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Yates JR. Aberrant glutamatergic systems underlying impulsive behaviors: Insights from clinical and preclinical research. Prog Neuropsychopharmacol Biol Psychiatry 2024; 135:111107. [PMID: 39098647 PMCID: PMC11409449 DOI: 10.1016/j.pnpbp.2024.111107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 07/07/2024] [Accepted: 07/24/2024] [Indexed: 08/06/2024]
Abstract
Impulsivity is a broad construct that often refers to one of several distinct behaviors and can be measured with self-report questionnaires and behavioral paradigms. Several psychiatric conditions are characterized by one or more forms of impulsive behavior, most notably the impulsive/hyperactive subtype of attention-deficit/hyperactivity disorder (ADHD), mood disorders, and substance use disorders. Monoaminergic neurotransmitters are known to mediate impulsive behaviors and are implicated in various psychiatric conditions. However, growing evidence suggests that glutamate, the major excitatory neurotransmitter of the mammalian brain, regulates important functions that become dysregulated in conditions like ADHD. The purpose of the current review is to discuss clinical and preclinical evidence linking glutamate to separate aspects of impulsivity, specifically motor impulsivity, impulsive choice, and affective impulsivity. Hyperactive glutamatergic activity in the corticostriatal and the cerebro-cerebellar pathways are major determinants of motor impulsivity. Conversely, hypoactive glutamatergic activity in frontal cortical areas and hippocampus and hyperactive glutamatergic activity in anterior cingulate cortex and nucleus accumbens mediate impulsive choice. Affective impulsivity is controlled by similar glutamatergic dysfunction observed for motor impulsivity, except a hyperactive limbic system is also involved. Loss of glutamate homeostasis in prefrontal and nucleus accumbens may contribute to motor impulsivity/affective impulsivity and impulsive choice, respectively. These results are important as they can lead to novel treatments for those with a condition characterized by increased impulsivity that are resistant to conventional treatments.
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Affiliation(s)
- Justin R Yates
- Department of Psychological Science, Northern Kentucky University, 1 Nunn Drive, Highland Heights, KY 41099, USA.
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Smith T, Fitch A, Deavours A, Kirkpatrick K. Active and passive waiting in impulsive choice: Effects of fixed-interval and fixed-time delays. Learn Behav 2024; 52:249-261. [PMID: 38216839 PMCID: PMC11239795 DOI: 10.3758/s13420-023-00622-z] [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] [Accepted: 12/19/2023] [Indexed: 01/14/2024]
Abstract
Behavioral interventions to improve self-control, preference for a larger-later (LL) reward over a smaller-sooner (SS) reward, involve experience with delayed rewards. Whether they involve timing processes remains controversial. In rats, there have been inconsistent results on whether timing processes may be involved in intervention-induced improvements in self-control. Interventions that improved self-control with corresponding timing improvements used fixed-interval (FI) delays, whereas interventions that failed to find corresponding timing improvements used fixed-time (FT) delays. The FI schedule includes a response contingency (active waiting), whereas the FT schedule delivers reward automatically (passive waiting). The present study compared the effects of FI and FT schedules in interventions and impulsive choice tasks to evaluate effects on self-control and timing behavior. The impulsive choice task evaluated preference for an SS option (one pellet after 10-, 15-, 20-, 25-, and 30-s delays) versus an LL option (two pellets after a 30-s delay). The intervention task included forced-choice SS (one pellet after 10 s) and LL (two pellets after 30 s) sessions under FI or FT schedules. FI schedules produced greater sensitivity to SS delay in the impulsive choice task. Both FI and FT interventions increased LL choices. Following choice testing, temporal bisection and peak interval tasks revealed better timing precision for rats with an FI delay experience. Overall, the FI choice contingency was associated with improved temporal attention and timing precision.
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Affiliation(s)
- Travis Smith
- Department of Psychological Sciences, Kansas State University, 492 Bluemont Hall, 1114 Mid-Campus Drive N., Manhattan, KS, 66506, USA.
| | - Anderson Fitch
- Department of Psychological Sciences, Kansas State University, 492 Bluemont Hall, 1114 Mid-Campus Drive N., Manhattan, KS, 66506, USA
| | - Aubrey Deavours
- Department of Psychological Sciences, Kansas State University, 492 Bluemont Hall, 1114 Mid-Campus Drive N., Manhattan, KS, 66506, USA
| | - Kimberly Kirkpatrick
- Department of Psychological Sciences, Kansas State University, 492 Bluemont Hall, 1114 Mid-Campus Drive N., Manhattan, KS, 66506, USA
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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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Chen C, Zhang S, Hong H, Qiu S, Zhou Y, Zhao M, Pan M, Si F, Dong M, Li H, Wang Y, Liu L, Sonuga-Barke EJS, Qian Q. Psychometric properties of the Chinese version of the Quick Delay Questionnaire (C-QDQ) and ecological characteristics of reward-delay impulsivity of adults with ADHD. BMC Psychiatry 2024; 24:251. [PMID: 38566048 PMCID: PMC10988885 DOI: 10.1186/s12888-024-05706-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The Quick Delay Questionnaire (QDQ) is a short questionnaire designed to assess delay-related difficulties in adults. This study aimed to examine the reliability and validity of the Chinese version of the QDQ (C-QDQ) in Chinese adults, and explore the ecological characteristics of delay-related impulsivity in Chinese adults with attention-deficit/hyperactivity disorder (ADHD). METHODS Data was collected from 302 adults, including ADHD (n = 209) and healthy controls (HCs) (n = 93). All participants completed the C-QDQ. The convergent validity, internal consistency, retest reliability and confirmatory factor analysis (CFA) of the C-QDQ were analyzed. The correlations between C-QDQ and two laboratory measures of delay-related difficulties and Barratt Impulsiveness Scale-11 (BIS-11), the comparison of C-QDQ scores between ADHD subgroups and HCs were also analyzed. RESULTS The Cronbach's α of C-QDQ was between 0.83 and 0.89. The intraclass correlation coefficient of C-QDQ was between 0.80 and 0.83. The results of CFA of C-QDQ favoured the original two-factor model (delay aversion and delay discounting). Significant positive associations were found between C-QDQ scores and BIS-11 total score and performance on the laboratory measure of delay-related difficulties. Participants with ADHD had higher C-QDQ scores than HCs, and female ADHD reported higher scores on delay discounting subscale than male. ADHD-combined type (ADHD-C) reported higher scores on delay aversion subscale than ADHD-inattention type (ADHD-I). CONCLUSION The C-QDQ is a valid and reliable tool to measure delay-related responses that appears to have clinical utility. It can present the delay-related impulsivity of patients with ADHD. Compared to HCs, the level of reward-delay impulsivity was higher in ADHD.
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Affiliation(s)
- Caili Chen
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Shiyu Zhang
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Haiheng Hong
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Sunwei Qiu
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Yi Zhou
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Mengjie Zhao
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Meirong Pan
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Feifei Si
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Min Dong
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China
| | - Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China.
| | | | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, 100191, Beijing, China.
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), 100191, Beijing, China.
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Nejati V, Dehghan M, Shahidi S, Estaji R, Nitsche MA. Transcranial random noise stimulation (tRNS) improves hot and cold executive functions in children with attention deficit-hyperactivity disorder (ADHD). Sci Rep 2024; 14:7600. [PMID: 38556535 PMCID: PMC10982302 DOI: 10.1038/s41598-024-57920-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 03/22/2024] [Indexed: 04/02/2024] Open
Abstract
Children with attention deficit-hyperactivity disorder (ADHD) have impaired hot and cold executive functions, which is thought to be related to impaired ventromedial and dorsolateral prefrontal cortex (vmPFC and dlPFC) functions. The present study aimed to assess the impact concurrent stimulation of dlPFC and vmPFC through transcranial random noise stimulation (tRNS), a non-invasive brain stimulation tool which enhances cortical excitability via application of alternating sinusoidal currents with random frequencies and amplitudes over the respective target regions on hot and cold executive functions. Eighteen children with ADHD received real and sham tRNS over the left dlPFC and the right vmPFC in two sessions with one week interval. The participants performed Circle Tracing, Go/No-Go, Wisconsin Card Sorting, and Balloon Analogue Risk Tasks during stimulation in each session. The results showed improved ongoing inhibition, prepotent inhibition, working memory, and decision making, but not set-shifting performance, during real, as compared to sham stimulation. This indicates that simultaneous stimulation of the dlPFC and the vmPFC improves hot and cold executive functions in children with ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University Tehran, P.O. Box: 1983969411, Tehran, Iran.
| | - Mahshid Dehghan
- Department of Psychology, Shahid Beheshti University Tehran, P.O. Box: 1983969411, Tehran, Iran
| | - Shahriar Shahidi
- Department of Psychology, Shahid Beheshti University Tehran, P.O. Box: 1983969411, Tehran, Iran
| | - Reza Estaji
- Department of Psychology, Shahid Beheshti University Tehran, P.O. Box: 1983969411, Tehran, Iran
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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Sørensen L, Adolfsdottir S, Kvadsheim E, Eichele H, Plessen KJ, Sonuga-Barke E. Suboptimal decision making and interpersonal problems in ADHD: longitudinal evidence from a laboratory task. Sci Rep 2024; 14:6535. [PMID: 38503800 PMCID: PMC10951300 DOI: 10.1038/s41598-024-57041-x] [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: 05/24/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
Over half of children with Attention-Deficit/Hyperactivity Disorder (ADHD) display interpersonal and social problems. Several lines of research suggest that suboptimal decision making, the ability to adjust choices to different risk-varying options, influences poorer choices made in social interactions. We thus measured decision making and its prediction of social problems longitudinally with the Cambridge Gambling Task in children with ADHD over four years. Children with ADHD had shown suboptimal decision making driven mainly by delay aversion at baseline and we expected this to be a stabile trait which would predict greater parent-reported social problems. From the baseline assessment (n = 70), 67% participated at the follow-up assessment, 21 from the ADHD group and 26 from the typically developing group. The mean age at the follow-up was 14.5 years old. The results confirmed our expectations that suboptimal decision making was a stabile trait in children and adolescents with ADHD. Although delay aversion did not differ from controls at follow-up it still proved to be the main longitudinal predictor for greater social problems. Our findings indicate that impulsivity in social interactions may be due to a motivational deficit in youth with ADHD.
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Affiliation(s)
- L Sørensen
- Department of Biological and Medical Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway.
| | - S Adolfsdottir
- Department of Biological and Medical Psychology, University of Bergen, Jonas Liesvei 91, 5009, Bergen, Norway
- Division of Vision Impairments, Statped - National Service for Special Needs Education, Bergen, Norway
| | - E Kvadsheim
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - H Eichele
- Regional Resource Centre for Autism, ADHD and Tourette Syndrome Western Norway, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - K J Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - E Sonuga-Barke
- Department of Child and Adolescent Psychiatry, King's College London, London, UK
- Department of Child and Adolescent Psychiatry, Aarhus University, Aarhus, Denmark
- Department of Psychology, Hong Kong University, Hong Kong, China
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Smith TR, Southern R, Kirkpatrick K. Mechanisms of impulsive choice: Experiments to explore and models to map the empirical terrain. Learn Behav 2023; 51:355-391. [PMID: 36913144 PMCID: PMC10497727 DOI: 10.3758/s13420-023-00577-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
Impulsive choice is preference for a smaller-sooner (SS) outcome over a larger-later (LL) outcome when LL choices result in greater reinforcement maximization. Delay discounting is a model of impulsive choice that describes the decaying value of a reinforcer over time, with impulsive choice evident when the empirical choice-delay function is steep. Steep discounting is correlated with multiple diseases and disorders. Thus, understanding the processes underlying impulsive choice is a popular topic for investigation. Experimental research has explored the conditions that moderate impulsive choice, and quantitative models of impulsive choice have been developed that elegantly represent the underlying processes. This review spotlights experimental research in impulsive choice covering human and nonhuman animals across the domains of learning, motivation, and cognition. Contemporary models of delay discounting designed to explain the underlying mechanisms of impulsive choice are discussed. These models focus on potential candidate mechanisms, which include perception, delay and/or reinforcer sensitivity, reinforcement maximization, motivation, and cognitive systems. Although the models collectively explain multiple mechanistic phenomena, there are several cognitive processes, such as attention and working memory, that are overlooked. Future research and model development should focus on bridging the gap between quantitative models and empirical phenomena.
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Nejati V, Famininejad Z, Rad JA. Neural symphony of risky decision making in children with ADHD: Insights from transcranial alternating current stimulation and cognitive modeling. Neurophysiol Clin 2023; 53:102898. [PMID: 37659136 DOI: 10.1016/j.neucli.2023.102898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/29/2023] [Accepted: 07/31/2023] [Indexed: 09/04/2023] Open
Abstract
BACKGROUND The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are key brain regions involved in risky decision making, affected in individuals with attention deficit hyperactivity disorder (ADHD). This study aims to examine how entrainment of these areas impacts the process and outcome of risky decision making in children with ADHD. METHODS Eighteen children with ADHD performed the balloon analogue risk-taking task (BART) during five different sessions of tACS (1.5 mA, 6 Hz), separated by one-week intervals, via (1) two channels with synchronized stimulation over the left dlPFC and right vmPFC, (2) the same electrode placement with anti-phase stimulation, (3) stimulation over the left dlPFC only, (4) stimulation over right vmPFC only, and (5) sham stimulation. Four-parameter and constant-sensitivity models were used to model the data. RESULTS The study showed that synchronized stimulation was associated with a reduction in positive prior belief, risk propensity, and deterministic selection. Desynchronized stimulation was associated with accelerated learning from initial selections. Isolated stimulation of the dlPFC leads to riskier decision enhanced learning updates and risk propensity, whereas isolated stimulation of the vmPFC facilitated faster learning and increased probabilistic selection. CONCLUSION The results highlight the important roles of the dlPFC and vmPFC and their communication in decision making, showcasing their impact on various aspects of the decision-making process. The findings provide valuable insights into the complex interplay between cognitive and emotional factors in shaping our choices.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran.
| | | | - Jamal Amani Rad
- Department of Cognitive Modeling, Institute of Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
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Rosch KS, Batschelett MA, Crocetti D, Mostofsky SH, Seymour KE. Sex differences in atypical fronto-subcortical structural connectivity among children with attention-deficit/hyperactivity disorder: Associations with delay discounting. Behav Brain Res 2023; 452:114525. [PMID: 37271314 PMCID: PMC10527538 DOI: 10.1016/j.bbr.2023.114525] [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: 10/05/2022] [Revised: 05/30/2023] [Accepted: 05/31/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Atypical fronto-subcortical neural circuitry has been implicated in the pathophysiology of attention-deficit/hyperactivity disorder (ADHD), including connections between prefrontal cortical regions involved in top-down cognitive control and subcortical limbic structures (striatum and amygdala) involved in bottom-up reward and emotional processing. The integrity of fronto-subcortical connections may also relate to interindividual variability in delay discounting, or a preference for smaller, immediate over larger, delayed rewards, which is associated with ADHD, with recent evidence of ADHD-related sex differences. METHODS We applied diffusion tensor imaging to compare the integrity of the white matter connections within fronto-subcortical tracts among 187 8-12 year-old children either with ADHD ((n = 106; 29 girls) or typically developing (TD) controls ((n = 81; 28 girls). Analyses focused on diagnostic group differences in fractional anisotropy (FA) within fronto-subcortical circuitry implicated in delay discounting, connecting subregions of the striatum (dorsal executive and ventral limbic areas) and amygdala with prefrontal regions of interest (dorsolateral [dlPFC], orbitofrontal [OFC] and anterior cingulate cortex [ACC]), and associations with two behavioral assessments of delay discounting. RESULTS Children with ADHD showed reduced FA in tracts connecting OFC with ventral striatum, regardless of sex, whereas reduced FA in the OFC-amygdala and ventral ACC-amygdala tracts were specific to boys with ADHD. Across diagnostic groups and sex, reduced FA in the dorsal ACC-executive striatum tract correlated with greater game time delay discounting. CONCLUSIONS These results suggest a potential neurobiological substrate of heightened delay discounting in children with ADHD and support the need for additional studies including larger sample sizes of girls with ADHD to further elucidate ADHD-related sex differences in these relationships.
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Affiliation(s)
- Keri S Rosch
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, USA; Neuropsychology Department, Kennedy Krieger Institute, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA.
| | | | - Deana Crocetti
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, USA
| | - Stewart H Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA; Department of Neurology, Johns Hopkins University, USA
| | - Karen E Seymour
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA; Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA
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10
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Chen Y, Gao Y, Jiang A, Tang Y, Wang C. ADHD classification combining biomarker detection with attention auto-encoding neural network. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
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11
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Rastikerdar N, Nejati V, Sammaknejad N, Fathabadi J. Developmental trajectory of hot and cold executive functions in children with and without attention deficit-hyperactivity disorder (ADHD). RESEARCH IN DEVELOPMENTAL DISABILITIES 2023; 137:104514. [PMID: 37105003 DOI: 10.1016/j.ridd.2023.104514] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/25/2023] [Accepted: 04/16/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Children with attention deficit hyperactivity disorder (ADHD) have a delayed development. Two main cognitive models of ADHD are executive (cold) and motivational (hot) models. In this study, we aimed to compare the development of hot and cold executive functions in children with and without ADHD. METHODS AND PROCEDURES Forty-six children with ADHD symptoms (56% boys) and forty-four typically developing controls (54% boys), in three age groups of 6-8, 8-10 and 10-12 years, were participated in the study. Go/No-Go Task (GNGT), One-Back Test (OBT) and Shifting Attention Test (SAT), Delay Discounting Test (DDT) and Balloon Analogue Risk Task (BART) were used for assessment. OUTCOMES AND RESULTS Children with ADHD showed lower performance in GNG, OBT, SAT, and BART, but intact performance in DDT. The tasks' performance was significantly different between three age groups in GNG and SAT, but similar in OBT and BART. The interaction effect was significant only for the BART measures. CONCLUSIONS AND IMPLICATIONS Children with ADHD compared to typically developing children, experience impaired hot and cold executive functions. The cognitive delay was found only in risky decision making as a hot executive function.
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Affiliation(s)
- Najmeh Rastikerdar
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran.
| | - Negar Sammaknejad
- Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Jalil Fathabadi
- Department of Educational and Developmental Psychology, Shahid Beheshti University, Tehran, Iran
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Zheng Q, Cheng YY, Sonuga-Barke E, Shum KKM. Do Executive Dysfunction, Delay Aversion, and Time Perception Deficit Predict ADHD Symptoms and Early Academic Performance in Preschoolers. Res Child Adolesc Psychopathol 2022; 50:1381-1397. [PMID: 35689730 PMCID: PMC9187895 DOI: 10.1007/s10802-022-00937-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2022] [Indexed: 11/19/2022]
Abstract
Children with attention deficit/hyperactivity disorder (ADHD) are commonly observed to have learning difficulties. This study examined how three neuropsychological constructs—executive dysfunction, delay aversion, and time perception—were associated with ADHD symptoms and early academic performance in preschoolers at risk of ADHD. One hundred and thirty-one preschoolers (70 boys, 53%) aged 4 to 6 (M = 5.31 years) were assessed on their ADHD-related behaviors, neuropsychological functioning, word reading, and math abilities at two time points one year apart. Factor analysis indicated that inhibitory and attentional control deficit, delay aversion, and time perception/working memory deficit were three dissociable factors. Among the three factors, inhibitory and attentional control measured at Time 1 was the strongest predictor of ADHD symptoms at both Time 1 and Time 2. Time perception was closely related to working memory, and they predicted word reading and numeration across time most strongly among other neuropsychological constructs. Our findings suggested that inhibitory and attentional control, delay aversion, and time perception are dissociable neuropsychological deficits underlying ADHD symptoms in preschoolers. Poor time perception may serve as a marker for the early identification of preschoolers with potential learning problems, and a possible target of intervention for ADHD.
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Affiliation(s)
- Que Zheng
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Yu Yan Cheng
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Edmund Sonuga-Barke
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
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Colins OF, Bisback A, Reculé C, Batky BD, López-Romero L, Hare RD, Salekin RT. The Proposed Specifiers for Conduct Disorder (PSCD) Scale: Factor Structure and Validation of the Self-Report Version in a Forensic Sample of Belgian Youth. Assessment 2022; 30:1302-1320. [PMID: 35575157 DOI: 10.1177/10731911221094256] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This is the first study to test the psychometric properties of the self-report version of the Proposed Specifiers for Conduct Disorder (PSCD) in detained youth. The PSCD is a measure of the broad psychopathy construct, with grandiose-manipulative, callous-unemotional, daring-impulsive, and conduct disorder (CD) components. Participants (227 males) completed the PSCD along with other measures, including a diagnostic interview to assess Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) CD. Results support the PSCD's proposed hierarchical four-factor structure. Correlations with an alternate measure of psychopathy and symptoms of CD support the convergent validity of PSCD scores. PSCD scores showed positive associations with criterion variables of emotional and regulatory functioning, aggression, substance use, and school problems. Finally, PSCD scores were unrelated to anxiety and depression, supporting the PSCD's discriminant validity. Findings indicate that the PSCD is a promising measure for assessing psychopathic traits in detained male adolescents, though its incremental validity is in need of further scrutiny.
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Affiliation(s)
| | | | | | | | | | - Robert D Hare
- The University of British Columbia, Vancouver, Canada
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14
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Campez M, Raiker JS, Little K, Altszuler AR, Merrill BM, Macphee FL, Gnagy EM, Greiner AR, Musser ED, Coles EK, Pelham WE. An evaluation of the effect of methylphenidate on working memory, time perception, and choice impulsivity in children with ADHD. Exp Clin Psychopharmacol 2022; 30:209-219. [PMID: 33475395 PMCID: PMC8406432 DOI: 10.1037/pha0000446] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Individuals with Attention-Deficit Hyperactivity Disorder (ADHD) consistently exhibit a stronger preference for immediate rewards than for larger rewards available following a delay on tasks measuring choice impulsivity (CI). Despite this, however, there remains a dearth of studies examining the impact of stimulant treatment on CI as well as associated higher order (e.g., working memory [WM]) and perceptual (e.g., time perception) cognitive processes. The present study examines the effect of osmotic release oral system methylphenidate (OROS-MPH) on CI, WM and time perception processes as well as the relation among these processes before and after taking a regimen of OROS-MPH. Thirty-five children (aged 7-12 years) with a diagnosis of ADHD participating in a concurrent stimulant medication study were recruited to complete computerized assessments of CI, WM, and time perception. Children completed the assessments after administration of a placebo as well as their lowest effective dose of OROS-MPH following a 2-week titration period. The results from one-sample t-tests indicated that OROS-MPH improves both CI and WM in youth with ADHD but does not impact time perception. Further, results revealed no significant association among the various indices of cognitive performance while taking placebo or OROS-MPH. Overall, the findings suggest that while OROS-MPH improves both CI and WM in youth with ADHD, improvements in CI as a result of OROS-MPH are unlikely to be associated with the improvements in WM given the lack of association among the two. Future studies should consider alternate cognitive, emotional, and motivational mechanisms that may account for the impact of OROS-MPH on CI. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Mileini Campez
- Florida International University, Center for Children and Families
| | - Joseph S. Raiker
- Florida International University, Center for Children and Families
| | | | - Amy R. Altszuler
- Florida International University, Center for Children and Families
| | | | - Fiona L. Macphee
- Florida International University, Center for Children and Families
| | | | | | - Erica D. Musser
- Florida International University, Center for Children and Families
| | - Erika K. Coles
- Florida International University, Center for Children and Families
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15
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Connaughton M, Whelan R, O'Hanlon E, McGrath J. White matter microstructure in children and adolescents with ADHD. Neuroimage Clin 2022; 33:102957. [PMID: 35149304 PMCID: PMC8842077 DOI: 10.1016/j.nicl.2022.102957] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 12/31/2022]
Abstract
A systematic review of diffusion MRI studies in children and adolescents with ADHD. 46 studies included, encompassing multiple diffusion MRI techniques. Reduced white matter microstructure was reported in several studies. Mixed evidence linking white matter differences with specific cognitive processes. Common limitations included sample size, head motion and medication status.
Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Advances in diffusion magnetic resonance imaging (MRI) acquisition sequences and analytic techniques have led to growing body of evidence that abnormal white matter microstructure is a core pathophysiological feature of ADHD. This systematic review provides a qualitative assessment of research investigating microstructural organisation of white matter amongst children and adolescents with ADHD. This review included 46 studies in total, encompassing multiple diffusion MRI imaging techniques and analytic approaches, including whole-brain, region of interest and connectomic analyses. Whole-brain and region of interest analyses described atypical organisation of white matter microstructure in several white matter tracts: most notably in frontostriatal tracts, corpus callosum, superior longitudinal fasciculus, cingulum bundle, thalamic radiations, internal capsule and corona radiata. Connectomic analyses, including graph theory approaches, demonstrated global underconnectivity in connections between functionally specialised networks. Although some studies reported significant correlations between atypical white matter microstructure and ADHD symptoms or other behavioural measures there was no clear pattern of results. Interestingly however, many of the findings of disrupted white matter microstructure were in neural networks associated with key neuropsychological functions that are atypical in ADHD. Limitations to the extant research are outlined in this review and future studies in this area should carefully consider factors such as sample size, sex balance, head motion and medication status.
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Affiliation(s)
| | - Robert Whelan
- Dept of Psychiatry, School of Medicine, Trinity College Dublin, Ireland; School of Psychology, Trinity Dublin, Ireland
| | - Erik O'Hanlon
- Trinity College Institute of Neuroscience, Trinity Dublin, Ireland; Dept of Psychiatry, School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jane McGrath
- Dept of Psychiatry, School of Medicine, Trinity College Dublin, Ireland
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16
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Chen Y, Lei D, Cao H, Niu R, Chen F, Chen L, Zhou J, Hu X, Huang X, Guo L, Sweeney JA, Gong Q. Altered single-subject gray matter structural networks in drug-naïve attention deficit hyperactivity disorder children. Hum Brain Mapp 2022; 43:1256-1264. [PMID: 34797010 PMCID: PMC8837581 DOI: 10.1002/hbm.25718] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/09/2021] [Accepted: 11/04/2021] [Indexed: 02/05/2023] Open
Abstract
Altered topological organization of brain structural covariance networks has been observed in attention deficit hyperactivity disorder (ADHD). However, results have been inconsistent, potentially related to confounding medication effects. In addition, since structural networks are traditionally constructed at the group level, variabilities in individual structural features remain to be well characterized. Structural brain imaging with MRI was performed on 84 drug-naïve children with ADHD and 83 age-matched healthy controls. Single-subject gray matter (GM) networks were obtained based on areal similarities of GM, and network topological properties were analyzed using graph theory. Group differences in each topological metric were compared using nonparametric permutation testing. Compared with healthy subjects, GM networks in ADHD patients demonstrated significantly altered topological characteristics, including higher global and local efficiency and clustering coefficient, and shorter path length. In addition, ADHD patients exhibited abnormal centrality in corticostriatal circuitry including the superior frontal gyrus, orbitofrontal gyrus, medial superior frontal gyrus, precentral gyrus, middle temporal gyrus, and pallidum (all p < .05, false discovery rate [FDR] corrected). Altered global and nodal topological efficiencies were associated with the severity of hyperactivity symptoms and the performance on the Stroop and Wisconsin Card Sorting Test tests (all p < .05, FDR corrected). ADHD combined and inattention subtypes were differentiated by nodal attributes of amygdala (p < .05, FDR corrected). Alterations in GM network topologies were observed in drug-naïve ADHD patients, in particular in frontostriatal loops and amygdala. These alterations may contribute to impaired cognitive functioning and impulsive behavior in ADHD.
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Affiliation(s)
- Ying Chen
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of PsychiatryWest China Hospital of Sichuan UniversityChengduChina
| | - Du Lei
- Department of Psychiatry and Behavioral NeuroscienceUniversity of CincinnatiCincinnatiOhioUSA
| | - Hengyi Cao
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Center for Psychiatric NeuroscienceFeinstein Institute for Medical ResearchManhassetNew YorkUSA
- Division of Psychiatry ResearchZucker Hillside HospitalGlen OaksNew YorkUSA
- Department of PsychiatryUniversity of CincinnatiCincinnatiOhioUSA
| | - Running Niu
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Fuqin Chen
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Lizhou Chen
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Jinbo Zhou
- Department of PsychiatryWest China Hospital of Sichuan UniversityChengduChina
| | - Xinyu Hu
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
| | - Lanting Guo
- Department of PsychiatryWest China Hospital of Sichuan UniversityChengduChina
| | - John A. Sweeney
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Department of Psychiatry and Behavioral NeuroscienceUniversity of CincinnatiCincinnatiOhioUSA
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of RadiologyWest China Hospital of Sichuan UniversityChengduChina
- Research Unit of PsychoradiologyChinese Academy of Medical SciencesChengduChina
- Functional and Molecular Imaging Key Laboratory of Sichuan ProvinceHuaxi Xiamen Hospital of Sichuan UniversityXiamenFujianChina
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17
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Broulidakis MJ, Golm D, Cortese S, Fairchild G, Sonuga-Barke E. ssDefault mode network connectivity and attention-deficit/hyperactivity disorder in adolescence: Associations with delay aversion and temporal discounting, but not mind wandering. Int J Psychophysiol 2022; 173:38-44. [PMID: 35032471 DOI: 10.1016/j.ijpsycho.2022.01.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 11/27/2021] [Accepted: 01/09/2022] [Indexed: 12/21/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) has been associated with reduced resting state connectivity in the core subsystem of the default mode network (DMN; medial prefrontal cortex - posterior cingulate cortex). However, the neuropsychological consequences of this hypoconnectivity remain to be determined. Building on recent theoretical models of DMN function, we tested the association between DMN hypo-connectivity and three neuropsychological processes previously implicated in ADHD: (i) excessive task-unrelated spontaneous thought (i.e., mind-wandering); (ii) sub-optimal decision-making due to exaggerated temporal discounting; and (iii) delay aversion - a heightened emotional response to the imposition or experience of delay. METHODS Twenty male adolescents with a clinical diagnosis of ADHD and 18 typically developing adolescents (all aged 11-16 years) underwent a resting-state fMRI scan to assess DMN connectivity. An experimental paradigm was used to assess temporal discounting and self-report questionnaires were used to measure mind wandering and delay aversion. RESULTS ADHD was significantly associated with DMN hypo-connectivity specifically in the core subsystem, elevated levels of mind-wandering, delay aversion, and temporal discounting. Mediation analysis suggested that DMN hypoconnectivity mediated the link between ADHD and delay aversion. CONCLUSION The results provide initial evidence that disturbances in the DMN may impair ability to regulate delay-related negative affect in adolescents with ADHD.
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Affiliation(s)
- M John Broulidakis
- Department of Psychiatry, University of Southampton, United States of America; Department of psychology, College of Science, Northeastern University, Boston, MA, United States of America
| | - Dennis Golm
- Department of Psychology, University of Southampton, United States of America
| | - Samuele Cortese
- Department of Psychology, University of Southampton, United States of America; Solent NHS Trust, Southampton, United States of America; Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York, United States of America; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK
| | | | - Edmund Sonuga-Barke
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; Department of Child & Adolescent Psychiatry, Aarhus University, Denmark.
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18
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Dekkers TJ, de Water E, Scheres A. Impulsive and risky decision-making in adolescents with attention-deficit/hyperactivity disorder (ADHD): The need for a developmental perspective. Curr Opin Psychol 2021; 44:330-336. [PMID: 34953445 DOI: 10.1016/j.copsyc.2021.11.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 01/11/2023]
Abstract
Impulsive and risky decision-making peaks in adolescence, and is consistently associated with the neurodevelopmental disorder Attention-Deficit/Hyperactivity Disorder (ADHD), regardless of age. In this brief review, we demonstrate the similarity of theoretical models explaining impulsive and risky decision-making that originate in two relatively distinct literatures (i.e., on adolescence and on ADHD). We summarize research thus far and conclude that the presence of ADHD during adolescence further exacerbates the tendency that is already present in adolescents to make impulsive and risky decisions. We also conclude that much is still unknown about the developmental trajectories of individuals with ADHD with regard to impulsive and risky decision making, and we therefore provide several hypotheses that warrant further longitudinal research.
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Affiliation(s)
- Tycho J Dekkers
- University of Amsterdam, Department of Psychology, Amsterdam, the Netherlands; Levvel, Academic Center for Child and Adolescent Psychiatry en Specialized Youthcare, Amsterdam, the Netherlands; University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry, Groningen, the Netherlands; Accare Child Study Center, Groningen, the Netherlands; Amsterdam University Medical Centers, Department of Child and Adolescent Psychiatry, Amsterdam, the Netherlands
| | - Erik de Water
- Great Lakes Neurobehavioral Center, Edina, MN, United States
| | - Anouk Scheres
- Radboud University, Behavioural Science Institute, Nijmegen, the Netherlands.
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19
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Van Dessel J, Sonuga-Barke EJS, Moerkerke M, Van der Oord S, Morsink S, Lemiere J, Danckaerts M. The Limits of Motivational Influence in ADHD: No Evidence for an Altered Reaction to Negative Reinforcement. Soc Cogn Affect Neurosci 2021; 17:482-492. [PMID: 34643738 PMCID: PMC9071417 DOI: 10.1093/scan/nsab111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/14/2021] [Accepted: 10/12/2021] [Indexed: 11/24/2022] Open
Abstract
Functional magnetic resonance imaging studies have reported a diminished response in the brain’s reward circuits to contingent cues predicting future monetary gain in adolescents with attention-deficit/hyperactivity disorder (ADHD). The situation with regard to monetary loss is less clear, despite recognition that both positive and negative consequences impact ADHD behaviour. Here, we employ a new Escape Monetary Loss Incentive task in an MRI scanner, which allows the differentiation of contingency and valence effects during loss avoidance, to examine ADHD-related alterations in monetary loss processing. There was no evidence of atypical processing of contingent or non-contingent monetary loss cues in ADHD — either in terms of ratings of emotional and motivational significance or brain responses. This suggests that the ability to process contingencies between performance and negative outcomes is intact in ADHD and that individuals with ADHD are no more (or less) sensitive to negative outcomes than controls. This latter finding stands in stark contrast to recent evidence from a similar task of atypical emotion network recruitment (e.g. amygdala) in ADHD individuals to cues predicting another negative event, the imposition of delay, suggesting marked specificity in the way they respond to negative events.
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Affiliation(s)
- Jeroen Van Dessel
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Edmund J S 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
| | - Sarah Morsink
- Center for Developmental Psychiatry, Department of Neurosciences, UPC, KU Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- 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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20
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Blair RJ, Zhang RU, Bashford-Largo J, Bajaj S, Mathur A, Ringle J, Schwartz A, Elowsky J, Dobbertin M, Blair KS, Tyler PM. Reduced neural responsiveness to looming stimuli is associated with increased aggression. Soc Cogn Affect Neurosci 2021; 16:1091-1099. [PMID: 33960389 PMCID: PMC8483278 DOI: 10.1093/scan/nsab058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/22/2021] [Accepted: 05/06/2021] [Indexed: 12/13/2022] Open
Abstract
While neuro-cognitive work examining aggression has examined patients with conditions at increased risk for aggression or individuals self-reporting past aggression, little work has attempted to identify neuro-cognitive markers associated with observed/recorded aggression. The goal of the current study was to determine the extent to which aggression by youth in the first three months of residential care was associated with atypical responsiveness to threat stimuli. This functional MRI study involved 98 (68 male; mean age = 15.96 [sd = 1.52]) adolescents in residential care performing a looming threat task involving images of threatening and neutral human faces or animals that appeared to be either loom or recede. Level of aggression was negatively associated with responding to looming stimuli (irrespective of whether these were threatening or neutral) within regions including bilateral inferior frontal gyrus, right inferior parietal lobule, right superior/middle temporal gyrus and a region of right uncus proximal to the amygdala. These data indicate that aggression level is associated with a decrease in responsiveness to a basic threat cue-looming stimuli. Reduced threat responsiveness likely results in the individual being less able to represent the negative consequences that may result from engaging in aggression, thereby increasing the risk for aggressive episodes.
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Affiliation(s)
- R James Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - R u Zhang
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Johannah Bashford-Largo
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Sahil Bajaj
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Avantika Mathur
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Jay Ringle
- Translational Research Center, Boys Town, NE 68154, USA
| | - Amanda Schwartz
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Jaimie Elowsky
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Matthew Dobbertin
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
| | - Karina S Blair
- Center for Neurobehavioral Research, Boys Town National Research Hospital, Boys Town, NE 68154, USA
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21
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Targeting working memory to modify emotional reactivity in adult attention deficit hyperactivity disorder: a functional magnetic resonance imaging study. Brain Imaging Behav 2021; 16:680-691. [PMID: 34524649 PMCID: PMC9010388 DOI: 10.1007/s11682-021-00532-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2021] [Indexed: 11/10/2022]
Abstract
Understanding the neural mechanisms of emotional reactivity in Attention-Deficit/Hyperactivity Disorder (ADHD) may help develop more effective treatments that target emotion dysregulation. In adult ADHD, emotion regulation problems cover a range of dimensions, including emotional reactivity (ER). One important process that could underlie an impaired ER in ADHD might be impaired working memory (WM) processing. We recently demonstrated that taxing WM prior to the exposure of emotionally salient stimuli reduced physiological and subjective reactivity to such cues in heavy drinkers, suggesting lasting effects of WM activation on ER. Here, we investigated neural mechanisms that could underlie the interaction between WM and ER in adult ADHD participants. We included 30 male ADHD participants and 30 matched controls. Participants performed a novel functional magnetic resonance imaging paradigm in which active WM-blocks were alternated with passive blocks of negative and neutral images. We demonstrated group-independent significant main effects of negative emotional images on amygdala activation, and WM-load on paracingulate gyrus and dorsolateral prefrontal cortex activation. Contrary to earlier reports in adolescent ADHD, no impairments were found in neural correlates of WM or ER. Moreover, taxing WM did not alter the neural correlates of ER in either ADHD or control participants. While we did find effects on the amygdala, paCG, and dlPFC activation, we did not find interactions between WM and ER, possibly due to the relatively unimpaired ADHD population and a well-matched control group. Whether targeting WM might be effective in participants with ADHD with severe ER impairments remains to be investigated.
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22
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Lee YA, Goto Y. The Habenula in the Link Between ADHD and Mood Disorder. Front Behav Neurosci 2021; 15:699691. [PMID: 34248519 PMCID: PMC8264146 DOI: 10.3389/fnbeh.2021.699691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 05/25/2021] [Indexed: 12/11/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a childhood-onset, neurodevelopmental disorder, whereas major depressive disorder (MDD) is a mood disorder that typically emerges in adulthood. Accumulating evidence suggests that these seemingly unrelated psychiatric disorders, whose symptoms even appear antithetical [e.g., psychomotor retardation in depression vs. hyperactivity (psychomotor acceleration) in ADHD], are in fact associated with each other. Thus, individuals with ADHD exhibit high comorbidity with MDD later in life. Moreover, genetic studies have shown substantial overlaps of susceptibility genes between ADHD and MDD. Here, we propose a novel and testable hypothesis that the habenula, the epithalamic brain region important for the regulation of monoamine transmission, may be involved in both ADHD and MDD. The hypothesis suggests that an initially hypoactive habenula during childhood in individuals with ADHD may undergo compensatory changes during development, priming the habenula to be hyperactive in response to stress exposure and thereby increasing vulnerability to MDD in adulthood. Moreover, we propose a new perspective on habenular deficits in psychiatric disorders that consider the habenula a neural substrate that could explain multiple psychiatric disorders.
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Affiliation(s)
- Young-A Lee
- Department of Food Science and Nutrition, Daegu Catholic University, Gyeongsan, South Korea
| | - Yukiori Goto
- Primate Research Institute, Kyoto University, Inuyama, Japan
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23
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Scheres A, Solanto MV. Do ADHD Symptoms, Executive Function, and Study Strategies Predict Temporal Reward Discounting in College Students with Varying Levels of ADHD Symptoms? A Pilot Study. Brain Sci 2021; 11:brainsci11020181. [PMID: 33540665 PMCID: PMC7912943 DOI: 10.3390/brainsci11020181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/20/2021] [Accepted: 01/27/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to examine the relationship between temporal reward discounting and attention deficit hyperactivity disorder (ADHD) symptoms in college students. Additionally, we examined whether temporal reward discounting was associated with executive functioning in daily life and with learning and study strategies in this group. Thirty-nine college students (19 with ADHD and 20 controls) participated after meeting criteria for ADHD or non-ADHD based on standardized assessment. Strong preferences for small immediate rewards were specifically associated with the ADHD symptom domain hyperactivity–impulsivity. Additionally, these preferences were associated with daily life executive function problems and with weak learning and study strategies. This suggests that steep temporal discounting may be a key mechanism playing a role in the daily life challenges that college students with ADHD symptoms face. If these findings are replicated in larger samples, then intervention strategies may profitably be developed to counteract this strong preference for small immediate rewards in college students with ADHD symptoms.
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Affiliation(s)
- Anouk Scheres
- Behavioural Science Institute, Radboud University, 6525 GA Nijmegen, The Netherlands
- Correspondence:
| | - Mary V. Solanto
- Zucker School of Medicine at Hofstra-Northwell, New York, NY 11042, USA;
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24
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Task-related motivation and academic achievement in children and adolescents with ADHD. Eur Child Adolesc Psychiatry 2021; 30:131-141. [PMID: 32157390 DOI: 10.1007/s00787-020-01494-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
Academic impairment in individuals with attention-deficit/hyperactivity disorder (ADHD) is in part due to reduced motivation for academic tasks, which is likely to vary as a function of task characteristics. The current study employed a new questionnaire-the Child and Adolescent Motivational Profile (CHAMP)-to examine; (1) which task characteristic participants with ADHD perceive as most motivating relative to typically developing peers (TDP) and (2) whether these differences mediate academic functioning. 34 participants with ADHD and 435 TDP (8-16 years) completed the CHAMP. Academic achievement (grade point average) and self-reported positive/negative classroom experiences were recorded. No task characteristics were rated higher in terms of their motivational salience in the ADHD group than in the control sample. Marked/graded, Socially evaluated, Collaborative, Requiring focus and Cognitively challenging task characteristics were rated significantly lower by the ADHD group than controls. The lower rating of Socially evaluated was explained by comorbid ODD symptoms. Cognitively challenging was rated as particularly unmotivating by individuals with ADHD. ADHD was associated with a decreased GPA and a more negative classroom experience. The associations between ADHD and GPA/negative classroom experience were both partially mediated by scores on the Cognitively Challenging scale. For children and adolescents with ADHD tasks that are cognitively challenging were not particularly motivating. To increase task motivation, and improve academic performance of individuals with ADHD, it may be important to include rewarded task elements as they are appraised as particularly motivating by these individuals and this appraisal was similar to that of TDP.
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25
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van der Oord S, Tripp G. How to Improve Behavioral Parent and Teacher Training for Children with ADHD: Integrating Empirical Research on Learning and Motivation into Treatment. Clin Child Fam Psychol Rev 2020; 23:577-604. [PMID: 32968886 PMCID: PMC7585566 DOI: 10.1007/s10567-020-00327-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2020] [Indexed: 12/17/2022]
Abstract
Attention deficit hyperactivity disorder [ADHD] is one of the most common psychiatric disorders of childhood with poor prognosis if not treated effectively. Recommended psychosocial evidence-based treatment for preschool and school-aged children is behavioral parent and teacher training [BPT]. The core elements of BPT are instrumental learning principles, i.e., reinforcement of adaptive and the ignoring or punishment of non-adaptive behaviors together with stimulus control techniques. BPT is moderately effective in reducing oppositional behavior and improving parenting practices; however, it does not reduce blinded ratings of ADHD symptoms. Also after training effects dissipate. This practitioner review proposes steps that can be taken to improve BPT outcomes for ADHD, based on purported causal processes underlying ADHD. The focus is on altered motivational processes (reward and punishment sensitivity), as they closely link to the instrumental processes used in BPT. Following a critical analysis of current behavioral treatments for ADHD, we selectively review motivational reinforcement-based theories of ADHD, including the empirical evidence for the behavioral predictions arising from these theories. This includes consideration of children's emotional reactions to expected and unexpected outcomes. Next we translate this evidence into potential ADHD-specific adjustments designed to enhance the immediate and long-term effectiveness of BPT programs in addressing the needs of children with ADHD. This includes the use of remediation strategies for proposed deficits in learning not commonly used in BPT programs and cautions regarding the use of punishment. Finally, we address how these recommendations can be effectively transferred to clinical practice.
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Affiliation(s)
- Saskia van der Oord
- Behavior, Health and Psychopathology, KU Leuven, Tiensestraat 102, 3000, Leuven, Belgium.
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS, Amsterdam, The Netherlands.
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, 1919-1 Tancha, Onna, Kunigami District, Okinawa Prefecture, 904-0495, Japan.
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26
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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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27
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Mphahlele RM, Pillay BJ, Meyer A. Delay aversion in school-aged children with attention-deficit hyperactivity disorder. SOUTH AFRICAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1177/0081246320964350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study considered whether children with attention-deficit hyperactivity disorder displayed a stronger preference for smaller, more immediate rewards over larger, but delayed rewards (delay aversion) when compared to typically developing controls and, furthermore, whether age and gender influenced their preference in any way. Children, between 6 and 15 years of age, living in Limpopo province of South Africa, participated in the study. Two hundred sixteen children in total (108 with attention-deficit hyperactivity disorder and 108 matched controls without attention-deficit hyperactivity disorder symptoms) were assessed, on a task of delay aversion. The Two Choice Impulsivity Paradigm, which assesses immediate and delayed responses, was administered to both the attention-deficit hyperactivity disorder and control groups. The performance of both groups was compared on the Two Choice Impulsivity Paradigm, and the scores were analysed as a function of gender and age. The attention-deficit hyperactivity disorder group chose significantly more immediate, smaller responses than the neurotypical control group, which preferred significantly more delayed but larger responses. Gender and age did not affect the response choices for both immediate and delayed measurements. Children with attention-deficit hyperactivity disorder show a greater need for more immediate gratification, even if the reward is smaller, than the neurotypical control group who could delay gratification to receive a larger reward. Gender and age did not influence their preferences.
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Affiliation(s)
- Ramatladi Meriam Mphahlele
- Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Basil Joseph Pillay
- Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
| | - Anneke Meyer
- Department of Behavioural Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
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28
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Delaney PF, Barden EP, Smith WG, Wisco BE. What can directed forgetting tell us about clinical populations? Clin Psychol Rev 2020; 82:101926. [PMID: 33011552 DOI: 10.1016/j.cpr.2020.101926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 11/24/2022]
Abstract
This paper reviews and critically assesses the implications of directed forgetting (DF) research on clinical populations. We begin by reviewing the typical methods and results of the item method and list method directed forgetting procedures and provide best practice recommendations for future studies using clinical populations. Next, we note that DF was often interpreted as being due to inhibition, and when clinical populations showed impaired directed forgetting, it was treated as evidence in inhibitory control difficulties. However, inhibition may not be the cause of DF effects, based on current understanding of these cognitive tasks. We instead suggest that item method DF is tied to attentional control, which might include inhibitory mechanisms (or might not). In contrast, list method DF is tied to two forms of memory control: control of mental context (indicated by effective forgetting of List 1), and changes in the strategies used to remember (indicated by better learning of List 2). We review the current state of the clinical DF literature, assess its strength based on our best practice recommendations, and call for more research when warranted.
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Affiliation(s)
- Peter F Delaney
- Department of Psychology, University of North Carolina at Greensboro, United States of America.
| | - Eileen P Barden
- Department of Psychology, Binghamton University (SUNY), United States of America
| | - Wyatt G Smith
- Department of Psychology, University of North Carolina at Greensboro, United States of America
| | - Blair E Wisco
- Department of Psychology, University of North Carolina at Greensboro, United States of America
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29
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Kaga Y, Ueda R, Tanaka M, Kita Y, Suzuki K, Okumura Y, Egashira Y, Shirakawa Y, Mitsuhashi S, Kitamura Y, Nakagawa E, Yamashita Y, Inagaki M. Executive dysfunction in medication-naïve children with ADHD: A multi-modal fNIRS and EEG study. Brain Dev 2020; 42:555-563. [PMID: 32532641 DOI: 10.1016/j.braindev.2020.05.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Children with attention deficit hyperactivity disorder (ADHD) exhibit deficits in executive function. Since there are no clear biomarkers for the disorder, this study aimed to investigate the neurophysiological biomarkers for deficits in executive function in children with ADHD using functional near-infrared spectroscopy (fNIRS) and electroencephalography. METHODS Twenty patients diagnosed with ADHD and 19 typically developing children (TDC; 8-11 years old) were included. Event related potentials (ERPs) were recorded using an electroencephalogram (EEG) and oxygenated hemoglobin concentrations (Oxy-Hb) were recorded using fNIRS during a colored Go/NoGo task, simultaneously. Latencies and amplitudes of NoGo-N2 and NoGo/Go-P3 tasks were measured using EEG. RESULTS Children with ADHD showed significantly decreased Oxy-Hb in the right frontal cortex as well as longer NoGo-P3 latencies and a decreased NoGo/Go-P3 amplitude. There was a significant positive correlation between the Oxy-Hb and NoGo/Go-P3 amplitude. CONCLUSIONS These results suggest that children with ADHD experience executive dysfunction. Hemodynamic and electrophysiological findings during the Go/NoGo task might be useful as a biomarker of executive function. SIGNIFICANCE These findings have key implications for understanding the pathophysiology of deficits in executive function in ADHD.
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Affiliation(s)
- Yoshimi Kaga
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Department of Pediatrics, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi 409-3898, Japan.
| | - Riyo Ueda
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Miho Tanaka
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Yosuke Kita
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Cognitive Brain Research Unit (CBRU), Faculty of Medicine, University of Helsinki, 3 Haartmaninkatu, Helsinki 00290, Finland
| | - Kota Suzuki
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Faculty of Education, Shitennoji University, 3-2-1 Gakuenmae, Habikino, Osaka 583-8501, Japan
| | - Yasuko Okumura
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Japan Society for the Promotion of Science, Research Fellow, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan
| | - Yuka Egashira
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Yuka Shirakawa
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Shota Mitsuhashi
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
| | - Yuzuki Kitamura
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan; Japan Society for the Promotion of Science, Research Fellow, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo 102-0083, Japan; Graduate School of Design, Kyushu University, 4-9-1, Shiobaru Minami-ku, Fukuoka 815-8540, Japan
| | - Eiji Nakagawa
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8551, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan
| | - Masumi Inagaki
- Department of Developmental Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira, Tokyo 187-8553, Japan
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30
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Van der Oord S, Boyer BE, Van Dyck L, Mackay KJ, De Meyer H, Baeyens D. A Randomized Controlled Study of a Cognitive Behavioral Planning Intervention for College Students With ADHD: An Effectiveness Study in Student Counseling Services in Flanders. J Atten Disord 2020; 24:849-862. [PMID: 29998770 DOI: 10.1177/1087054718787033] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective: The effectiveness of a short (six session) individual cognitive behavioral planning intervention for college students with attention-deficit/hyperactivity disorder (ADHD) was tested. Method: In three student counseling services in Flanders, individuals with ADHD (N = 58) were randomized to the intervention or waitlist condition. Pre- and posttreatment assessments were conducted, and within the intervention group, a 4-month follow-up was conducted. Primary outcomes were ADHD symptoms and study skills; secondary outcomes were comorbid symptoms and planning skills on a neuropsychological task. Results: Intent-to-treat analyses showed a significant interaction on one outcome: inattention symptoms. The treatment condition improved from pretest to posttest, whereas the waitlist did not. Other measures showed large significant time effects (improved skills, reduction of symptoms in both groups) but no interactions. Stability analyses were not possible due to substantial dropout at follow-up. Conclusion: Specific treatment effects are on one outcome (inattention) and modest; for further implementation, the treatment needs adaptation.
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Affiliation(s)
- S Van der Oord
- KU Leuven, Belgium.,University of Amsterdam, The Netherlands
| | - B E Boyer
- University of Amsterdam, The Netherlands
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31
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Multimodal neuroimaging-based prediction of adult outcomes in childhood-onset ADHD using ensemble learning techniques. NEUROIMAGE-CLINICAL 2020; 26:102238. [PMID: 32182578 PMCID: PMC7076568 DOI: 10.1016/j.nicl.2020.102238] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 03/05/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent and heterogeneous neurodevelopmental disorder, which is diagnosed using subjective symptom reports. Machine learning classifiers have been utilized to assist in the development of neuroimaging-based biomarkers for objective diagnosis of ADHD. However, existing basic model-based studies in ADHD report suboptimal classification performances and inconclusive results, mainly due to the limited flexibility for each type of basic classifier to appropriately handle multi-dimensional source features with varying properties. This study applied ensemble learning techniques (ELTs), a meta-algorithm that combine several basic machine learning models into one predictive model in order to decrease variance, bias, or improve predictions, in multimodal neuroimaging data collected from 72 young adults, including 36 probands (18 remitters and 18 persisters of childhood ADHD) and 36 group-matched controls. All currently available optimization strategies for ELTs (i.e., voting, bagging, boosting and stacking techniques) were tested in a pool of semifinal classification results generated by seven basic classifiers. The high-dimensional neuroimaging features for classification included regional cortical gray matter (GM) thickness and surface area, GM volume of subcortical structures, volume and fractional anisotropy of major white matter fiber tracts, pair-wise regional connectivity and global/nodal topological properties of the functional brain network for cue-evoked attention process. As a result, the bagging-based ELT with the base model of support vector machine achieved the best results, with significant improvement of the area under the receiver of operating characteristic curve (0.89 for ADHD vs. controls and 0.9 for ADHD persisters vs. remitters). Features of nodal efficiency in right inferior frontal gyrus, right middle frontal (MFG)-inferior parietal (IPL) functional connectivity, and right amygdala volume significantly contributed to accurate discrimination between ADHD probands and controls; higher nodal efficiency of right MFG greatly contributed to inattentive and hyperactive/impulsive symptom remission, while higher right MFG-IPL functional connectivity strongly linked to symptom persistence in adults with childhood ADHD. Considering their improved robustness than the commonly implemented basic classifiers, findings suggest that ELTs may have the potential to identify more reliable neurobiological markers for neurodevelopmental disorders.
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32
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Bellato A, Arora I, Hollis C, Groom MJ. Is autonomic nervous system function atypical in attention deficit hyperactivity disorder (ADHD)? A systematic review of the evidence. Neurosci Biobehav Rev 2020; 108:182-206. [DOI: 10.1016/j.neubiorev.2019.11.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 12/26/2022]
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Scholten H, Scheres A, de Water E, Graf U, Granic I, Luijten M. Behavioral trainings and manipulations to reduce delay discounting: A systematic review. Psychon Bull Rev 2019; 26:1803-1849. [PMID: 31270766 PMCID: PMC6863952 DOI: 10.3758/s13423-019-01629-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In everyday decision-making, individuals make trade-offs between short-term and long-term benefits or costs. Depending on many factors, individuals may choose to wait for larger delayed reward, yet in other situations they may prefer the smaller, immediate reward. In addition to within-subject variation in the short-term versus long-term reward trade-off, there are also interindividual differences in delay discounting (DD), which have been shown to be quite stable. The extent to which individuals discount the value of delayed rewards turns out to be associated with important health and disorder-related outcomes: the more discounting, the more unhealthy or problematic choices. This has led to the hypothesis that DD can be conceptualized as trans-disease process. The current systematic review presents an overview of behavioral trainings and manipulations that have been developed to reduce DD in human participants aged 12 years or older. Manipulation studies mostly contain one session and measure DD directly after the manipulation. Training studies add a multiple session training component that is not per se related to DD, in between two DD task measurements. Ninety-eight studies (151 experiments) were identified that tested behavioral trainings and manipulations to decrease DD. Overall, results indicated that DD can be decreased, showing that DD is profoundly context dependent and changeable. Most promising avenues to pursue in future research seem to be acceptance-based/mindfulness-based trainings, and even more so manipulations involving a future orientation. Limitations and recommendations are discussed to identify the mechanistic processes that allow for changes in discount rate and behavior accordingly.
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Affiliation(s)
- Hanneke Scholten
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands.
| | - Anouk Scheres
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
| | - Erik de Water
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Uta Graf
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
| | - Isabela Granic
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
| | - Maartje Luijten
- Behavioural Science Institute, Radboud University, P.O. Box 9104, 6500, HE, Nijmegen, The Netherlands
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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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35
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De Meyer H, Beckers T, Tripp G, van der Oord S. Deficits in Conditional Discrimination Learning in Children with ADHD are Independent of Delay Aversion and Working Memory. J Clin Med 2019; 8:E1381. [PMID: 31484457 PMCID: PMC6780856 DOI: 10.3390/jcm8091381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/28/2019] [Accepted: 08/28/2019] [Indexed: 11/28/2022] Open
Abstract
Adaptive behavior requires the adjustment of one's behavioral repertoire to situational demands. The learning of situationally appropriate choice behavior can be operationalized as a task of Conditional Discrimination Learning (CDL). CDL requires the acquisition of hierarchical reinforcement relations, which may pose a particular challenge for children with Attention Deficit Hyperactivity Disorder (ADHD), particularly in light of documented deficits in short-term/working memory and delay aversion in ADHD. Using an arbitrary Delayed Matching-To-Sample task, we investigated whether children with ADHD (N = 46), relative to Typically Developing children (TD, N = 55), show a deficit in CDL under different choice delays (0, 8, and 16 seconds) and whether these differences are mediated by short-term/working memory capacity and/or delay aversion. Children with ADHD demonstrated poorer CDL than TD children under 8 and 16-second delays. Non-delayed CDL performance did not differ between groups. CDL differences were not mediated by short-term/working memory performance or delay aversion. Moreover, CDL performance under an 8-second delay was a better predictor of clinical status than short-term/working memory performance or delay aversion. CDL, under conditions of delay, is impaired in children with ADHD. This may lead to difficulties discriminating between different situational demands and adapting behavior according to the prevailing reward contingencies or expectations.
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Affiliation(s)
- Hasse De Meyer
- Research Unit Behavior, Health and Psychopathology, KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium; (H.D.M.); (T.B.)
- Department of Psychology, Faculty of Behavioural Sciences, HELP University Subang 2, Persiaran Cakerawala, Seksyen U4, Shah Alam 40150, Selangor, Malaysia
| | - Tom Beckers
- Research Unit Behavior, Health and Psychopathology, KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium; (H.D.M.); (T.B.)
- Leuven Brain Institute, KU Leuven, 3000 Leuven, Belgium
| | - Gail Tripp
- Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, 1919-1 Tancha, Onna, Kunigami District, Okinawa, Prefecture 904-0412, Japan;
| | - Saskia van der Oord
- Research Unit Behavior, Health and Psychopathology, KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium; (H.D.M.); (T.B.)
- Developmental Psychology, University of Amsterdam, Nieuwe Achtergracht 129, 1018 WS Amsterdam, The Netherlands
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36
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Mies GW, Moors P, Sonuga-Barke EJ, van der Oord S, Wiersema JR, Scheres A, Lemiere J, Danckaerts M. A Pilot Study of Behavioral, Physiological, and Subjective Responses to Varying Mental Effort Requirements in Attention-Deficit/Hyperactivity Disorder. Front Psychol 2019; 9:2769. [PMID: 30687201 PMCID: PMC6336710 DOI: 10.3389/fpsyg.2018.02769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Accepted: 12/24/2018] [Indexed: 01/17/2023] Open
Abstract
Background: Attention-deficit/hyperactivity disorder (ADHD) is presumed to involve mental effort application difficulties. To test this assumption, we manipulated task difficulty and measured behavioral, as well as subjective and psychophysiological indices of effort. Methods: Fifteen adolescent ADHD boys and 16 controls performed two tasks. First, subjective estimates and behavioral and pupillary measures of effort were recorded across five levels of N-back task difficulties. Second, effort discounting was assessed. In the latter, participants made repeated choices between performing a difficult N-back task for a high reward versus an easier N-back task for a smaller reward. Results: Increasing task difficulty led to similar deteriorations in performance for both groups – although ADHD participants performed more poorly at all difficulty levels than controls. While ADHD and control participants rated the tasks equally difficult and discounted effort similarly, those with ADHD displayed slightly different pupil dilation patterns with increasing task difficulty. Conclusion: The behavioral results did not provide evidence for mental effort problems in adolescent boys with ADHD. The subtle physiological effects, however, suggest that adolescents with ADHD may allocate effort in a different way than controls.
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Affiliation(s)
- Gabry W Mies
- Center for Developmental Psychiatry, UPC-KU Leuven, Leuven, Belgium.,Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Pieter Moors
- Laboratory for Experimental Psychology, Department of Brain and Cognition, KU Leuven, Leuven, Belgium
| | - Edmund J Sonuga-Barke
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Saskia van der Oord
- Department of Clinical Psychology, KU Leuven, Leuven, Belgium.,Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Jan R Wiersema
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Anouk Scheres
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Jurgen Lemiere
- Center for Developmental Psychiatry, UPC-KU Leuven, Leuven, Belgium
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Mies GW, de Water E, Wiersema JR, Scheres A. Delay discounting of monetary gains and losses in adolescents with ADHD: Contribution of delay aversion to choice. Child Neuropsychol 2018; 25:528-547. [PMID: 30111229 DOI: 10.1080/09297049.2018.1508563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Adolescents with attention-deficit/hyperactivity disorder (ADHD) are known to have stronger preferences for smaller immediate rewards over larger delayed rewards in delay discounting tasks than their peers, which has been argued to reflect delay aversion. Here, participants performed a delay discounting task with gains and losses. In this latter condition, participants were asked whether they were willing to wait in order to lose less money. Following the core assumption of the delay aversion model that individuals with ADHD have a general aversion to delay, one would predict adolescents with ADHD to avoid waiting in both conditions. Adolescents (12-17 years) with ADHD (n = 29) and controls (n = 28) made choices between smaller immediate and larger delayed gains, and between larger immediate and smaller delayed losses. All delays (5-25 s) and gains/losses (2-10 cents) were experienced. In addition to an area under the curve approach, a mixed-model analysis was conducted to disentangle the contributions of delay duration and immediate gain/delayed loss amount to choice. The ADHD group chose the immediate option more often than controls in the gain condition, but not in the loss condition. The contribution of delay duration to immediate choices was stronger for the ADHD group than the control group in the gain condition only. In addition, the ADHD group scored higher on self-reported delay aversion, and delay aversion was associated with delay sensitivity in the gain condition, but not in the loss condition. In sum, we found no clear evidence for a general aversion to delay in adolescents with ADHD.
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Affiliation(s)
- Gabry W Mies
- a Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Erik de Water
- a Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
| | - Jan R Wiersema
- b Department of Experimental Clinical and Health Psychology , Ghent University , Ghent , Belgium
| | - Anouk Scheres
- a Behavioural Science Institute , Radboud University , Nijmegen , The Netherlands
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Waiting and working for rewards: Attention-Deficit/Hyperactivity Disorder is associated with steeper delay discounting linked to amygdala activation, but not with steeper effort discounting. Cortex 2018; 106:164-173. [PMID: 30005368 DOI: 10.1016/j.cortex.2018.05.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 04/20/2018] [Accepted: 05/28/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Children and adolescents with ADHD have a relatively strong preference for smaller immediate rewards over larger delayed rewards (steep delay discounting). It is unknown whether such steep discounting of rewards is specific for delayed rewards, i.e., supporting the delay aversion account of ADHD, or whether it is also present for effortful rewards, i.e., representing general reward insensitivity. Therefore, this study examined behavioral and BOLD responses during delay discounting (DD) and effort discounting (ED) in ADHD. METHOD Thirty adolescents with ADHD and 28 controls (12-17 years) were scanned while performing a DD-ED task (fMRI findings were based on 21 and 25 participants, respectively). During DD, participants were presented with a series of choices between a small reward delivered immediately and a larger reward delivered after 5-25s. During ED, participants were presented with choices between a small reward that was delivered after exerting 15% of their maximal hand grip strength and a larger reward delivered after exerting 30-90% of their strength. RESULTS Analyses on the subjective values of delayed and effortful rewards and on the Area Under the discounting Curves (AUCs) indicated that adolescents with ADHD showed steeper discounting than controls for DD, but not for ED. This was accompanied by a slightly stronger delay dose-response relationship in the amygdala for adolescents with ADHD who reported to be more delay averse in daily life. CONCLUSION Together, these results-steeper DD in the ADHD group and a stronger delay dose-response relationship in the amygdala, while no evidence for group differences in ED was found-support the delay aversion account of ADHD.
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