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Stopping and changing in adults with ADHD

Published online by Cambridge University Press:  31 August 2004

E. M. BEKKER
Affiliation:
Department of Psychopharmacology, Utrecht University, The Netherlands
C. C. OVERTOOM
Affiliation:
Department of Psychopharmacology, Utrecht University, The Netherlands Department of Developmental Psychology, University of Amsterdam, The Netherlands
J. L. KENEMANS
Affiliation:
Department of Psychopharmacology, Utrecht University, The Netherlands Department of Psychonomics, Utrecht University, The Netherlands
J. J. KOOIJ
Affiliation:
Parnassia Psycho-medical Center, The Hague, The Netherlands
I. DE NOORD
Affiliation:
Parnassia Psycho-medical Center, The Hague, The Netherlands
J. K. BUITELAAR
Affiliation:
Department of Psychiatry & Child and Adolescent Psychiatry, University Medical Center St. Radboud, Nijmegen, The Netherlands
M. N. VERBATEN
Affiliation:
Department of Psychopharmacology, Utrecht University, The Netherlands

Abstract

Background. A lack of inhibitory control has been suggested to be the core deficit in children with attention deficit hyperactivity disorder (ADHD). This means that a primary deficit in behavioral inhibition mediates a cascade of secondary deficits in other executive functions, such as arousal regulation. Clinical observations have revealed that with increasing age symptoms of hyperactivity and impulsivity decline at a higher rate than those of inattention. This might imply that a deficit in attention rather than a lack of inhibitory control is the major feature in adult ADHD.

Method. To study whether an attentional or inhibitory deficit predominates, the stop-signal task and the stop-change task were presented to 24 adults with ADHD combined subtype and 24 controls.

Results. Relative to controls, the stop-signal reaction time (SSRT) was significantly more prolonged than the go-stimulus reaction time (RT) in patients with ADHD. This disproportionate elongation of the SSRT was comparable across tasks, even though the stop-change task exerted more complex (or at least different) demands on the inhibitory system than the stop-signal task. ADHD patients had a higher proportion of choice errors, possibly reflecting more premature responses. Specifically in the stop-change task, patients had more variable choice responses and made more inappropriate change responses, which may also reflect enhanced impulsivity.

Conclusions. The results support a core deficit in behavioral inhibition in adults with ADHD. We further suggest that there is more evidence for a critical role of deficient inhibitory control in adults than in children with ADHD.

Type
Research Article
Copyright
© 2004 Cambridge University Press

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