Lin Sørensen

The attention network test: a characteristic pattern of deficits in children with ADHD

BackgroundThe Attention Network test (ANT) gives measures of different aspects of the complex process of attention. We ask if children with Attention Deficit Hyperactivity Disorder (ADHD) will show a characteristic pattern of deficits on this test.MethodsThe sample included 157 children (M = 10 years) who performed the child version of ANT as participants of the Bergen Child Study. Children with an ADHD diagnosis (N = 45) were compared to a group of children with other diagnoses (N = 55) and a group of children without any diagnosis (N = 57).ResultsThe group of children with ADHD showed low accuracy scores and a variable response set, indicating an inattentive response style. No differences were found between the groups on RT and accuracy measures of the alerting, orienting, and conflict networks. A high correlation between full scale IQ (FSIQ) and ANT measures was only found in the ADHD group. When FSIQ score was included as a covariate, the group differences were not statistically significant on any ANT measure.ConclusionThe present study showed that accuracy and variability measures rather than measures of the three attention networks conveyed the characteristic pattern of deficits in children with ADHD. The results emphasized the importance of including these measures to extend the sensitivity of the ANT, and the importance of reporting results both with and without FSIQ as a covariate.

Enduring cognitive dysfunction in unipolar major depression: a test-retest study using the Stroop paradigm.

The aim of the study was to investigate automatic and effortful information processing with the Stroop paradigm in a long term perspective in patients with major depressive disorder (MDD). Patients were tested at two test occasions: at inclusion with a Hamilton Depression Rating Scale (HDRS) score >18, and after 6 months, when most patients had experienced symptom reduction. The Stroop paradigm is considered to measure aspects of attention and executive functioning and consists of three conditions/cards: naming the color of the patches (Color), reading of the color-words (Word) and naming the ink color of color-words (Color-Word). The Color-Word condition is proved to be the most cognitive demanding task and requires the proband to actively suppress interference and is therefore considered to require more effortful information processing, whereas naming the color of the patches and reading the color-words are expected to be more automatic and less cognitive demanding. A homogenous group of 19 patients with unipolar recurrent MDD according to DSM-IV and a HDRS score of >18 were included in the study. A control group was individually matched for age, gender and level of education. Depressed patients performed equal to the control group on the Color and Word cards at both test occasions. However, the patients were impaired compared with the control group on the Color-Word card task at both test occasions. Thus, the depressed patients showed no improvement of effortful attention/executive performance as a function of symptom reduction. The results indicate that the depressed patients showed impaired cognitive performance on cognitive demanding tasks when symptomatic and that this impairment prevailed after 6 months, despite significant improvement in their depressive symptoms.

Is Behavioral Regulation in Children with ADHD Aggravated by Comorbid Anxiety Disorder

Background: The present study investigated the impact of coexisting anxiety disorder in children with ADHD on their ability to regulate behavior. Method: Parent reports on the Behavior Rating Inventory of Executive Function (BRIEF) in a comorbid group of children with ADHD and anxiety (n = 11) were compared to BRIEF reports in a group of children with a “pure” ADHD (n = 23), a “pure” anxiety (n = 24) and a group without any diagnosis (n = 104) in a 2 (ADHD vs. no ADHD) × 2 (anxiety vs. no anxiety) design. Results: The children with ADHD and anxiety disorder scored significantly higher on the Inhibit scale than children within the other three groups. Main effects of diagnosis appeared in ADHD children on the Inhibit, Emotional Control, and Working Memory scales, and on the Shift and Emotional Control scales in anxious children. Conclusion: The results indicate that a behavioral dysregulation in ADHD children is aggravated by comorbid anxiety.

Attention Deficits in Children With Combined Autism and ADHD: A CPT Study

Objective: To investigate characteristics of attention in children with the combination of autism spectrum disorder (ASD) and ADHD. Method: Four groups of 8- to 10-year-old children were compared on the Conners’ Continuous Performance Test–Second Edition (CCPT-II): (a) ASD + ADHD (n = 11), (b) ASD only (n = 9), (c) ADHD only (n = 38), and (d) no diagnosis (n = 134). Results: There was an overall effect of group on the Continuous Performance Test (CPT) index and measures of hit reaction time, accuracy, response style, variability, and consistency. The ASD + ADHD group, much like the ADHD only group, had a more risky response style, a higher variability, and a lower consistency than the ASD only group. The impact of intellectual function on CCPT-II performance was considerable in children within the ASD subgroups. Conclusion: The findings underscore the importance of including measures of attention and intellectual function when assessing children with the combination of ASD and ADHD.

Intellectual Deficits in Children with ADHD Beyond Central Executive and Non-Executive Functions

This study aimed to specify the deficit in intellectual ability in children with attention deficit hyperactivity disorder (ADHD), by studying the mediating role of impairments in central executive function (EF)-related components (working memory, inhibition, sustained attention) and non-EFs (short-term memory and processing speed). Two hundred and thirty children aged 8-11 years from a population-based sample were assigned to either the ADHD group, the clinical comparison group, or the normal comparison group. The results showed that children with ADHD had poorer fluid and crystallized intelligence, relative to both comparison groups. Further, regarding fluid intelligence, these deficits were not fully mediated by, but rather went beyond, poorer functioning on the studied EF-related components and non-EFs. We tentatively interpret these fluid deficits in children with ADHD as representing deficiencies in a general intellectual resource reflecting executive attentional processes. Concerning crystallized ability, in contrast, the deficit signified impairment in the studied cognitive functions, as indicated by the significant full mediation effect.

Trait Self-Compassion Reflects Emotional Flexibility Through an Association with High Vagally Mediated Heart Rate Variability

Converging evidence shows a positive effect of self-compassion on self-reported well-being and mental health. However, few studies have examined the relation between self-compassion and psychophysiological measures. In the present study, we therefore examined the relation between trait self-compassion and vagally mediated heart rate variability (vmHRV) in 53 students (39 female, mean age = 23.63). Trait self-compassion was assessed using the Self-Compassion Scale, and resting vmHRV was measured during a 5-min ECG baseline period. We hypothesized that higher levels of trait self-compassion would predict higher levels of resting vmHRV. Controlling for potential covariates (including age, gender, and BMI), the results confirmed our hypotheses, showing that higher levels of trait self-compassion predicted higher vmHRV. These results were validated with a 24-h measure of vmHRV, acquired from a subsample of the participants (n = 26, 16 female, mean age = 23.85), confirming the positive correlation between high trait self-compassion and higher vmHRV. The relation between trait self-compassion, vmHRV, self-reported trait anxiety (the trait scale of the State-Trait Anxiety Inventory; STAI) and self-reported rumination (the Rumination subscale of the Rumination-Reflection Questionnaire; RRQ-Rum) was also investigated. Higher levels of trait anxiety and rumination were highly correlated with low levels of trait self-compassion. Trait anxiety, but not rumination, correlated marginally significantly with the level of vmHRV. The findings of the present study indicate that trait self-compassion predicts a better ability to physiologically and psychologically adapt emotional responses. Possible implications and limitations of the study are discussed.

Intelligence and Specific Cognitive Abilities in Children

This community-based study investigated the relationships between measures of specific cognitive functions (such as working memory [WM] and interference control) and intelligence in 283 8- to 11-year-old children, including 124 children who fulfilled criteria for a psychiatric diagnosis. A hierarchical regression analysis was used to overcome issues of overlapping predictor constructs. The results generally showed that measures of processing speed, WM, as well as inhibitory interference control entered in the order of presentation, each contributed uniquely to the explanation of fluid intelligence performance. The results for crystallized intelligence performance generally showed that the measures of processing speed, short-term memory (STM), WM, and sustained attention – entered in that order – made significant independent contributions. While effect sizes varied somewhat for contributions in the whole sample compared with the subgroup not meeting criteria for a psychiatric diagnosis, there were no signi...

A Longitudinal Examination of the Developmental Executive Function Hierarchy in Children With Externalizing Behavior Problems

Objective: Using a 4-year longitudinal design, we evaluated two hypotheses based on developmental executive function (EF) hierarchy accounts in a sample of children with externalizing problems. Method: The participants performed EF tasks when they were between 8 and 12 years (M = 9.93), and again approximately 4 years later when they were between 12 and 15 years (M = 13.36). Results: Inhibition in middle childhood predicted working memory (WM) 4 years later. Further, deficits in inhibition and sustained attention were more prominent in middle rather than late childhood, whereas poor WM was salient throughout these periods. Conclusions: These findings support the hypotheses that EFs develop hierarchically and that EF deficits in ADHD are more prominent in actively developing EFs. They also emphasize ADHD as a developmental disorder.

Emotional Symptoms in Inattentive Primary School Children: A Population-Based Study

Objective: The present study investigates teacher and parent reports of inattention and emotional symptoms in 6,229 primary school children. Method: The assessment included the Emotional Symptoms subscale and the Impact scale from the Strengths and Difficulties Questionnaire and the inattention items from the Swanson, Nolan, and Pelham IV Questionnaire. Results: Children defined as inattentive showed a high risk of being defined as high scorers on the Emotional Symptoms subscale. A high score on both the Inattention and Emotional Symptoms subscales was associated with a high impact score. Teachers but not parents reported a higher risk of such co-occurrence of symptoms in girls than in boys. Conclusion: Inattentive children should be screened for emotional problems by use of the multi-informants method. (J. of Att. Dis. 2008; 11(5) 580-587 )

Performance Monitoring in Medication-Naïve Children with Tourette Syndrome.

Background: Tourette syndrome (TS) is a childhood-onset neurodevelopmental disorder and its impact on cognitive development needs further study. Evidence from neuropsychological, neuroimaging and electrophysiological studies suggests that the decline in tic severity and the ability to suppress tics relate to the development of self-regulatory functions in late childhood and adolescence. Hence, tasks measuring performance monitoring might provide insight into the regulation of tics in children with TS. Method: Twenty-five children with TS, including 14 with comorbid Attention-deficit/ hyperactivity disorder (ADHD), 39 children with ADHD and 35 typically developing children aged 8–12 years were tested with a modified Eriksen-Flanker task during a 34-channel electroencephalography (EEG) recording. Task performance, as well as stimulus-locked and response-locked event-related potentials (ERP) were analyzed and compared across groups. Results: Participants did not differ in their behavioral performance. Children with TS showed higher amplitudes of an early P3 component of the stimulus-locked ERPs in ensemble averages and in separate trial outcomes, suggesting heightened orienting and/or attention during stimulus evaluation. In response-locked averages, children with TS had a slightly higher positive complex before the motor response, likely also reflecting a late P3. Groups did not differ in post-response components, particularly in the error-related negativity (ERN) and error-related positivity (Pe). Conclusions: These findings suggest that children with TS may employ additional attentional resources as a compensatory mechanism to maintain equal behavioral performance.