective of response speed (CERTAIN DELAY), a second that delay would only follow if the response was too slow (CONDITIONAL DELAY), and a third that no delay would follow the response whatever its speed (NO DELAY). Delay levels were 2, 6, or 14 s. Participants also rated their own delay aversion in everyday life. RESULTS Individuals with ADHD rated themselves as more delay averse than controls. Significantly greater activation to CERTAIN DELAY cues relative to NO DELAY cues was found in participants with ADHD compared to controls (bilaterally) in amygdala, anterior insula, temporal pole, dorsolateral prefrontal cortex (DLPFC), and ventromedial prefrontal cortex. Amygdala and DLPFC activation strength were strongly and delay-dose dependently correlated with delay aversion ratings, and statistically mediated the relationship between ADHD status and delay aversion. CONCLUSIONS When presented with cues predicting impending delay, adolescents with ADHD, relative to controls, displayed a delay-related increase in activation in amygdala and DLPFC, regions known to be implicated in the processing of aversive events. Future studies should examine the specificity of these effects to delay aversion compared to aversive events in general.
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Affiliation(s)
- Jeroen Van Dessel
- Center for Developmental Psychiatry, UPC - KU Leuven, Leuven, Belgium
| | - Edmund Sonuga-Barke
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Gabry Mies
- Center for Developmental Psychiatry, UPC - KU Leuven, Leuven, Belgium.,Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Jurgen Lemiere
- Center for Developmental Psychiatry, UPC - KU Leuven, Leuven, Belgium
| | - Saskia Van der Oord
- Clinical Psychology, KU Leuven, Leuven, Belgium.,Developmental Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Sarah Morsink
- Center for Developmental Psychiatry, UPC - KU Leuven, Leuven, Belgium
| | - Marina Danckaerts
- Center for Developmental Psychiatry, UPC - KU Leuven, Leuven, Belgium
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Jepsen JRM, Rydkjaer J, Fagerlund B, Pagsberg AK, Jespersen RAF, Glenthøj BY, Oranje B. Overlapping and disease specific trait, response, and reflection impulsivity in adolescents with first-episode schizophrenia spectrum disorders or attention-deficit/hyperactivity disorder. Psychol Med 2018; 48:604-616. [PMID: 28712363 DOI: 10.1017/s0033291717001921] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Schizophrenia and attention-deficit/hyperactivity disorder (ADHD) are developmental disorders with shared clinical characteristics such as cognitive impairments and impulsivity. Impulsivity is a core feature of ADHD and an important factor in aggression, violence, and substance use in schizophrenia. Based on the hypothesis that schizophrenia and ADHD represent a continuum of neurodevelopmental impairments, the aim was to identify overlapping and disease specific forms of impulsivity. METHODS Adolescents between 12 and 17 years of age were assessed with the Schedule for Affective Disorders and Schizophrenia for School-aged Children - Present and Lifetime Version. Subjects with early-onset, first-episode schizophrenia spectrum disorders (EOS) (N = 29) or ADHD (N = 29) and healthy controls (N = 45) were compared on two performance measures (Information Sampling Task, Stop Signal Task) and a subjective personality trait measure of impulsivity (Barratt Impulsiveness Scale, Version 11 (BIS-11)). RESULTS Significantly increased reflection impulsivity was observed in ADHD but not in the EOS group. No significant response inhibition deficits (stop signal reaction time) were found in the two clinical groups. The ADHD and the EOS group showed significantly increased motor, attentional, and non-planning subtraits of impulsivity. CONCLUSIONS Impaired pre-decisional information gathering appeared to be specific for ADHD while the information gathering was not significantly reduced in subjects with EOS. Neither the ADHD nor EOS group showed impaired response inhibition but shared increased personality subtraits of attentional, non-planning, and motor impulsivity although the latter was significantly more pronounced in ADHD. These increased subtraits of impulsivity may reflect diagnostic non-specific neurodevelopmental impairments in ADHD and EOS in adolescence.
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Affiliation(s)
- J R M Jepsen
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - J Rydkjaer
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - B Fagerlund
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - A K Pagsberg
- Child and Adolescent Mental Health Center,Mental Health Services,Capital Region of Denmark,Copenhagen,Denmark
| | - R Av F Jespersen
- Department of Child and Adolescent Psychiatry,Landssjúkrahusid (National Hospital),Torshavn,Faroe Islands
| | - B Y Glenthøj
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
| | - B Oranje
- Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS) and Center for Neuropsychiatric Schizophrenia Research (CNSR),Mental Health Centre Glostrup,University of Copenhagen,Glostrup,Denmark
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Imeraj L, Antrop I, Roeyers H, Deboutte D, Deschepper E, Bal S, Sonuga-Barke E. The Impact of Idle Time in the Classroom: Differential Effects on Children With ADHD. J Atten Disord 2016; 20:71-81. [PMID: 23548869 DOI: 10.1177/1087054713478464] [Citation(s) in RCA: 10] [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 Studies have identified an exacerbation of ADHD deficits under specific laboratory conditions. Less is known about the significance of such contextual factors in relation to everyday functioning in naturalistic settings. METHOD This study investigated the differential impact of classroom "idle time"--periods when students are not actively engaged or waiting for a task--on the behavior of 31 children with ADHD (25 boys and 6 girls; aged 6-12 years) and 31 sex- and age-matched typically developing classmates, who were simultaneously observed in their normal classroom during two school days. RESULTS Both groups experienced the same amount of idle time (12% of the time). During idle time, however, levels of hyperactivity and noisiness increased significantly more in children with ADHD than in their classmates (p < .05). CONCLUSION Findings highlight the differential susceptibility of ADHD children to classroom idle time. Classroom interventions might consider targeting specifically these periods to reduce disruptive behavior in these children.
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Affiliation(s)
- Lindita Imeraj
- Ghent University, Belgium Ghent University Hospital, Belgium
| | - Inge Antrop
- Ghent University, Belgium Ghent University Hospital, Belgium
| | | | - Dirk Deboutte
- Ghent University, Belgium University of Antwerp, Belgium University Center Child and Adolescent Psychiatry, Antwerp, Belgium
| | | | - Sarah Bal
- Ghent University, Belgium Ghent University Hospital, Belgium
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Williams NJ, Harries M, Williams AM. Gaining Control: A New Perspective on the Parenting of Children with AD/HD. QUALITATIVE RESEARCH IN PSYCHOLOGY 2014. [DOI: 10.1080/14780887.2014.902524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Sonuga-Barke EJS, Fairchild G. Neuroeconomics of attention-deficit/hyperactivity disorder: differential influences of medial, dorsal, and ventral prefrontal brain networks on suboptimal decision making? Biol Psychiatry 2012; 72:126-33. [PMID: 22560046 DOI: 10.1016/j.biopsych.2012.04.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 03/19/2012] [Accepted: 04/05/2012] [Indexed: 12/31/2022]
Abstract
Psychiatric neuroeconomics offers an alternative approach to understanding mental disorders by studying the way disorder-related neurobiological alterations constrain economic agency, as revealed through decisions about choices between future goods. In this article, we apply this perspective to understand suboptimal decision making in attention-deficit/hyperactivity disorder (ADHD) by integrating recent advances in the neuroscience of decision making and studies of the pathophysiology of ADHD. We identify three brain networks as candidates for further study and develop specific hypotheses about how these could be implicated in ADHD. First, we postulate that altered patterns of connectivity within a network linking medial prefrontal cortex and posterior cingulate cortex (i.e., the default mode network) disrupts ordering of utilities, prospection about desired future states, setting of future goals, and implementation of aims. Second, we hypothesize that deficits in dorsal frontostriatal networks, including the dorsolateral prefrontal cortex and dorsal striatum, produce executive dysfunction-mediated impairments in the ability to compare outcome options and make choices. Third, we propose that dopaminergic dysregulation in a ventral frontostriatal network encompassing the orbitofrontal cortex, ventral striatum, and amygdala disrupts processing of cues of future utility, evaluation of experienced outcomes (feedback), and learning of associations between cues and outcomes. Finally, we extend this perspective to consider three contemporary themes in ADHD research.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Institute for Disorders of Impulse & Attention, School of Psychology, University of Southampton, Southampton, United Kingdom.
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16
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Lemiere J, Danckaerts M, Van Hecke W, Mehta MA, Peeters R, Sunaert S, Sonuga-Barke E. Brain activation to cues predicting inescapable delay in adolescent Attention Deficit/Hyperactivity Disorder: An fMRI pilot study. Brain Res 2012; 1450:57-66. [DOI: 10.1016/j.brainres.2012.02.027] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2011] [Revised: 02/01/2012] [Accepted: 02/13/2012] [Indexed: 11/29/2022]
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17
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Verbeken S, Braet C, Claus L, Nederkoorn C, Oosterlaan J. Childhood Obesity and Impulsivity: An Investigation With Performance-Based Measures. BEHAVIOUR CHANGE 2012. [DOI: 10.1375/bech.26.3.153] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractThe study investigated whether obese children are more impulsive than lean children, taking into account the multidimensionality of the construct. Responses of 41 overweight children were compared to those of 40 lean children. The Stop Task, Circle Drawing Task and Opposite Worlds Task were administered to measure executive inhibitory control, and the Maudsley Index of Childhood Delay Aversion and the Door Opening Task were administered to measure motivational inhibitory control. On the Stop Task, the overweight children showed less inhibitory control. On the Opposite Worlds task, we found no significant difference, whereas on the Circle Drawing Task an unexpected group difference was found. Although on the Door Opening Task the overweight children showed greater reward sensitivity, they were equally motivated to wait on the Maudsley Index of Childhood Delay. We conclude that the findings were different depending on the measure used, but that they suggest that overweight children can be characterised by a decrease in executive and motivational inhibitory control.
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Urcelay GP, Dalley JW. Linking ADHD, impulsivity, and drug abuse: a neuropsychological perspective. Curr Top Behav Neurosci 2012; 9:173-197. [PMID: 21365439 DOI: 10.1007/7854_2011_119] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In this chapter, we consider the relevance of impulsivity as both a psychological construct and endophenotype underlying attention-deficit/hyperactivity disorder (ADHD) and drug addiction. The case for executive dysfunction in ADHD and drug addiction is critically reviewed in the context of dissociable cognitive control processes mediated by the dorsolateral prefrontal cortex (DLPFC), the orbital and ventral medial prefrontal cortex (VMPFC). We argue that such neuroanatomical divisions within the prefrontal cortex are likely to account for the multidimensional basis of impulsivity conceptually categorized in terms of "motoric" and "choice" impulsivity. The relevance of this distinction for the etiology of ADHD and drug addiction is integrated within a novel theoretical framework. This scheme embraces animal learning theory to help explain the heterogeneity of impulse control disorders, which are exemplified by ADHD as a vulnerability disorder for drug addiction.
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Affiliation(s)
- Gonzalo P Urcelay
- Behavioural and Clinical Neuroscience Institute, Department of Experimental Psychology, University of Cambridge, Downing St., Cambridge, CB2 3EB, UK
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Alloway TP. A comparison of working memory profiles in children with ADHD and DCD. Child Neuropsychol 2011; 17:483-94. [DOI: 10.1080/09297049.2011.553590] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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The quick delay questionnaire: a measure of delay aversion and discounting in adults. ACTA ACUST UNITED AC 2010; 2:43-8. [PMID: 21432589 DOI: 10.1007/s12402-010-0020-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2009] [Accepted: 01/31/2010] [Indexed: 10/19/2022]
Abstract
Individuals with ADHD often display an altered response to delay. To date, assessment of this has typically involved neuropsychological testing-however, such tests are designed specifically for children and may not be suitable for adults. They are also relatively time-consuming and expensive. In the current paper, we describe the initial validation of a short questionnaire to assess delay-related behaviour in adults. The Quick Delay Questionnaire (QDQ) is a 10-item scale. The questionnaire was administered to 575 participants from the normal population (ranging in age from 18 to 77 years). Forty of the original sample were selected at random and tested 1 week later. Data on ADHD, anxiety and depression were also collected. There were two five-item scales-(1) delay aversion; and (2) delay discounting. These had internal consistency and had good reliability. Subscales were differentially associated with ADHD, anxiety and depression. The QDQ is a potentially valuable way of assessing response to delay in adults. Further work is required to validate the scale against direct observation and neuropsychological assessment in clinically ascertained samples.
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Sonuga-Barke EJS, Wiersema JR, van der Meere JJ, Roeyers H. Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion. Neuropsychol Rev 2009; 20:86-102. [DOI: 10.1007/s11065-009-9115-0] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2009] [Accepted: 08/17/2009] [Indexed: 11/30/2022]
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Soliva JC, Carmona S, Fauquet J, Hoekzema E, Bulbena A, Hilferty J, Vilarroya O. Neurobiological substrates of social cognition impairment in attention-deficit hyperactivity disorder: gathering insights from seven structural and functional magnetic resonance imaging studies. Ann N Y Acad Sci 2009; 1167:212-20. [PMID: 19580568 DOI: 10.1111/j.1749-6632.2009.04604.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Social cognitive neuroscience is beginning to unravel a neuroanatomy of social cognition, networks of brain regions especially involved in social cognition and social functioning. It is widely acknowledged that social functioning and social cognition are impaired in attention-deficit hyperactivity disorder (ADHD). Although an impressive amount of neuroscientific research has been conducted in ADHD, little effort has been made to link those deficits in social cognition and functioning to the well-known brain abnormalities detected in structural and functional neuroimaging studies. We review seven functional and magnetic resonance studies conducted at our laboratory in ADHD samples during the last 5 years in order to scrutinize whether the putative neuroanatomic regions underpinning social cognition are affected in ADHD. The orbitofrontal cortex (OFC), the caudate nucleus, the ventral striatum, and the cerebellum are among those regions that displayed functional or morphometric abnormalities in our ADHD samples. The OFC is clearly involved in social cognition, and several features of OFC dysfunction may be related to the social cognition and function impairment in ADHD. In contrast to the OFC, the role of the caudate nucleus, the ventral striatum, and the cerebellum is elusive. However, on one hand, there is converging evidence from human and animal neuropsychology, neuroscience, and psychiatry that support the role of such areas in social cognition, mainly through its involvement in emotional processing. On the other hand, the morphometric and functional ADHD abnormalities in these regions could account for the impoverished social functioning and the deficient social cognition skills of ADHD children.
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Affiliation(s)
- Joan Carles Soliva
- Unitat de Recerca en Neurociència Cognitiva, Department of Psychiatry, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Johnson KA, Wiersema JR, Kuntsi J. What would Karl Popper say? Are current psychological theories of ADHD falsifiable? Behav Brain Funct 2009; 5:15. [PMID: 19257888 PMCID: PMC2654902 DOI: 10.1186/1744-9081-5-15] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Accepted: 03/03/2009] [Indexed: 01/01/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a common and highly heritable neurodevelopmental psychiatric disorder. Here, we critically review four major psychological theories of ADHD - the Executive Dysfunction, the State Regulation, the Delay Aversion and the Dynamic Developmental - on their abilities to explain all the symptoms of ADHD, their testability and their openness to falsification. We conclude that theoreticians should focus, to a greater extent than currently practiced, on developing refutable theories of ADHD.
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Affiliation(s)
- Katherine A Johnson
- School of Psychology and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin 2, Ireland.
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25
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Wåhlstedt C. Neuropsychological deficits in relation to symptoms of ADHD: independent contributions and interactions. Child Neuropsychol 2008; 15:262-79. [PMID: 19089681 DOI: 10.1080/09297040802524198] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to investigate possible independent and combined effects of inhibitory control, delay aversion, and RT variability in relation to symptoms of hyperactivity/impulsivity and inattention. A community-based sample of school children (N = 111) completed neuropsychological tasks designed to measure inhibitory control, delay aversion, and RT variability. Behavioral symptoms were measured through parental and teacher ratings of the DSM-IV criteria for ADHD and ODD. The results showed that inhibitory control and RT variability were primarily related to symptoms of inattention rather than hyperactivity/impulsivity. Further, out of the three neuropsychological factors studied, only inhibitory control contributed uniquely to the variance of ADHD symptoms. However, significant interaction effects of delay aversion and RT variability on symptoms of both hyperactivity/impulsivity and inattention were found. This study shows the importance of searching for possible combined effects of neuropsychological factors to learn more about the different pathways that lead to ADHD symptoms in children.
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Bitsakou P, Psychogiou L, Thompson M, Sonuga-Barke EJS. Delay Aversion in Attention Deficit/Hyperactivity Disorder: an empirical investigation of the broader phenotype. Neuropsychologia 2008; 47:446-56. [PMID: 18929587 DOI: 10.1016/j.neuropsychologia.2008.09.015] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2008] [Revised: 09/17/2008] [Accepted: 09/21/2008] [Indexed: 11/26/2022]
Abstract
BACKGROUND Delay-related motivational processes are impaired in children with Attention Deficit/Hyperactivity Disorder (ADHD). Here we explore the impact of ADHD on the performance of three putative indices of Delay Aversion (DAv): (i) the choice for immediate over delayed reward; (ii) slower reaction times following delay; and (iii) increased delay-related frustration-to see whether these tap into a common DAv construct that differentiates ADHD cases from controls and shows evidence of familiality. METHOD Seventy seven male and female individuals (age range 6-17) with a research diagnosis combined type ADHD, 65 of their siblings unaffected by ADHD and 50 non-ADHD controls completed three delay tasks. RESULTS As predicted the size of the correlation between tasks was small but a common latent component was apparent. Children with ADHD differed from controls on all tasks (d=.4-.7) and on an overall DAv index (d=.9): The battery as a whole demonstrated moderate sensitivity and specificity. In general, deficits were equally marked in childhood and adolescence and were independent of comorbid ODD. IQ moderated the effect on the MIDA. Scores on the DAv factor co-segregated within ADHD families. DISCUSSION There is value in exploring the broader DAv phenotype in ADHD. The results illustrate the power of multivariate approaches to endophenotypes. By highlighting the significant, but limited, role of DAv in ADHD these results are consistent with recent accounts that emphasize neuropsychological heterogeneity.
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Dennis M, Sinopoli KJ, Fletcher JM, Schachar R. Puppets, robots, critics, and actors within a taxonomy of attention for developmental disorders. J Int Neuropsychol Soc 2008; 14:673-90. [PMID: 18764966 PMCID: PMC2593155 DOI: 10.1017/s1355617708080983] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This review proposes a new taxonomy of automatic and controlled attention. The taxonomy distinguishes among the role of the attendee (puppet and robot, critic and actor), the attention process (stimulus orienting vs. response control), and the attention operation (activation vs. inhibition vs. adjustment), and identifies cognitive phenotypes by which attention is overtly expressed. We apply the taxonomy to four childhood attention disorders: attention deficit hyperactivity disorder, spina bifida meningomyelocele, traumatic brain injury, and acute lymphoblastic leukemia. Variations in attention are related to specific brain regions that support normal attention processes when intact, and produce disordered attention when impaired. The taxonomy explains group differences in behavioral inattention, hyperactivity, and impulsiveness, as well as medication response. We also discuss issues relevant to theories of the cognitive and neural architecture of attention: functional dissociations within and between automatic and controlled attention; the relative importance of type of brain damage and developmental timing to attention profile; cognitive-energetic models of attention and white matter damage; temporal processing deficits, attention deficits and cerebellar damage; and the issue of cognitive phenotypes as candidate endophenotypes.
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Affiliation(s)
- Maureen Dennis
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Canada.
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Enhanced resting-state brain activities in ADHD patients: a fMRI study. Brain Dev 2008; 30:342-8. [PMID: 18060712 DOI: 10.1016/j.braindev.2007.10.005] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2007] [Revised: 09/20/2007] [Accepted: 10/13/2007] [Indexed: 11/21/2022]
Abstract
Resting-state functional MRI (fMRI) could be an advantageous choice for clinical applications by virtue of its clinical convenience and non-invasiveness. Without explicit stimulus, resting-state brain activity patterns cannot be obtained using any model-driven method. In this study, we advanced a measure named resting-state activity index (RSAI) to evaluate the resting-state brain activities. Using RSAI, we first investigated the resting-state brain activity patterns in normal adolescents to test the validity of this RSAI measure. Then we compared the resting-state brain activity patterns of Attention deficit hyperactivity disorder (ADHD) patients to those of their matched controls. According to the resultant brain activity patterns, we suggest that RSAI could be an applicable measure to evaluate resting-state brain activities. As compared to the controls, the ADHD patients exhibited more significant resting-state activities in basic sensory and sensory-related cortices. This finding was in accordance with ADHD symptoms of inattention.
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Wu KK, Anderson V, Castiello U. Attention-Deficit/Hyperactivity Disorder and Working Memory: A Task Switching Paradigm. J Clin Exp Neuropsychol 2007; 28:1288-306. [PMID: 17050259 DOI: 10.1080/13803390500477267] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This study investigated working memory (WM) in children with Attention-Deficit/Hyperactivity Disorder (ADHD) using a task switching paradigm with Stroop color-word stimuli which required participants to switch from color-naming to word-reading. High and low WM load conditions were compared by manipulation of task reminders as a tempo cue. The sample comprised 83 children with ADHD and 29 normal children comparable in age (aged 7 to 13). Within the ADHD group, participants were divided according to the presence or absence of Learning Disability (LD). Results indicated that children with ADHD had slower response times and less accurate responses in general, however, the ADHD groups were not consistently slower in the high WM load condition. Instead, an impairment in adjusting response speed to cope with higher task demands (i.e., high WM load condition) was found. These results do not support the previously documented association between ADHD and a primary deficit in WM for task switching. However, children with ADHD do demonstrate a specific difficulty in slowing down for a demanding task. Present findings suggest that earlier proposals of under-arousal and poor state regulation in ADHD deserve renewed attention.
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Affiliation(s)
- K K Wu
- Department of Clinical Psychology, Caritas Medical Centre, Hospital Authority of Hong Kong
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Antrop I, Stock P, Verté S, Wiersema JR, Baeyens D, Roeyers H. ADHD and delay aversion: the influence of non-temporal stimulation on choice for delayed rewards. J Child Psychol Psychiatry 2006; 47:1152-8. [PMID: 17076754 DOI: 10.1111/j.1469-7610.2006.01619.x] [Citation(s) in RCA: 104] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Delay aversion, the motivation to escape or avoid delay, results in preference for small immediate over large delayed rewards. Delay aversion has been proposed as one distinctive psychological process that may underlie the behavioural symptoms and cognitive deficits of attention deficit/hyperactivity disorder (ADHD). Furthermore, the delay aversion hypothesis predicts that ADHD children's preference for immediate small over large delayed rewards will be reduced when stimulation, which makes time appear to pass more quickly, is added to the delay interval. The current paper tests these predictions. METHODS A group of children with a diagnosis of ADHD (with or without oppositional defiant disorder (ODD)), a group with a diagnosis of high-functioning autism (HFA), and a normal control group were compared on an experimental paradigm giving repeated choices between small immediate and large delayed rewards (Maudsley Index of Delay Aversion-MIDA) under two conditions (stimulation and no stimulation). RESULTS As predicted, ADHD children displayed a stronger preference than the HFA and control children for the small immediate rewards under the no-stimulation condition. The ADHD children preferences were normalised under the stimulation condition with no differences between the groups. This pattern of results was the same whether the ADHD children had comorbid ODD or not. DISCUSSION The findings from the MIDA are consistent with the delay aversion hypothesis of ADHD in showing that preference for small immediate rewards over large delayed rewards is a specific feature of ADHD and that this preference can be reduced by the addition of stimulation. Further research is required to better understand the emotional and motivational mechanisms underpinning delay aversion.
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Abstract
We assessed choices on a computerized test of self-control (CTSC) for a group of children with features of attention deficit hyperactivity disorder (ADHD) and a group of controls. Thirty boys participated in the study. Fifteen of the children had been rated by their parents as hyperactive and inattentive, and 15 were age- and gender-matched controls in the same classroom. The children were observed in the classroom for three consecutive mornings, and data were collected on their activity levels and attention. The CTSC consisted of two tasks. In the delay condition, children chose to receive three rewards after a delay of 60 s or one reward immediately. In the task-difficulty condition, the children chose to complete a difficult math problem and receive three rewards or complete an easier problem for one reward. The children with ADHD features made more impulsive choices than their peers during both conditions, and these choices correlated with measures of their activity and attention in the classroom.
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Affiliation(s)
- Marguerite L Hoerger
- Wales Centre for Behaviour Analysis, University of Wales, Gwynedd, Bangor LL57 2AS, United Kingdom.
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Wiersema R, van der Meere J, Antrop I, Roeyers H. State regulation in adult ADHD: an event-related potential study. J Clin Exp Neuropsychol 2006; 28:1113-26. [PMID: 16840239 DOI: 10.1080/13803390500212896] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The state regulation hypothesis postulates that poor task performance of children with ADHD is related to poor energetical state control. The current study aimed to investigate whether such a deficit persists in adult ADHD. Event-related potentials (ERPs) were recorded during administration of a Go/No-Go task that incorporated the stressor presentation rate of stimuli. It was found that males with ADHD responded slower than control males in the slow condition, which was accompanied by smaller parietal P3s, suggesting less effort allocation. No group differences were found with respect to the response inhibition measures (errors of commission and the N2 effect). In conclusion, problems in state regulation seem to persist in male adults with ADHD.
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Affiliation(s)
- Roeljan Wiersema
- Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
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Abstract
ADHD is defined by behavioral characteristics similar to neuropsychological disorders of executive dysfunction. This paper is a literature review of the neurocognitive characteristics of ADHD from early childhood through adulthood. The author addresses the development of the concept of attention and executive function (EF) deficits in ADHD, clinical neuropsychological studies of pre-teenage children, teenagers and adults with ADHD, gender and the role of psychiatric co-morbidity including the relationship of learning disabilities to ADHD, heterogeneity of neuropsychological dysfunctions, experimental neuropsychological studies, the relationship of brain structure to function, psychopharmacology of ADHD, and clinical neuropsychological assessment. The group data clearly supports the hypothesis that executive dysfunctions are correlates of ADHD regardless of gender and age, and these EF deficits are exacerbated by co-morbidity with learning disabilities such as dyslexia. However, there is limited data on children under the age of 5, teenagers from age 13-18, and adults with ADHD over the age of 40. Studies of individual classification of people with ADHD compared to healthy, non-psychiatric controls do not support the use of neuropsychological tests for the clinical diagnosis of ADHD, and indicate that not all persons with ADHD have EF deficits. Some persons with ADHD may have deficits in brain reward systems that are relatively independent of EF impairments. Future research should clarify the multiple sources of ADHD impairments, continue to refine neuropsychological tools optimized for assessment, and incorporate longitudinal, developmental designs to understand ADHD across the lifespan.
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Affiliation(s)
- Larry J Seidman
- Pediatric Psychopharmacology Clinical and Research Program, Boston, MA, USA.
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Seidman LJ, Biederman J, Valera EM, Monuteaux MC, Doyle AE, Faraone SV. Neuropsychological functioning in girls with attention-deficit/hyperactivity disorder with and without learning disabilities. Neuropsychology 2006; 20:166-77. [PMID: 16594777 DOI: 10.1037/0894-4105.20.2.166] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The authors' goal was to assess neuropsychological performance in girls with attention-deficit/hyperactivity disorder (ADHD) and evaluate the role of comorbid learning disabilities (LDs). Participants were 140 girls with ADHD and 122 girls without ADHD, ages 6-17 years. Neuropsychological performance was measured in a standardized manner, blind to clinical status. LD was defined by a combined regression-based and low-achievement classification. ADHD was associated with modest, but significant, neuropsychological impairment, as measured with an aggregate measure of performance and with the Stroop Color-Word Test, independent of age, social class, IQ, and psychiatric comorbidity. Neuropsychological deficits were most pronounced in girls with both ADHD and an LD and in those without medications. These results extend to females the previously documented association of LDs with neuropsychological functioning in males with ADHD.
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Bitsakou P, Antrop I, Wiersema JR, Sonuga-Barke EJS. Probing the limits of delay intolerance: preliminary young adult data from the Delay Frustration Task (DeFT). J Neurosci Methods 2005; 151:38-44. [PMID: 16364448 DOI: 10.1016/j.jneumeth.2005.06.031] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Revised: 06/14/2005] [Accepted: 06/14/2005] [Indexed: 02/06/2023]
Abstract
Delay intolerance/aversion is one amongst a number of candidate neuropsychological endophenotypes for ADHD. Pilot data suggest that, because of potential ceiling effects, simple choice measures of delay tolerance used for children are probably not appropriate for adolescents and adults. The Delay Frustration Task (DeFT) is a new measure of delay intolerance, designed to be used in a similar form with adolescents and adults as well as children. In it delay frustration is indexed as the number and duration of responses made on a response key during a series of unpredictable and unsignalled delay periods, which interrupt the completion of a simple computer-based tests. The aim of this study was to provide preliminary data on the applicability of the task in a sample of young adults. The DeFT was administered to 49 male and female undergraduate students selected from a normal population-base. Their mean age was 23.14 (S.D.=1.54). Three measures of delay frustration were recorded across time intervals during the response window; the number of responses, their duration and their combined product (total time button was pressed) was calculated for each second interval bin during the post-response delay period. The AARS and HADS were used as screening questionnaires for ADHD and anxiety behaviour, respectively. The results indicated that young adults with high-ADHD symptoms scores pressed the button more than those with low ADHD scores during the post-response delay condition. While both groups increased responding across time within intervals this was significantly more marked in the high-ADHD symptom group. These effects became more pronounced when anxiety was controlled. Young adults with high-ADHD symptoms appear to be more sensitive to the imposition of unscheduled and unsignalled delay during a simple maths test. DeFT may provide a useful index of delay tolerance in young adults with ADHD. Future research needs to examine DeFT performance in different age groups and in clinical and non-clinical populations.
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Affiliation(s)
- Paraskevi Bitsakou
- Developmental Brain-Behaviour Unit, School of Psychology, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
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Antrop I, Buysse A, Roeyers H, Van Oost P. Activity in children with ADHD during waiting situations in the classroom: a pilot study. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2005; 75:51-69. [PMID: 15831181 DOI: 10.1348/000709905x36100] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND According to the optimal stimulation theory and the delay aversion hypothesis, children with attention deficit hyperactivity disorder (ADHD) experience difficulties when they are confronted with low levels of stimulation and delay, respectively. AIM This study investigated the activity level of children with ADHD during waiting situations in the classroom. Three series of hypothesis were made: (1) with respect to the comparison between waiting and non-waiting intervals, (2) with respect to the effects of non-temporal stimulation, and (3) with respect to the effects of temporal stimulation on behaviour during waiting. SAMPLE AND METHOD The activity level of 14 children with ADHD and 14 control children between the ages of 6 and 11 years was observed during two non-waiting class situations and three waiting situations: without any stimulation, in the presence of nontemporal stimulation and in the presence of temporal stimulation. RESULTS Both groups of children obtained higher activity scores for all behavioural dimensions during waiting compared with non-waiting situations. The results further revealed additive effects of waiting and diagnostic group on behaviour. Additional nontemporal stimulation during waiting affected the behaviour of all children for most behavioural characteristics. For noisiness, additive effects were also found for diagnostic group and either non-temporal stimulation or temporal stimulation. For restlessness, a trend for an interaction effect between diagnostic group and nontemporal stimulation was found. CONCLUSION The findings have clear implications for school observations within an assessment protocol.
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Affiliation(s)
- Inge Antrop
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium.
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Sonuga-Barke EJS. Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry 2005; 57:1231-8. [PMID: 15949993 DOI: 10.1016/j.biopsych.2004.09.008] [Citation(s) in RCA: 597] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2004] [Revised: 08/30/2004] [Accepted: 09/14/2004] [Indexed: 11/22/2022]
Abstract
Until recently, causal models of attention-deficit/hyperactivity disorder (ADHD) have tended to focus on the role of common, simple, core deficits. One such model highlights the role of executive dysfunction due to deficient inhibitory control resulting from disturbances in the frontodorsal striatal circuit and associated mesocortical dopaminergic branches. An alternative model presents ADHD as resulting from impaired signaling of delayed rewards arising from disturbances in motivational processes, involving frontoventral striatal reward circuits and mesolimbic branches terminating in the ventral striatum, particularly the nucleus accumbens. In the present article, these models are elaborated in two ways. First, they are each placed within their developmental context by consideration of the role of person x environment correlation and interaction and individual adaptation to developmental constraint. Second, their relationship to one another is reviewed in the light of recent data suggesting that delay aversion and executive functions might each make distinctive contributions to the development of the disorder. This provides an impetus for theoretical models built around the idea of multiple neurodevelopmental pathways. The possibility of neuropathologic heterogeneity in ADHD is likely to have important implications for the clinical management of the condition, potentially impacting on both diagnostic strategies and treatment options.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Developmental Brain-Behaviour Unit, School of Psychology, University of Southampton, Southampton, United Kingdom.
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Sonuga-Barke EJS, De Houwer J, De Ruiter K, Ajzenstzen M, Holland S. AD/HD and the capture of attention by briefly exposed delay-related cues: evidence from a conditioning paradigm. J Child Psychol Psychiatry 2004; 45:274-83. [PMID: 14982241 DOI: 10.1111/j.1469-7610.2004.00219.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The selective attention of children with attention deficit/hyperactivity disorder (AD/HD) to briefly exposed delay-related cues was examined in two experiments using a dot-probe conditioning paradigm. METHOD Colour cues were paired with negatively (i.e., imposition of delay) and positively valenced cues (i.e., escape from or avoidance of delay) during a conditioning phase. These cues were presented alongside neutral cues in a subsequent dot-probe detection phase. RESULTS In experiment 1 teacher-identified children with AD/HD (N = 12), but not controls (N = 12), displayed an attentional bias towards both positively and negatively valenced cues. In experiment 2 children with a diagnosis of hyperkinetic disorder (N = 15), but not controls (N = 15), displayed a bias towards delay-related cues. However, this effect was largely carried by the response to positively valenced cues. CONCLUSIONS These results confirm the dot-probe conditioning paradigm as a useful test of motivational influence on attention. They provide the first evidence of qualitative differences in the attentional style of children with AD/HD and give further support to those theories that highlight the motivational significance of delay in AD/HD.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Centre for Research into Psychological Development, Department of Psychology, University of Southampton, Highfield, UK.
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Sonuga-Barke EJS. The dual pathway model of AD/HD: an elaboration of neuro-developmental characteristics. Neurosci Biobehav Rev 2004; 27:593-604. [PMID: 14624804 DOI: 10.1016/j.neubiorev.2003.08.005] [Citation(s) in RCA: 508] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The currently dominant neuro-cognitive model of Attention Deficit Hyperactivity Disorder (AD/HD) presents the condition as executive dysfunction (EDF) underpinned by disturbances in the fronto-dorsal striatal circuit and associated dopaminergic branches (e.g. meso-cortical). In contrast, motivationally-based accounts focus on altered reward processes and implicate fronto-ventral striatal reward circuits and those meso-limbic branches that terminate in the ventral striatum especially the nucleus accumbens. One such account, delay aversion (DEL), presents AD/HD as a motivational style-characterised by attempts to escape or avoid delay-arising from fundamental disturbances in these reward centres. While traditionally regarded as competing, EDF and DEL models have recently been presented as complimentary accounts of two psycho-patho-physiological subtypes of AD/HD with different developmental pathways, underpinned by different cortico-striatal circuits and modulated by different branches of the dopamine system. In the current paper we describe the development of this model in more detail. We elaborate on the neuro-circuitry possibly underpinning these two pathways and explore their developmental significance within a neuro-ecological framework.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Department of Psychology, Centre for the Study of Psychological Development, University of Southampton, Southampton S017 1BJ, UK.
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Sonuga-Barke EJS, Dalen L, Remington B. Do executive deficits and delay aversion make independent contributions to preschool attention-deficit/hyperactivity disorder symptoms? J Am Acad Child Adolesc Psychiatry 2003; 42:1335-42. [PMID: 14566171 DOI: 10.1097/01.chi.0000087564.34977.21] [Citation(s) in RCA: 166] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To test whether deficits in executive function and delay aversion make independent contributions to levels of attention-deficit/hyperactivity disorder (ADHD) symptoms exhibited by preschool children. METHOD One hundred fifty-six children between 3 and 5.5 years old (78 girls and 78 boys) selected from the community completed an age-appropriate battery of tests measuring working memory, set shifting, planning, delay of gratification, and preference for delayed rewards. Parents completed a clinical interview about their children's ADHD symptoms. RESULTS Analysis of test performance revealed two factors: executive dysfunction and delay aversion. Multivariate analysis demonstrated that when other factors (i.e., age, IQ, and conduct problems) were controlled, executive dysfunction and delay aversion each made significant independent contributions to predictions of ADHD symptoms. CONCLUSIONS Preschool ADHD symptoms are psychologically heterogeneous. Executive dysfunction and delay aversion may represent two distinct and early appearing neurodevelopmental bases for ADHD symptoms.
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Hinshaw SP, Carte ET, Sami N, Treuting JJ, Zupan BA. Preadolescent girls with attention-deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification. J Consult Clin Psychol 2002; 70:1099-111. [PMID: 12362960 DOI: 10.1037/0022-006x.70.5.1099] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined executive functions, motor speed, and language processing in a diverse, preadolescent sample of 93 girls with attention-deficit/hyperactivity disorder (ADHD) combined type, 47 ADHD inattentive type, and 88 age- and ethnicity-matched comparison girls. Testing was performed without stimulant medication. All 10 neuropsychological variables showed significant omnibus subgroup differences, with 8 of 10 combined versus comparison contrasts significant (average effect size medium) and 6 of 10 inattentive versus comparison contrasts significant (average effect size small to medium), but only 2 of 10 combined versus inattentive contrasts significant (average effect size small). Results were robust to statistical control of demographic variables, comorbidities, and IQ. Discriminant function analysis revealed relatively high sensitivity but only modest specificity in predicting ADHD from comparison status from test performance; classification of the inattentive type was extremely poor.
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Affiliation(s)
- Stephen P Hinshaw
- Department of Psychology, University of California, Berkeley 94720-1650, USA.
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Antrop I, Buysse A, Roeyers H, Van Oost P. Stimulation seeking and hyperactive behavior in children with ADHD: a re-analysis. Percept Mot Skills 2002; 95:71-90. [PMID: 12365278 DOI: 10.2466/pms.2002.95.1.71] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To examine the stimulation-seeking function of hyperactivity in children with ADHD, Antrop and colleagues analyzed the behavior of 30 hyperactive and 30 nonhyperactive children during a waiting situation, either with or without extra stimulation. The behavior was assessed by frequency measures. In their study it was hypothesized that children with ADHD would show a greater decrease in activity in the presence of stimulation than control children. Since confirmation for this hypothesis was only found for 2 of 25 target behaviors, the present re-analysis included other behavioral measures to assess two relationships: first, how hyperactivity varies under fixed time conditions, using measures of duration and intensity of behavior instead of frequency measures, and second, how the perceived duration of waiting time affects behavior. Analysis indicated that children with ADHD showed a greater decrease in behavior in the presence of stimulation for touching objects and movements of trunk, as reported. Further, children who underestimated the waiting period were more apt to seek additional stimulation in its absence than those who overestimated the waiting period.
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Affiliation(s)
- Inge Antrop
- Ghent University, Department of Clinical Psychology, H. Dunantlaan 2, B-9000 Gent, Belgium.
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Sonuga-Barke EJS. Interval length and time-use by children with AD/HD: a comparison of four models. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2002; 30:257-64. [PMID: 12041711 DOI: 10.1023/a:1015154829796] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Predictions made by 4 competing models of time use by children with AD/HD were tested using a computerized version of the Matching Familiar Figures Test in 2 studies. In Study 1 teacher-identified AD/HD children (N = 10) and non-AD/HD controls (N = 10) completed the task under 3 different trial duration conditions (5, 10, and 15 s). In Study 2 the same task was completed by a group of children with a diagnosis of Hyperkinetic Disorder (N = 12) and controls (N = 12). In both studies AD/HD children performed poorly on trials of both 5- and 15-s duration but as well as controls on the 10-s trials. This quadratic function provided support for the State Regulation Deficit model of time use in AD/HD. The value of tailoring the temporal features of learning contexts to the conceptual style of AD/HD children is discussed.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Centre for Research into Psychological Development, Department of Psychology, University of Southhampton at Highfield, England.
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Sonuga-Barke EJS. Psychological heterogeneity in AD/HD--a dual pathway model of behaviour and cognition. Behav Brain Res 2002; 130:29-36. [PMID: 11864715 DOI: 10.1016/s0166-4328(01)00432-6] [Citation(s) in RCA: 528] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Psychological accounts have characterised attention-deficit/hyperactivity disorder (AD/HD) as either a neuro-cognitive disorder of regulation or a motivational style. Poor inhibitory control is thought to underpin AD/HD children's dysregulation while delay aversion is a dominant characteristic of their motivational style. A recent 'head to head' study of these two accounts suggest that delay aversion and poor inhibitory control are independent co-existing characteristics of AD/HD (combined type). In the present paper we build on these findings to propose a dual pathway model of AD/HD that recognises two quite distinct sub-types of the disorder. In one AD/HD is the result of the dysregulation of action and thought resulting from poor inhibitory control associated with the meso-cortical branch of the dopamine system projecting in the cortical control centres (e.g. pre-frontal cortex). In the other AD/HD is a motivational style characterised by an altered delay of reward gradient linked to the meso-limbic dopamine branch associated with the reward circuits (e.g. nucleus accumbens). The two pathways are further distinguished at the levels of symptoms, cognitive and motivation profiles and genetic and non-genetic origins.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Centre for Research into Psychological Development, Department of Psychology, University of Southampton, SO17 1BJ, UK.
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45
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Brophy M, Taylor E, Hughes C. To go or not to go: inhibitory control in ?hard to manage? children. INFANT AND CHILD DEVELOPMENT 2002. [DOI: 10.1002/icd.301] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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46
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ANTROP INGE. STIMULATION SEEKING AND HYPERACTIVE BEHAVIOR IN CHILDREN WITH ADHD: A RE-ANALYSIS. Percept Mot Skills 2002. [DOI: 10.2466/pms.95.5.71-90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Charman T, Carroll F, Sturge C. Theory of mind, executive function and social competence in boys with ADHD. EMOTIONAL AND BEHAVIOURAL DIFFICULTIES 2001. [DOI: 10.1080/13632750100507654] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kuntsi J, Stevenson J. Hyperactivity in children: a focus on genetic research and psychological theories. Clin Child Fam Psychol Rev 2000; 3:1-23. [PMID: 11228764 DOI: 10.1023/a:1009580718281] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Hyperactivity has attracted a large amount of research interest in recent years. Here we review developments in genetic research and in research testing psychological theories of the condition. Family, adoptee and twin studies indicate a strong role for genetic factors in the etiology of hyperactivity. Evidence is emerging also from molecular genetic studies, implicating specific genes that may be involved. At the level of cognitive functioning, a divided, focused or sustained attention deficit does not seem to be a 'core' deficit in hyperactivity. Although children with hyperactivity often perform poorly on certain executive function tasks, there is disagreement about the interpretation of these findings. The association reported in some studies between a slow inhibitory process and hyperactivity may reflect a generally slow, variable in speed and inaccurate pattern of responding. Hypotheses about psychological mechanisms such as state regulation or delay aversion provide alternative, and particularly encouraging, interpretations of the findings. We discuss the possible integration of the two lines of research--those of genetic research and research on psychological mechanisms.
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Affiliation(s)
- J Kuntsi
- Behavioural Sciences Unit, Institute of Child Health, University College London Medical School, 30 Guilford Street, London WC1N 1EH, England.
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Sonuga-Barke EJ, Saxton T, Hall M. The role of interval underestimation in hyperactive children's failure to suppress responses over time. Behav Brain Res 1998; 94:45-50. [PMID: 9708838 DOI: 10.1016/s0166-4328(97)00168-x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The relationship between response inhibition and time estimation abilities was investigated in a group of hyperactive and non-hyperactive children. Children performed a discrete trials intertemporal response task under two conditions. Under both conditions children had to respond within a 2 s window, which was delayed for a set period (either 5 or 15 s). In condition one (signalled condition), these response requirements were signalled by changes in the expression of a face drawn on a computer screen. In condition two (unsignalled condition), always presented on the trial following the signalled condition, these changes in expression were obscured by a hand drawn over the mouth of the face so that effective performance depended on the childs ability to estimate the point at which the facial expression changed on the preceding trial. Both groups of children had little difficulty inhibiting responses when the response requirements were signalled. All children made far more errors under the unsignalled condition. Hyperactive children displayed a systematic tendency to respond before the response window occurred. Taken together, these data give no support to the idea that hyperactivity is essentially a problem of disinhibition and raise interesting questions about the role of time mis-estimation in the disorder.
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Abstract
The nature of impulsivity in hyperactive and conduct-disordered children was examined in two experiments, one involving a priming task, the other a delayed reaction time task. Four groups of children, aged 7 to 8 years and with IQs in the normal range, were recruited for study: (1) a pure hyperactive group (HA), (2) a hyperactive/conduct-disordered group (HA+CD), (3) a pure conduct-disordered group (CD), and (4) a normal control group (N). When the stimulus configuration and presentation were simple and well organized, none of the three clinical groups displayed any sign of impulsivity at the input/perceptual stage; there was no tendency to rush responding before adequate consideration of the relevant stimuli, i.e. a trading of accuracy for speed. Instead, the HA children were found to be disinhibited at the output/motor stage, i.e. failing to temporarily withhold activated responses. This deficit was found to be specific to the HA children; it was not observed in the CD and HA+CD children.
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Affiliation(s)
- P W Leung
- Department of Psychology, The Chinese University of Hong Kong, Shatin, New Territories
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