A Developmental Perspective on the Measurement of Cognitive Deficits in Attention-Deficit/Hyperactivity Disorder

doi:10.1016/j.biopsych.2005.03.012

Biological Psychiatry

Volume 57, Issue 11, 1 June 2005, Pages 1256-1260

https://doi.org/10.1016/j.biopsych.2005.03.012 Get rights and content

Research on the cognitive deficits associated with attention-deficit/hyperactivity disorder has highlighted deficits in executive function in individuals with the disorder. This article suggests deconstructing the umbrella term “executive function” and focuses on one of its component processes: cognitive inhibition. Cognitive developmental psychology research suggests that component processes, such as cognitive inhibition, should be examined from a variety of approaches to fully appreciate patterns of competency and deficit. This article contrasts cognitive inhibition from behavioral inhibition and resistance to interference. Two types of cognitive inhibition, automatic and intentional, are proposed. Finally, suggestions for guiding research design are taken from the cognitive developmental psychology literature. These include studying very limited age ranges and conducting longitudinal research, investigating qualitative and quantitative differences in performance, examining the underlying processing and strategy differences between populations, and investigating multiple aspects of performance between populations.

Section snippets

Defining Cognitive Inhibition

Cognitive inhibition is the active suppression of cognitive contents currently activated in working memory or the active suppression of cognitive processes currently executing in working memory (Harnishfeger 1995). Cognitive inhibition is defined as a basic cognitive suppression that contributes to task performance by keeping task-irrelevant information from being maintained in working memory. If processing efficiency is conceptualized as speed of activation, such as in a semantic network

Evaluating Cognitive Inhibition in ADHD

The differences in definitions of cognitive inhibition among scientific disciplines have been a major obstacle in the search for its causal models. It is often the case that a global “inhibition” term is used to apply to situations that might more properly refer to different types of inhibition (e.g., behavioral vs. cognitive, automatic vs. intentional) (Brodeur and Pond 2001, Bull and Scerif 2001, Carlson et al 2002). Although it is not known whether these distinctions will ultimately be found

Age Ranges

The basic processes of executive function are distinct; therefore, they might follow different developmental trajectories, and comparisons across groups, such as individuals with ADHD and those without ADHD, might also vary at different developmental levels. For example, automatic cognitive inhibitory processing might develop simultaneously with other basic information processing abilities across the elementary school years. Conscious and strategic control of intentional inhibitory abilities,

Summary

As research continues to reveal more about the specific deficits associated with ADHD, and as that information is used for diagnosis and treatment approaches, cognitive developmental psychology can help to inform the research, specifically the cognitive processes included in executive function. This article highlighted one aspect of executive function, cognitive inhibition, as an example of the deconstruction necessary for understanding basic cognitive processes. Cognitive inhibition is

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Rational numbers, such as fractions, decimals, and percentages, are a persistent challenge in the mathematics curriculum. An underappreciated source of rational number difficulties are whole number properties that apply to some, but not all, rational numbers. I contend that mastery of rational numbers involves refining and expanding whole number representations. Behavioral evidence for the role inhibitory control and magnitude-based processing of rational numbers supports this hypothesis, although more attention is needed to task and stimuli selection, especially among fractions. In the brain, there is scant evidence on the role of inhibitory control in rational number processing, but surprisingly good correspondence, in the parietal lobe, between the handful of neuroimaging studies of rational numbers and the accumulated whole number literature. Decimals and discrete nonsymbolic representations are fruitful domains for probing the neural basis role of whole number interference in rational number processing.
Structure of executive functions in typically developing kindergarteners
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Whereas studies of the past 10 years have shown the executive functions (EFs) in adults to be differentiated into at least three principal components (working memory, inhibition, and flexibility), EF structure in children is far less well understood despite a large body of research on the subject. A study was undertaken to test different structural models of EFs through confirmatory factor analysis (CFA) on a large sample of typically developing kindergarteners (N = 272). The method employed sought to remedy the shortcomings of past research in this field such as absence of CFA, insufficient number of EF components tested, insufficient number of indicators per latent variable, and absence of control on processing speed. Children were assessed using a battery of EF tasks developed by the researchers to measure working memory (WM), flexibility, and inhibition (backward word span, backward block span, fruit Stroop, day–night test, hand Stroop, Trails-P, card sort, face sort, and verbal fluency shift). CFA results show the best-fitting model to comprise two factors, namely, an inhibition factor and a WM–flexibility factor. Invariance analyses suggest that this structure is the same for girls and boys and that latent variable means do not differ by sex. These results support the hypothesis of EF differentiation during development. The researchers formulate other hypotheses regarding neurophysiological development.
Is the impairment in temporal allocation of visual attention in children with ADHD related to a developmental delay or a structural cognitive deficit?
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Time processing, selective attention and inhibition efficiency all improve with age (Chevalier, 2010; Cragg & Nation, 2008; Huang-Pollock, Carr, & Nigg, 2002; Pennequin, Nanty, & Khomsi, 2004; Wright, Waterman, Prescott, & Murdoch-Eaton, 2003;), thus paralleling executive functions and frontal cortex maturation (Halperin & Schulz, 2006). It is therefore essential to screen for putative developmental effects in these general executive functions by comparing performance levels in children with ADHD and younger and age-matched healthy children (Kipp, 2005). Addressing the issue of development is particularly relevant because a recent study showed that ADHD is characterized by a delay in cortical maturation (Gonon, Guilé, & Cohen, 2010; Shaw et al., 2007).
We investigated the temporal allocation of visual attention in 11-year-old children with attention-deficit/hyperactivity disorder (ADHD) by comparing their attentional blink (AB) parameters (duration, amplitude and minimum performance) with those observed in three groups of healthy control participants (8-year-olds, 11-year-olds and adults). The AB is a marker of impaired ability to detect a second target following the identification of a first target when both appear randomly within a rapid sequence of distractor items. Our results showed developmental effects; with age, the AB duration decreased and the AB minimum moved to shorter lag times. Importantly, 11-year old children with ADHD presented much the same similar AB patterns (in terms of duration and minimum position) as the healthy 8-year-old controls. Our results support the hypothesis whereby impaired allocation of temporal selective attention in children with ADHD is due to a developmental delay and not a specific cognitive deficit.
Inhibition and impulsivity: Behavioral and neural basis of response control
2013, Progress in Neurobiology
Citation Excerpt :
The relationship between inhibition of mental processes and of physical responses is not yet entirely clear (but see Fig. 4 for a tentative classification of inhibitory processes). Harnishfeger (Harnishfeger, 1995; Kipp, 2005) invokes a sharp distinction between cognitive and motor forms of inhibition – the first mediating the control of cognitive contents and attentional processes, the second relating to overt behavior such as response inhibition and delayed gratification. According to this view, cognitive inhibition strictly refers to mental processes such as when during the attentional processing of stimuli we have to inhibit the irrelevant ones (Friedman and Miyake, 2004; Nigg, 2000), although this phenomenon is often referred to as ‘resistance to interference’ or simply ‘interference control’ (Klein and Taylor, 1994; Tipper, 1992).
In many circumstances alternative courses of action and thoughts have to be inhibited to allow the emergence of goal-directed behavior. However, this has not been the accepted view in the past and only recently has inhibition earned its own place in the neurosciences as a fundamental cognitive function. In this review we first introduce the concept of inhibition from early psychological speculations based on philosophical theories of the human mind. The broad construct of inhibition is then reduced to its most readily observable component which necessarily is its behavioral manifestation. The study of ‘response inhibition’ has the advantage of dealing with a relatively simple and straightforward process, the overriding of a planned or already initiated action. Deficient inhibitory processes profoundly affect everyday life, causing impulsive conduct which is generally detrimental for the individual. Impulsivity has been consistently linked to several types of addiction, attention deficit/hyperactivity disorder, mania and other psychiatric conditions. Our discussion of the behavioral assessment of impulsivity will focus on objective laboratory tasks of response inhibition that have been implemented in parallel for humans and other species with relatively few qualitative differences. The translational potential of these measures has greatly improved our knowledge of the neurobiological basis of behavioral inhibition and impulsivity. We will then review the current models of behavioral inhibition along with their expression via underlying brain regions, including those involved in the activation of the brain's emergency ‘brake’ operation, those engaged in more controlled and sustained inhibitory processes and other ancillary executive functions.
Development and initial assessment of a new paradigm for assessing cognitive and motor inhibition: The bimodal virtual-reality Stroop
2012, Journal of Neuroscience Methods
Citation Excerpt :
Motor control is best evaluated with computerized measures, which are generally based on go no-go paradigms (e.g. CPT-II, Conners et al., 2003; the TOVA, Leark et al., 2007; The Stop-it task; Verbruggen et al., 2008). The most commonly used variable for motor control assessment is the commission error, a reactive act performed with low reaction time and reflection, associated with low impulse control, high risk taking tendencies, poor decision making, low gratification delay capacities and weak resistance to temptation (e.g. Kipp, 2005; White et al., 1994). Motor inhibition and commission errors are closely dependent upon integrity of brain circuits involving the lower parts of the frontal lobes (e.g. Bechara and van der Linden, 2005; Horn et al., 2003).
Assessing and predicting inhibition in adults is a common assignment for clinicians. However, there is no single measure of inhibition that is complete, sensitive and enjoyable. The main goal of this study was to develop a virtual reality neuropsychological task (the bimodal VR-Stroop) capable of measuring both cognitive (control of internal and external interference) and motor inhibition (a go no-go paradigm with reaction time variation, commission errors and omissions). Preliminary data obtained with 71 healthy adult participants confirmed that the VR-Stroop is capable of eliciting the Stroop effect with bimodal stimuli. Initial validation data also suggested that measures of the VR-Stroop significantly correlate with measures of the Elevator counting with distracters, the Continuous Performance Task (CPT-II), and the Stop-it task. Finally, regression analyses indicated that commission errors and variability of reaction times at the VR-Stroop were significantly predicted by scores of the Elevator task and the CPT-II. These preliminary results suggest that the VR-Stroop is an interesting measure of cognitive and motor inhibition for adults, although confirmatory investigations are warranted.
Automated test of behavioral flexibility in mice using a behavioral sequencing task in IntelliCage
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There has been a long-standing need to develop efficient and standardized behavioral test methods for evaluating higher-order brain functions in mice. Here, we developed and validated a behavioral flexibility test in mice using IntelliCage, a fully automated behavioral analysis system for mice in a group-housed environment. We first developed a “behavioral sequencing task” in the IntelliCage that enables us to assess the learning ability of place discrimination and behavioral sequence for reward acquisition. In the serial reversal learning using the task, the discriminated spatial patterns of the rewarded and never-rewarded places were serially reversed, and thus, mice were accordingly expected to realign the previously acquired behavioral sequence. In general, the tested mice showed rapid acquisition of the behavioral sequencing task and behavioral flexibility in the subsequent serial reversal stages both in intra- and inter-session analyses. It was found that essentially the same results were obtained among three different laboratories, which confirm the high stability of the present test protocol in different strains of mice (C57BL/6, DBA/2, and ICR). In particular, the most trained cohort of C57BL/6 mice achieved a markedly rapid adaptation to the reversal task in the final phase of the long-term serial reversal test, which possibly indicated that the mice adapted to the “reversal rule” itself. In conclusion, the newly developed behavioral test was shown to be a valid assay of behavioral flexibility in mice, and is expected to be utilized in tests of mouse models of cognitive deficits.

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Advancing the neuroscience of ADHDA Developmental Perspective on the Measurement of Cognitive Deficits in Attention-Deficit/Hyperactivity Disorder

Section snippets

Defining Cognitive Inhibition

Evaluating Cognitive Inhibition in ADHD

Age Ranges

Summary

J Exp Child Psychol

Dev Rev

Cognition

Learn Individual Differences

J Exp Child Psychol

Cogn Dev

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Exploring the central executive

Q J Exp Psychol

Behavioral inhibition, sustained attention, and executive functionsConstructing a unifying theory of ADHD

Psychol Bull

A multitrait-multimethod analysis of reflectionimpulsivity

Child Dev

Children’s ThinkingCognitive Development and Individual Differences

Parental investment theory and gender differences in the evolution of inhibition mechanisms

Psychol Bull

The role of knowledge in the development of strategies

The development of selective attention in children with attention deficit hyperactivity disorder

J Abnorm Child Psychol

Executive functioning as a predictor of children’s mathematics abilityInhibition, switching, and working memory

Dev Neuropsychol

How specific is the relation between executive function and Theory of Mind? Contributions of inhibitory control and working memory

Infant Child Dev

The role of inhibitory processes in young children’s difficulties with deception and false belief

Child Dev

Developmental norms for the Wisconsin Card Sorting Test

J Clin Exp Neuropsychol

Prefrontal-subcortical circuits in developmental disorders

Neuropsychological insights into the meaning of object concept development

Conditions under which young children can hold two rules in mind and inhibit a prepotent response

Dev Psychol

Links between conscious awareness and response inhibitionEvidence from masked priming

Psychonom Bull Rev

Inhibition and mental effort in Attention Deficit Hyperactivity Disorder

J Dev Phys Disabilities

Age and the availability of inferences

Psychol Aging

The ontogeny of inhibition mechanismsA renewed approach to cognitive development

Executive function in preschoolersLinks with theory of mind and verbal ability

Br J Dev Psychol

The development of cognitive inhibition in a reading comprehension task

Eur Rev Appl Psychol

Impaired and enhanced attentional function in children with attention deficit/hyperactivity disorder

Psychol Med

Advancing the neuroscience of ADHD
A Developmental Perspective on the Measurement of Cognitive Deficits in Attention-Deficit/Hyperactivity Disorder