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The Ecological Validity of Delay Aversion and Response Inhibition as Measures of Impulsivity in AD/HD: A Supplement to the NIMH Multimodal Treatment Study of AD/HD

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Abstract

Impulsivity is a primary symptom of the combined type of Attention Deficit/Hyperactivity Disorder (AD/HD). The Stop Signal Paradigm is premised upon a primary deficit in inhibitory control in AD/HD, whereas the Delay Aversion Hypothesis, by contrast, conceptualizes impulsivity in AD/HD, not as an inability to inhibit a response, but rather as a choice to avoid delay. This study compared the ecological validity of the Stop Signal Task (SST) and Choice-Delay Task (C-DT) measure of delay aversion, with respect to their relative utility in discriminating AD/HD children from normal control participants, and their correlations with classroom observations and with ratings of impulsivity and other core AD/HD symptoms on the Conners and SNAP-IV checklists. The tasks exhibited modest discriminant validity when used individually and excellent discriminant validity when used in combination. The C-DT correlated with teacher ratings of impulsivity, hyperactivity, and conduct problems, and with observations of gross motor activity, physical aggression, and an AD/HD composite score. The SST correlated with the observations only. These results suggest that delay aversion is associated with a broad range of AD/HD characteristics whereas inhibitory failure seems to tap a more discrete dimension of executive control

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REFERENCES

  • Abikoff, H., & Gittelman, R. (1985). Classroom Observation Code: A modification of the Stony Brook Code. Psychopharmacology Bulletin, 21, 901–909.

    Google Scholar 

  • Abikoff, H., Gittelman, R., & Klein, D. F. (1980). A classroom observation code for hyperactive children:Areplication of validity. Journal of Consulting and Clinical Psychology, 48, 555–565.

    Google Scholar 

  • Abikoff, H., Gittelman-Klein, R., & Klein, D. F. (1977). Validation of a classroom observation code for hyperactive children. Journal of Consulting and Clinical Psychology, 45, 772–783.

    Google Scholar 

  • Anderson, B., Burd, L., Dodd, J., & Kelk, K. (1980). A comparative study of time estimation. Journal of American Indian Education, 19, 1–4.

    Google Scholar 

  • Arnold, L. E., Abikoff, H. B., Cantwell, D. P., Conners, C. K., Elliott, G. R., Greenhill, L. L., Hechtman, L., Hinshaw, S. P., Hoza, B., Jensen, P. S., Kraemer, H. C., March, J. S., Vereen, D., & Well, K. C. (1997). NIMH collaborative multimodal treatment study of children withADHD(MTA): II. Design, methodology, and protocol evolution. Archives of General Psychiatry, 54, 865–870.

    Google Scholar 

  • Atkins, M. S., & Stoff, D. M. (1993). Instrumental and hostile aggression in childhood disruptive behavior disorders. Journal of Abnormal Child Psychology, 21, 165–178.

    Google Scholar 

  • Atkins, M. S., Stoff, D., Osborne, M. L., & Brown, K. (1993). Distinguishing instrumental and hostile aggression: Does it make a difference? Journal of Abnormal Child Psychology, 21, 355–365.

    Google Scholar 

  • Barkley, R. A. (1989). The problem of stimulus control and rule-governed behavior in attention deficit disorder with hyperactivity. In L. M. Bloomingdale & J. Swanson (Eds.), Attention Deficit Disorder: Current concepts and emerging trends in attentional and behavioral disorders of childhood (pp. 203–232). Elmsford, NY: Pergamon Press.

    Google Scholar 

  • Barkley, R. A. (1991). The ecological validity of laboratory and analogue assessments of ADHD symptoms. Journal of Abnormal Child Psychology, 19, 149–178.

    Google Scholar 

  • Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94.

    Google Scholar 

  • Barkley, R. A., & Biederman, J. (1997). Toward a broader definition of the age-of-onset criterion for attention-deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1204–1210.

    Google Scholar 

  • Barkley, R. A., Grodzinsky, G., & DuPaul, G. J. (1992). Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report. Journal of Abnormal Child Psychology, 20, 163–188.

    Google Scholar 

  • Brown, S. W. (1985). Time perception and attention: The effects of prospective versus retrospective paradigms and task demands in period estimation. Perception and Psychophysics, 38, 115–124.

    Google Scholar 

  • Conners, C. K. (1990). Manual for the Conners' Rating Scales. Toronto, Ontario: Multihealth Systems.

    Google Scholar 

  • Douglas, V. I. (1979). Toward a clearer definition of the attentional deficit of hyperactive children. In G. A. Hale & M. Lewis (Eds.), Attention and the Development of Cognitive Skills (pp. 173–247). New York: Plenum Press.

    Google Scholar 

  • Douglas, V. I., & Parry, P. A. (1994). Effects of reward and nonreward on frustration and attention in attention deficit disorder. Journal of Abnormal Child Psychology, 22, 281–302.

    Google Scholar 

  • Falk, J. L., & Bindra, D. (1954). Judgment of time as a function of serial position and stress. Journal of Experimental Psychology, 47, 279–282.

    Google Scholar 

  • Fraisse, P. (1963). The psychology of time. New York: Harper & Row.

    Google Scholar 

  • Gelfand, D. M., & Hartmann, D. P. (1975). Child behavior analysis and therapy. New York: Pergamon Press.

    Google Scholar 

  • Gittelman-Klein, R., Abikoff, H., Pollack, E., Klein, D. F., Katz, S., & Mattes, J. (1980). A controlled trial of behavior modification and methylphenidate in hyperactive children. In C. Whalen & B. Henker (Eds.), Hyperactive children: The social ecolory of identification and treatment (pp. 221–243). New York: Academic Press.

    Google Scholar 

  • Grodzinsky, G. M., & Barkley, R. A. (1999). Predictive power of frontal lobe tests in the diagnosis of attention deficit hyperactivity disorder. Clinical Neuropsychology, 13, 11–21.

    Google Scholar 

  • Haenlein, M., & Caul, W. (1987). Attention deficit disorder with hyperactivity: A specific hypothesis of reward dysfunction. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 356–362.

    Google Scholar 

  • Hicks, R. E., Miller, G. W., Gaes, G., & Bierman, K. (1977). Concurrent processing demands and the experience of time in passing. American Journal of Psychology, 90, 431–446.

    Google Scholar 

  • Hicks, R. E., Miller, G. W., & Kinsbourne, M. (1976). Prospective and retrospective judgments of time as a function of amount of information processed. American Journal of Psychology, 89, 719–730.

    Google Scholar 

  • Kagan, J. (1965). Reflection-impulsivity and reading ability in primary grade children. Child Development, 36, 609–628.

    Google Scholar 

  • Kikkawa,M. (1983). The effects of distribution of attention on prospective and retrospective estimations of long temporal intervals. Journal of Child Development, 19, 14–22.

    Google Scholar 

  • Kindlon, D., Mezzacappa, E., & Earls, F. (1995). Psychometric properties of impulsivity measures: Temporal stability, validity and factor structure. Journal of Child Psychology and Psychiatry, 36, 645–661.

    Google Scholar 

  • Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, H. A., Hynd, G., Russo, M., Hartdagen, S., & Lorys-Vernon, A. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of the Child and Adolescent Psychiatry, 27, 330–335.

    Google Scholar 

  • Langer, J., Wadner, S., & Werner, H. (1961). The effect of danger upon the experience of time. American Journal of Psychology, 74, 94–97.

    Google Scholar 

  • Levy, F., & Hobbes, G. (1979). The influences of social class and sex on sustained attention (vigilance) and motor inhibition in children. Australia New Zealand Journal of Psychiatry, 13, 231–234.

    Google Scholar 

  • Logan, G. D., & Cowan, W. B. (1984). On the ability to inhibit thought and action: A theory of an act of control. Psychological Review, 91, 295–327.

    Google Scholar 

  • Logan, G., Cowan, W., & Davis, K. (1984). On the ability to inhibit simple and choice reaction time responses: A model and a method. Journal of Experimental Psychology and Human Perceptual Performance, 10, 276–292.

    Google Scholar 

  • Losier, B. J., McGrath, P. J., & Klein, R. M. (1996). Error patterns on the continuous performance test in non-medicated and medicated samples of children with and without ADHD: A meta-analytic review. Journal of Child Psychology and Psychiatry, 37, 971–987.

    Google Scholar 

  • March, J., Parker, J., Sullivan, K., Stallings, P., & Conners, C. K. (1997).The Multidimensional Anxiety Scale for Children (MASC): Factor structure, reliability, and validity. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 554–565.

    Google Scholar 

  • Milich, R., & Kramer, J. (1985). Reflections on impulsivity:Anempirical investigation of impulsivity as a construct. In K. Gadow & I. Bialer (Eds.), Advances in learning and behavioral disabilities (Vol. 3). Greenwich, CT: JAI.

    Google Scholar 

  • Mischel,W., Shoda,Y., & Rodriguez, M. L. (1989). Delay of gratification in children. Science, 244, 933–938.

    Google Scholar 

  • Oosterlaan, J., Logan, G. D., & Sergeant, J. A. (1998). Response inhibition in AD/HD, CD, co-morbid AD/HDCCD, anxious, and control children; a meta-analysis of studies with the stop task. Journal of Child Psychology and Psychiatry, 39, 411–425.

    Google Scholar 

  • Palkes, H., Stewart, M., & Kahana, B. (1968). Porteus maze performance of hyperactive boys after training in self-directed verbal commands. Child Development, 39, 817–826.

    Google Scholar 

  • Pelham, W. E., Milich, R., & Walker, J. L. (1986). Effects of continuous and partial reinforcement and methylphenidate on learning in children with attention deficit disorder. Journal of Abnormal Psychology, 95, 319–325.

    Google Scholar 

  • Pliszka, S. R., Borcherding, S. H., Spratley, K., Leon, S., & Irick, S. (1997). Measuring inhibitory control in children. Journal of Developmental and Behavioral Pediatrics, 18, 254–259.

    Google Scholar 

  • Rapport, M. D., Tucker, S. B., DuPaul, G. J., Merlo, M., & Stoner, G. (1986). Hyperactivity and frustration: The influence of control over and size of rewards in delaying gratification. Journal of Abnormal Child Psychology, 14, 191–204.

    Google Scholar 

  • Rielly, N. E., Cunningham, C. E., Richards, J. E., Elbard, H. J., & Mahoney, W. J. (1999). Detecting Attention Deficit Hyperactivity Disorder in a communications clinic: Diagnostic utility of the Gordon Diagnostic System. Journal of Clinical and Experimental Neuropsychology, 21, 685–700.

    Google Scholar 

  • Schachar, R., & Logan, G. D. (1990). Impulsivity and inhibitory control in normal development and childhood psychopathology. Developmental Psychology, 26, 710–720.

    Google Scholar 

  • Schachar, R., & Tannock, R. (1995). Test of four hypotheses for the comorbidity of attention-deficit hyperactivity disorder and conduct disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 639–648.

    Google Scholar 

  • Schachar, R., Tannock, R., Marriott, M., & Logan, G. (1995). Deficient inhibitory control in attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 23, 411–437.

    Google Scholar 

  • Schreiber, H. E., Javorsky, D. J., Robinson, J. E., & Stern, R. A. (1999). Rey-Osterrieth Complex Figure performance in adults with attention deficit hyperactivity disorder: A validation study of the Boston Qualitative Scoring System. Clinical Neuropsychology, 13, 509–520.

    Google Scholar 

  • Shaffer, D., Fisher, P., Dulcan, M., Davies, M., Piacentini, J., Schwab-Stone, M., Lahey, B. B., Bourdon, K., Jensen, P. S., Bird, H. R., Canino, G., & Regier, D. (1996). The NIMH Diagnostic Interview Schedule for ChildrenVersion 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 865–877.

    Google Scholar 

  • Solanto, M. V. (1990). The effects of reinforcement and response-cost on a delayed response task in children with attention deficit hyperactivity disorder: A research note. Journal of Child Psychology and Psychiatry, 31, 803–808.

    Google Scholar 

  • Solanto, M. V. (2001). Attention-Deficit/Hyperactivity Disorder: Clinical Features. In M. V. Solanto, A. F. T. Arnsten, & F. X. Castellanos (Eds.), Stimulant drugs and ADHD: Basic and clinical neuroscience. (pp. 3–30). New York: Oxford University Press.

    Google Scholar 

  • Sonuga-Barke, E. J. S., Houlberg, K. & Hall, M. (1994). When is “impulsiveness” not impulsive? The case of hyperactive children's cognitive style. Journal of Child Psychology and Psychiatry, 35, 1247–1253.

    Google Scholar 

  • Sonuga-Barke, E. J. S., & Taylor, E. (1992). The effect of delay on hyperactive and non-hyperactive children's response times: A research note. Journal of Child Psychology and Psychiatry, 33, 1091–1096.

    Google Scholar 

  • Sonuga-Barke, E. J. S., Taylor, E., & Heptinstall, E. (1992a). Hyperactivity and delay aversion II: The effects of self-imposed and externally imposed presentation time on memory. Journal of Child Psychology and Psychiatry, 33, 399–409.

    Google Scholar 

  • Sonuga-Barke, E. J. S., Taylor, E., Sembi, S., & Smith, J. (1992b). Hyperactivity and delay aversion I: The effect of delay on choice. Journal of Child Psychology and Psychiatry, 33, 387–398.

    Google Scholar 

  • Sonuga-Barke, E. J. S., Williams, E., Hall, M., & Saxton, T. (1996). Hyperactivity and delay aversion III: The effect on cognitive style of imposing delay after errors.Journal of Child Psychology and Psychiatry, 37, 189–194.

    Google Scholar 

  • Swanson, J., & Carlson, C. L. (1994). DSM-IV rating scale for ADHD and ODD. Unpublished manuscript.

  • Tannock, R., Schachar, R. J., Carr, R. P., Chajczyk, D., & Logan, G. D. (1989). Effects of methylphenidate on inhibitory control in hyperactive children. Journal of Abnormal Child Psychology, 17, 473–491.

    Google Scholar 

  • Tannock, R., Schachar, R., & Logan, G. (1995). Methylphenidate and cognitive flexibility: Dissociated dose effects in hyperactive children. Journal of Abnormal Child Psychology, 23, 235–266.

    Google Scholar 

  • Zentall, S. S., & Meyer, M. J. (1987). Self-regulation of stimulation for ADD-H children during reading and vigilance task performance. Journal of Abnormal Child Psychology, 15, 519–536.

    Google Scholar 

  • Zentall, S. S., & Zentall, T. R. (1983). Optimal stimulation: A model of disordered activity and performance in normal and deviant children. Psychological Bulletin, 94, 446–471.

    Google Scholar 

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Solanto, M.V., Abikoff, H., Sonuga-Barke, E. et al. The Ecological Validity of Delay Aversion and Response Inhibition as Measures of Impulsivity in AD/HD: A Supplement to the NIMH Multimodal Treatment Study of AD/HD. J Abnorm Child Psychol 29, 215–228 (2001). https://doi.org/10.1023/A:1010329714819

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