Stopping and changing in adults with ADHD.

Full Abstract

BACKGROUND: A lack of inhibitory control has been suggested to be the core deficit in children with attention deficit hyperactivity disorder (ADHD). This means that a primary deficit in behavioral inhibition mediates a cascade of secondary deficits in other executive functions, such as arousal regulation. Clinical observations have revealed that with increasing age symptoms of hyperactivity and impulsivity decline at a higher rate than those of inattention. This might imply that a deficit in attention rather than a lack of inhibitory control is the major feature in adult ADHD. METHOD: To study whether an attentional or inhibitory deficit predominates, the stop-signal task and the stop-change task were presented to 24 adults with ADHD combined subtype and 24 controls. RESULTS: Relative to controls, the stop-signal reaction time (SSRT) was significantly more prolonged than the go-stimulus reaction time (RT) in patients with ADHD. This disproportionate elongation of the SSRT was comparable across tasks, even though the stop-change task exerted more complex (or at least different) demands on the inhibitory system than the stop-signal task. ADHD patients had a higher proportion of choice errors, possibly reflecting more premature responses. Specifically in the stop-change task, patients had more variable choice responses and made more inappropriate change responses, which may also reflect enhanced impulsivity. CONCLUSIONS: The results support a core deficit in behavioral inhibition in adults with ADHD. We further suggest that there is more evidence for a critical role of deficient inhibitory control in adults than in children with ADHD.

Author information

Author/s: Bekker, E M (EM); Overtoom, C C (CC); Kenemans, J L (JL); Kooij, J J (JJ); De Noord, I (I); Buitelaar, J K (JK); Verbaten, M N (MN);

Affiliation: Department of Psychopharmacology, Utrecht University, The Netherlands. E.M.Bekker(-atsign-)pharm.uu.nl

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Psychological medicine (Psychol Med), published in England. (Language: eng)

Reference: 2005-Jun; vol 35 (issue 6) : pp 807-16

Dates: Created 2005/07/06; Completed 2005/10/20; Revised 2006/11/15;

PMID: 15997601, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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