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Colonna S, Eyre O, Agha SS, Thapar A, van Goozen S, Langley K. Investigating the associations between irritability and hot and cool executive functioning in those with ADHD. BMC Psychiatry 2022; 22:166. [PMID: 35247998 PMCID: PMC8898423 DOI: 10.1186/s12888-022-03818-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Irritability is especially pertinent to those with Attention Deficit Hyperactivity Disorder (ADHD) as it is highly prevalent and associated with a more severe clinical presentation and poorer longitudinal outcomes. Preliminary evidence suggests that top-down cognitive processes taking place in emotional contexts (i.e., hot executive functions) as opposed to those evoked in abstract scenarios (i.e., cool executive functions) may be relevant to the presentation of irritability in ADHD. This study explored the cognitive mechanisms underlying irritability in young people with ADHD, hypothesising that irritability would be associated with hot, but not cool, executive function impairments. METHODS Our sample included 219 individuals with ADHD. A composite irritability score was derived extracting items from a parent interview, with scores ranging from 0 to 5. Associations were investigated using linear regression analyses, between irritability and four hot tasks measuring sensitivity to risk, risk-taking behaviour following reward or punishment, acceptance of reward delay and reaction to unfair behaviour from others, and two cool tasks measuring set-shifting and motor inhibition. RESULTS As hypothesised, there were no significant associations between irritability and cool executive functions in those with ADHD; however, contrary to expectations, there was also no significant evidence that hot executive functions were associated with irritability. CONCLUSIONS These results, in a large well characterised sample and using a comprehensive task battery, suggest that the variation in irritability in those with ADHD may not be associated with differences in hot or cool executive function performance.
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Affiliation(s)
- Silvia Colonna
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK
| | - Olga Eyre
- grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK
| | - Sharifah Shameem Agha
- grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK ,Cwm Taf Morgannwg University Health Board, Pontypridd, Wales, UK
| | - Anita Thapar
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK ,grid.5600.30000 0001 0807 5670MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK
| | - Stephanie van Goozen
- grid.5600.30000 0001 0807 5670School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT UK
| | - Kate Langley
- School of Psychology, Cardiff University, Tower Building, 70 Park Place, Cardiff, CF10 3AT, UK. .,MRC Centre for Psychiatric Genetics & Genomics, Division of Psychological Medicine, School of Medicine, Cardiff University, Maindy Road, Cardiff, UK.
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Arabi Z, Moghaddam LF, Sahebalzamani M. The effect of emotion regulation training on family relationships of hyperactive children. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:101. [PMID: 32509909 PMCID: PMC7271928 DOI: 10.4103/jehp.jehp_738_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 01/05/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION One of the psychiatric disorders related to childhood is attention deficit hyperactivity disorder that can negatively affect the family interactions of these children. Parents of these children, especially the mother as the main caregiver, need comprehensive training to make a positive difference in their attitudes and behaviors with these children. The purpose of this study was to investigate the effect of emotion regulation training on family relationships in hyperactive children. METHODS This was a randomized clinical trial study with a control group performed on eighty mothers of hyperactive children who were selected randomly. The intervention group members attended emotion regulation skills training sessions for one session of 90 min each week for 8 weeks. During the training course in the intervention group, the control group did not receive any training. Data collection tools included demographic information questionnaires, Mother-Child Relationship Evaluation, and Rahim Organizational Conflict Inventory-II. Data analysis was performed by descriptive statistics and the analysis of covariance. RESULTS The mean scores of the mother-child relationship in the intervention group showed a significant improvement in the subscales of acceptance, overprotection, facilitation, and rejection (P < 0.0001). The results of this research also showed improvements in all the five communication styles of integrating, avoiding, compromising, obliging (P < 0.0001), and dominating (P < 0.012) between spouses. CONCLUSION It seems that the emotion regulation training approach in mothers with hyperactive children improved both the mother-child relationship and the interactive spousal styles and can be considered by the managers of treatment and rehabilitation field as an adjunctive therapy for the families of these children.
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Affiliation(s)
- Zohre Arabi
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of Nursing, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mohammad Sahebalzamani
- Department of Management, Faculty of Health, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
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Early Attentional Modulation by Working Memory Training in Young Adult ADHD Patients during a Risky Decision-Making Task. Brain Sci 2020; 10:brainsci10010038. [PMID: 31936483 PMCID: PMC7017173 DOI: 10.3390/brainsci10010038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/17/2019] [Accepted: 01/03/2020] [Indexed: 12/23/2022] Open
Abstract
Background: Working memory (WM) deficits and impaired decision making are among the characteristic symptoms of patients affected by attention deficit/hyperactivity disorder (ADHD). The inattention associated with the disorder is likely to be due to functional deficits of the neural networks inhibiting irrelevant sensory input. In the presence of unnecessary information, a good decisional process is impaired and ADHD patients tend to take risky decisions. This study is aimed to test the hypothesis that the level of difficulty of a WM training (WMT) is affecting the top-down modulation of the attentional processes in a probabilistic gambling task. Methods: Event-related potentials (ERP) triggered by the choice of the amount wagered in the gambling task were recorded, before and after WMT with a the dual n-back task, in young ADHD adults and matched controls. For each group of participants, randomly assigned individuals were requested to perform WMT with a fixed baseline level of difficulty. The remaining participants were trained with a performance-dependent adaptive n-level of difficulty. Results: We compared the ERP recordings before and after 20 days of WMT in each subgroup. The analysis was focused on the time windows with at least three recording sites showing differences before and after training, after Bonferroni correction ( p < 0.05 ). In ADHD, the P1 wave component was selectively affected at frontal sites and its shape was recovered close to controls' only after adaptive training. In controls, the strongest contrast was observed at parietal level with a left hemispheric dominance at latencies near 900 ms, more after baseline than after adaptive training. Conclusion: Partial restoration of early selective attentional processes in ADHD patients might occur after WMT with a high cognitive load. Modified frontal sites' activities might constitute a neural marker of this effect in a gambling task. In controls, conversely, an increase in late parietal negativity might rather be a marker of an increase in transfer effects to fluid intelligence.
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Airdrie JN, Langley K, Thapar A, van Goozen SH. Facial Emotion Recognition and Eye Gaze in Attention-Deficit/Hyperactivity Disorder With and Without Comorbid Conduct Disorder. J Am Acad Child Adolesc Psychiatry 2018; 57:561-570. [PMID: 30071977 PMCID: PMC6081050 DOI: 10.1016/j.jaac.2018.04.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 04/12/2018] [Accepted: 06/11/2018] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Conduct disorder (CD) is associated with impairments in facial emotion recognition. However, CD commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD); thus, it is unclear whether these impairments are explained by ADHD or by one of its core features-inattention. We explored whether emotion recognition impairments are specific to individuals with ADHD and comorbid CD while also examining the mechanisms that might explain such deficits. METHOD A total of 63 male and female adolescents with ADHD (mean age = 14.2 years, age range = 11-18 years) and with (ADHD+CD) or without (ADHD) comorbid CD, and 41 typically developing controls (healthy controls [HC]; mean age = 15.5, age range = 11-18 years) performed an emotion recognition task with concurrent eye-tracking. RESULTS Participants with ADHD+CD were less accurate at recognizing fear and neutral faces, and more likely to confuse fear with anger than participants with ADHD alone and HC. Both ADHD subgroups fixated the eye region less than HC. Although there was a negative correlation between ADHD symptom severity and eye fixation duration, only CD severity was inversely related to emotion recognition accuracy. CONCLUSION Only ADHD participants with comorbid CD showed impairments in emotion recognition, suggesting that these deficits are specific to individuals with conduct problems. However, lack of attention to the eye region of faces appears to be a characteristic of ADHD. These findings suggest that emotion recognition impairments in those with ADHD+CD are related to misinterpretation rather than poor attention, offering interesting opportunities for intervention.
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Affiliation(s)
| | - Kate Langley
- Cardiff University, Wales, UK,MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK
| | - Anita Thapar
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Wales, UK and the Institute of Psychological Medicine and Clinical Neurosciences, Cardiff University, Wales, UK
| | - Stephanie H.M. van Goozen
- Cardiff University, Wales, UK,Leiden University, the Netherlands,Correspondence to Stephanie H. M. van Goozen, PhD, Cardiff University School of Psychology, Tower Building, Park Place, CF10 7AT, UK
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Hinterbuchinger B, Kaltenboeck A, Baumgartner JS, Mossaheb N, Friedrich F. Do patients with different psychiatric disorders show altered social decision-making? A systematic review of ultimatum game experiments in clinical populations. Cogn Neuropsychiatry 2018; 23:117-141. [PMID: 29608131 DOI: 10.1080/13546805.2018.1453791] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Impairments in social functioning are a common feature of psychiatric disorders. Game paradigms pose a unique way for studying how people make decisions in interpersonal contexts. In the last decade, researchers have started to use these paradigms to study social decision-making in patients with psychiatric disorders. PURPOSE The aim of this systematic literature review is to summarise the currently available evidence on the behaviour of patients with psychiatric disorders in the commonly used Ultimatum Game (UG). METHOD A systematic literature search including MEDLINE, PsycINFO, PSYNDEXplus Tests, PSYNDEXPLUS Literature, EBM Reviews-Cochrane Central Register of Controlled Trials, Embase and PASCAL was performed via the Ovid interface. RESULTS We found evidence for alterations in UG behaviour for patients with frontotemporal dementia, schizophrenia, affective disorders, alcohol, cocaine, heroin and 3,4-methylenedioxymethamphetamine consumption, alcohol dependence, anxiety disorders, borderline personality disorder, autism, Tourette syndrome and oppositional defiant disorder. CONCLUSION There is some evidence that different psychiatric disorders might go along with alterations in social decision-making. However, in general, data are currently limited and studies are hard to compare due to differences in methodologies.
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Affiliation(s)
- Barbara Hinterbuchinger
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | | | - Josef Severin Baumgartner
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | - Nilufar Mossaheb
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
| | - Fabian Friedrich
- a Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy , Medical University of Vienna , Vienna , Austria
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Leibenluft E. Pediatric Irritability: A Systems Neuroscience Approach. Trends Cogn Sci 2017; 21:277-289. [PMID: 28274677 PMCID: PMC5366079 DOI: 10.1016/j.tics.2017.02.002] [Citation(s) in RCA: 124] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/27/2017] [Accepted: 02/02/2017] [Indexed: 02/03/2023]
Abstract
Irritability, defined as an increased propensity to exhibit increased anger relative to one's peers, is a common clinical problem in youth. Irritability can be conceptualized as aberrant responses to frustration (where frustration is the emotional response to blocked goal attainment) and/or aberrant 'approach' responses to threat. Irritable youth show hyper-reactivity to threat mediated by dysfunction in amygdala, medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), insula, striatum, and association cortex. Irritable youth also show abnormalities in reward learning, cognitive control, and responses to frustration. These abnormalities are mediated by circuitry that includes the inferior frontal gyrus (iFG), striatum, ACC, and parietal cortex. Effective treatments for irritability are lacking, but pathophysiological research could lead to more precisely targeted interventions.
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Affiliation(s)
- Ellen Leibenluft
- Section on Bipolar Spectrum Disorders, Emotion and Development Branch, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA.
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Schoorl J, van Rijn S, de Wied M, van Goozen S, Swaab H. Emotion Regulation Difficulties in Boys with Oppositional Defiant Disorder/Conduct Disorder and the Relation with Comorbid Autism Traits and Attention Deficit Traits. PLoS One 2016; 11:e0159323. [PMID: 27420110 PMCID: PMC4946778 DOI: 10.1371/journal.pone.0159323] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 06/30/2016] [Indexed: 11/19/2022] Open
Abstract
Previous research has pointed towards a link between emotion dysregulation and aggressive behavior in children. Emotion regulation difficulties are not specific for children with persistent aggression problems, i.e. oppositional defiant disorder or conduct disorder (ODD/CD), children with other psychiatric conditions, such as autism spectrum disorders or attention-deficit/hyperactivity disorder, have emotion regulation difficulties too. On a behavioral level some overlap exists between these disorders and comorbidity is high. The aim of this study was therefore twofold: 1) to examine emotion regulation difficulties in 65 boys with ODD/CD in comparison to a non-clinical control group (NC) of 38 boys (8–12 years) using a performance measure (Ultimatum Game), parent report and self-report, and 2) to establish to what extent emotion regulation in the ODD/CD group was correlated with severity of autism and/or attention deficit traits. Results on the Ultimatum Game showed that the ODD/CD group rejected more ambiguous offers than the NC group, which is seen as an indication of poor emotion regulation. Parents also reported that the ODD/CD group experienced more emotion regulation problems in daily life than the NC group. In contrast to these cognitive and behavioral measures, self-reports did not reveal any difference, indicating that boys with ODD/CD do not perceive themselves as having impairments in regulating their emotions. Emotional decision making within the ODD/CD group was not related to variation in autism or attention deficit traits. These results support the idea that emotion dysregulation is an important problem within ODD/CD, yet boys with ODD/CD have reduced awareness of this.
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Affiliation(s)
- Jantiene Schoorl
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
- * E-mail:
| | - Sophie van Rijn
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Minet de Wied
- Department of Adolescent Development, Utrecht University, Utrecht, The Netherlands
| | - Stephanie van Goozen
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
- School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Hanna Swaab
- Department of Clinical Child and Adolescent Studies, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands
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