Skip to main content

Advertisement

SpringerLink
Log in

Affective processing bias in youth with primary bipolar disorder or primary attention-deficit/hyperactivity disorder

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

High rates of comorbidity and overlapping diagnostic criteria between pediatric bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD) contribute to diagnostic and treatment confusion. To advance what is known about both disorders, we compared effect of emotional stimuli on response control in children with primary BD, primary ADHD and typically developing controls (TDC). Participants included 7–17 year olds with either “narrow-phenotype” pediatric BD (n = 25), ADHD (n = 25) or TDC (n = 25). Groups were matched on participant age and FSIQ. The effect of emotional stimuli on response control was assessed using the Cambridge Neuropsychological Test Automated Battery Affective Go/No-Go task (CANTAB AGN). We found a group by target valence interaction on commission errors [F(2,71) = 5.34, p < 0.01, ƞ 2p  = 0.13] whereby ADHD, but not TDC participants, made more errors on negative than positive words [t(24) = −2.58, p < 0.05, r = 0.47]. In contrast, there was a nonsignificant trend for BD participants to make fewer errors on negative versus positive words compared to ADHD and TDC participants. Between-subjects effects showed that ADHD participants made more errors than TDC, but not BD participants. Our main finding advances what is known about the effect of emotional stimuli on response control in children with ADHD. Our results suggesting a positive affective processing bias in children with ADHD compliment emerging literature show that difficulties with emotional processing and regulation may be core features of ADHD. Further, given the observed pattern of results in children with ADHD compared to BD children, our behavioral results suggest the importance of examining differences in the brain–behavior mechanisms involved in affective processing in children with ADHD compared to BD children.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Moreno C, Laje G, Blanco C, Jiang H, Schmidt AB, Olfson M (2007) National trends in outpatient diagnosis and treatment of bipolar disorder in youth. Arch Gen Psychiatry 64(9):1032–1039

    Article  PubMed  Google Scholar 

  2. Blader JC, Carlson GA (2007) Increased rates of bipolar disorder diagnoses among US child, adolescent, and adult inpatients, 1996–2004. Biol Psychiatry 62(2):107–114. doi:10.1016/j.biopsych.2006.11.006

    Article  PubMed Central  PubMed  Google Scholar 

  3. Getahun D, Jacobsen SJ, Fassett MJ, Chen W, Demissie K, Rhoads GG (2013) Recent trends in childhood attention-deficit/hyperactivity disorder. JAMA Pediatr 167(3):282–288. doi:10.1001/2013.jamapediatrics.401

    Article  PubMed  Google Scholar 

  4. Hurtig T, Ebeling H, Taanila A, Miettunen J, Smalley S, McGough J, Loo S, Jarvelin MR, Moilanen I (2007) ADHD and comorbid disorders in relation to family environment and symptom severity. Eur Child Adolesc Psychiatry 16(6):362–369. doi:10.1007/s00787-007-0607-2

    Article  PubMed  Google Scholar 

  5. Wozniak J, Biederman J, Kiely K, Ablon JS, Faraone SV, Mundy E, Mennin D (1995) Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. J Am Acad Child Adolesc Psychiatry 34(7):867–876. doi:10.1097/00004583-199507000-00010

    Article  CAS  PubMed  Google Scholar 

  6. Kowatch RA, Youngstrom EA, Danielyan A, Findling RL (2005) Review and meta-analysis of the phenomenology and clinical characteristics of mania in children and adolescents. Bipolar Disord 7(6):483–496. doi:10.1111/j.1399-5618.2005.00261.x

    Article  PubMed  Google Scholar 

  7. Youngstrom EA, Arnold LE, Frazier TW (2010) Bipolar and ADHD comorbidity: both artifact and outgrowth of shared mechanisms. Clin Psychol 17(4):350–359

    Google Scholar 

  8. Galanter CA, Leibenluft E (2008) Frontiers between attention deficit hyperactivity disorder and bipolar disorder. Child Adolesc Psychiatr Clin N Am 17(2):325–346. doi:10.1016/j.chc.2007.11.001 (viii–ix)

    Article  PubMed  Google Scholar 

  9. American Psychiatric A (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington

    Google Scholar 

  10. Walshaw PD, Alloy LB, Sabb FW (2010) Executive function in pediatric bipolar disorder and attention-deficit hyperactivity disorder: in search of distinct phenotypic profiles. Neuropsychol Rev 20(1):103–120. doi:10.1007/s11065-009-9126-x

    Article  PubMed Central  PubMed  Google Scholar 

  11. Rucklidge JJ (2006) Impact of ADHD on the neurocognitive functioning of adolescents with bipolar disorder. Biol Psychiatry 60(9):921–928. doi:10.1016/j.biopsych.2006.03.067

    Article  PubMed  Google Scholar 

  12. Geller B, Zimerman B, Williams M, Delbello MP, Bolhofner K, Craney JL, Frazier J, Beringer L, Nickelsburg MJ (2002) DSM-IV mania symptoms in a prepubertal and early adolescent bipolar disorder phenotype compared to attention-deficit hyperactive and normal controls. J Child Adolesc Psychopharmacol 12(1):11–25. doi:10.1089/10445460252943533

    Article  PubMed  Google Scholar 

  13. Shaw P, Stringaris A, Nigg J, Leibenluft E (2014) Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry. doi:10.1176/appi.ajp.2013.13070966

    PubMed Central  Google Scholar 

  14. LeDoux J (2012) Rethinking the emotional brain. Neuron 73(4):653–676. doi:10.1016/j.neuron.2012.02.004

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Phillips ML, Drevets WC, Rauch SL, Lane R (2003) Neurobiology of emotion perception I: the neural basis of normal emotion perception. Biol Psychiatry 54(5):504–514. doi:10.1016/s0006-3223(03)00168-9

    Article  PubMed  Google Scholar 

  16. Phillips ML, Ladouceur CD, Drevets WC (2008) A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Mol Psychiatry 13(9:829):833–857. doi:10.1038/mp.2008.65

    Article  Google Scholar 

  17. Ochsner KN, Gross JJ (2005) The cognitive control of emotion. Trends Cogn Sci 9(5):242–249. doi:10.1016/j.tics.2005.03.010

    Article  PubMed  Google Scholar 

  18. Rothbart M, Posner M (2006) Temperament, attention, and developmental psychopathology. In: Cicchetti D, Cohen D (eds) Developmental psychopathology, vol 2., Developmental neuroscienceWiley, Hoboken, pp 465–501

    Google Scholar 

  19. Rosen HR, Rich BA (2010) Neurocognitive correlates of emotional stimulus processing in pediatric bipolar disorder: a review. Postgrad Med 122(4):94–104. doi:10.3810/pgm.2010.07.2177

    Article  PubMed  Google Scholar 

  20. Brotman MA, Guyer AE, Lawson ES, Horsey SE, Rich BA, Dickstein DP, Pine DS, Leibenluft E (2008) Facial emotion labeling deficits in children and adolescents at risk for bipolar disorder. Am J Psychiatry 165(3):385–389. doi:10.1176/appi.ajp.2007.06122050

    Article  PubMed  Google Scholar 

  21. Dickstein DP, Castellanos FX (2012) Face processing in attention deficit/hyperactivity disorder. Curr Top Behav Neurosci 9:219–237. doi:10.1007/7854_2011_157

    Article  PubMed  Google Scholar 

  22. Seymour KE, Pescosolido MF, Reidy BL, Galvan T, Kim KL, Young M, Dickstein DP (2013) Emotional face identification in youths with primary bipolar disorder or primary attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 52(5):537–546 e533. doi:10.1016/j.jaac.2013.03.011

    Article  PubMed Central  PubMed  Google Scholar 

  23. Arnsten AF, Rubia K (2012) Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: disruptions in neurodevelopmental psychiatric disorders. J Am Acad Child Adolesc Psychiatry 51(4):356–367. doi:10.1016/j.jaac.2012.01.008

    Article  PubMed  Google Scholar 

  24. Alderson RM, Rapport MD, Kofler MJ (2007) Attention-deficit/hyperactivity disorder and behavioral inhibition: a meta-analytic review of the stop-signal paradigm. J Abnorm Child Psychol 35(5):745–758. doi:10.1007/s10802-007-9131-6

    Article  PubMed  Google Scholar 

  25. Passarotti AM, Sweeney JA, Pavuluri MN (2010) Differential engagement of cognitive and affective neural systems in pediatric bipolar disorder and attention deficit hyperactivity disorder. J Int Neuropsychol Soc 16(1):106–117. doi:10.1017/S1355617709991019

    Article  PubMed Central  PubMed  Google Scholar 

  26. Leibenluft E, Rich BA, Vinton DT, Nelson EE, Fromm SJ, Berghorst LH, Joshi P, Robb A, Schachar RJ, Dickstein DP, McClure EB, Pine DS (2007) Neural circuitry engaged during unsuccessful motor inhibition in pediatric bipolar disorder. Am J Psychiatry 164(1):52–60. doi:10.1176/appi.ajp.164.1.52

    Article  PubMed  Google Scholar 

  27. Rubia K, Smith A, Taylor E (2007) Performance of children with attention deficit hyperactivity disorder (ADHD) on a test battery of impulsiveness. Child Neuropsychol 13(3):276–304. doi:10.1080/09297040600770761

    Article  PubMed  Google Scholar 

  28. Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57(11):1336–1346. doi:10.1016/j.biopsych.2005.02.006

    Article  PubMed  Google Scholar 

  29. Nigg JT (2005) Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Biol Psychiatry 57(11):1424–1435. doi:10.1016/j.biopsych.2004.11.011

    Article  PubMed  Google Scholar 

  30. Posner J, Maia TV, Fair D, Peterson BS, Sonuga-Barke EJ, Nagel BJ (2011) The attenuation of dysfunctional emotional processing with stimulant medication: an fMRI study of adolescents with ADHD. Psychiatry Res 193(3):151–160. doi:10.1016/j.pscychresns.2011.02.005

    Article  PubMed Central  PubMed  Google Scholar 

  31. Murphy FC, Sahakian BJ, Rubinsztein JS, Michael A, Rogers RD, Robbins TW, Paykel ES (1999) Emotional bias and inhibitory control processes in mania and depression. Psychol Med 29(6):1307–1321

    Article  CAS  PubMed  Google Scholar 

  32. Garcia-Blanco AC, Perea M, Livianos L (2013) Mood-congruent bias and attention shifts in the different episodes of bipolar disorder. Cogn Emot 27(6):1114–1121. doi:10.1080/02699931.2013.764281

    Article  PubMed  Google Scholar 

  33. Whitney J, Joormann J, Gotlib IH, Kelley RG, Acquaye T, Howe M, Chang KD, Singh MK (2012) Information processing in adolescents with bipolar I disorder. J Child Psychol Psychiatry 53(9):937–945. doi:10.1111/j.1469-7610.2012.02543.x

    Article  PubMed Central  PubMed  Google Scholar 

  34. Gotlib IH, Traill SK, Montoya RL, Joormann J, Chang K (2005) Attention and memory biases in the offspring of parents with bipolar disorder: indications from a pilot study. J Child Psychol Psychiatry 46(1):84–93. doi:10.1111/j.1469-7610.2004.00333.x

    Article  PubMed  Google Scholar 

  35. Fried R, Hirshfeld-Becker D, Petty C, Batchelder H, Biederman J (2012) How informative is the CANTAB to assess executive functioning in children with ADHD? A controlled study. J Atten Disord. doi:10.1177/1087054712457038

    Google Scholar 

  36. Surman CB, Hammerness PG, Petty C, Spencer T, Doyle R, Napolean S, Chu N, Yorks D, Biederman J (2013) A pilot open label prospective study of memantine monotherapy in adults with ADHD. World J Biol Psychiatry 14(4):291–298. doi:10.3109/15622975.2011.623716

    Article  PubMed  Google Scholar 

  37. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, Williamson D, Ryan N (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988. doi:10.1097/00004583-199707000-00021

    Article  CAS  PubMed  Google Scholar 

  38. Wechsler D (2005) Wechsler abbreviated scale of intelligence. The Psychological Corporation, San Antonio

    Google Scholar 

  39. American Psychiatric A (2000) Diagnostics and statistics manual of mental disorders 4th edition text-revision (DSM-IV-TR), 4th edn. American Psychiatric Association, Washington

    Book  Google Scholar 

  40. Leibenluft E, Charney DS, Towbin KE, Bhangoo RK, Pine DS (2003) Defining clinical phenotypes of juvenile mania. Am J Psychiatry 160(3):430–437

    Article  PubMed  Google Scholar 

  41. Shaffer D, Gould M, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40(11):1228–1231

    Article  CAS  PubMed  Google Scholar 

  42. Conners CK, Wells KC, Parker JD, Sitarenios G, Diamond JM, Powell JW (1997) A new self-report scale for assessment of adolescent psychopathology: factor structure, reliability, validity, and diagnostic sensitivity. J Abnorm Child Psychol 25(6):487–497

    Article  CAS  PubMed  Google Scholar 

  43. Young RC, Biggs JT, Ziegler VE, Meyer DA (1978) A rating scale for mania: reliability, validity, and sensitivity. Br J Psychiatry 133:429–435

    Article  CAS  PubMed  Google Scholar 

  44. Poznanski EO, Cook SC, Carroll BJ (1979) A depression rating scale for children. Pediatrics 64(4):442–450

    CAS  PubMed  Google Scholar 

  45. Achenbach TM, Rescorla LA (2001) Manual for the ASEBA school age forms & profiles. University of Vermont: Research Center for Children, Youth & Families, Burlington

    Google Scholar 

  46. Cambridge Neuropsychological Test Automated Battery (CANTAB) (2013) Cambridge cognition, Cambridge, UK

  47. Field A (2013) Discovering statistics using IBM SPSS statistics, 4th edn. SAGE Publications Ltd, Los Angeles

    Google Scholar 

  48. Rosnow RL (2003) Effect sizes for experimenting psychologists. Can J Exp Psychol 57(3):221–237

    Article  PubMed  Google Scholar 

  49. Rubia K, Smith A, Taylor E (2007) Performance of children with attention deficit hyperactivity disorder (ADHD) on a test battery of impulsiveness. Child Neuropsychol 13(3):276–304. doi:10.1080/09297040600770761

    Article  PubMed  Google Scholar 

  50. Willcutt E, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57(11):1336–1346. doi:10.1016/j.biopsych.2005.02.006

    Article  PubMed  Google Scholar 

  51. Phillips ML, Drevets WC, Rauch SL, Lane R (2003) Neurobiology of emotion perception II: implications for major psychiatric disorders. Biol Psychiatry 54(5):515–528. doi:10.1016/s0006-3223(03)00171-9

    Article  PubMed  Google Scholar 

  52. Walcott CM, Landau S (2004) The relation between disinhibition and emotion regulation in boys with attention deficit hyperactivity disorder. J Clin Child Adolesc Psychol 33(4):772–782. doi:10.1207/s15374424jccp3304_12

    Article  PubMed  Google Scholar 

  53. Roiser J, Farmer A, Lam D, Burke A, O’Neill N, Keating S, Smith GP, Sahakian B, McGuffin P (2009) The effect of positive mood induction on emotional processing in euthymic individuals with bipolar disorder and controls. Psychol Med 39(5):785–791. doi:10.1017/S0033291708004200

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  54. Gopin CB, Burdick KE, Derosse P, Goldberg TE, Malhotra AK (2011) Emotional modulation of response inhibition in stable patients with bipolar I disorder: a comparison with healthy and schizophrenia subjects. Bipolar Disord 13(2):164–172. doi:10.1111/j.1399-5618.2011.00906.x

    Article  PubMed Central  PubMed  Google Scholar 

  55. Seymour KE, Chronis-Tuscano A, Halldorsdottir T, Stupica B, Owens K, Sacks T (2012) Emotion regulation mediates the relationship between ADHD and depressive symptoms in youth. J Abnorm Child Psychol 40(4):595–606. doi:10.1007/s10802-011-9593-4

    Article  PubMed  Google Scholar 

  56. Seymour KE, Chronis-Tuscano A, Iwamoto DK, Kurdziel G, Macpherson L (2013) Emotion regulation mediates the association between ADHD and depressive symptoms in a community sample of youth. J Abnorm Child Psychol. doi:10.1007/s10802-013-9799-8

    Google Scholar 

Download references

Acknowledgments

This work was supported by NIMH (5K22MH074945 and 3K22MH074945-02S1 PI = DP Dickstein) and Bradley Hospital. We are grateful to all children and families without whose participation this study would not have been possible.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Bradley Hospital’s Pediatric, Mood, Imaging and Neuro Developmental (PediMIND) Program, The Alpert Medical School of Brown University, Providence, USA

    Kerri L. Kim, Grace K. Cushman, Megan E. Puzia, Alexandra B. Weissman, Thania Galvan & Daniel P. Dickstein

  2. Divison of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, 550 North Broadway Street, Suite 943, Baltimore, MD, 21205, USA

    Karen E. Seymour

Authors
  1. Karen E. Seymour
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kerri L. Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Grace K. Cushman
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Megan E. Puzia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alexandra B. Weissman
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Thania Galvan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daniel P. Dickstein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karen E. Seymour.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 53 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Seymour, K.E., Kim, K.L., Cushman, G.K. et al. Affective processing bias in youth with primary bipolar disorder or primary attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 24, 1349–1359 (2015). https://doi.org/10.1007/s00787-015-0686-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-015-0686-4

Keywords

Search

Navigation