Waiting impulsivity: a distinctive feature of ADHD neuropsychology?

Impulsivity is a core feature of attention-deficit hyperactivity disorder (ADHD). It has been conceptualized in a number of different ways. In the current article, we examine how the new concept of “waiting impulsivity”, which refers to premature responding before a scheduled target appears, adds to our understanding of impulsivity in ADHD. Sixty children (8–12 years old; 30 ADHD; 30 typically developing controls) completed the 4-choice serial reaction time task, a measure of waiting impulsivity, alongside tasks measuring inhibitory control and temporal discounting and questionnaires measuring behavioral disorder symptoms, delay aversion, and various aspects of impulsivity. A multiple logistic regression model was used to explore the contribution of the primary task outcomes to predict group membership. Children with ADHD displayed more waiting impulsivity and less inhibitory control; they did not differ in temporal discounting. There was no correlation between waiting impulsivity and inhibitory control. Waiting impulsivity was correlated with parent-reported ratings of hyperactivity/impulsivity, inattention, oppositional defiant disorder (ODD), and conduct disorder (CD) and with self-reported delay aversion ratings. Only waiting impulsivity was a significant predictor of ADHD status. In conclusion, waiting impulsivity is distinct from inhibitory control deficits and predicts ADHD status independently of it. Future research needs to examine the relationship with delay aversion and ODD/CD more thoroughly.     

The Interim Service Preferences of Parents Waiting for Children’s Mental Health Treatment: A Discrete Choice Conjoint Experiment

Parents seeking help for children with mental health problems are often assigned to a waiting list. We used a discrete choice conjoint experiment to model preferences for interim services that might be used while waiting for the formal assessment and treatment process to begin. A sample of 1,059 parents (92 % mothers) seeking mental health services for 4 to 16 year olds chose between hypothetical interim services composed by experimentally varying combinations of the levels of 13 interim service attributes. Latent Class analysis yielded a four–segment solution. All segments preferred interim options helping them understand how agencies work, enhancing their parenting knowledge and skill, and providing an opportunity to understand or begin dealing with their own difficulties. The Group Contact segment (35.1 %) preferred interim services in meetings with other parents, supported by phone contacts, frequent checkup calls, and wait–time updates. Virtual Contact parents (29.2 %) preferred to meet other parents in small internet chat groups supported by e–mail contact. Membership in this segment was linked to higher education and computer skills. Frequent Contact parents (24.4 %) preferred face–to–face interim services supported by weekly progress checks and wait time updates. Limited Contact parents (11.3 %) were less intent on using interim services. They preferred to pursue interim services alone, with contacts by phone, supported by fewer check–up calls and less frequent wait time updates. All segments were more likely to enroll in interim services involving their child.     

Totalitarian politics and individual responsibility: Revising Hannah Arendt’s inner dialogue through the notion of confession in J. M. Coetzee’s Waiting for the Barbarians

Hannah Arendt’s writings concerning individual responsibility create an important – and under-examined – context for reading J. M. Coetzee’s oeuvre, particularly his novel Waiting for the Barbarians. For Arendt, when a society fails to offer ethical codes of conduct to follow, people should determine those codes by themselves, since morality concerns people in their individuality during totalitarian times. Arendt’s ideas bear important similarities to Coetzee’s representation of the magistrate in the novel, as this character struggles to live with his conscience in a totalitarian regime. In Arendt’s world, introspection is only needed when the world around us fails to guarantee moral laws, and even then one should not focus on oneself only, but instead try to focus on the world around us. Coetzee, however, shows through the character of the magistrate how this internal dialogue easily becomes torturous in its nature. If political action is the most important aspect of Arendt’s thinking, then Coetzee shows through the character of the magistrate how modern, conscientious humans cannot just act politically; instead, their action is always marked by their personal weaknesses, including their feelings of inadequacy. Nevertheless, even if Arendt emphasises political action more than Coetzee, who shows that such action is necessarily marked by individual doubt, self-questioning and other personal inadequacies, the reliance on radical thinking, which is at odds with conformism, is a concern they share.