Reduced Value-Driven Attentional Capture Among Children with ADHD Compared to Typically Developing Controls

The effect of reward and punishment on the extinction of attentional capture elicited by value-related stimuli

Particular features of the stimuli that predict significant outcomes tend to capture our attention in a rather automatic and inflexible way. This form of attention has been described as a Pavlovian bias that mimics the phenomenon of sign-tracking described in animals, where reward-predictive cues become motivational magnets. In humans, Value-Modulated Attentional Capture (VMAC) refers to a phenomenon where distractors that signal high-value outcomes receive higher attentional priority. VMAC is particularly difficult to extinguish, showing a similar persistence often described in animal sign-tracking. In the present study, we evaluated to what extent VMAC would persist using a more specific extinction procedure than previous research, where instead of removing the possibility of obtaining rewards, the different discriminant stimuli that signal reward equate its value. Furthermore, we manipulated between experiments whether the high-value distractor predicted high-reward and high-punishment contingent to response accuracy (mimicking previous research; Experiment 1) or only high-reward (Experiment 2), and also explored the association of VMAC and its persistence with measures of emotional impulsivity employed in past research. Our results show that when both rewards and punishments are possible, VMAC does not extinguish after an extensive extinction stage, nor is it associated with measures of emotional impulsivity. When punishments were removed, we showed that VMAC gradually extinguished both in response times and accuracy and that the persistence of VMAC was significantly associated with positive urgency. We discussed these results on the potential of punishments to qualitatively alter learning and response strategies employed by participants.

On the reliability of value-modulated attentional capture: An online replication and multiverse analysis

Stimuli predicting rewards are more likely to capture attention, even when they are not relevant to our current goals. Individual differences in value-modulated attentional capture (VMAC) have been associated with various psychopathological conditions in the scientific literature. However, the claim that this attentional bias can predict individual differences requires further exploration of the psychometric properties of the most common experimental paradigms. The current study replicated the VMAC effect in a large online sample (N = 182) and investigated the internal consistency, with a design that allowed us to measure the effect during learning (rewarded phase) and after acquisition, once feedback was omitted (unrewarded phase). Through the rewarded phase there was gradual increase of the VMAC effect, which did not decline significantly throughout the unrewarded phase. Furthermore, we conducted a reliability multiverse analysis for 288 different data preprocessing specifications across both phases. Specifications including more blocks in the analysis led to better reliability estimates in both phases, while specifications that removed more outliers also improved reliability, suggesting that specifications with more, but less noisy, trials led to better reliability estimates. Nevertheless, in most instances, especially those considering fewer blocks of trials, reliability estimates fell below the minimum recommended thresholds for research on individual differences. Given the present results, we encourage researchers working on VMAC to take into account reliability when designing studies aimed at capturing individual differences and provide recommendations to improve methodological practices.

Learned cognitive control counteracts value-driven attentional capture

Stimuli formerly associated with monetary reward capture our attention, even if this attraction is contrary to current goals (so-called value-driven attentional capture [VDAC], see Anderson (Ann N Y Acad Sci 1369:24-39, 2016), for a review). Despite the growing literature to this topic, little is known about the boundary conditions for the occurrence of VDAC. In three experiments, we investigated the role of response conflicts and spatial uncertainty regarding the target location during the training and test phase for the emergence of value-driven effects. Thus, we varied the occurrence of a response conflict, search components, and the type of task in both phases. In the training, value-driven effects were rather observed if the location of the value-associated target was not predictable and a response conflict was present. Value-driven effects also only occurred, if participants have not learned to deal with a response conflict, yet. However, the introduction of a response conflict during learning of the color-value association seemed to prevent attention to be distracted by this feature in a subsequent test. The study provides new insights not only into the boundary conditions of the learning of value associations, but also into the learning of cognitive control.

Rewarding outcomes enhance attentional capture and delay attentional disengagement

Attentional capture and disengagement are distinct process involved in attentional orienting. Most current studies have examined either the process of attentional capture or disengagement by manipulating stimuli associated with either positive (gains) or negative outcomes (losses). However, few studies have investigated whether attentional capture and disengagement are modulated by reward and loss outcomes. In the current study, we want to examine whether positive or negative outcomes could modulate distinguishing process of attentional capture and disengagement. Here, we manipulated different colored singleton stimuli associated with reward or loss outcomes; these stimuli were either presented at the center of screen or at the peripheral location. The participants' task was to search the target and identify the orientation of line segment in target as quickly as possible. The results showed that people had difficulty disengaging from a central reward-distractor, in comparison to loss- and neutral-distractor when target was presented at peripheral location. Similarly, peripheral reward-distractor captured more attention than loss- and neutral-distractor when target was presented at the center of screen after central fixation disappeared. Through our discoveries, we can conclude that positive rewards can increase attentional capture and delay attentional disengagement in healthy people.

The persistence of value-driven attention capture is task-dependent

Visual features previously associated with reward can capture attention even when task-irrelevant, a phenomenon known as value-driven attention capture (VDAC). VDAC persists without reinforcement, unlike other forms of learning, where removing reinforcement typically leads to extinction. In five experiments, factors common to many studies were manipulated to examine their impact on VDAC and its extinction. All experiments included learning and test phases. During learning, participants completed a visual search task during which one of two target colors was associated with a reward, and the other with no reward. During test, 1 week later, participants completed another visual search task in which the reward association was not reinforced. When a rewarded feature remained task-relevant (Experiment 1), VDAC was observed. When the rewarded feature was made task-irrelevant (Experiments 2-5) there was no evidence of a VDAC effect, except when the target feature was physically salient and there was a reduction in the frequency of exposure to the reward-associated feature (Experiment 5). We failed to find evidence of VDAC in Experiments 2-4, suggesting that VDAC may depend on the demands of the task resulting in vulnerability to VDAC. When VDAC was observed, extinction was also observed. This indicates that VDAC is subject to extinction as would be expected from an effect driven by reinforcement learning.

Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors

Background

Pediatric brain tumor (PBT) survivors are at risk for developing sleep disturbances. While in other pediatric populations sleep disturbance has been associated with worse cognitive functioning, it is unclear to what extent this relationship generalizes to PBT survivors. The aim of the current study was to assess the relationship between sleep disturbance and aspects of cognition, including sluggish cognitive tempo (SCT) as well as attention and working memory.

Materials and Methods

Eighty-three PBT survivors 6–18 years of age who were at least 3 months post-treatment were included in the present cross-sectional study. Level of sleep disturbance was measured as a composite score reflecting various sleep problems as rated by caregivers. Cognitive measures included caregiver-ratings of sluggish cognitive tempo and attention problems, as well as performance-based cognitive measures assessing attention and executive functioning. Hierarchical regression analysis was used to assess associations between sleep and cognition.

Results

Of all caregivers, 32.5% reported one or more sleep disturbances as “very/often true” and over 68% of caregivers rated at least one sleep-related item as “somewhat true.” Of all cognitive variables, scores were most frequently impaired for SCT (30%). A higher level of sleep disturbance was associated with worse SCT and parent-rated attention problems. Associations between sleep and performance-based cognitive measures assessing attention and working memory were not statistically significant.

Conclusion

Findings of the current study highlight the importance of further investigation into the relationship between sleep and cognition in PBT survivors, which may assist efforts to maximize cognitive outcome and health-related quality of life in PBT survivors. The current study additionally suggests further investigation of SCT in this population is warranted, as it may be more sensitive to detecting possible associations with sleep disturbance relative to discrete measures that assess cognitive performance under ideal circumstances.

Shared and Distinct Patterns of Functional Connectivity to Emotional Faces in Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder Children

Impairments in emotional face processing are demonstrated by individuals with neurodevelopmental disorders (NDDs), including autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which is associated with altered emotion processing networks. Despite accumulating evidence of high rates of diagnostic overlap and shared symptoms between ASD and ADHD, functional connectivity underpinning emotion processing across these two neurodevelopmental disorders, compared to typical developing peers, has rarely been examined. The current study used magnetoencephalography to investigate whole-brain functional connectivity during the presentation of happy and angry faces in 258 children (5–19 years), including ASD, ADHD and typically developing (TD) groups to determine possible differences in emotion processing. Data-driven clustering was also applied to determine whether the patterns of connectivity differed among diagnostic groups. We found reduced functional connectivity in the beta band in ASD compared to TD, and a further reduction in the ADHD group compared to the ASD and the TD groups, across emotions. A group-by-emotion interaction in the gamma frequency band was also observed. Greater connectivity to happy compared to angry faces was found in the ADHD and TD groups, while the opposite pattern was seen in ASD. Data-driven subgrouping identified two distinct subgroups: NDD-dominant and TD-dominant; these subgroups demonstrated emotion- and frequency-specific differences in connectivity. Atypicalities in specific brain networks were strongly correlated with the severity of diagnosis-specific symptoms. Functional connectivity strength in the beta network was negatively correlated with difficulties in attention; in the gamma network, functional connectivity strength to happy faces was positively correlated with adaptive behavioural functioning, but in contrast, negatively correlated to angry faces. Our findings establish atypical frequency- and emotion-specific patterns of functional connectivity between NDD and TD children. Data-driven clustering further highlights a high degree of comorbidity and symptom overlap between the ASD and ADHD children.

The past, present, and future of selection history

The last ten years of attention research have witnessed a revolution, replacing a theoretical dichotomy (top-down vs. bottom-up control) with a trichotomy (biased by current goals, physical salience, and selection history). This third new mechanism of attentional control, selection history, is multifaceted. Some aspects of selection history must be learned over time whereas others reflect much more transient influences. A variety of different learning experiences can shape the attention system, including reward, aversive outcomes, past experience searching for a target, target‒non-target relations, and more. In this review, we provide an overview of the historical forces that led to the proposal of selection history as a distinct mechanism of attentional control. We then propose a formal definition of selection history, with concrete criteria, and identify different components of experience-driven attention that fit within this definition. The bulk of the review is devoted to exploring how these different components relate to one another. We conclude by proposing an integrative account of selection history centered on underlying themes that emerge from our review.

Testing reward-cue attentional salience: Attainment and dynamic changes

A great wealth of studies has investigated the capacity of motivationally relevant stimuli to bias attention, suggesting that reward predicting cues are prioritized even when reward is no longer delivered and when attending to such stimuli is detrimental to reward achievement. Despite multiple procedures have been adopted to unveil the mechanisms whereby reward cues gain attentional salience, some open questions remain. Indeed, mechanisms different from motivation can be responsible for the capture of attention triggered by the reward cue. In addition, we note that at present only a few studies have sought to address whether the cue attractiveness dynamically follows changes in the associated reward value. Investigating how and to what extent the salience of the reward cue is updated when motivation changes, could help shedding light on how reward‐cues attain and maintain their capacity to attract attention, and therefore on apparent irrational attentive behaviors.

How to Improve Behavioral Parent and Teacher Training for Children with ADHD: Integrating Empirical Research on Learning and Motivation into Treatment

Attention deficit hyperactivity disorder [ADHD] is one of the most common psychiatric disorders of childhood with poor prognosis if not treated effectively. Recommended psychosocial evidence-based treatment for preschool and school-aged children is behavioral parent and teacher training [BPT]. The core elements of BPT are instrumental learning principles, i.e., reinforcement of adaptive and the ignoring or punishment of non-adaptive behaviors together with stimulus control techniques. BPT is moderately effective in reducing oppositional behavior and improving parenting practices; however, it does not reduce blinded ratings of ADHD symptoms. Also after training effects dissipate. This practitioner review proposes steps that can be taken to improve BPT outcomes for ADHD, based on purported causal processes underlying ADHD. The focus is on altered motivational processes (reward and punishment sensitivity), as they closely link to the instrumental processes used in BPT. Following a critical analysis of current behavioral treatments for ADHD, we selectively review motivational reinforcement-based theories of ADHD, including the empirical evidence for the behavioral predictions arising from these theories. This includes consideration of children's emotional reactions to expected and unexpected outcomes. Next we translate this evidence into potential ADHD-specific adjustments designed to enhance the immediate and long-term effectiveness of BPT programs in addressing the needs of children with ADHD. This includes the use of remediation strategies for proposed deficits in learning not commonly used in BPT programs and cautions regarding the use of punishment. Finally, we address how these recommendations can be effectively transferred to clinical practice.

Examining cognitive control and reward interactions in adolescent externalizing symptoms

During adolescence, rapid development and reorganization of the dopaminergic system supports increasingly sophisticated reward learning and the ability to exert behavioral control. Disruptions in the ability to exert control over previously rewarded behavior may underlie some forms of adolescent psychopathology. Specifically, symptoms of externalizing psychopathology may be associated with difficulties in flexibly adapting behavior in the context of reward. However, the direct interaction of cognitive control and reward learning in adolescent psychopathology symptoms has not yet been investigated. The present study used a Research Domain Criteria framework to investigate whether behavioral and neuronal indices of inhibition to previously rewarded stimuli underlie individual differences in externalizing symptoms in N = 61 typically developing adolescents. Using a task that integrates the Monetary Incentive Delay and Go-No-Go paradigms, we observed a positive association between externalizing symptoms and activation of the left middle frontal gyrus during response inhibition to cues with a history of reward. These associations were robust to controls for internalizing symptoms and neural recruitment during inhibition of cues with no reward history. Our findings suggest that inhibitory control over stimuli with a history of reward may be a useful marker for future inquiry into the development of externalizing psychopathology in adolescence.

Relating value-driven attention to psychopathology

Reward-associated objects receive preferential attention, reflecting a bias in information processing that develops automatically following associative learning. Mounting evidence suggests that such value-driven attention operates abnormally in certain psychopathologies, with attentional biases for reward-associated objects being either exaggerated or blunted compared to healthy controls. Here, I review the evidence linking value-driven attention to psychopathology, including drug addiction, depression, attention-deficit hyperactivity disorder (ADHD), compulsivity, and impulsive and risky decision-making. I conclude by offering an integrative framework for conceptualizing the link between value-driven attention and psychopathology, along with suggestions for future research into this burgeoning area of investigation, including research on object attachment.

Neural Mechanisms of Strategic Adaptation in Attentional Flexibility

Individuals are able to adjust their readiness to shift spatial attention, referred to as "attentional flexibility," according to the changing demands of the environment, but the neural mechanisms underlying learned adjustments in flexibility are unknown. In the current study, we used fMRI to identify the brain structures responsible for learning shift likelihood. Participants were cued to covertly hold or shift attention among continuous streams of alphanumeric characters and to indicate the parity of target stimuli. Unbeknown to the participants, the stream locations were predictive of the likelihood of having to shift (or hold) attention. Participants adapted their attentional flexibility according to contextual demands, such that the RT cost associated with shifting attention was smallest when shift cues were most likely. Learning model-derived shift prediction error scaled positively with activity within dorsal and ventral frontoparietal regions, documenting that these regions track and update shift likelihood. A complementary inverted encoding model analysis revealed that the pretrial difference in attentional selection strength between to-be-attended and to-be-ignored locations did not change with increasing shift likelihood. The behavioral improvement associated with learned flexibility may primarily arise from a speeding of the shift process rather than from preparatory broadening of attentional selection.

Attentional avoidance of threatening stimuli

Aversive conditioning has been shown to influence the control of attention, such that aversively conditioned stimuli receive elevated priority. Although aversively conditioned but task-irrelevant distractors are known to capture attention during speeded search in rapid orienting tasks, it is unclear whether this bias extends to situations where orienting can be more deliberate. We demonstrate that punishment, via electric shock, does not give rise to oculomotor capture by shock-associated stimuli during a foraging task; rather, such aversively conditioned stimuli are actively avoided when searching through a display. On the other hand, even during a foraging task, we found some evidence for a covert attentional bias to threat. Our findings indicate that the previously described effects of aversive conditioning on visual search may not generalize beyond the initial glance and can be suppressed when conditions allow for more deliberate search strategies. More generally, our findings reveal that sustained attentional avoidance of aversively conditioned stimuli is possible during active search.

Value-driven attentional capture enhances distractor representations in early visual cortex

When a behaviorally relevant stimulus has been previously associated with reward, behavioral responses are faster and more accurate compared to equally relevant but less valuable stimuli. Conversely, task-irrelevant stimuli that were previously associated with a high reward can capture attention and distract processing away from relevant stimuli (e.g., seeing a chocolate bar in the pantry when you are looking for a nice, healthy apple). Although increasing the value of task-relevant stimuli systematically up-regulates neural responses in early visual cortex to facilitate information processing, it is not clear whether the value of task-irrelevant distractors influences behavior via competition in early visual cortex or via competition at later stages of decision-making and response selection. Here, we measured functional magnetic resonance imaging (fMRI) in human visual cortex while subjects performed a value-based learning task, and we applied a multivariate inverted encoding model (IEM) to assess the fidelity of distractor representations in early visual cortex. We found that the fidelity of neural representations related to task-irrelevant distractors increased when the distractors were previously associated with a high reward. This finding suggests that value-driven attentional capture begins with sensory modulations of distractor representations in early areas of visual cortex.

Measuring attention to reward as an individual trait: the value-driven attention questionnaire (VDAQ)

Reward history is a powerful determinant of what we pay attention to. This influence of reward on attention varies substantially across individuals, being related to a variety of personality variables and clinical conditions. Currently, the ability to measure and quantify attention-to-reward is restricted to the use of psychophysical laboratory tasks, which limits research into the construct in a variety of ways. In the present study, we introduce a questionnaire designed to provide a brief and accessible means of assessing attention-to-reward. Scores on the questionnaire correlate with other measures known to be related to attention-to-reward and predict performance on multiple laboratory tasks measuring the construct. In demonstrating this relationship, we also provide evidence that attention-to-reward as measured in the lab, an automatic and implicit bias in information processing, is related to overt behaviors and motivations in everyday life as assessed via the questionnaire. Variation in scores on the questionnaire is additionally associated with a distinct biomarker in brain connectivity, and the questionnaire exhibits acceptable test-retest reliability. Overall, the Value-Driven Attention Questionnaire (VDAQ) provides a useful proxy-measure of attention-to-reward that is much more accessible than typical laboratory assessments.

Development of the frontal lobe

Development of the frontal lobe is critical to acquisition, execution, and control of a wide range of functions, from basic motor response to complex decision-making. These functions are influenced by contingency-based (e.g., reward and response-cost/punishment) feedback that is mediated through the adaptive integration of fronto-subcortical neural circuitry. The frontal lobe manages incoming information and chooses the appropriate action based on one's goals in a particular context. This aspect of frontal function, while only one component, is crucial to development and maintenance of approach and avoidance behavior central to all human (and animal) behavior. Furthermore, disruptions in fronto-subcortical circuitry governing motivated behavior appear to contribute to a range of developmental disorders, including attention-deficit/hyperactivity disorder (ADHD), and confer vulnerability for psychopathology more broadly. The particular deficits that manifest in altered behavior depend upon the specific circuitry that is compromised due to the functional specificity of distinct regions of the frontal lobe and its interconnections with subcortical structures. Neurobiologic models of motivated behavior provide a valuable framework for characterizing developmental disorders from a transdiagnostic dimensional systems perspective. Improved characterization of approach and avoidance motivation across neurodevelopmental disorders has the potential to inform the development of novel interventions and personalized medicine.

Test-retest reliability of value-driven attentional capture

Attention is biased toward learned predictors of reward. The degree to which attention is automatically drawn to arbitrary reward cues has been linked to a variety of psychopathologies, including drug dependence, HIV-risk behaviors, depressive symptoms, and attention deficit/hyperactivity disorder. In the context of addiction specifically, attentional biases toward drug cues have been related to drug craving and treatment outcomes. Given the potential role of value-based attention in psychopathology, the ability to quantify the magnitude of such bias before and after a treatment intervention in order to assess treatment-related changes in attention allocation would be desirable. However, the test-retest reliability of value-driven attentional capture by arbitrary reward cues has not been established. In the present study, we show that an oculomotor measure of value-driven attentional capture produces highly robust test-retest reliability for a behavioral assessment, whereas the response time (RT) measure more commonly used in the attentional bias literature does not. Our findings provide methodological support for the ability to obtain a reliable measure of susceptibility to value-driven attentional capture at multiple points in time, and they highlight a limitation of RT-based measures that should inform the use of attentional-bias tasks as an assessment tool.