Sustained attention and behavioral characteristics associated with ADHD in adults

Selective attention and sensitivity to auditory disturbances in a virtually-real Classroom: Comparison of adults with and without AD(H)D

Many people, and particularly individuals with Attention Deficit (Hyperactivity) Disorder (AD(H)D), find it difficult to maintain attention during classroom learning. However, traditional paradigms used to evaluate attention do not capture the complexity and dynamic nature of real-life classrooms. Using a novel Virtual Reality platform, coupled with measurement of neural activity, eye-gaze and skin conductance, here we studied the neurophysiological manifestations of attention and distractibility, under realistic learning conditions. Individuals with AD(H)D exhibited higher neural responses to irrelevant sounds and reduced speech tracking of the teacher, relative to controls. Additional neurophysiological measures, such the power of alpha-oscillations and frequency of gaze-shifts away from the teacher, contributed to explaining variance in self-reported AD(H)D symptoms across the sample. These ecologically-valid findings provide critical insight into the neurophysiological mechanisms underlying individual differences in the capacity for sustained attention and the proneness to distraction and mind-wandering, experienced in real-life situations.

Comparison of Cold and Cool Cognition in Children With and Without Attention Deficit-Hyperactivity Disorder (ADHD)

Children with ADHD suffer from impaired attentional, executive, and emotional processing. This study aimed to compare attentional and executive processing using (non)emotional stimuli in children with and without ADHD. Eighty-five children with ADHD and 72 matched typically developing children performed the Stroop, continuous performance, and Go/No-Go tasks using (non)emotional stimuli. Greater performance in selective attention, inhibitory control, and sustained attention was found in emotional stimuli compared to non-emotional stimuli in both groups. Emotional stimuli facilitated attentional and executive functions in children with and without ADHD. Impaired attentional and executive functions in children with ADHD are not valence-sensitive.

Executive Functioning, Internalizing and Externalizing Symptoms: Understanding Developmental Dynamics Through Panel Network Approaches

Objective

Early adolescence is a transition period during which many mental health disorders emerge. The interplay between different internalizing and externalizing mental health problems in adolescence is poorly understood at the within-person level. Executive functioning (EF) in early adolescence has been shown to constitute a transdiagnostic risk factor, but the specificity of the associations between different domains of EF and mental health problems remains unclear.

Method

Network dynamics (ie, temporal effects) of different internalizing and externalizing symptoms were investigated leveraging data from the Tracking Adolescents' Individual Lives Survey (TRAILS), a large longitudinal panel study of adolescents (>1,641 participants) assessed at ages 11, 13, and 15. Two novel methodological panel network approaches were used: cross-lagged panel network models and graphical vector autoregressive models. Hierarchical regression models were used to investigate prospective associations between different measures of EF and broadband transdiagnostic dimensions.

Results

Depressive problems predicted a range of other internalizing symptoms (ie, panic, somatic problems, separation anxiety, general anxiety, social phobia) over time, particularly during early adolescence. Important feedback loops with reciprocal associations between different anxiety symptoms were identified. Different facets of EF assessed at age 11, particularly sustained attention, showed weak but significant prospective associations with internalizing and externalizing symptoms at age 13.

Conclusion

The present findings emphasize the importance of targeting depressive problems in early adolescence to prevent a spiral of different internalizing symptoms from arising later on.

Young Adult ADHD Symptoms in the General Population and Neurocognitive Impairment

OBJECTIVE

Neurocognitive impairments are associated with child and adult ADHD in clinical settings. However, it is unknown whether adult ADHD symptoms in the general population are associated with the same pattern of cognitive impairment. We examined this using a prospective, population-based cohort spanning birth to age 25 years.

METHODS

We examined associations between self-reported adult ADHD symptoms and cognitive task performance (attention and response inhibition) in adulthood and childhood.

RESULTS

Self-rated ADHD symptoms at age 25 were associated with poorer performance in age 25 cognitive tasks capturing ADHD-related functioning (attention B = -0.03, 95% CI [0.05, -0.01], p = .005; response inhibition B = -0.03, 95% CI [-0.05, -0.01], p = .002).

CONCLUSIONS

Neurocognitive impairments linked to adult ADHD symptoms in the general population, are similar to those found in people with childhood ADHD symptoms and are consistent with findings in adult ADHD clinical samples.

Does the Number of Stimuli Influence the Formation of the Endogenous Components of the Event-Related Auditory Evoked Potentials?

Introduction  The number of stimuli is important to determine the quality of auditory evoked potential records. However, there is no consensus on that number in studies, especially in the sample studied. Objectives  To investigate the influence of the number of rare stimuli on forming N2 and P3 components, with different types of acoustic stimuli. Methods  Cross-sectional, descriptive, comparative study, approved by the ethics committee of the institution. The sample comprised 20 normal hearing adults of both sexes, aged 18 to 29 years old, with normal scores in the mental state examination and auditory processing skills. The event-related auditory evoked potentials were performed with nonverbal (1 kHz versus 2 kHz) and verbal stimuli (/BA/ versus /DA/). The number of rare stimuli varied randomly in the recordings, with 10, 20, 30, 40, and 50 presentations. Results  P3 latency was significantly higher for nonverbal stimuli with 50 rare stimuli. N2 latency did not show any difference between the type and number of stimuli. The absolute P3 and N2-P3 amplitudes showed significant differences for both types of stimuli, with higher amplitude for 10 rare stimuli, in contrast with the other ones. The linear tendency test indicated significance only for the amplitude - as the number of rare stimuli increased, the amplitude tended to decrease. Conclusion  The components were identifiable in the different numbers of rare stimuli and types of stimuli. The P3 and N2-P3 latency and amplitude increased with fewer verbal and nonverbal stimuli. Recording protocols must consider the number of rare stimuli.

Is the deficit in attention-deficit/hyperactivity disorder a concentration deficit?

Attention-deficit/hyperactivity disorder (ADHD) is comprised of two behavioral clusters of symptoms, inattention and hyperactivity/impulsivity. Numerous studies have attempted to address the underlying neuropsychological mechanism of ADHD. However, there is still no uniform mechanism that can fully explain both inattention and hyperactivity/impulsivity symptoms. This review describes the research findings that have shifted the focus from cognitive selective attention to executive function deficits and notes that the prominence of the attention deficit remains unclear. As ADHD is not consistently explained by cognitive selective attention but rather with cognitive sustained attention/vigilance and executive function deficits, this review suggests that concentration deficit is likely the cause of inattention symptoms. Indeed, considering concentration deficit as the cause of inattention symptoms may better describe the underlying difficulties of maintaining and controlling attention in ADHD. In addition, as concentration, impulsivity, and hyperactivity may share a common cognitive deficit, this shift in focus may help in identifying a single mechanism for all ADHD symptoms.

Short form Conners' Adult ADHD Rating Scales: Factor structure and measurement invariance by sex in emerging adults

INTRODUCTION

The short version of the Conners' Adult ADHD Rating Scales (CAARS-S:S) is a self-report measure used to identify symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) during adulthood. However, its psychometric properties specifically in emerging adults, or the transitional age group between adolescence and adulthood, remain understudied. This study aimed to validate the factor structure of the CAARS-S:S in a sample of emerging adults.

METHOD

The CAARS-S:S measure was completed by adults (n = 591) aged 18 to 29 located in English-speaking countries, including Australia, Canada and the United States. Confirmatory factor analysis was used to test a four-factor model of Inattention/Memory Problems, Hyperactivity/Restlessness, Impulsivity/Emotional Lability and Problems with Self-Concept, as well as the model's invariance by sex. Sex was also included as a covariate in the model to examine differences in males' and females' scores on each factor.

RESULTS

Overall, the four-factor structure fit the data and was invariant across males and females. All factors demonstrated high internal reliability (average ωt and α = .86). It was observed that males tended to score higher on Inattention/Memory Problems while females scored higher on Problems with Self-Concept.

CONCLUSION

This research establishes the psychometric properties of the CAARS-S:S, placing greater confidence in using it to screen for ADHD symptoms in emerging adults living in a Westernized cultural context. The detailed findings of this research, implications for the use of the CAARS-S:S in this age group and potential future directions for examining the properties of the measure are discussed.

Near and Far Transfer Effects of Computerized Progressive Attention Training (CPAT) Versus Mindfulness Based Stress Reduction (MBSR) Practice Among Adults With ADHD

OBJECTIVE

The present study evaluated the near (attention) and far (reading, ADHD symptoms, learning, and quality of life) transfer effects of a Computerized Progressive Attention Training (CPAT) versus Mindfulness Based Stress Reduction (MBSR) practice among adults with ADHD compared to a passive group.

METHOD

Fifty-four adults participated in a non-fully randomized controlled trial. Participants in the intervention groups completed eight 2-hr weekly training sessions. Outcomes were assessed before, immediately after, and 4 months post-intervention, using objective tools: attention tests, eye-tracker, and subjective questionnaires.

RESULTS

Both interventions showed near-transfer to various attention functions. The CPAT produced far-transfer effects to reading, ADHD symptoms, and learning while the MBSR improved the self-perceived quality of life. At follow-up, all improvements except for ADHD symptoms were preserved in the CPAT group. The MBSR group showed mixed preservations.

CONCLUSION

Both interventions have beneficial effects, however only the CPAT group exhibited improvements compared to the passive group.

Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements

BACKGROUND

Cognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD.

AIMS

Gauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load.

METHODS AND PROCEDURES

Twenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked.

OUTCOMES AND RESULTS

In the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD.

CONCLUSIONS AND IMPLICATIONS

ADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. WHAT THIS PAPER ADDS?: We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.

Sex differences in the sustained attention of elementary school children

BACKGROUND

The study investigates sex differences in sustained attention among children.

METHODS

Forty-five children (23 girls) from Grades 2-5 (mean age of 7.47 ± 0.73 years) wore an actigraph for a continuous five to seven days including school and non-school days. Sustained attention using the psychomotor vigilance test (PVT) was measured twice a day on two school days and on one non-school day.

RESULTS

No sex differences were found for sleep patterns. However, sex differences in PVT performance were documented. While boys were faster (shorter reaction time) and showed fewer lapses than girls, they showed higher number of false starts than girls, on both weekdays and weekends.

CONCLUSIONS

The findings suggest that sex differences should been taken into account in studies investigating neurobehavioral functioning, particularly, sustained attention across various age groups.

Personal Values and Sustained Attention as Predictors of Children's Helping Behavior in Middle Childhood

OBJECTIVE

This study tested the effect of personal values (motivation) and sustained attention (cognitive ability) on children's helping behavior.

METHOD

Children (N = 162, age range 8-9 years, mean = 8.81, SD =.43) completed value ranking and go/no-go tasks, and their helping behavior was examined.

RESULTS

Children who valued self-transcendence over self-enhancement helped more than others. Surprisingly, children's lack of sustained attention was associated with more helping among those who valued self-transcendence over self-enhancement or openness-to-change over conservation values. Valuing both self-transcendence and openness-to-change was also associated with more helping.

CONCLUSIONS

Children are more likely to help others if they value self-transcendence and openness to change. Notably, children's tendency to act upon these values may be facilitated (rather than obstructed by) low attention skills.

Circadian Effects on Attention and Working Memory in College Students With Attention Deficit and Hyperactivity Symptoms

Objective

Individuals with an evening chronotype prefer to sleep later at night, wake up later in the day and perform best later in the day as compared to individuals with morning chronotype. Thus, college students without ADHD symptoms with evening chronotypes show reduced cognitive performance in the morning relative to nighttime (i.e., desynchrony effect). In combination with symptoms presented in attention deficit hyperactivity disorder (ADHD), we predicted that having evening chronotype renders impairment in attention during the morning, when students require optimal performance, amplifying desynchrony.

Method

Four hundred college students were surveyed for evening chronotype and symptoms of ADHD. Of those surveyed, 43 students with evening chronotype (19 with ADHD symptoms) performed laboratory attention tasks and were queried about fatigue during morning and evening sessions.

Results

Students with ADHD symptoms demonstrated a greater decrement in sustained attentional vigilance when abstaining from stimulants and asked to perform cognitive tests at times misaligned with natural circadian rhythms in arousal compared to their non-ADHD counterparts with the same chronotype. While individuals with ADHD symptoms had slower reaction-times during sustained attention tasks in the morning session compared to those without symptoms, there was no significant group difference in working memory performance, even though both groups made more errors in the morning session compared to the evening session.

Conclusion

These findings suggest that evening chronotype students with ADHD symptoms are at a greater disadvantage when having to perform sustained attention tasks at times that are not aligned to their circadian rhythm compared to their neuro-typical peers. The implications of this finding may be useful for the provision of disability accommodations to college age students with ADHD when they are expected to perform tasks requiring sustained attention at times misaligned with their circadian rhythms.

Personality Traits and Body Weight Measures: Concurrent and Across–Time Associations

We tested the possibility that the five–factor model of personality is associated with three measures of body weight and with changes in their levels over time and that these associations are gender specific. The study was conducted at two points of time, Time 1 (2664 participants) and Time 2 (1492 participants), over approximately 4 years, controlling for gender, age, education, and having a chronic disease. Body weight was assessed by body mass index, waist circumference, waist–to–hip ratio, and the five–factor model by Saucier's Mini–Markers. Cross–sectional regression results indicated that conscientiousness was negatively associated with the three body weight measures, whereas neuroticism and extraversion were positively associated with the three body weight measures. The longitudinal regression results indicate that extraversion was associated with an increase in two of the body weight measures. Neuroticism was associated with increase in all three body weight measures and more strongly for women than for men. Openness was associated with a decrease in all three body weight measures for women, but this association was not significant for men. These findings help identify personality traits that lead to risk of weight gain and point to the modifying role of gender. Copyright © 2013 John Wiley & Sons, Ltd.

A novel dopamine D3R agonist SK609 with norepinephrine transporter inhibition promotes improvement in cognitive task performance in rodent and non-human primate models of Parkinson's disease

Mild cognitive impairment is present in a number of neurodegenerative disorders including Parkinson's disease (PD). Mild cognitive impairment in PD (PD-MCI) often manifests as deficits in executive functioning, attention, and spatial and working memory. Clinical studies have suggested that the development of mild cognitive impairment may be an early symptom of PD and may even precede the onset of motor impairment by several years. Dysfunction in several neurotransmitter systems, including dopamine (DA), norepinephrine (NE), may be involved in PD-MCI, making it difficult to treat pharmacologically. In addition, many agents used to treat motor impairment in PD may exacerbate cognitive impairment. Thus, there is a significant unmet need to develop therapeutics that can treat both motor and cognitive impairments in PD. We have recently developed SK609, a selective, G-protein biased signaling agonist of dopamine D3 receptors. SK609 was successfully used to treat motor impairment and reduce levodopa-induced dyskinesia in a rodent model of PD. Further characterization of SK609 suggested that it is a selective norepinephrine transporter (NET) inhibitor with the ability to increase both DA and NE levels in the prefrontal cortex. Pharmacokinetic analysis of SK609 under systemic administration demonstrated 98% oral bioavailability and high brain distribution in striatum, hippocampus and prefrontal cortex. To evaluate the effects of SK609 on cognitive deficits of potential relevance to PD-MCI, we used unilateral 6-hydroxydopamine (6-OHDA) lesioned rats and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated cynomolgus macaques, with deficits in performance in a sustained attention and an object retrieval task, respectively. SK609 dose dependently improved the performance of 6-OHDA-lesioned rats, with peak performance achieved using a 4 mg/kg dose. This improvement was predominantly due to a significant reduction in the number of misses and false alarm errors, contributing to an increase in sustained attention. In MPTP-lesioned monkeys, this same dose also improved performance in an object retrieval task, significantly reducing cognitive errors (barrier reaches) and motor errors (fine motor dexterity problems). These data demonstrate that SK609 with its unique pharmacological effects on modulating both DA and NE can ameliorate cognitive impairment in PD models and may provide a therapeutic option to treat both motor and cognitive impairment in PD patients.

Longitudinal Trajectories of Sustained Attention Development in Children and Adolescents with ADHD

The present study characterizes changes in sustained attention ability over ages 9-14, and whether longitudinal trajectories of attention development differ between persistent ADHD, remitted ADHD and control groups. The Sustained Attention to Response Task (SART) was administered to 120 children with ADHD and 123 controls on three occasions between ages 9 and 14. Trajectories of sustained attention development, indicated by changes in SART performance (standard deviation of response time [SDRT], omission errors, and ex-Gaussian parameters sigma and tau), were examined using generalized additive mixed models. For all measures there was a significant main effect of age; response time variability and number of omission errors improved linearly as children aged. However, children with ADHD had significantly greater SDRT, tau and omission errors than controls across waves. There were no significant group differences in sigma, indicating that the greater overall response time variability (SDRT) observed in ADHD was likely driven by more intermittent long responses (larger tau). Trajectories of sustained attention performance did not differ between children with persistent ADHD or ADHD in remission. Longitudinal trajectories of sustained attention development are comparable between ADHD and controls, however children with ADHD (regardless of remission status) display a performance deficit equivalent to typical controls 1-3 years younger. Findings highlight the need for continued clinical support for children in remission from ADHD and provide support for tau as an endophenotype of ADHD.

Childhood Adversity and Dimensional Variations in Adult Sustained Attention

Background and Objective

Sustained attention is a transdiagnostic phenotype linked with most forms of psychopathology. We sought to understand factors that influence the development of sustained attention, by looking at the relationship between childhood adversity and adult sustained attention.

Participants, Setting, and Methods

Participants were 5,973 TestMyBrain.org visitors from English-speaking countries who completed a continuous performance task (gradCPT) of sustained attention and a childhood adversity questionnaire. We analyzed gradCPT performance using a signal detection approach.

Results

Discrimination ability (the main metric of performance on the gradCPT) was associated with total childhood adversity load, even when controlling for covariates related to age, gender, parental education, race, country of origin, and relative socioeconomic status (β = −0.079, b = −0.032).

Conclusion

Our results demonstrate that attention differences related to childhood adversity exposure can (1) be measured using brief, performance-based measures of sustained attention, (2) persist into adulthood, and (3) be detected at the population level. These results, paired with the well-documented associations between sustained attention and psychopathology, indicate that sustained attention may be an important mechanism for understanding early influences on mental health.

The Dynamics of Attention Shifts Among Concurrent Speech in a Naturalistic Multi-speaker Virtual Environment

Focusing attention on one speaker on the background of other irrelevant speech can be a challenging feat. A longstanding question in attention research is whether and how frequently individuals shift their attention towards task-irrelevant speech, arguably leading to occasional detection of words in a so-called unattended message. However, this has been difficult to gauge empirically, particularly when participants attend to continuous natural speech, due to the lack of appropriate metrics for detecting shifts in internal attention. Here we introduce a new experimental platform for studying the dynamic deployment of attention among concurrent speakers, utilizing a unique combination of Virtual Reality (VR) and Eye-Tracking technology. We created a Virtual Café in which participants sit across from and attend to the narrative of a target speaker. We manipulated the number and location of distractor speakers by placing additional characters throughout the Virtual Café. By monitoring participant's eye-gaze dynamics, we studied the patterns of overt attention-shifts among concurrent speakers as well as the consequences of these shifts on speech comprehension. Our results reveal important individual differences in the gaze-pattern displayed during selective attention to speech. While some participants stayed fixated on a target speaker throughout the entire experiment, approximately 30% of participants frequently shifted their gaze toward distractor speakers or other locations in the environment, regardless of the severity of audiovisual distraction. Critically, preforming frequent gaze-shifts negatively impacted the comprehension of target speech, and participants made more mistakes when looking away from the target speaker. We also found that gaze-shifts occurred primarily during gaps in the acoustic input, suggesting that momentary reductions in acoustic masking prompt attention-shifts between competing speakers, in line with "glimpsing" theories of processing speech in noise. These results open a new window into understanding the dynamics of attention as they wax and wane over time, and the different listening patterns employed for dealing with the influx of sensory input in multisensory environments. Moreover, the novel approach developed here for tracking the locus of momentary attention in a naturalistic virtual-reality environment holds high promise for extending the study of human behavior and cognition and bridging the gap between the laboratory and real-life.

Cognitive consequences of timeframe bias. On the link between working memory, cognitive switching, and time perspective

The present study examined how time perspective is associated with working memory updating and cognitive switching. Additionally, stress states and mood as potential mediators of the relationship between time perspective and cognitive performance were analysed. During two sessions participants (n = 200) completed a set of questionnaires measuring time perspective, task-related stress states, and mood. Moreover, in two separate sessions they performed working memory updating and switching tasks. The results indicated that two time perspectives, i.e. Present Fatalism and Past Positive, were associated with updating. Furthermore, mediation analysis showed that positive mood accounted for these relationships. Specifically, Present Fatalism was correlated with low positive mood and in turn, worse working memory scores, whereas Past Positive was associated with high positive mood leading to better performance on the working memory task. None of the time perspective dimensions correlated with cognitive switching. These findings shed more light on the cognitive consequences of timeframe bias and suggest new approaches in research on time perspective and cognitive functioning.

Sustained attention in sensory modulation disorder and attention deficit/hyperactivity disorder

BACKGROUND

There are high comorbidity rates between sensory modulation disorder (SMD) and attention deficit hyperactivity disorder (ADHD). Knowledge regarding the objective neuropsychological differentiation between them is scarce.

AIM

This study examines the effects of SMD and ADHD on a sustained attention task with and without aversive auditory conditions.

METHOD

Sixty six young adult females were tested on the Conjunctive - Continuous Performance Task-Visual (CCPT-V) measuring sustained attention, under two conditions: 1) aversive condition (with the three most aversive sounds chosen by the participant), and 2) non-aversive condition (without sounds).

RESULTS

Both the SMD and ADHD factors exhibited performance deficits in the sustained attention task. All study participants performed worse on both sustained attention and speed of processing when aversive sounds were present.

CONCLUSION

We conclude that impaired sustained attention cannot differentiate between SMD and ADHD. Hence, these results should be taken under consideration in the assessment process of ADHD vs. SMD.

The complexity of the interaction between binge-eating and attention

OBJECTIVE

To investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits.

METHODS

We studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored.

RESULTS

Patients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits.

CONCLUSION

Binge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.

The origin of the centrality deficit in individuals with attention-deficit/hyperactivity disorder

INTRODUCTION

Studies have shown that skilled and disabled readers recall central ideas, which are important to the overall comprehension of the text, to a greater extent than peripheral, less important ideas after reading. However, readers with attention-deficit/hyperactivity disorder (ADHD) recall significantly fewer central ideas than skilled readers. The present study was designed to examine whether difficulties in identifying, attending, and/or retrieving central ideas underlie their centrality deficit.

METHOD

28 adult university students with ADHD and 27 control students read three expository texts (successively) to summarize their central ideas, while their eye-movements were recorded. After reading, the participants recalled, recognized, and estimated the centrality level of all text ideas, which were divided into central and peripheral based on pretest ratings.

RESULTS

The participants with ADHD recalled fewer central ideas than controls, although they recognized and estimated their centrality to the same extent as controls. Moreover, the participants with ADHD invested more time in rereading central ideas than peripheral ones, to a greater extent than controls.

CONCLUSIONS

The eye-movement data suggest that our university students with ADHD were aware of the reading task requirements, their difficulties, and the appropriate strategies for coping with them (i.e., rereading central ideas). More importantly, the present findings suggest that readers with ADHD have specific difficulty in retrieving central ideas that are available in their long-term memory. It supports the hypothesis that readers with ADHD establish fewer connections between text ideas during reading, and consequently benefit from a reduced number of retrieval cues after reading.

Sustained attention in adult ADHD: time-on-task effects of various measures of attention

Neuropsychological research on adults with ADHD showed deficits in various aspects of attention. However, the majority of studies failed to explore the change of performance over time, so-called time-on-task effects. As a consequence, little is known about sustained attention performance of adults with ADHD. The aim of the present study was therefore to test the hypothesis of sustained attention deficits of adults with ADHD. Twenty-nine adults with ADHD and 30 healthy individuals were assessed on four 20-min tests of sustained attention, measuring alertness, selective attention, divided attention and flexibility. The deterioration of performance over time (time-on-task effects) was compared between patients with ADHD and healthy individuals to conclude on sustained attention performance. Compared to healthy individuals, patients with ADHD showed significant deficits of medium size in selective attention and divided attention. Furthermore, medium sustained attention deficits was observed in measures of alertness, selective attention and divided attention. This study supports the notion of sustained attention deficits of adults with ADHD.

Online inferential and textual processing by adolescents with attention-deficit/hyperactivity disorder during reading comprehension: Evidence from a probing method

INTRODUCTION

Previous studies have demonstrated that students with attention-deficit/hyperactivity disorder (ADHD) struggle particularly with grasping the implicit, inferential level of narratives that is crucial for story comprehension. However, these studies used offline tasks (i.e., after story presentation), used indirect measurements (e.g., identifying main ideas), and/or yielded inconclusive results using think-aloud techniques. Moreover, most studies were conducted with preschool or elementary school children with ADHD, using listening or televised story comprehension. In this study, we were interested in examining the spontaneous, immediate activation and/or suppression of forward-predictive inferences, backward-explanatory inferences, and inference-evoking textual information, as they occur online during reading comprehension by adolescents with ADHD.

METHOD

Participants with and without ADHD read short narrative texts, each of which included a predictive sentence, a bridging sentence that referred back to the predictive sentence via actualization of the predicted event, and two intervening sentences positioned between the predictive and bridging sentences that introduced a temporary transition from the main (predictive) episode. Activation and suppression of inferential and/or textual information were assessed using naming times of word probes that were implied by the preceding text, explicitly mentioned in it, or neither when following control texts. In some cases, a true-false inferential or textual question followed the probe.

RESULTS

Naming facilitations were observed for the control but not for the ADHD group, in responding to inference probes that followed the predictive and bridging sentences, and to text probes that followed the predictive sentences. Participants with ADHD were accurate, albeit slower, than controls in answering the true-false questions.

CONCLUSIONS

Adolescents with ADHD have difficulties in generating predictive and explanatory inferences and in retaining relevant textual information in working memory while reading, although they can answer questions after reading when texts are relatively short. These findings are discussed with regard to development of comprehension strategies for individuals with ADHD.

Neurofeedback Therapy for Enhancing Visual Attention: State-of-the-Art and Challenges

We have witnessed a rapid development of brain-computer interfaces (BCIs) linking the brain to external devices. BCIs can be utilized to treat neurological conditions and even to augment brain functions. BCIs offer a promising treatment for mental disorders, including disorders of attention. Here we review the current state of the art and challenges of attention-based BCIs, with a focus on visual attention. Attention-based BCIs utilize electroencephalograms (EEGs) or other recording techniques to generate neurofeedback, which patients use to improve their attention, a complex cognitive function. Although progress has been made in the studies of neural mechanisms of attention, extraction of attention-related neural signals needed for BCI operations is a difficult problem. To attain good BCI performance, it is important to select the features of neural activity that represent attentional signals. BCI decoding of attention-related activity may be hindered by the presence of different neural signals. Therefore, BCI accuracy can be improved by signal processing algorithms that dissociate signals of interest from irrelevant activities. Notwithstanding recent progress, optimal processing of attentional neural signals remains a fundamental challenge for the development of efficient therapies for disorders of attention.

Semantic conflicts are resolved differently by adults with and without ADHD

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder characterized by various behavioral and cognitive difficulties. Previous studies indicated that children with ADHD have language difficulties, including difficulties in metaphor understanding but the relation between metaphor processing and specific cognitive functions needs further investigation. In the current study we examined how adults with and without ADHD resolve semantic conflicts between a metaphorical prime and a metaphorical or literal target sentence. Twenty-six adults with ADHD and 24 age-matched control participants underwent a thorough evaluation of neuropsychological skills, as well as assessment of various aspects of attention. Results suggested that people with ADHD were less efficient than controls in resolving conflicts between metaphorical and literal meanings of sentence pairs. In addition they showed deficient sustained attention and executive attention. Moreover, the ability to resolve semantic conflicts was related to semantic fluency in the ADHD group, but to executive attention in the control group. These findings emphasize the various specific difficulties of adults with ADHD and shed light on the different role of attention in the resolution of semantic conflicts among ADHD individuals as compared to controls.

The impact of acute tryptophan depletion on attentional performance in adult patients with ADHD

OBJECTIVE

To date, the impact of the neurotransmitter serotonin (5-HT) on different neuropsychological functions in adults with attention deficit hyperactivity disorder (ADHD) is underinvestigated. We aimed to examine the effects of acute tryptophan depletion (ATD) and the resulting reduction in central nervous 5-HT synthesis on target/non-target discrimination ability and sustained attention in adults with ADHD using an AX-Continuous Performance Test (AX-CPT).

METHOD

Twenty male patients with ADHD (age: M = 30.25 SD = 9.37) and twenty male healthy controls (age: M = 27.90 SD = 6.01) received ATD on one day and a tryptophan-balanced control condition (BAL) on another day in a double-blind within-subject crossover design. A continuous performance test (AX-CPT) with three conditions (AX, AY, and BX) was administered on both days under depleted and sham-depleted conditions.

RESULTS

In patients omissions increased after ATD when compared with BAL. Patient's reaction time decreased after ATD when compared with BAL, which was contrasted by opposite effects in controls. Patients showed fewer correct responses (AX condition) and showed a higher rate of errors (condition AXE ) independent of ATD or BAL intake.

CONCLUSION

The present preliminary results are indicative of the contribution of serotonergic neurotransmission to attentional processes in adults with ADHD.

Cognitive Correlates of Personality

Research examining associations between executive functioning (EF) and personality traits has demonstrated promising results; however, examination of associations between Big Five personality traits and EF using an established EF framework has yet to be demonstrated. The present study examines associations between three aspects of EF (i.e., Cognitive Flexibility, Inhibition, and Updating/Monitoring), based upon a well-established EF framework, and Big Five personality traits. Participants (N = 182) completed neuropsychological measures of Cognitive Flexibility, Inhibition, and Updating/Monitoring as well as a self-report measure of personality. Better Updating/Monitoring was associated with lower Neuroticism and higher Openness. Openness was also positively associated with Cognitive Flexibility. These findings suggest that there may be a common underlying cognitive characteristic (i.e., Updating/Monitoring) linked with Neuroticism and Openness. Additional implications of these findings are discussed.

The role of sustained attention and display medium in reading comprehension among adolescents with ADHD and without it

Difficulties in reading comprehension are common in children and adolescents with Attention Deficit/Hyperactivity Disorder (ADHD). The current study aimed at investigating the relation between sustained attention and reading comprehension among adolescents with and without ADHD. Another goal was to examine the impact of two manipulations of the text on the efficiency of reading comprehension: Spacing (standard- vs. double-spacing) and Type of presentation (computer screen vs. hard copy). Reading comprehension of two groups of adolescents (participants with ADHD and normal controls) was assessed and compared in four different conditions (standard printed, spaced printed, standard on computer screen, spaced on computer screen). In addition, participants completed a visual sustained attention task. Significant differences in reading comprehension and in sustained attention were obtained between the two groups. Also, a significant correlation was obtained between sustained attention and reading comprehension. Moreover, a significant interaction was revealed between presentation-type, spacing and level of sustained attention on reading comprehension. Implications for reading intervention and the importance of early assessment of attention functioning are discussed.