Cognitive Control and Attentional Selection in Adolescents with ADHD Versus ADD

Abstract

An important research question is whether Attention Deficit Hyperactivity Disorder (ADHD) is related to early- or late-stage attentional control mechanisms and whether this differentiates a nonhyperactive subtype (ADD). This question was addressed in a sample of 145 ADD/ADHD and typically developing comparison adolescents (aged 13–17). Attentional blink and antisaccade tasks were used to assay early- and late-stage control, respectively. ADD was defined using normative cutoffs to ensure low activity level in children who otherwise met full criteria for ADHD. The ADD group had an attenuated attentional blink versus controls and ADHD-combined. The effect was not produced using DSM-–IV definition of ADHD-primarily inattentive type or DSM symptom counts. ADHD-combined showed greater weakness in response inhibition, as manifest in the antisaccade task. Combining tasks yielded an interaction differentiating group performance on the two tasks.

This work was supported by NIH R01 MH-59105 and MH- MH63146.

Notes

Note. Data include the subset of participants who completed both saccade and attentional blink tasks. Values in parentheses indicate standard deviations.

DSM–IV = Diagnostic and statistical manual of mental disorders (4th ed.); ADHD = Attention Deficit Hyperactivity Disorder; C = combined subtype; PI = primarily inattentive; ADD = ADHD-PI (with below average mean activity scores (mean of Parent & Teacher Conners Hyperactivity, T < 50); KSAD = Kiddie Schedule for Affective Disorders and Schizophrenia; ODD = oppositional defiant disorder; CD = conduct disorder; MDD = major depressive disorder; GAD = generalized anxiety disorder (includes GAD-Not Otherwise Specified); BASC = Behavioral Assessment Scale for Children; YSR = Youth Self-Report; WIAT/WRAT = Wechsler Individual Achievement Test/Wide Range Achievement Test.

^a Median group income reported in the thousands, based on 66 reports for Control group, 31 for ADHD-PI group and 33 for ADHD-C group.

^b Conners T scores reflect the mean of mother & teacher T-scores; KSAD inattentive and hyperactivity/impulsivity scores reflect the mean of parent and teacher symptom counts.

P = Parent, T = Teacher, Hyper = Hyperactivity.

†N for ADD participants in both tasks, N for all completing blink task.

‡Main effect of group was not significant.

P = Parent, T = Teacher, Hyper = Hyperactivity.

‡Main effect of group was not significant.

P = Parent, T = Teacher, Hyper = Hyperactivity.

*Antisaccade condition error rate and attentoinal blink dual task probe detection (A') scores were transformed to z-scores; z-scores served as the dependent variable in a repeated measures ANCOVA with task as the within group factor.