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Disentangling deficits in adults with attention-deficit/hyperactivity disorder.
Arch Gen Psychiatry 2005; 62(10):1129-36AG

Abstract

CONTEXT

A lack of inhibitory control has been suggested to be the core deficit in attention-deficit/hyperactivity disorder (ADHD), especially in adults. This means that a primary deficit in inhibition mediates a cascade of secondary deficits in other executive functions, such as attention. Impaired stopping has been claimed to support the inhibition hypothesis. However, executive functions such as inhibition and attention are hard to disentangle.

OBJECTIVE

To use event-related potentials in adult patients with ADHD to show that impaired stopping is associated with abnormalities of attention.

DESIGN

The stop signal task was presented to 24 adults with ADHD combined subtype and 24 controls. Stop event-related potentials are distorted by overlap from event-related potentials to other stimuli in close temporal proximity, but we applied a method (Adjar level 2) to effectively remove this overlap.

RESULTS

In line with an inhibitory control deficit, the stop signal reaction time was longer in adults with ADHD (F(1,46) = 7.12, P<.01) whereas there was no significant difference for go stimulus reaction time. Overlap-free stop event-related potentials revealed smaller stop P3s in adults with ADHD (F(1,44) = 4.20, P<.05). In children with ADHD, this has been interpreted to reflect deficient inhibitory control. However, controls were also found to have larger early responses in the auditory cortex (N1) when stop signals resulted in successful stops, relative to failed stops, signifying increased attention (F(1,23) = 11.88, P<.01). This difference was completely absent in adults with ADHD.

CONCLUSIONS

Disturbed attentional processing of the stop signal contributed to impaired stopping in adults with ADHD. This finding may have implications for treatment.

Authors+Show Affiliations

Department of Psychopharmacology, Utrecht University, Utrecht, the Netherlands. embekker@ucdavis.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16203958

Citation

Bekker, Evelijne M., et al. "Disentangling Deficits in Adults With Attention-deficit/hyperactivity Disorder." Archives of General Psychiatry, vol. 62, no. 10, 2005, pp. 1129-36.
Bekker EM, Overtoom CC, Kooij JJ, et al. Disentangling deficits in adults with attention-deficit/hyperactivity disorder. Arch Gen Psychiatry. 2005;62(10):1129-36.
Bekker, E. M., Overtoom, C. C., Kooij, J. J., Buitelaar, J. K., Verbaten, M. N., & Kenemans, J. L. (2005). Disentangling deficits in adults with attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 62(10), pp. 1129-36.
Bekker EM, et al. Disentangling Deficits in Adults With Attention-deficit/hyperactivity Disorder. Arch Gen Psychiatry. 2005;62(10):1129-36. PubMed PMID: 16203958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Disentangling deficits in adults with attention-deficit/hyperactivity disorder. AU - Bekker,Evelijne M, AU - Overtoom,Carin C E, AU - Kooij,J J Sandra, AU - Buitelaar,Jan K, AU - Verbaten,Marinus N, AU - Kenemans,J Leon, PY - 2005/10/6/pubmed PY - 2005/10/26/medline PY - 2005/10/6/entrez SP - 1129 EP - 36 JF - Archives of general psychiatry JO - Arch. Gen. Psychiatry VL - 62 IS - 10 N2 - CONTEXT: A lack of inhibitory control has been suggested to be the core deficit in attention-deficit/hyperactivity disorder (ADHD), especially in adults. This means that a primary deficit in inhibition mediates a cascade of secondary deficits in other executive functions, such as attention. Impaired stopping has been claimed to support the inhibition hypothesis. However, executive functions such as inhibition and attention are hard to disentangle. OBJECTIVE: To use event-related potentials in adult patients with ADHD to show that impaired stopping is associated with abnormalities of attention. DESIGN: The stop signal task was presented to 24 adults with ADHD combined subtype and 24 controls. Stop event-related potentials are distorted by overlap from event-related potentials to other stimuli in close temporal proximity, but we applied a method (Adjar level 2) to effectively remove this overlap. RESULTS: In line with an inhibitory control deficit, the stop signal reaction time was longer in adults with ADHD (F(1,46) = 7.12, P<.01) whereas there was no significant difference for go stimulus reaction time. Overlap-free stop event-related potentials revealed smaller stop P3s in adults with ADHD (F(1,44) = 4.20, P<.05). In children with ADHD, this has been interpreted to reflect deficient inhibitory control. However, controls were also found to have larger early responses in the auditory cortex (N1) when stop signals resulted in successful stops, relative to failed stops, signifying increased attention (F(1,23) = 11.88, P<.01). This difference was completely absent in adults with ADHD. CONCLUSIONS: Disturbed attentional processing of the stop signal contributed to impaired stopping in adults with ADHD. This finding may have implications for treatment. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/16203958/Disentangling_deficits_in_adults_with_attention_deficit/hyperactivity_disorder_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=16203958.ui DB - PRIME DP - Unbound Medicine ER -