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Research on Child and Adolescent Psychopathology

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20-05-2015

Reinforcement and Stimulant Medication Ameliorate Deficient Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder

Auteurs: Keri S. Rosch, Whitney D. Fosco, William E. Pelham Jr., James G. Waxmonsky, Michelle G. Bubnik, Larry W. Hawk Jr.

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 2/2016

Abstract

This study examined the degree to which reinforcement, stimulant medication, and their combination impact response inhibition in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Across three studies, participants with ADHD (n = 111, 25 girls) and typically-developing (TD) controls (n = 33, 6 girls) completed a standard version of the stop signal task (SST) and/or a reinforcement-manipulation SST with performance-contingent points. In two of these studies, these tasks were performed under placebo or 0.3 and 0.6 mg/kg methylphenidate (MPH) conditions. Cross-study comparisons were conducted to test hypotheses regarding the separate and combined effects of reinforcement and methylphenidate on response inhibition among children with ADHD relative to TD controls. Baseline response inhibition was worse among children with ADHD compared to controls. MPH produced dose-related improvements in response inhibition in children with ADHD; compared to non-medicated TD controls, 0.3 mg/kg MPH normalized deficient response inhibition, and 0.6 mg/kg MPH resulted in better inhibition in children with ADHD. Reinforcement improved response inhibition to a greater extent for children with ADHD than for TD children, normalizing response inhibition. The combination of MPH and reinforcement improved response inhibition among children with ADHD compared to reinforcement alone and MPH alone, also resulting in normalization of response inhibition despite repeated task exposure. Deficient response inhibition commonly observed in children with ADHD is significantly improved with MPH and/or reinforcement, normalizing inhibition relative to TD children tested under standard conditions.

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Although we have published data from other tasks completed in one or more of these studies (Ashare et al. 2010; Bubnik et al. 2015; Shiels et al. 2009; Spencer et al. 2009; Strand et al. 2012) the present manuscript is the first to report the SST data.

Previous studies with the SST have varied in their criteria for exclusion of task blocks, with some studies reporting no exclusions (Epstein et al. 2011; Huang-Pollock et al. 2007; Shanahan et al. 2008) and other studies eliminating blocks with percent inhibition <20 or >80 % or percent accuracy <70–80 % (Nigg 1999). Our primary analyses included all task blocks. However, we conducted supplementary analyses in which we eliminated blocks with percent inhibition <20 or >80 % or percent accuracy <80 %. Except where noted, the results did not change.

When analyses were restricted to include only blocks with percent inhibition between 20 and 80 % and percent accuracy of at least 80 %, 5 participants are excluded (4 ADHD, 1 TD); the Diagnostic Group × Reinforcement interaction was no longer significant, F(1, 50) = 1.8, p = 0.18, although the pattern of means was similar.

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Titel: Reinforcement and Stimulant Medication Ameliorate Deficient Response Inhibition in Children with Attention-Deficit/Hyperactivity Disorder
Auteurs: Keri S. Rosch
Whitney D. Fosco
William E. Pelham Jr.
James G. Waxmonsky
Michelle G. Bubnik
Larry W. Hawk Jr.
Publicatiedatum: 20-05-2015
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 2/2016
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-015-0031-x

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