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Gepubliceerd in: Journal of Abnormal Child Psychology 5/2012

01-07-2012

Objectively-Measured Impulsivity and Attention-Deficit/Hyperactivity Disorder (ADHD): Testing Competing Predictions from the Working Memory and Behavioral Inhibition Models of ADHD

Auteurs: Joseph S. Raiker, Mark D. Rapport, Michael J. Kofler, Dustin E. Sarver

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 5/2012

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Abstract

Impulsivity is a hallmark of two of the three DSM-IV ADHD subtypes and is associated with myriad adverse outcomes. Limited research, however, is available concerning the mechanisms and processes that contribute to impulsive responding by children with ADHD. The current study tested predictions from two competing models of ADHD—working memory (WM) and behavioral inhibition (BI)—to examine the extent to which ADHD-related impulsive responding was attributable to model-specific mechanisms and processes. Children with ADHD (n = 21) and typically developing children (n = 20) completed laboratory tasks that provided WM (domain-general central executive [CE], phonological/visuospatial storage/rehearsal) and BI indices (stop-signal reaction time [SSRT], stop-signal delay, mean reaction time). These indices were examined as potential mediators of ADHD-related impulsive responding on two objective and diverse laboratory tasks used commonly to assess impulsive responding (CPT: continuous performance test; VMTS: visual match-to-sample). Bias-corrected, bootstrapped mediation analyses revealed that CE processes significantly attenuated between-group impulsivity differences, such that the initial large-magnitude impulsivity differences were no longer significant on either task after accounting for ADHD-related CE deficits. In contrast, SSRT partially mediated ADHD-related impulsive responding on the CPT but not VMTS. This partial attenuation was no longer significant after accounting for shared variance between CE and SSRT; CE continued to attenuate the ADHD-impulsivity relationship after accounting for SSRT. These findings add to the growing literature implicating CE deficits in core ADHD behavioral and functional impairments, and suggest that cognitive interventions targeting CE rather than storage/rehearsal or BI processes may hold greater promise for alleviating ADHD-related impairments.
Voetnoten
1
Briefly, the wider 95% confidence interval increases the likelihood that the confidence interval for c′ will include 0.0, indicating that diagnostic status and impulsivity scores are no longer related significantly after accounting for the mediator (i.e., full mediation in Baron and Kenny [1986] terminology). In contrast, the narrower 90% confidence interval is less likely to include 0.0, and therefore is likely to result in a more conservative conclusion regarding the magnitude of the relationship between diagnostic status and impulsivity scores after accounting for the mediator (i.e., partial mediation). For discussion and specific examples of this phenomenon, see Shrout and Bolger (2002).
 
2
As argued by Hayes (2009), significant a and b pathways are not prerequisites for a significant mediating indirect ab effect.
 
3
The hyperactivity/impulsivity items from the ADHD subscale on the CSI were used and include hyperactivity/impulsivity DSM-IV symptom items similar to those used in the cited studies above.
 
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Metagegevens
Titel
Objectively-Measured Impulsivity and Attention-Deficit/Hyperactivity Disorder (ADHD): Testing Competing Predictions from the Working Memory and Behavioral Inhibition Models of ADHD
Auteurs
Joseph S. Raiker
Mark D. Rapport
Michael J. Kofler
Dustin E. Sarver
Publicatiedatum
01-07-2012
Uitgeverij
Springer US
Gepubliceerd in
Research on Child and Adolescent Psychopathology / Uitgave 5/2012
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI
https://doi.org/10.1007/s10802-011-9607-2

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