Effects of methylphenidate on inhibitory control in hyperactive children

This study investigated the effects of methylphenidate (MPH) on inhibitory control in hyperactive children. A double-blind, placebo-control, within-subject (crossover) design was used in which 12 children, between 6 and 11 years of age, were each tested four times in each drug condition: 0.3 mg/kg and 1.0 mg/kg of methylphenidate, and placebo. Dependent measures included (a) the probability of inhibiting responses to a primary choice reaction time task given a stop signal, on the Stopping Task, and (b) response latency and errors on the Matching Familiar Figures Test (MFFT). MPH improved the efficiency of the central inhibitory mechanism by speeding the inhibitory process, thereby affording the children greater control over their actions and enabling them to increase the probability with which they inhibited responses given a stop signal. MPH increased response latency but did not reduce errors on the MFFT, and observation of the children's task performance highlighted the interpretive problems associated with this task. Performance on both tasks was better at a dosage of 1.0 mg/kg than at 0.3 mg/kg.     

Prepotent response inhibition predicts treatment outcome in attention deficit/hyperactivity disorder

Objective: Inhibition deficits, including deficits in prepotent response inhibition and interference control, are core deficits in ADHD. The predictive value of prepotent response inhibition and interference control was assessed for outcome in a 10-week treatment trial with methylphenidate. Methods: Thirty-four children with ADHD (ages 8–12) received 10 weeks of methylphenidate treatment. At pretest prepotent response inhibition was assessed using the Stop-Signal Task; interference control was assessed using the Stroop Color-Word task. Methylphenidate was individually titrated to an optimal dose. Treatment outcome was assessed by parent- and teacher-rated ADHD behavior. Results: Only stop-signal reaction time of the Stop-Signal Task was a significant predictor of parent-rated levels of inattention and hyperactivity/impulsivity at outcome. Children with lower levels of inhibition showed worse outcome after 10 weeks of treatment, independent of medication dose. Conclusions: Low levels of prepotent response inhibition are associated with worse response to treatment with methylphenidate. Prepotent response inhibition may be an intermediate phenotypical predictor of treatment outcome.     

The Ecological Validity of Delay Aversion and Response Inhibition as Measures of Impulsivity in AD/HD: A Supplement to the NIMH Multimodal Treatment Study of AD/HD

Impulsivity is a primary symptom of the combined type of Attention Deficit/Hyperactivity Disorder (AD/HD). The Stop Signal Paradigm is premised upon a primary deficit in inhibitory control in AD/HD, whereas the Delay Aversion Hypothesis, by contrast, conceptualizes impulsivity in AD/HD, not as an inability to inhibit a response, but rather as a choice to avoid delay. This study compared the ecological validity of the Stop Signal Task (SST) and Choice-Delay Task (C-DT) measure of delay aversion, with respect to their relative utility in discriminating AD/HD children from normal control participants, and their correlations with classroom observations and with ratings of impulsivity and other core AD/HD symptoms on the Conners and SNAP-IV checklists. The tasks exhibited modest discriminant validity when used individually and excellent discriminant validity when used in combination. The C-DT correlated with teacher ratings of impulsivity, hyperactivity, and conduct problems, and with observations of gross motor activity, physical aggression, and an AD/HD composite score. The SST correlated with the observations only. These results suggest that delay aversion is associated with a broad range of AD/HD characteristics whereas inhibitory failure seems to tap a more discrete dimension of executive control     

On the role of different subdimensions of inhibition for successful motor skill change

Modifying already automatized movement skills often causes proactive interference resulting in initial performance decrements. Dealing with interference is closely linked to inhibitory functions, since inhibition is needed to suppress automatic, but undesired behavior. The aim of this study was to investigate the role of three different inhibition dimensions for interference control in motor skill change. To this end, 42 participants performed three tests each measuring a different dimension of inhibition: resistance to distractor interference (Eriksen-Flanker Task), resistance to proactive interference (Brown-Peterson Variant) and prepotent response inhibition (Stop-Signal Task). To examine the amount of proactive interference in a motor skill change task, participants were then asked to type a short paragraph as fast and accurately as possible on a regular computer keyboard. After this baseline measure, in order to induce proactive interference, they were confronted with a manipulated keyboard on which the letters S and L were switched. This change led to an immediate performance decline, observable in increased typing times and errors. Results also showed that larger performance decrements were significantly associated with better baseline performance, lower scores on prepotent response inhibition and higher scores on resistance to distractor interference. Besides supporting the idea of inhibition as a multidimensional construct, these findings replicate and confirm recent research indicating that the success in motor skill change is predicted by the ability to suppress prepotent response tendencies.     

Aging and inhibition of a prepotent motor response during an ongoing action

Inhibitory functions are key mechanisms underlying age related decline (Park & Gutchess, 2000, in: Cognitive aging: A primer. Hove: Psychology Press), yet few studies have investigated their impact on everyday tasks involving action as well as cognition. Using an everyday-based go/no-go task we devised a motor analogy of traditional neuropsychological tests to investigate in 134 older (aged 60-88) and 133 younger adults (aged 20-59) the ability to inhibit a prepotent motor response during an ongoing action. Older adults produced more inhibition failures as expected, but more strikingly inhibitory errors were not all or none; even when the inappropriate response was successfully inhibited, difficulties controlling ongoing movements emerged from as young as people in their 40s. The ability to inhibit therefore does not ensure control of ongoing tasks, and traditional cognitive tests may be unable to detect such difficulties. Furthermore, performance did not covary with education or action speed. Implications for neuropsychological theory and assessing/enhancing functional ability are discussed.     

Heterogeneous inhibition processes involved in different facets of self-reported impulsivity: evidence from a community sample

Whiteside and Lynam (Whiteside, S. P., & Lynam, D. R. (2001). The Five Factor Model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689) clarified the multifaceted nature of impulsivity by identifying four distinct facets of self-reported impulsive behaviors: urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Building on work by Bechara and Van der Linden (Bechara, A., & Van der Linden, M. (2005). Decision-making and impulse control after frontal lobe injuries. Current Opinion in Neurology, 18, 734-739), the main objective of this study was to investigate the hypothesis that perseverance and urgency map onto the two distinct inhibitory functions distinguished by Friedman and Miyake (Friedman, N. P., & Miyake, A. (2004). The relations among inhibition and interference control functions: A latent-variable analysis. Journal of Experimental Psychology: General, 133, 101-135): prepotent response inhibition and resistance to proactive interference. Participants (N = 126) completed the UPPS Impulsive Behavior Scale and three tasks: a recent-negatives task to assess proactive interference in working memory, and two Go/No-Go tasks at different paces, the slower of which also assessed task-unrelated thoughts (TUTs). Consistent with the hypothesis, TUTs were positively correlated with lack of perseverance, and multiple regressions revealed that urgency was specifically related to errors in prepotent response inhibition, and lack of perseverance to errors due to difficulties overcoming proactive interference.     

Response inhibition and interference control: Effects of schizophrenia,genetic risk,and schizotypy

The ability to inhibit inappropriate responses and suppress irrelevant information is a core feature of executive control. In this study, we provide a detailed analysis of prepotent response inhibition and interference in patients with schizophrenia. To further test the role of genetic factors and subclinical schizophrenia‐like traits, we additionally studied clinically unaffected, first‐degree relatives of schizophrenia patients and assessed dimensions of schizotypy in both relatives and healthy controls. Inhibition and interference control were assessed using a battery comprising the antisaccade, Stroop, stop signal, go/no‐go, flanker, and Simon tasks. Schizophrenia patients differed from both relatives and controls in making more errors on the antisaccade task and having longer response times on the Stroop task, especially the incongruent condition. Patients also had general, that is, condition independent, increases in reaction times on the go/no‐go and flanker tasks and made more errors on the flanker and Simon tasks, suggesting general performance impairments independent of inhibitory demand. Relatives were characterized by hypometric antisaccade amplitude gain despite normal prosaccades, suggesting a selective deficit in non‐standard sensorimotor transformations. Schizotypy was correlated with inhibitory performance across a number of tasks in both relatives and controls. Generally, these effects were independent of verbal intelligence levels. Overall, the findings point to rather selective impairments of inhibitory control in the schizophrenia spectrum and confirm a previously observed deficit in antisaccade spatial accuracy as an endophenotype of schizophrenia.     

自闭症谱系障碍者抑制控制的影响因素及神经机制

自闭症谱系障碍(ASD)是一种起源于儿童期的神经发育障碍, ASD的重复刻板行为与其抑制控制发展有密切关系。使用Go/No-go、Flanker及Stroop等范式的研究发现, ASD者抑制控制受损主要表现为反应抑制和干扰抑制能力存在缺陷; 其主要影响因素是任务状态、被试年龄及取样; 涉及的脑区和脑网络集中在前额皮层、前扣带回和基底神经节; 涉及的基因集中在谷氨酸盐、γ-氨基丁酸与5-羟色胺三种神经递质。未来应从脑机制研究入手, 综合考虑任务状态、个体特征对研究结果造成的影响, 并着力开发更有效的干预模式。     

Hot and Cool Forms of Inhibitory Control and Externalizing Behavior in Children of Mothers who Smoked during Pregnancy: An Exploratory Study

This study examined whether children exposed to prenatal smoking show deficits in “hot” and/or “cool” executive functioning (EF). Hot EF is involved in regulation of affect and motivation, whereas cool EF is involved in handling abstract, decontextualized problems. Forty 7 to 9-year-old children (15 exposed to prenatal smoking, 25 non-exposed) performed two computerized tasks. The Sustained Attention Dots (SA-Dots) Task (as a measure of “cool” inhibitory control) requires 400 non-dominant hand and 200 dominant hand responses. Inhibitory control of the prepotent response is required for dominant hand responses. The Delay Frustration Task (DeFT) (as a measure of “hot” inhibitory control) consists of 55 simple maths exercises. On a number of trials delays are introduced before the next question appears on the screen. The extent of response-button pressing during delays indicates frustration-induced inhibitory control. Prenatally exposed children showed poorer inhibitory control in the DeFT than non-exposed children. A dose–response relationship was also observed. In addition, prenatally exposed children had significantly higher (dose-dependent) conduct problem- and hyperactivity-inattention scores. There were no significant group differences in inhibitory control scores from the SA-Dots. These results indicate that children exposed to prenatal smoking are at higher risk of hot but not cool executive function deficits.     

Response Inhibition in Children With DSM-IV Subtypes of AD/HD and Related Disruptive Disorders: The Role of Reward

The current study had four aims: (a) to replicate previous findings of slow response inhibition in Attention Deficit/Hyperactivity Disorder (AD/HD), (b) to explore whether poor response inhibition in children with AD/HD is a core problem or rather a result of an underlying problem related to reward, (c) to investigate the specificity of poor response inhibition and the role of reward in relation to AD/HD, and (d) to study whether findings would be different for three subtypes of AD/HD. In order to address these issues, a stop paradigm was administered under a reward condition and under a nonreward condition to an AD/HD group (n = 24), an Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD) group (n = 21), a comorbid AD/HD+ODD/ CD group (n = 27), and a normal control (NC) group (n = 41). Firstly, contrary to prediction, none of the Disruptive Behavior Disorder (DBD) groups differed from the NC group with respect to the speed of the inhibition process. Secondly, it was shown that children with AD/HD and children with comorbid AD/HD+ODD/CD, but not children with ODD/CD alone, slowed down more dramatically in the reward condition than normal controls. This finding was interpreted as a strategy to increase the chance of being rewarded in children with AD/HD and children with comorbid AD/HD+ODD/CD, but not in children with pure ODD/CD. Finally, analysis of AD/HD subtypes did not change the main findings of this study.     

Response inhibition in children with DSM-IV subtypes of AD/HD and related disruptive disorders: the role of reward.

The current study had four aims: (a) to replicate previous findings of slow response inhibition in Attention Deficit/Hyperactivity Disorder (AD/HD), (b) to explore whether poor response inhibition in children with AD/HD is a core problem or rather a result of an underlying problem related to reward, (c) to investigate the specificity of poor response inhibition and the role of reward in relation to AD/HD, and (d) to study whether findings would be different for three subtypes of AD/HD. In order to address these issues, a stop paradigm was administered under a reward condition and under a nonreward condition to an AD/HD group (n=24), an Oppositional Defiant Disorder (ODD)/Conduct Disorder (CD) group (n=21), a comorbid AD/HD+ODD/CD group (n=27), and a normal control (NC) group (n=41). Firstly, contrary to prediction, none of the Disruptive Behavior Disorder (DBD) groups differed from the NC group with respect to the speed of the inhibition process. Secondly, it was shown that children with AD/HD and children with comorbid AD/HD+ODD/CD, but not children with ODD/CD alone, slowed down more dramatically in the reward condition than normal controls. This finding was interpreted as a strategy to increase the chance of being rewarded in children with AD/HD and children with comorbid AD/HD+ODD/CD, but not in children with pure ODD/CD. Finally, analysis of AD/HD subtypes did not change the main findings of this study.     

ADHD outside the laboratory: boys' executive function performance on tasks in videogame play and on a visit to the zoo

One current theory of attention-deficit/hyperactivity disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in 4 executive functions and motor control. To date, empirical support for this model is based primarily on laboratory-based cognitive methods. This study assessed behavioral inhibition and executive functioning in children with ADHD in 2 real-life contexts: videogames (motor-skill target game, cognitively demanding adventure game) and an outing at the zoo (route tasks). Participants were a community sample of 57 boys diagnosed with ADHD (20 inattentive, 37 combined type) and 57 normally developing control boys, matched individually for age and nonverbal IQ. Operationally defined measures of behavioral inhibition and specific executive functions were derived from these activities and assessed under contrasting conditions of low or high working memory and distractor loads. There were no group differences in basic motor skills on the target game, nor in terms of the ability to inhibit a prepotent or ongoing response in the adventure videogame. However, boys with ADHD exhibited more self-talk, more effortful response preparation, and completed fewer challenges in the latter videogame. Also, they manifested inhibition deficits in terms of interference control during the route task at the zoo and took longer to complete the tasks. Typically, these differences were greatest under conditions of high working memory and distractor loads. Findings from this study suggest that cognitive difficulties in ADHD may be context dependent and that ADHD is associated with deficits in some but not all aspects of behavioral inhibition.     

Delta plots in the study of individual differences: new tools reveal response inhibition deficits in AD/Hd that are eliminated by methylphenidate treatment

The authors highlight the utility of distribution-analytical techniques in the study of individual differences and clinical disorders. Cognitive deficits associated with attention-deficit/hyperactivity disorder (AD/HD) were examined by using delta-plot analyses of performance data (reaction time and accuracy) obtained through the use of a prototypical conflict task, the Eriksen flanker task. In 20 children with AD/HD (compared with matched control participants), overall performance measures indicated a marginal performance deficit. Delta-plot analyses indicated that performance deficits associated with AD/HD involve response inhibition but not automatic response activation. In a within-subjects titration study, the response inhibition deficit was eliminated by methylphenidate treatment, but these effects were highly dose specific. The beneficial effect of methylphenidate was clarified further after correcting for inter-individual variation in sensitivity to medicine dosage.     

Effect of attention control on sustained attention during induced anxiety

Anxiety has wide-reaching and complex effects on cognitive performance. Although it can intrude on cognition and interfere with performance, it can also facilitate information processing and behavioural responses. In a previous study, we showed that anxiety induced by threat of shock facilitates performance on the Sustained Attention to Response Task, a vigilance test, which probes response inhibition to infrequent nogo stimuli. The present study sought to identify factors that may have contributed to such improved performance, including on- and off-task thinking (assessed with thought probes) and individual differences in attention control, as measured with the Attention Control Scale. Replicating our prior finding, we showed that shock threat significantly reduced errors of commission on the nogo trials. However, we extended this finding in demonstrating that this effect was driven by subjects with low attention control. We therefore confirm that anxiety increases inhibitory control of prepotent responses—a mechanism which is adaptive under threat—and show that this effect is greater in those who rely more upon such prepotent responding, i.e., those with low attentional control.     

Executive functions in children with Autism Spectrum Disorders

Executive dysfunction is a characteristic impairment of individuals with Autism Spectrum Disorders (ASD). However whether such deficits are related to autism per se, or to associated intellectual disability is unclear. This paper examines executive functions in a group of children with ASD (N = 54, all IQ?70) in relation to a typically developing control group individually matched on the basis of age, gender, IQ and vocabulary. Significant impairments in the inhibition of prepotent responses (Stroop, Junior Hayling Test) and planning (Tower of London) were reported for children with ASD, with preserved performance for mental flexibility (Wisconsin Card Sorting Task) and generativity (Verbal Fluency). Atypical age-related patterns of performance were reported on tasks tapping response inhibition and self-monitoring for children with ASD compared to controls. The disparity between these and previous research findings are discussed. A multidimensional notion of executive functions is proposed, with difficulties in planning, the inhibition of prepotent responses and self-monitoring reflecting characteristic features of ASD that are independent of IQ and verbal ability, and relatively stable across the childhood years.     

Executive functions in children with Autism Spectrum Disorders

Executive dysfunction is a characteristic impairment of individuals with Autism Spectrum Disorders (ASD). However whether such deficits are related to autism per se, or to associated intellectual disability is unclear. This paper examines executive functions in a group of children with ASD (N = 54, all IQ⩾70) in relation to a typically developing control group individually matched on the basis of age, gender, IQ and vocabulary. Significant impairments in the inhibition of prepotent responses (Stroop, Junior Hayling Test) and planning (Tower of London) were reported for children with ASD, with preserved performance for mental flexibility (Wisconsin Card Sorting Task) and generativity (Verbal Fluency). Atypical age-related patterns of performance were reported on tasks tapping response inhibition and self-monitoring for children with ASD compared to controls. The disparity between these and previous research findings are discussed. A multidimensional notion of executive functions is proposed, with difficulties in planning, the inhibition of prepotent responses and self-monitoring reflecting characteristic features of ASD that are independent of IQ and verbal ability, and relatively stable across the childhood years.     

Effects of Reward and Response Cost on Response Inhibition in AD/HD, Disruptive, Anxious, and Normal Children

In previous research, children with attention deficit/hyperactivity disorder (AD/HD) have demonstrated impaired response inhibition on the stop paradigm. In this study we examined whether this impairment in fact reflects a motivational deficit. Four groups of children (age range 7–13 years) participated in the study: 14 AD/HD children, 21 normal controls, 14 disruptive children, and 14 anxious children. The psychopathological groups were recruited from special educational services and mental health outpatient clinics. Parent, teacher, and child questionnaires were used to select children with pervasive disorders. Normal controls attended regular classes and scored low on all questionnaires. Children were tested once with reward contingencies and once with response cost contingencies in a randomized cross-over design. We hypothesized that if a motivational deficit underlies poor response inhibition in AD/HD children, this deficit will be remedied by response contingencies. Despite the presence of response contingencies, AD/HD children showed poor response inhibition compared with normal controls. Findings argue against a motivational explanation for the response inhibition deficit in AD/HD children     

Motor limitation in dual-task processing with different effectors

According to the extended bottleneck model, dual-task interference does not arise only from a central bottleneck but also from processing limitations at the motor stage. Evidence for this assumption has previously been found only for same-effector tasks but not for different-effector tasks. In order to examine the existence of motor interference with different effectors, we used the psychological refractory period paradigm and employed response sequences of different length in Task 1 (R1 sequence length). Experiment 1 incorporated vocal response sequences in Task 1 and a manual response in Task 2. In Experiment 2, the assignment of the effectors to the two tasks was reversed. In both experiments, the long R1 sequence prolonged reaction time for Task 2 (RT2), and this effect was reduced with decreasing temporal overlap of the two tasks. Thus, the present experiments demonstrate motor interference between different-effector tasks. This interference may be due to on-line programming or to central response monitoring.     

Methylphenidate and cognitive flexibility: Dissociated dose effects in hyperactive children

A randomized, double-blind, placebo-controlled trial was conducted to assess the acute effects of placebo and three doses of methylphenidate (MPH) (0.3, 0.6, 0.9 mg/kg) on cognitive flexibility and overt behavior in 28 children with a confirmed diagnosis of attention deficit-hyperactivity disorder. Two underlying cognitive processes (response inhibition and response reengagement) were assessed by measuring the probability and speed with which subjects could inhibit responses to a primary task (forced-choice letter discrimination) and immediately execute a response to a secondary task (simple reaction time) when given a signal to do so. Results indicated that MPH enhanced cognitive flexibility, although the high dose was less effective than lower doses in enhancing response inhibition. Dissociations of dose effects on cognitive function and behavior were demonstrated: Dose-response functions for changes in behavior were linear, whereas the function for response inhibition was U-shaped. Findings argue against the typical clinical practice of determining the response to stimulant treatment from a single measure such as parent report of child behavior.     

The Opposites Task: Using General Rules to Test Cognitive Flexibility in Preschoolers

Executive functions play an important role in cognitive development, and during the preschool years especially, children's performance is limited in tasks that demand flexibility in their behavior. We asked whether preschoolers would exhibit limitations when they are required to apply a general rule in the context of novel stimuli on every trial (the “opposites” task). Two types of inhibitory processing were measured: response interference (resistance to interference from a competing response) and proactive interference (resistance to interference from a previously relevant rule). Group data show 3-year-olds have difficulty inhibiting prepotent tendencies under these conditions, whereas 5-year-olds’ accuracy is near ceiling in the task.