Testing assumptions for endophenotype studies in ADHD: Reliability and validity of tasks in a general population sample

BACKGROUND: Advances in both genetic and cognitive-experimental studies on attention deficit hyperactivity disorder (ADHD) have opened new opportunities for cognitive endophenotype research. In such genetic designs the focus is on individual differences in characteristics, associated with ADHD, that can be measured reliably over time. Genetic studies that take a 'quantitative trait loci' approach hypothesise that multiple susceptibility genes contribute to a continuous dimension of ADHD symptoms. As an important initial step, we aimed to investigate the underlying assumptions that (1) key cognitive-experimental tasks indicate adequate test-retest reliability and (2) ADHD symptom scores in a general population sample are associated with performance on these tasks. METHODS: Forty-nine children were assessed on a go/no-go task and a reaction time task (the 'fast task') that included manipulations with event rate and incentives. The children were assessed twice, with a test-retest interval of two weeks. RESULTS: The majority of the task variables demonstrated moderate-to-good test-retest reliability. The correlations between teacher ratings of ADHD symptoms and key task variables were .4–.6: ADHD symptoms were associated with poor performance (especially high reaction time variability) in a slow baseline condition, whereas there was low or no association in conditions with a faster event rate or incentives. In contrast, no clear pattern of findings emerged based on parent ratings of ADHD symptoms. CONCLUSION: The data support the usefulness of the go/no-go and fast tasks for genetic studies, which require reliable and valid indices of individual differences. The overall pattern of associations between teacher ratings of ADHD symptoms and task variables is consistent with effects of event rate and incentives on performance, as predicted by the model of activation and arousal regulation. The lack of a clear pattern of findings with parent ratings of ADHD symptoms warrants further study

Flanker performance in female college students with ADHD: a diffusion model analysis

Attention-deficit hyperactivity disorder (ADHD) is characterized by poor adaptation to environmental demands, which leads to various everyday life problems. The present study had four aims: (1) to compare performance in a flanker task in female college students with and without ADHD (N = 39) in a classical analyses of reaction time and error rate and studying the underlying processes using a diffusion model, (2) to compare the amount of focused attention, (3) to explore the adaptation of focused attention, and (4) to relate adaptation to psychological functioning. The study followed a 2-between (group: ADHD vs. control) × 2-within (flanker conflict: incongruent vs. congruent) × 2-within (conflict frequency: 20 vs. 80 %) design. Compared to a control group, the ADHD group displayed prolonged response times accompanied by fewer errors in a flanker task. Results from the diffusion model analyses revealed that the members of the ADHD group showed deficits in non-decisional processes (i.e., higher non-decision time) and leaned more toward accuracy than participants without ADHD (i.e., setting higher boundaries). The ADHD group showed a more focused attention and less adaptation to the task conditions which is related to psychological functioning. Deficient non-decisional processes and poor adaptation are in line with theories of ADHD and presumably typical for the ADHD population, although this has not been shown using a diffusion model. However, we assume that the cautious strategy of trading speed of for accuracy is specific to the subgroup of female college students with ADHD and might be interpreted as a compensation mechanism

The genetic overlap of Attention-Deficit/Hyperactivity Disorder and Autistic-like traits: an investigation of individual symptom scales and cognitive markers

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorders (ASDs) frequently co-occur. However, due to previous exclusionary diagnostic criteria, little is known about the underlying causes of this covariation. Twin studies assessing ADHD symptoms and autistic-like traits (ALTs) suggest substantial genetic overlap, but have largely failed to take into account the genetic heterogeneity of symptom subscales. This study aimed to clarify the phenotypic and genetic relations between ADHD and ASD by distinguishing between symptom subscales that characterise the two disorders. Moreover, we aimed to investigate whether ADHD-related cognitive impairments show a relationship with ALT symptom subscales; and whether potential shared cognitive impairments underlie the genetic risk shared between the ADHD and ALT symptoms. Multivariate structural equation modelling was conducted on a population-based sample of 1312 twins aged 7–10. Social-communication ALTs correlated moderately with both ADHD symptom domains (phenotypic correlations around 0.30) and showed substantial genetic overlap with both inattention and hyperactivity-impulsivity (genetic correlation = 0.52 and 0.44, respectively). In addition to previously reported associations with ADHD traits, reaction time variability (RTV) showed significant phenotypic (0.18) and genetic (0.32) association with social-communication ALTs. RTV captured a significant proportion (24 %) of the genetic influences shared between inattention and social-communication ALTs. Our findings suggest that social-communication ALTs underlie the previously observed phenotypic and genetic covariation between ALTs and ADHD symptoms. RTV is not specific to ADHD symptoms, but is also associated with social-communication ALTs and can, in part, contribute to an explanation of the co-occurrence of ASD and ADHD

ERP correlates of impaired error monitoring in children with ADHD

Objective: The purpose of the current study was to elaborate on error monitoring in children with Attention Deficit Hyperactivity Disorder (ADHD) using the ERP methodology. Method: Children with ADHD executed a visual Go/No-Go task with 25 percent No-Go trials; and a two stimulus reaction time task wherein a neutral warning signal (S1) was presented to inform the child to prepare for an imperative stimulus (S2). Results: In both tasks, children with ADHD responded as fast as controls but made twice as many errors. In addition, they failed to adjust their speed of responding after making an error. Exploring the error-related potentials revealed that the error-related negativity (ERN) was the same for the two groups, but that children with ADHD showed a diminished error positivity (Pe). Conclusions: Based on these findings, we conclude that children with ADHD are normal in early error monitoring processes related to error detection, but show abnormal response strategy adjustments and are deviant in later error monitoring processes associated with the subjective/emotional, conscious evaluation of the error

State regulation and response inhibition in children with ADHD and children with early- and continuously treated phenylketonuria: An event-related potential comparison

Background: The presentation rate of stimuli plays an important role in explaining the performance inefficiency in children with ADHD. In general, children with ADHD have been found to perform more poorly in conditions of relatively slow event rates as compared with fast and moderate event rates. The state regulation hypothesis states that these children have problems in correcting their energetic state necessary to counteract a performance decrement, which requires extra effort allocation. In this study, we investigated state regulation in children with ADHD and used children with early- and continuously treated phenylketonuria (PKU) as a clinical contrast group. Method: We measured the parietal P3 during a Go/No-Go task that incorporated a condition with a fast and a slow presentation rate. Results: We were able to show that children with ADHD, relative to controls, responded more slowly and more variably in the slow condition only, which was accompanied by a smaller P3, suggesting less effort allocation. In contrast, the children with PKU did not show a state regulation deficit. The PKU group showed prolonged stimulus evaluation processing, as indexed by P3 latency, compared to controls and children with ADHD. In addition, they made more errors of commission than the controls and the ADHD group. Conclusions: Our electrophysiological data support the state regulation hypothesis of ADHD. Only the children with PKU had more problems in inhibiting pre-potent responding than controls, which is in accord with the prefrontal dysfunction hypothesis of PKU

Motor problems in children with early-treated congenital hypothyroidism: A matter of failing cerebellar motor control?

This study addresses the question of whether "clumsiness" in children with early treated Congenital Hypothyroidism (CH) might be attributable to cerebellar dysfunction. CH is known to affect rapid perinatal growth of the cerebellum. If this would affect the supposed motor timing function of the cerebellum this should be especially reflected by difficulty in producing fast aiming movements. An experiment was devised in which children made sequences of fast, goal directed movements in order to examine two aspects of fast voluntary movements that are known to be affected by cerebellar injury: dysmetria and dysdiadochokinesis. Three groups of children between the ages of 9 and ii participated: a group with severe CH (thyroid agenesis, n = 18), a group with mild CH (thyroid dysgenesis, n = 23) and a control group (n = 31). In comparison with controls, motor performance in children with severe CH was characterized by more overshoots, shorter movement times, higher velocity and a larger initial force Impulse. In line with previous findings from the same population, it is concluded that motor problems in early treated CH are primarily related to peripheral processes associated with motor execution rather than to central cerebellar processes associated with motor timing. (C) 1998 Elsevier Science B.V. All rights reserved