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Mette C. Time Perception in Adult ADHD: Findings from a Decade-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3098. [PMID: 36833791 PMCID: PMC9962130 DOI: 10.3390/ijerph20043098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Time perception is impaired in adult ADHD. Since the term time perception subsumes different constructs, including time estimation, time reproduction, time production, and duration discrimination, it remains open whether certain domains are more affected than other domains in adult ADHD. The aim of this explorative review is to present the current state of research on time perception in adult ADHD by analysing studies from the past 10 years. A review of the literature addressing adult ADHD time perception, time estimation, and time reproduction was performed. The search strategy was conducted by using the databases "PubMed", "Medline", and "PSYNDEX". The results of the present review indicate that the number of studies on time perception in adult ADHD is very scarce. Moreover, the main investigated domains of time perception in the past decade were time estimation, time reproduction and time management. Whereas some of the found studies were able to demonstrate a distinct deficit in time estimation, time reproduction and time management other studies were unable to demonstrate a clear association between ADHD and time estimation and time reproduction deficits. However, the diagnostic protocols, study design, and methodology varied between studies. Further studies on time estimation and time reproduction need to be carried out.
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Affiliation(s)
- Christian Mette
- Department of Psychology, Immanuel-Kant-Str. 18-20, Protestant University of Applied Sciences, 44809 Bochum, Germany
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Marx I, Cortese S, Koelch MG, Hacker T. Meta-analysis: Altered Perceptual Timing Abilities in Attention-Deficit/Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2022; 61:866-880. [PMID: 34923055 DOI: 10.1016/j.jaac.2021.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 11/19/2021] [Accepted: 12/09/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE We meta-analyzed studies comparing perceptual timing abilities in the range of milliseconds to several seconds in persons with attention-deficit/hyperactivity disorder (ADHD) and neurotypical participants, using the well-established time discrimination, time estimation, time production, and time reproduction paradigms. METHOD We searched PubMed, OVID databases, and Web of Knowledge through September 17, 2020. From 2,266 records, 55 studies were retained and meta-analyzed with random effects models. We conducted meta-regression analyses to explore moderating effects of task parameters and neuropsychological measures of working memory, attention, and inhibition on timing performance. RESULTS Compared with persons without ADHD, those with ADHD had significantly more severe difficulties in discriminating stimuli of very brief durations, especially in the sub-second range. They also had more variability in estimating the duration of stimuli lasting several seconds. Moreover, they showed deficits in time estimation and time production accuracy, indicative of an accelerated internal clock. Additional deficits in persons with ADHD were also found in the time reproduction paradigm, involving attentional (slower counting at short time intervals due to distraction) and motivational (faster counting at long time intervals due to increased delay aversion) functions. CONCLUSION There is meta-analytic evidence of a broad range of timing deficits in persons with ADHD. Results have implications for advancing our knowledge in the field (eg, for refinement of recent timing models in ADHD) and clinical practice (eg, testing timing functions to characterize the clinical phenotype of the patient and implementation of interventions to improve timing abilities).
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Affiliation(s)
- Ivo Marx
- Rostock University Medical Center, Rostock, Germany.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, United Kingdom; New York University Grossman School of Medicine, New York
| | | | - Thomas Hacker
- Rostock University Medical Center, Rostock, Germany; Helios Hanseklinikum Stralsund, Stralsund, Germany
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Taş Dölek G, Tugba Ozel-Kizil E, Bastug G, Baran Z, Colak B. Impaired auditory and visual time reproduction in adult patients with attention deficit-hyperactivity disorder. J Clin Exp Neuropsychol 2021; 43:176-186. [PMID: 33779502 DOI: 10.1080/13803395.2021.1898549] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Objective: Although impaired time perception is associated with significant disturbance in the everyday functioning of adult patients with Attention Deficit-Hyperactivity Disorder (ADHD), it is not very well studied. The present study aimed to evaluate both visual and auditory time reproduction (TR) by using eight time intervals in adult ADHD patients compared to healthy controls (HC).Method: Wechsler Adult Intelligence Scale-R (WAIS-R), Adult Attention Deficit-Hyperactivity Disorder Self-Report Scale (ASRS), Wender Utah Rating Scale (WURS), Hyperfocusing Scale (HS), Beck Depression Inventory (BDI) and a 2-back task were administered to participants. In TR tasks, participants reproduced the same duration of the auditory/visual stimulus by pressing a key and absolute discrepancy scores (ADS) were calculated. A 2 (Group) x 2 (Task Modality) x 8 (Time Interval: 500, 1000, 2000, 4000, 6000, 8000, 12000 and 16000 msec) mixed-design ANOVA was performed.Results: All clinical scores of ADHD group were higher than HC (p < .001) while WAIS-R and 2-back performances of the groups were similar. Mixed-design ANOVA yielded significant Group and Time Interval main effects as well as a Group X Time Interval effect (both p < .001). ADHD patients had larger ADS than HC and as time intervals increased, error levels increased. Errors for time intervals >8000 msec were more prominent in patients. For both TR tasks, ASRS-hyperactivity/impulsivity scores were the main predictor of ADS in the linear regression analysis, while ASRS-attention deficit and HS scores were excluded.Conclusion: Results of the present study indicate significant TR impairment in adult ADHD regardless of task modality (visual or auditory), depressive symptoms and working memory performances. Longer time intervals in TR tasks differentiated patients better and TR impairment was associated with hyperactivity/impulsivity. These findings should be replicated in larger samples and underlying neurobiological components of impaired TR need to be examined in future research.
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Affiliation(s)
- Gamze Taş Dölek
- School of Medicine Department of Psychiatry, Ankara University, Ankara, Turkey
| | | | - Gulbahar Bastug
- Vocational School of Health Services, Ankara University, Ankara, Turkey
| | - Zeynel Baran
- Department of Psychology, Hacettepe University, Ankara, Turkey
| | - Burcin Colak
- School of Medicine Department of Psychiatry, Ankara University, Ankara, Turkey
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Figueiredo T, Fortes D, Erthal P, Bortolini T, Segenreich D, Malloy-Diniz L, Mattos P. Impulsivity as an Endophenotype in ADHD: Negative Findings. J Atten Disord 2021; 25:502-507. [PMID: 30520670 DOI: 10.1177/1087054718816161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Impulsivity has a strong genetic component and is considered an endophenotype in many psychiatric disorders. Impulsivity in adult ADHD has become a focus of interest more recently because of its suggested prominence in this age. Objective: This study aimed to access self-reported impulsivity levels in biological parents of ADHD offspring, according to their status: non-ADHD (controls), remitted, nonremitted. Method: Impulsivity levels of 155 parents of ADHD children were compared according to their status using the Barratt Impulsiveness Scale (BIS-11). Results: The ADHD group presented the highest levels of impulsivity compared with all other groups. The remitted ADHD and control groups showed no significant differences in impulsivity levels. Conclusion: Impulsivity tended to remit alongside ADHD symptoms in remitters and to persist in those presenting with the residual form of adult ADHD suggesting it should not be considered as an endophenotype. Only the attentional dimension was impaired, cautioning against Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) impulsivity proposed criteria.
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Affiliation(s)
- Tiago Figueiredo
- Federal University of Rio de Janeiro, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Dídia Fortes
- Federal University of Rio de Janeiro, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Pilar Erthal
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Tiago Bortolini
- D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | | | - Paulo Mattos
- Federal University of Rio de Janeiro, Brazil.,D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
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Ptacek R, Weissenberger S, Braaten E, Klicperova-Baker M, Goetz M, Raboch J, Vnukova M, Stefano GB. Clinical Implications of the Perception of Time in Attention Deficit Hyperactivity Disorder (ADHD): A Review. Med Sci Monit 2019; 25:3918-3924. [PMID: 31129679 PMCID: PMC6556068 DOI: 10.12659/msm.914225] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a lifelong neurodevelopmental disorder that can affect many areas of the daily life of individuals and is associated with poor health outcomes and with debilitating deficits in executive function. Recently, increasing numbers of research studies have begun to investigate the associations between neural and behavioral manifestations of ADHD. This review summarizes recent research on the perception of time in ADHD and proposes that this symptom is a possible diagnostic characteristic. Controlled studies on time perception have compared individuals with ADHD with typically developing controls (TDCs) and have used methods that include the Zimbardo Time Perspective Inventory (ZTPI). Practical approaches to time perception and its evaluation have shown that individuals with ADHD have difficulties in time estimation and discrimination activities as well as having the feeling that time is passing by without them being able to complete tasks accurately and well. Although ADHD has been associated with neurologic abnormalities in the mesolimbic and dopaminergic systems, recent studies have found that when individuals with ADHD are treated medically, their perception of time tends to normalize. The relationship between ADHD and the perception of time requires greater attention. Further studies on time perception in ADHD with other abnormalities, including executive function, might be approaches that refine the classification and diagnosis of ADHD and should include studies on its varied presentation in different age groups.
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Affiliation(s)
- Radek Ptacek
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Simon Weissenberger
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - Ellen Braaten
- Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program and Clay Center for Young Healthy Minds, Massachusetts General Hospital, Boston, MA, USA
| | | | - Michal Goetz
- Department of Paediatric Psychiatry, Second Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Jiri Raboch
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
| | - Martina Vnukova
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic.,Department of Psychology, University of New York in Prague, Prague, Czech Republic
| | - George B Stefano
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic
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Tourjman SV, Potvin S, Corbalan F, Djouini A, Purdon SE, Stip E, Juster RP, Kouassi E. Rapid screening for cognitive deficits in attention deficit and hyperactivity disorders with the screen for cognitive impairment in psychiatry. ACTA ACUST UNITED AC 2018; 11:139-147. [PMID: 30225804 DOI: 10.1007/s12402-018-0268-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 09/10/2018] [Indexed: 02/07/2023]
Abstract
Cognitive impairments constitute a core feature of attention deficit and hyperactivity disorders (ADHD), but are infrequently assessed in the clinical setting. We have previously demonstrated the ability of an objective cognitive battery, the Screen for Cognitive Impairment in Psychiatry (SCIP), to differentiate adult ADHD patients from healthy controls in five cognitive domains. Here, we further characterize these subtle cognitive deficits by conducting additional univariate analyses on our ADHD dataset to assess the contributions of various demographic characteristics on SCIP performance and to determine correlations between SCIP scores and scores on other measures evaluating illness severity, perceived cognitive deficits, and overall functioning. Age and years of education were moderately associated with performance on the SCIP and/or its subscales in our ADHD cohort. The SCIP global index score was moderately correlated with clinician-rated measures of illness severity and weakly associated with clinician-rated overall functional status. Intriguingly, overall SCIP performance was only weakly associated with patient self-reported measures of cognitive functioning. Of practical importance, small-to-moderate associations were consistently observed between performances on two subscales of the SCIP and the other measures evaluating illness severity, overall functioning, and patient self-reported cognitive functioning (the working memory and visuomotor tracking subscales). Thus, these data demonstrate that the SCIP, particularly the working memory and visuomotor tracking subscales, is sensitive enough to detect cognitive deficits in adult patients with ADHD, and that these deficits are correlated with functional impairments. Furthermore, these data highlight the importance of integrating both objective and subjective evaluations of cognition in adult ADHD.
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Affiliation(s)
- Smadar Valérie Tourjman
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada.
| | - Stéphane Potvin
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada
| | - Fernando Corbalan
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada
| | - Akram Djouini
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada
| | - Scot E Purdon
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Emmanuel Stip
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada.,Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montréal, QC, Canada
| | - Robert-Paul Juster
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
| | - Edouard Kouassi
- Department of Psychiatry, Institut Universitaire en Santé Mentale de Montréal, l'Université de Montréal, 7401 Hochelaga, Montréal, QC, H1N 3M5, Canada
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