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Parker AJ, Walker JC, Jordan LS, Takarae Y, Wiggins JL, Dougherty LR. Neural mechanisms of inhibitory control in preadolescent irritability: Insights from the ABCD study. Biol Psychol 2024; 192:108856. [PMID: 39154835 DOI: 10.1016/j.biopsycho.2024.108856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 07/19/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE Elevated pediatric irritability is a transdiagnostic symptom that predicts multiple mental health problems in adolescence and adulthood. Altered top-down regulatory networks, such as inhibitory control networks that suppress an impulse in favor of goal-directed behavior, are thought to contribute to high levels of youth irritability. Nevertheless, little work has examined links between youth irritability and neural processes supporting inhibitory control in large diverse samples, nor have they focused on the key period ramping up to adolescence (i.e., preadolescence). METHOD Functional MRI data from 5380 preadolescents (age M=9.97 years, SD=0.62) in the baseline Adolescent Brain and Cognitive Development (ABCD) Study were analyzed. Parents reported on their preadolescent's irritability. The stop signal task (SST) was leveraged to probe successful and failed inhibitory control. Activation and functional connectivity with amygdala, ventral striatum, and prefrontal seed regions were calculated during the SST and used in whole brain and region of interest (ROI) group-level analyses evaluating irritability effects. RESULTS Preadolescents with higher levels of irritability displayed decreases in functional connectivity among amygdala, ventral striatum, and prefrontal cortex regions during both successful and failed inhibitory control conditions. These results remained after adjusting for co-occurring anxiety, depression, and attention-deficit/hyperactivity symptoms. CONCLUSIONS Findings suggest neural aberrations in inhibitory control play a role in the pathophysiology of preadolescent irritability and associations are not merely due to co-occurring symptoms. Neural mechanisms of inhibitory control associated with irritability may provide novel intervention targets.
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Affiliation(s)
- Alyssa J Parker
- Department of Psychology, University of Maryland, College Park, United States.
| | - Johanna C Walker
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States
| | - Leslie S Jordan
- Department of Psychology, University of Maryland, College Park, United States; Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, United States; Institute for Clinical & Translational Research (ICTR), University of Maryland Baltimore, United States
| | - Yukari Takarae
- Department of Psychology, San Diego State University, United States
| | - Jillian Lee Wiggins
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, United States; Department of Psychology, San Diego State University, United States
| | - Lea R Dougherty
- Department of Psychology, University of Maryland, College Park, United States
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2
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Vera JD, Freichel R, Michelini G, Loo SK, Lenartowicz A. A Network Approach to Understanding the Role of Executive Functioning and Alpha Oscillations in Inattention and Hyperactivity-Impulsivity Symptoms of ADHD. J Atten Disord 2024; 28:1357-1367. [PMID: 38798087 PMCID: PMC11292971 DOI: 10.1177/10870547241253999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
OBJECTIVE ADHD is a prevalent neurodevelopmental disorder characterized by symptoms of inattention and hyperactivity-impulsivity. Impairments in executive functioning (EF) are central to models of ADHD, while alpha-band spectral power event-related decreases (ERD) have emerged as a putative electroencephalography (EEG) biomarker of EF in ADHD. Little is known about the roles of EF and alpha ERD and their interactions with symptoms of ADHD. METHOD We estimated network models of ADHD symptoms and integrated alpha ERD measures into the symptom network. RESULTS EF emerges as a bridge network node connecting alpha ERD and the hyperactivity/impulsivity and inattention symptoms. We found that EF most closely relates to a subset of symptoms, namely the motoric symptoms, "seat" (difficulty staying seated), and "runs" (running or climbing excessively). CONCLUSIONS EF functions as a bridge node connecting alpha ERD and the ADHD symptom network. Motoric-type symptoms and EF deficits may constitute important nodes in the interplay between behavior/symptoms, cognition, and neurophysiological markers of ADHD.
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Affiliation(s)
| | | | - Giorgia Michelini
- University of California, Los Angeles, USA
- Queen Mary University of London, UK
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3
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Hawkey EJ, Williams AI, Chung S, Owens EB, Pfiffner LJ. Emotion Regulation and Organizational Skills in Children With ADHD Symptoms Are Associated With Behavioral Parent Training Adherence. J Atten Disord 2024; 28:1320-1330. [PMID: 38726593 DOI: 10.1177/10870547241251725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Behavioral parent training (BPT) is a well-established treatment for ADHD; however, treatment response is variable. Consistency in parent skill use during BPT is known to influence child outcomes post-treatment, while less research has focused on specific child factors that may be impacting parent skill utilization during treatment. The current study examined associations between child organizational skills and emotion dysregulation (ED) with parent treatment adherence during BPT and post-treatment child impairment. METHOD Parents of 72 children (Mage = 8.31) with ADHD symptoms and impairment participated in BPT which was embedded in a 12-week, multicomponent, school-based intervention for children delivered by school mental health clinicians. Outcomes included parent treatment adherence and child improvements in global impairment post-treatment. RESULTS Greater pre-treatment child organizational problems were associated with less parent treatment adherence regardless of ADHD symptom severity. Worse pre-treatment child ED was associated with more impairment post-treatment regardless of ADHD symptom severity whereas the effects of child ED on parent treatment adherence were moderated by child ADHD symptom severity. CONCLUSION The current study suggests that pre-treatment child ED and organizational difficulties impact parent treatment adherence to behavioral interventions targeting ADHD symptoms, potentially in unique ways, and should be considered in future BPT treatment studies.
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Affiliation(s)
| | | | - Sara Chung
- University of California, San Francisco, CA, USA
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4
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Karalunas SL, Dude J, Figuracion M, Lane SP. Momentary Dynamics Implicate Emotional Features in the ADHD Phenotype. Res Child Adolesc Psychopathol 2024:10.1007/s10802-024-01206-9. [PMID: 38771497 DOI: 10.1007/s10802-024-01206-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/22/2024]
Abstract
Emotional dysregulation is increasingly recognized as important to the attention-deficit/hyperactivity disorder (ADHD) phenotype alongside inattention and hyperactivity-impulsivity. Studies of ADHD have relied primarily on trait-based conceptualizations that emphasize stability of symptoms across moderate developmental timescales (i.e., months to years). Trait-based conceptualizations provide a critical view but fail to account for short-term dynamic variations in the expression of ADHD symptoms and emotion. This leaves a gap in our understanding of the short-term variation in ADHD symptom expression and the dynamic relationships among ADHD symptoms and emotion. Here, we assessed caregiver report of ADHD symptoms and positive and negative emotion using ecological momentary approaches over 2 weeks in a sample of 36 children with and without ADHD between the ages of 7-12 years old. Between-person (RKF) and within-person (RC) reliability were estimated. Multilevel models tested specific covariation hypotheses between ADHD symptoms and emotion. Analyses confirmed that ADHD and emotion ratings were reliable as individual differences (i.e., between-person; RKF range 0.93-1.0) and moment-to-moment change (i.e., within-person; Rc range 0.66-0.88) measures. Multilevel models found little evidence for lagged effects between domains, but consistently identified concurrent expression of ADHD symptoms and emotions; inattention covaried most strongly with negative emotion and hyperactivity-impulsivity covaried most strongly with positive emotion. Results demonstrate the importance of complementing trait-level conceptualizations with assessment of momentary dynamics. Momentary assessment suggests important covariation of ADHD symptoms and emotion as part of the ADHD phenotype.
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Affiliation(s)
| | - Jason Dude
- Washington University in Saint Louis, Saint Louis, MO, USA
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5
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McKay CC, De Jesus AV, Peterson O, Leibenluft E, Kircanski K. Cross-Sectional and Longitudinal Relations Among Irritability, Attention-Deficit/Hyperactivity Disorder Symptoms, and Inhibitory Control. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00003-0. [PMID: 38272350 DOI: 10.1016/j.jaac.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 09/29/2023] [Accepted: 01/16/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Irritability and attention-deficit/hyperactivity disorder (ADHD) symptoms frequently co-occur in youth. Although ADHD has been associated with inhibitory control deficits, the literature on irritability and inhibitory control is mixed. Examining how irritability, ADHD symptoms, and inhibitory control interrelate both cross-sectionally and longitudinally across development could shed light on common and distinct mechanisms of youth psychopathology. METHOD We utilized a cross-lagged panel model with data from 2 time points (at ages 10 and 12 years) of the Adolescent Brain and Cognitive Development (ABCD) Study (N = 7,444, or ∼63% of the baseline sample with full data at each time point) to test cross-sectional and longitudinal associations among parent-reported irritability and ADHD symptoms and behaviorally assessed inhibitory control. This was performed separately across discovery and replication subsamples, each n = 3,722. RESULTS As expected, irritability and ADHD symptoms exhibited strong cross-sectional and reciprocal cross-lagged associations. Higher ADHD symptoms at age 10 years were associated concurrently with poorer inhibitory control and predicted poorer inhibitory control at age 12. Contrary to predictions, inhibitory control was not significantly associated with irritability cross-sectionally, nor was it predictive of later irritability or ADHD symptoms. CONCLUSION These findings highlight strong links between irritability and ADHD. Although inhibitory control deficits were linked to ADHD and predictive of its symptom course, inhibitory control had no significant associations with irritability. Future research should investigate other candidate mechanisms of the co-occurrence of irritability and ADHD symptoms and predictors of their developmental trajectories.
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Affiliation(s)
- Cameron C McKay
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland.
| | - Alethea Vittali De Jesus
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Olivia Peterson
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Katharina Kircanski
- Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
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6
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Kember J, Stepien L, Panda E, Tekok-Kilic A. Resting-state EEG dynamics help explain differences in response control in ADHD: Insight into electrophysiological mechanisms and sex differences. PLoS One 2023; 18:e0277382. [PMID: 37796795 PMCID: PMC10553225 DOI: 10.1371/journal.pone.0277382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 05/12/2023] [Indexed: 10/07/2023] Open
Abstract
Reductions in response control (greater reaction time variability and commission error rate) are consistently observed in those diagnosed with attention-deficit/hyperactivity disorder (ADHD). Previous research suggests these reductions arise from a dysregulation of large-scale cortical networks. Here, we extended our understanding of this cortical-network/response-control pathway important to the neurobiology of ADHD. First, we assessed how dynamic changes in three resting-state EEG network properties thought to be relevant to ADHD (phase-synchronization, modularity, oscillatory power) related with response control during a simple perceptual decision-making task in 112 children/adolescents (aged 8-16) with and without ADHD. Second, we tested whether these associations differed in males and females who were matched in age, ADHD-status and ADHD- subtype. We found that changes in oscillatory power (as opposed to phase-synchrony and modularity) are most related with response control, and that this relationship is stronger in ADHD compared to controls. Specifically, a tendency to dwell in an electrophysiological state characterized by high alpha/beta power (8-12/13-30Hz) and low delta/theta power (1-3/4-7Hz) supported response control, particularly in those with ADHD. Time in this state might reflect an increased initiation of alpha-suppression mechanisms, recruited by those with ADHD to suppress processing unfavourable to response control. We also found marginally significant evidence that this relationship is stronger in males compared to females, suggesting a distinct etiology for response control in the female presentation of ADHD.
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Affiliation(s)
- Jonah Kember
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada
- Department of Child and Youth Studies, Brock University, St. Catharine’s, Ontario, Canada
| | - Lauren Stepien
- Department of Child and Youth Studies, Brock University, St. Catharine’s, Ontario, Canada
| | - Erin Panda
- Department of Child and Youth Studies, Brock University, St. Catharine’s, Ontario, Canada
| | - Ayda Tekok-Kilic
- Department of Child and Youth Studies, Brock University, St. Catharine’s, Ontario, Canada
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7
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Skymba HV, Shields AN, Rauch AA, Phillips MS, Bing-Canar H, Finley JCA, Khan H, Ovsiew GP, Durkin NM, Jennette KJ, Resch ZJ, Soble JR. Does comorbid depression impact executive functioning (EF) in adults diagnosed with ADHD?: a comparison of EF across diagnoses in clinically-referred individuals. J Clin Exp Neuropsychol 2023; 45:1-11. [PMID: 37083506 DOI: 10.1080/13803395.2023.2203464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
INTRODUCTION Executive functioning (EF) is a salient factor in both ADHD as well as depressive disorders. However, sparse literature has examined whether depression severity impacts EF concurrently among adults with ADHD. The goal of this study was to examine differences in EF between adult patients diagnosed with ADHD and those diagnosed with a non-ADHD primary psychopathological condition, as a function of both ADHD presentation and depression severity in a diverse clinical sample. METHOD This crosssectional study included 404 adult patients clinically referred for neuropsychological evaluation to assist with differential diagnosis and/or treatment planning related to known or suspected ADHD. Various EF tasks and a measure of depression severity were administered. One-way MANOVA analyses were conducted to compare EF performance between individuals diagnosed with ADHD or a non-ADHD primary psychopathological condition, with additional analyses examining group differences based on ADHD presentation and depression severity. Regression analyses also examined the potential contribution of depression severity to each EF measure within each group. RESULTS No significant EF performance differences were found when comparing individuals diagnosed with ADHD and those with a non-ADHD primary psychopathological condition, nor based on ADHD presentation. When comparing across groups using cut-offs for high or low depression, only one EF measure showed significant differences between groups. Further, depression severity generally did not predict reduced EF performances with the exception of verbal fluency and working memory performances in select groups. CONCLUSIONS This study demonstrated that individuals with ADHD generally perform comparably on EF measures regardless of the presence or absence of comorbid depression. These results suggest further examination of EF deficits when they emerge for adults with ADHD, especially beyond comorbid depression severity.
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Affiliation(s)
- Haley V Skymba
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Allison N Shields
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - Andrew A Rauch
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, Loyola University, Chicago, Illinois, USA
| | - Matthew S Phillips
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, The Chicago School of Professional Psychology, Chicago, Illinois, USA
| | - Hanaan Bing-Canar
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - John-Christopher A Finley
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, Northwestern University, Evanston, Illinois, USA
| | - Humza Khan
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Psychology, Illinois Institute of Technology, Chicago, Illinois, USA
| | - Gabriel P Ovsiew
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
| | - Nicole M Durkin
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
| | - Kyle J Jennette
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
| | - Zachary J Resch
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
| | - Jason R Soble
- Department of Psychiatry, University of Illinois College of Medicine, Urbana, Illinois, USA
- Department of Neurology, University of Illinois College of Medicine, Chicago, Illinois, USA
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8
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Karr JE, Rodriguez JE, Rast P, Goh PK, Martel MM. A Network Analysis of Executive Functions in Children and Adolescents With and Without Attention-Deficit/Hyperactivity Disorder. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01518-9. [PMID: 36890331 DOI: 10.1007/s10578-023-01518-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2023] [Indexed: 03/10/2023]
Abstract
This study applied network analysis to executive function test performances to examine differences in network parameters between demographically matched children and adolescents with and without attention-deficit/hyperactivity disorder (ADHD) (n = 141 per group; M = 12.7 ± 2.9 years-old; 72.3% boys, 66.7% White, 65.2% ≥ 12 years maternal education). All participants completed the NIH Toolbox Cognition Battery, including the Flanker, measuring inhibition, Dimensional Change Card Sort, measuring shifting, and List Sorting test, measuring working memory. Children with and without ADHD had comparable mean test performances (d range: .05-0.11) but presented with differences in network parameters. Among participants with ADHD, shifting was less central, had a weaker relationship with inhibition, and did not mediate the relationship between inhibition and working memory. These network characteristics were consistent with the executive function network structure of younger ages in prior research and may reflect an immature executive function network among children and adolescents with ADHD, aligning with the delayed maturation hypothesis.
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Affiliation(s)
- Justin E Karr
- Department of Psychology, University of Kentucky, 171 Funkhouser Drive, 012D Kastle Hall, Lexington, KY, 40506-0044, USA.
| | - Josue E Rodriguez
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - Philippe Rast
- Department of Psychology, University of California Davis, Davis, CA, USA
| | - Patrick K Goh
- Department of Psychology, University of Hawai'i at Manoa, Honolulu, Hawai'i, USA
| | - Michelle M Martel
- Department of Psychology, University of Kentucky, 171 Funkhouser Drive, 012D Kastle Hall, Lexington, KY, 40506-0044, USA
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9
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Ben-Dor Cohen M, Maeir A, Eldar E, Nahum M. Everyday Cognitive Control and Emotion Dysregulation in Young Adults With and Without ADHD: An Ecological Momentary Assessment Study. J Atten Disord 2023; 27:539-553. [PMID: 36779529 PMCID: PMC9978869 DOI: 10.1177/10870547231153934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVE This study examined the contribution of the temporal dynamics of two cognitive control mechanisms-inhibitory control (IC) and working memory (WM)-to emotion dysregulation (ED) in attention-deficit/hyperactivity disorder (ADHD) in ecological settings. METHOD One hundred twenty-two participants (age 18-33 years; 60 with ADHD) reported their ED at baseline, followed by a 5-day ecological momentary assessment (EMA) study, with short behavioral IC and WM tasks performed five times/day. RESULTS For IC, mean and lability of performance over EMA significantly accounted for differences in ED but not baseline performance. For WM, both baseline and mean of EMA, but not EMA lability, accounted for ED variance. ADHD status further contributed to the explained variance of ED. CONCLUSIONS Our results support the contribution of dynamic IC processes to ED in ADHD, in addition to WM performance level, and highlight the importance of dynamic and ecological investigation of different cognitive control components.
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Affiliation(s)
| | - Adina Maeir
- Hebrew University of Jerusalem,
Jerusalem, Israel
| | - Eran Eldar
- Hebrew University of Jerusalem,
Jerusalem, Israel
| | - Mor Nahum
- Hebrew University of Jerusalem,
Jerusalem, Israel,Mor Nahum, Faculty of Medicine, School of
Occupational Therapy, Hebrew University, Mt Scopus Campus, Jerusalem 9190501,
Israel.
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10
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Soler-Gutiérrez AM, Pérez-González JC, Mayas J. Evidence of emotion dysregulation as a core symptom of adult ADHD: A systematic review. PLoS One 2023; 18:e0280131. [PMID: 36608036 PMCID: PMC9821724 DOI: 10.1371/journal.pone.0280131] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 12/21/2022] [Indexed: 01/07/2023] Open
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder, with an onset in childhood, that accompanies the person throughout their life, with prevalence between 3 and 5% in adults. Recent studies point towards a fourth core symptom of the disorder related to the emotional information processing that would explain the repercussions that ADHD has on the social, academic, and professional life of the people affected. This review aims to describe emotion dysregulation features as well as the brain activity associated in adults with ADHD. A search of the scientific literature was launched in specialized databases: PsycInfo, Medline, Eric, PsycArticle, Psicodoc and Scopus, following PRISMA guidelines. Twenty-two articles met the inclusion criteria: (a) an ADHD clinical diagnosis, (b) participants over 18 years old, (c) emotion regulation measurement, (d) empirical studies, and (c) in English. Due to the heterogeneity of the studies included, they were classified into three sections: measures and features of emotion regulation (ER) in people with ADHD, neurological and psychophysiological activity related to ER, and treatments. The studies found that meet the selection criteria are scarce and very heterogeneous both in aims and in sample features. Adults with ADHD show a more frequent use of non-adaptive emotion regulation strategies compared to people without ADHD symptoms. Moreover, emotion dysregulation was associated with symptom severity, executive functioning, psychiatric comorbidities, and even with criminal conviction. Different patterns of brain activity were observed when people with and without ADHD were compared. These results may suggest that psychopharmacological treatments as well as behavioral therapies could be useful tools for improving emotional difficulties in adult ADHD.
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Affiliation(s)
- Ana-María Soler-Gutiérrez
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- Escuela Internacional de Doctorado de la UNED (EIDUNED), Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
| | | | - Julia Mayas
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
- * E-mail:
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11
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Zainal NH, Newman MG. Executive Functioning Constructs in Anxiety, Obsessive-Compulsive, Post-Traumatic Stress, and Related Disorders. Curr Psychiatry Rep 2022; 24:871-880. [PMID: 36401677 PMCID: PMC9676877 DOI: 10.1007/s11920-022-01390-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE OF REVIEW We synthesize theories proposing complex relations between cognitive functioning and anxiety-related concepts. We evaluate vulnerability theories suggesting that deficits in various cognitive functioning domains predict future anxiety-associated concepts. We examine scar theories asserting the opposite direction of effects (i.e., anxiety predicting cognitive dysfunction). Furthermore, we examine more novel frameworks on this topic. RECENT FINDINGS Reliable evidence exists for the scar and vulnerability theories. This includes mounting data on diverse anxiety symptoms predicting cognitive dysfunction (and conversely) unfolding at between- and within-person levels (dynamic mutualism theory). It also includes data on the stronger effects or central influence of anxiety (versus non-anxiety) symptoms on executive functioning (EF; i.e., higher-order cognitive control governing myriad thinking and action repertoires) versus non-EF domains and vice versa (network theory). In addition, it reviews emerging evidence that enhanced cognitive control can correlate with higher anxiety among children (overgeneralized control theory). The generally inverse relations between anxiety symptoms and cognitive dysfunction are bidirectional and complex within and between persons. Plausible mediators and moderators merit more attention, including immune, metabolism, and neural markers and the social determinants of health.
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Affiliation(s)
| | - Michelle G Newman
- The Pennsylvania State University, 371 Moore Building, University Park, PA, 16802, USA.
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12
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Liu L, Wang Y, Chen W, Gao Y, Li H, Wang Y, Chan RCK, Qian Q. Network analysis of 18 attention-deficit/hyperactivity disorder symptoms suggests the importance of " Distracted" and " Fidget" as central symptoms: Invariance across age, gender, and subtype presentations. Front Psychiatry 2022; 13:974283. [PMID: 36339870 PMCID: PMC9633674 DOI: 10.3389/fpsyt.2022.974283] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
The network theory of mental disorders conceptualizes psychiatric symptoms as networks of symptoms that causally interact with each other. Our present study aimed to explore the symptomatic structure in children with attention-deficit/hyperactivity disorder (ADHD) using network analyses. Symptom network based on 18 items of ADHD Rating Scale-IV was evaluated in 4,033 children and adolescents with ADHD. The importance of nodes was evaluated quantitatively by examining centrality indices, including Strength, Betweenness and Closeness, as well as Predictability and Expected Influence (EI). In addition, we compared the network structure across different subgroups, as characterized by ADHD subtypes, gender and age groups to evaluate its invariance. A three-factor-community structure was identified including inattentive, hyperactive and impulsive clusters. For the centrality indices, the nodes of "Distracted" and "Fidget" showed high closeness and betweenness, and represented a bridge linking the inattentive and hyperactive/impulsive domains. "Details" and "Fidget" were the most common endorsed symptoms in inattentive and hyperactive/impulsive domains respectively. On the contrary, the "Listen" item formed a peripheral node showing weak links with all other items within the inattentive cluster, and the "Loss" item as the least central node by all measures of centrality and with low predictability value. The network structure was relatively invariant across gender, age and ADHD subtypes/presentations. The 18 items of ADHD core symptoms appear not equivalent and interchangeable. "Distracted" and "Fidget" should be considered as central, or core, symptoms for further evaluation and intervention. The network-informed differentiation of these symptoms has the potentials to refine the phenotype and reduce heterogeneity.
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Affiliation(s)
- Lu Liu
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wai Chen
- Mental Health Service, Fiona Stanley Hospital, Perth, WA, Australia.,Curtin Medical School, Curtin University, Perth, WA, Australia.,Curtin enAble Institute, Curtin University, Bentley, WA, Australia.,Graduate School of Education, University of Western Australia, Perth, WA, Australia.,School of Medicine, University of Notre Dame Australia, Fremantle, WA, Australia.,School of Psychology, Murdoch University, Perth, WA, Australia
| | - Yuan Gao
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Haimei Li
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Yufeng Wang
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qiujin Qian
- Peking University Sixth Hospital/Institute of Mental Health, Beijing, China.,National Clinical Research Center for Mental Disorders, Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, China
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