Elsevier

Biological Psychiatry

Volume 68, Issue 12, 15 December 2010, Pages 1114-1119
Biological Psychiatry

Archival Report
Basic Impairments in Regulating the Speed-Accuracy Tradeoff Predict Symptoms of Attention-Deficit/Hyperactivity Disorder

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Background

Attention-deficit/hyperactivity disorder (ADHD) is characterized by poor optimization of behavior in the face of changing demands. Theoretical accounts of ADHD have often focused on higher-order cognitive processes and typically assume that basic processes are unaffected. It is an open question whether this is indeed the case.

Method

We explored basic cognitive processing in 25 subjects with ADHD and 30 typically developing children and adolescents with a perceptual decision-making paradigm. We investigated whether individuals with ADHD were able to balance the speed and accuracy of decisions.

Results

We found impairments in the optimization of the speed-accuracy tradeoff. Furthermore, these impairments were directly related to the hyperactive and impulsive symptoms that characterize the ADHD-phenotype.

Conclusions

These data suggest that impairments in basic cognitive processing are central to the disorder. This calls into question conceptualizations of ADHD as a “higher-order” deficit, as such simple decision processes are at the core of almost every paradigm used in ADHD research.

Section snippets

Participants

Fifty-seven children participated in the study, including 25 children with ADHD. Two control subjects were excluded from the analyses due to poor performance on the task, because more than two-thirds of their choices constituted fast guesses (impulsive choices based on a guess or caused by a distraction). Demographic information is listed in Table S1 in Supplement 1. Subjects with ADHD were matched to typically developing control subjects, for age, Tanner stage, gender, IQ, hand preference, and

Speed-Accuracy Tradeoff

Most subjects had fewer correct choices and faster RTs for speed than accuracy sessions, reflecting the speed-accuracy tradeoff [F(1,53) > 60.7, p < .0001] (Figure 3A). Furthermore, most subjects made more errors and responded more slowly when choices were more difficult [F(1,53) > 21.5, p < .0001]. For RT, there was a group × session interaction, where subjects with ADHD were faster than control subjects on accuracy but not speed sessions [F(1,53) = 8.5, p = .005]. There were no differences

Discussion

We explored basic cognitive processing in ADHD with a perceptual decision-making paradigm. We investigated whether individuals with ADHD were able to balance the speed and accuracy of decisions. We found impairments in this basic regulation that predicted hyperactive and impulsive symptoms.

Interestingly, individuals with ADHD were not impaired on all aspects of task performance (Figure 3): although they showed a preference for speed, they did not make more errors than control subjects in either

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