Parent Emotion Expression and Autonomic-Linked Emotion Dysregulation in Childhood ADHD

Despite evidence that ADHD is associated with disruptions in emotion regulation, few studies have examined the biological correlates of emotion dysregulation among children with this disorder. Prior work has pointed to roles of the parasympathetic and sympathetic nervous system, as indexed via respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP), respectively. Work in typically developing populations suggests that parenting behavior and parental emotion expression may shape the development of these systems. To date, a single study has examined the independent and interactive roles of autonomic nervous system functioning and parent emotion expression in youth with ADHD. This study seeks to extend that work. 86 children (42 with ADHD), aged 8–12 years, and a parent completed a parent-child interaction task, while electrocardiography and impedance cardiography data were recorded to derive RSA and PEP. Parent and child emotion word use (positive and negative valence) were coded from recordings of the task. Parents of youth with ADHD used fewer positive emotion words throughout the task. Additionally, throughout the task, children with ADHD engaged in excessive RSA withdrawal from baseline. Further, the association between RSA reactivity and ADHD diagnosis was moderated by parent positive emotion word use. Specifically, those with RSA augmentation and parents displaying high positive affect across the task conditions were least likely to have an ADHD diagnosis. If replicated and extended, these results support the use of interventions specifically designed to increase parental modeling of positive emotions, while simultaneously focusing on building emotion regulation skills in youth with ADHD.     

学前儿童迷走神经活动与情绪反应、情绪调节及冲动性的关系

Porges的多迷走神经理论提出迷走神经活动(vagal activity)与儿童的情绪及社会行为密切联系,已有研究探讨了儿童迷走神经活动与儿童的情绪反应及调节的关系,但研究结论不够清晰,需要进一步研究澄清。本研究选取93名4-6岁学前儿童被试,运用生理测量手段与呼吸性窦性心律不齐(respiratory sinus arrhythmia,RSA)分析的方法,采用父母报告的学前儿童情绪反应强度、情绪调节能力、冲动性为结果变量,进一步探讨儿童迷走神经活动(以基线RSA、RSA撤出、RSA恢复为指标)与情绪反应、情绪调节及冲动性的关系。研究发现:(1)基线RSA与儿童情绪反应强度显著负相关,与儿童情绪调节能力显著正相关,基线RSA是儿童情绪反应强度显著负向预测因子,是儿童情绪调节能力的显著正向预测因子;(2)RSA撤出、RSA恢复性与儿童冲动性显著负相关,是儿童冲动性显著负向预测因子。研究结果支持了Porges的多迷走神经理论,表明迷走神经活动与儿童情绪反应、情绪调节及冲动性密切联系。     

Post-event Processing in Children with Social Phobia

In the aftermath of a distressing social event, adults with social phobia (SP) engage in a review of this event with a focus on its negative aspects. To date, little is known about this post-event processing (PEP) and its relationship with perceived performance in SP children. We measured PEP in SP children (n = 24) and healthy controls (HC; n = 22), aged from 8 to 12 years, after the Trier Social Stress Test for Children (TSST-C). Children also rated their performance immediately after the TSST-C and 2.5 h later. SP children reported more negative and less positive PEP than controls. Regression analyses indicated that negative PEP was associated with social anxiety and perceived task performance independent of comorbid depression. The SP group rated their performance immediately after the TSST-C as worse compared to HCs and ratings remained stable over the following 2.5 h. Results are discussed in relation to current theories of SP.     

Physiological Emotion Regulation in Children with ADHD with and without Comorbid Internalizing Disorders: a Preliminary Study

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) experience deficits in emotion regulation that can be measured physiologically under environmental stress conditions by examining respiratory sinus arrhythmia (RSA), a marker of parasympathetic nervous system (PNS) withdrawal. The current pilot study examined the impact of comorbid internalizing disorders and comorbid Oppositional Defiant Disorder (ODD) on emotion regulation in children with ADHD by measuring RSA as an indicator of dysregulated emotional reactivity. Twenty-four 7–10 year old children with ADHD participated in the current study. Children completed a 5-min resting attending baseline while electrocardiogram data (ECG) were recorded to examine baseline RSA. Children then completed a stress inducing, blocked goal, Card Sorting Task to measure RSA reactivity to stress. Results revealed a significant effect of internalizing disorder status on RSA difference score, F (1, 18)?=?5.83, p?=?.03, η² = .25. Children in the comorbid internalizing disorder group had a significantly greater decrease in RSA from the baseline time period to the card sorting task. There was no significant effect of ODD diagnostic status on RSA difference score, p?>?.05. The results of this preliminary study suggest that among children with ADHD, the presence of a comorbid internalizing disorder predicts greater withdrawal of the PNS. These findings represent an important step in understanding autonomic functioning of children with ADHD and comorbid disorders.     

Differentiating challenge reactivity from psychomotor activity in studies of children's psychophysiology: considerations for theory and measurement

Current methods of assessing children’s physiological “stress reactivity” may be confounded by psychomotor activity, biasing estimates of the relation between reactivity and health. We examined the joint and independent contributions of psychomotor activity and challenge reactivity during a protocol for 5- and 6-year-old children (N = 338). Measures of parasympathetic reactivity (respiratory sinus arrhythmia [RSA]) and sympathetic reactivity (preejection period [PEP]) were calculated for social, cognitive, sensory, and emotional challenge tasks. Reactivity was calculated relative to both resting and a paired comparison task that accounted for psychomotor activity effects during each challenge. Results indicated that comparison tasks themselves elicited RSA and PEP responses, and reactivity adjusted for psychomotor activity was incongruent with reactivity calculated using rest. Findings demonstrate the importance of accounting for confounding psychomotor activity effects on physiological reactivity.     

Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

We tested a conceptual model involving the inter-relations among affective decision-making (indexed by a gambling task), autonomic nervous system (ANS) activity, and attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms in a largely impoverished, inner city sample of first through third grade children (N=63, 54% male). The present study hypothesized that impaired affective decision-making and decreased sympathetic and parasympathetic activation would be associated with higher levels of ADHD and ODD symptoms, and that low sympathetic and parasympathetic activation during an emotion-inducing task would mediate the relation between affective decision-making and child externalizing symptoms. In support of our model, disadvantageous decision-making on a gambling task was associated with ADHD hyperactivity/impulsivity symptoms among boys, and attenuated sympathetic activation during an emotion-inducing task mediated this relation. Support for the model was not found among girls.     

Examining Manual and Visual Response Inhibition Among ADHD Subtypes

This study compared inhibitory functioning among ADHD subtype groups on manual and visual versions of the stop task. Seventy-six children, identified as ADHD/I (n = 17), ADHD/C (n = 43), and comparison (n = 20) completed both tasks. Results indicated that both ADHD groups were slower to inhibit responses than the comparison group on both tasks. Comparison children were faster to inhibit than activate responses on both tasks. Children in the ADHD groups also demonstrated this robust pattern on the manual task. However, on the visual task, the ADHD groups evidenced slowed inhibition comparable to the time required to activate responding. This implies that the visual task is more sensitive than the manual task to inhibitory deficits associated with ADHD. The ADHD/I and the ADHD/C groups did not differ on most measures, suggesting that neither stop task is effective in differentiating the subtypes. These findings extend work highlighting the role of disinhibition in ADHD, and contrast recent work suggesting divergence between ADHD subtypes.     

Attentional Performance in Children and Adolescents with Tic Disorder and Co-Occurring Attention-Deficit/Hyperactivity Disorder: New Insights from a 2 × 2 Factorial Design Study

The aim of the present study was to investigate the effect of both tic disorder (TD) and attention-deficit/hyperactivity disorder (ADHD) on attentional functions. N = 96 children and adolescents participated in the study, including n = 21 subjects with TD, n = 23 subjects with ADHD, n = 25 subjects with TD+ADHD, and n = 27 controls. Attentional performance was tested based on four computerized attention tasks (sustained attention, divided attention, go/nogo and set shifting). The effect of TD as well as ADHD on attentional performance was tested using a 2 × 2 factorial approach. A diagnosis of TD had no negative impact on attentional functions but was associated with improved performance in the set shifting task. By contrast, regardless of a diagnosis of TD, subjects with ADHD were found to perform worse in the sustained attention, divided attention and go/nogo task. No interaction effect between the factors TD and ADHD was revealed for any of the attention measures. Our results add to findings from other areas of research, showing that in subjects with TD and ADHD, ADHD psychopathology is often the main source of impairment, whereas a diagnosis of TD has little or no impact on neuropsychological performance in most cases and even seems to be associated with adaptive mechanisms.     

Can Executive Functions Explain the Relationship Between Attention Deficit Hyperactivity Disorder and Social Adjustment?

This study examined the ability of executive functions (EF) to account for the relationship between Attention Deficit Hyperactivity Disorder (ADHD) status and social adjustment as indexed by parent and teacher report and by performance on a standardized observational “chat room” task. Children with the Combined subtype (ADHD-C; n = 23), the Primarily Inattentive Subtype (ADHD-I; n = 33), and non-ADHD controls (n = 36) participated. EF did not mediate the relationship between ADHD status and parent or teacher report of social adjustment. EF accounted for about 40–50% of the variance between ADHD status and the ability of children to detect subtle verbal cues as well as memory for the conversation in the chat room task, but did not mediate the relationship between ADHD and the number of prosocial, hostile, or on-topic statements that were made. Results are consistent with other recent reports, and suggest that the role of EF deficits in the production of social skill deficits in ADHD may not be as prominent as is typically assumed. The implications for the development of intervention programs designed to target core cognitive etiologic factors are discussed.     

Autonomic impairment in Borderline Personality Disorder: A laboratory investigation

Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained from an analogue sample of participants screening positive for BPD (n = 12) and healthy controls (n = 28). In general, BPD participants exhibited increased sympathetic activity (indexed by Cardiac Sympathetic Index, CSI; Toichi et al., 1997) and decreased parasympathetic activity (indexed by Respiratory Sinus Arrhythmia, RSA) compared to controls. During the stressful task, BPD and control participants exhibited different trajectories of sympathetic activation: estimates of sympathetic activity increased for BPD participants and decreased for controls. Furthermore, BPD participants reported the task (but not baseline or recovery phases) to be more frustrating than controls. Findings are interpreted in the context of Polyvagal theory.     

Are Elevations in ADHD Symptoms Associated with Physiological Reactivity and Emotion Dysregulation in Children?

The present study examined whether children with elevated attention-deficit/hyperactivity disorder (ADHD) symptoms display a unique pattern of emotion dysregulation as indexed by both parent report and physiological reactivity during experiences of failure. A sample of 61 children (9 to 13 years; M?=?11.62, SD?=?1.29; 48 % male) with and without clinical elevations in ADHD symptoms participated. Parent and teacher report of ADHD and oppositional defiant disorder (ODD) symptoms and parent report of internalizing problems were collected. Parents also provided ratings of children’s emotional negativity/lability and emotion regulation. Children’s physiological reactivity, based on changes in respiratory sinus arrhythmia (RSA) and skin conductance level (SCL), were assessed while they completed a manipulated social rejection task and impossible puzzle task. Regression analyses indicated that ADHD symptoms were associated with higher parent-rated emotional negativity/lability and with blunted RSA withdrawal in response to social rejection; these effects were not accounted for by co-occurring ODD symptoms or internalizing problems. ODD symptoms also were uniquely associated with parent ratings of poor emotion regulation. Internalizing problems were uniquely associated with emotional negativity/lability, poor emotion regulation, and increased SCL activity in response to social rejection. Results suggest that there may be a pattern of emotion dysregulation that is specific to ADHD symptomatology. The importance of contextual factors when examining physiological reactivity to stress in youth with ADHD is discussed.     

The heterogeneity of attention‐deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition,emotion regulation,emotionality, and disorganized attachment

This study examined the contributions of several important domains of functioning to attention‐deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.     

Autonomic impairment in Borderline Personality Disorder: A laboratory investigation

Recent research suggests that emotional dysfunction in psychiatric disorders can be reflected in autonomic abnormalities. The present study examines sympathetic and parasympathetic autonomic nervous system activity in individuals with Borderline Personality Disorder (BPD) before, during, and following a social stressor task. Data were obtained from an analogue sample of participants screening positive for BPD (n = 12) and healthy controls (n = 28). In general, BPD participants exhibited increased sympathetic activity (indexed by Cardiac Sympathetic Index, CSI; Toichi et al., 1997) and decreased parasympathetic activity (indexed by Respiratory Sinus Arrhythmia, RSA) compared to controls. During the stressful task, BPD and control participants exhibited different trajectories of sympathetic activation: estimates of sympathetic activity increased for BPD participants and decreased for controls. Furthermore, BPD participants reported the task (but not baseline or recovery phases) to be more frustrating than controls. Findings are interpreted in the context of Polyvagal theory.     

ADHD and Behavioral Inhibition: A Re-examination of the Stop-signal Task

The current study investigates two recently identified threats to the construct validity of behavioral inhibition as a core deficit of attention-deficit/hyperactivity disorder (ADHD) based on the stop-signal task: calculation of mean reaction time from go-trials presented adjacent to intermittent stop-trials, and non-reporting of the stop-signal delay metric. Children with ADHD (n = 12) and typically developing (TD) children (n = 11) were administered the standard stop-signal task and three variant stop-signal conditions. These included a no-tone condition administered without the presentation of an auditory tone; an ignore-tone condition that presented a neutral (i.e., not associated with stopping) auditory tone; and a second ignore-tone condition that presented a neutral auditory tone after the tone had been previously paired with stopping. Children with ADHD exhibited significantly slower and more variable reaction times to go-stimuli, and slower stop-signal reaction times relative to TD controls. Stop-signal delay was not significantly different between groups, and both groups’ go-trial reaction times slowed following meaningful tones. Collectively, these findings corroborate recent meta-analyses and indicate that previous findings of stop-signal performance deficits in ADHD reflect slower and more variable responding to visually presented stimuli and concurrent processing of a second stimulus, rather than deficits of motor behavioral inhibition.     

Treatment Response in CP/ADHD Children with Callous/Unemotional Traits

The current study examines the role of callous/unemotional (CU) traits in response to treatment among children with conduct problems (CP) and attention-deficit/hyperactivity disorder (ADHD). Fifty-four children with CP/ADHD and 16 controls (age = 9.48, SD = 1.58) took part in a summer treatment and research program. Simple correlations showed that CU and CP were associated with a number of treatment outcome measures. When examined together in regression analyses, CU and CP were uniquely associated with three treatment outcomes each (CU—improvement in social skills and problem solving, negative behaviors in time-out; CP—time-outs per day, peer ratings, peer dislike). The implications for these findings with regard to treatment response in children with CP/ADHD with and without CU traits are explored.     

Degree of extraversion and physiological responses to physical pain and sadness

Extraversion is a personality frequently discussed as one of the strongest and most consistent factors that relates to individual subjective wellbeing. The goal of this study was to better understand how people with varying degrees of extraversion psychologically and physiologically respond differently to unpleasant circumstances. Emotional responses (e.g., levels of intensity, valence, and arousal) were assessed in determining the sensitivity level to negative stimuli that were specifically designed to provoke physical pain and sadness emotion. Physiological changes (e.g., heart rate (HR), blood volume pulse (BVP), and respiratory sinus arrhythmia (RSA)) were also measured during pain and sadness to observe sympathetic and parasympathetic activities. Our results showed that the degree of extraversion was associated with less unpleasant responses to sadness, less HR responses to both pain and sadness, and greater RSA responses to sadness. The findings suggest that the lower HR reactivity to painful and sad situations and greater RSA reactivity to sad situations in extraversion could be possibly due to increased parasympathetic activity. Additionally, enhanced parasympathetic activity to negative situations may explain an important mechanism underlying the positive connection between extraversion and subjective wellbeing.     

How Distinctive are ADHD and RD? Results of a Double Dissociation Study

The nature of the comorbidity between Attention-Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) was examined using a double dissociation design. Children were between 8 and 12 years of age and entered into four groups: ADHD only (n = 24), ADHD+RD (n = 29), RD only (n = 41) and normal controls (n = 26). In total, 120 children participated in the study; 38 girls and 82 boys. Both ADHD and RD were associated with impairments in inhibition and lexical decision, although inhibition and lexical decision were more severely impaired in RD than in ADHD. Visuospatial working memory deficits were specific to children with only ADHD. It is concluded that there was overlap on lexical decision and to a lesser extent on inhibition between ADHD and RD. In ADHD, impairments were dependent on IQ, which suggest that the overlap in lexical decision and inhibition is different in origin for ADHD and RD. The ADHD only group was specifically characterized by deficits in visuospatial working memory. Hence, no double dissociation between ADHD and RD was found on executive functioning and lexical decision.     

情绪调节对消极元刻板印象激活的认知效应的影响

以101名中职生为被试,采用不同难度的工作记忆任务,探讨认知重评与表达抑制两种情绪调节策略对消极元刻板印象激活的认知效应的影响。结果发现:(1)情绪调节策略对元刻板印象激活的认知效应具有影响,且与认知任务的难度有关;(2)在低难度工作记忆任务中,情绪调节策略对元刻板印象激活的认知效应没有影响,在中等难度任务中,认知重评减弱了激活的认知效应,但表达抑制没有影响,在高难度任务中,认知重评没有影响,表达抑制反而增强了激活的认知效应。总之,不同情绪调节策略会对消极元刻板印象激活的认知效应产生不同的作用。     

Positive Illusions of Social Competence in Girls with and Without ADHD

We compared social self-competence ratings in 9–12 year old girls with (n = 42) versus without (n = 40) ADHD, relative to ratings of the girls’ social competence made by mothers, teachers, and blind raters during a social laboratory task. Relative to scores from mothers, teachers, and the lab-task, girls with ADHD over-estimated their competence significantly more than control girls. Over-estimates were greater for girls with ADHD who also had heightened oppositional-defiant symptoms, or lower depressive symptoms. Over-estimates were positively related to a socially desirable reporting bias for girls with ADHD, but not for control girls, suggesting that girls with ADHD attempt to present themselves in an unduly positive, self-protective light. For girls with ADHD, over-estimates also were positively related to maladjustment and negatively related to adjustment. However, for girls without ADHD, over-estimates were positively related to adjustment. Overall, over-estimates of competence function differently in girls with and without ADHD.     

Executive Functioning Characteristics Associated with ADHD Comorbidity in Adolescents with Disruptive Behavior Disorders

The nature of executive dysfunction in youth with disruptive behavior disorders (DBD) remains unclear, despite extensive research in samples of children with attention-deficit hyperactivity disorder (ADHD). To determine the relationship between DBD, ADHD, and executive function deficits in aggressive teens, adolescents with DBD and comorbid ADHD (DBD + ADHD; n = 25), DBD without ADHD (DBD-ADHD; n = 23), and healthy controls (HC; n = 25) were compared on neurocognitive tests and questionnaires measuring executive functioning. Teens with DBD + ADHD performed worse on both neurocognitive and questionnaire measures of executive function than the DBD-ADHD and HC groups. Results suggest that subgroups of DBD may exist depending on the presence or absence of comorbid ADHD, which may have implications for the selection and efficacy of treatment strategies.