Yvonne Groen

Risky Behavior in Gambling Tasks in Individuals with ADHD : A Systematic Literature Review

Objective The aim of this review was to gain insight into the relationship between Attention deficit hyperactivity disorder (ADHD) and risky performance in gambling tasks and to identify any potential alternate explanatory factors. Methods PsycINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing individuals with ADHD to normal controls (NCs) in relation to their risky performance on a gambling task. In total, fourteen studies in children/adolescents and eleven studies in adults were included in the review. Results Half of the studies looking at children/adolescents with ADHD found evidence that they run more risks on gambling tasks when compared to NCs. Only a minority of the studies on adults with ADHD reported aberrant risky behavior. The effect sizes ranged from small to large for both age groups and the outcome pattern did not differ between studies that applied an implicit or explicit gambling task. Two studies demonstrated that comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) increased risky behavior in ADHD. Limited and/or inconsistent evidence was found that comorbid internalizing disorders (IDs), ADHD subtype, methylphenidate use, and different forms of reward influenced the outcomes. Conclusion The evidence for increased risky performance of individuals with ADHD on gambling tasks is mixed, but is stronger for children/adolescents with ADHD than for adults with ADHD, which may point to developmental changes in reward and/or penalty sensitivity or a publication bias for positive findings in children/adolescents. The literature suggests that comorbid ODD/CD is a risk factor in ADHD for increased risky behavior. Comorbid IDs, ADHD subtype, methylphenidate use, and the form of reward received may affect risky performance in gambling tasks; however, these factors need further examination. Finally, the implications of the findings for ADHD models and the ecological validity of gambling tasks are discussed.

Physiological correlates of learning by performance feedback in children : a study of EEG event-related potentials and evoked heart rate

In this study we measured event-related potentials (ERPs) and evoked heart rate (EHR) to investigate performance monitoring in 10-12-year-old children. The children received feedback on their performance while conducting a probabilistic learning task. Error-related ERP components time-locked to the response increased in amplitude when the children had learned the task, whereas the feedback-locked components decreased. Concerning EHR, there was a general reduction in feedback-related heart rate deceleration when the children had learned. Moreover, a prolonged heart rate deceleration was observed at negative feedback onset in comparison to positive feedback, which shifted in timing when the task progressed. Together, the ERP and EHR-measures suggest a shift from external to internal monitoring when the children are learning by performance feedback. The data suggest that error- and feedback-related EHR deceleration is a reflection of the same error monitoring system that is responsible for the emergence of the error-related negativity (ERN).

Are there sex differences in ERPs related to processing empathy-evoking pictures?

OBJECTIVE This study aimed to investigate sex differences in the temporal dynamics of experiencing empathy by using electrophysiological measurements. METHODS Twenty-five females and 27 males viewed 414 pictures of the International affective picture system varying in emotional valence (positive, negative and neutral) and presence of humans (human and scenes). EEG event related potentials (ERPs) were obtained and correlations were computed with self-reported empathy. RESULTS Compared to males, females showed increased anterior N2 and parietal LPP amplitudes to humans contrasted with scenes (independent of emotional valence) and to negative contrasted with neutral emotions (independent of human presence). Independent of sex the N1 and anterior N2 were specifically increased for positive human emotions and the parietal LPP for negative human emotions. Across sexes, the N2 and LPP human emotion effects and LPP human effects were associated with self-reported affective empathy, but not with cognitive empathy. CONCLUSIONS This study provides electrophysiological evidence that women prioritize the processing of socially relevant and negative emotional information, but that women did not show enhanced brain potentials to pictures with positive or negative emotions in humans.

Detection of feigned attention deficit hyperactivity disorder

In recent years, there is an increasing awareness that individuals may purposely feign or exaggerate symptoms of attention deficit hyperactivity disorder (ADHD) to gain external incentives, including access to stimulant drugs or special academic accommodations. There are vast consequences of undetected feigned ADHD such as substantial costs covered by society for unnecessary assessments and treatments, unjustified occupation of limited medical resources and undermining society’s trust in the existence of the disorder or the effectiveness of treatment. In times of economic crisis and cost savings in the medical sector, the detection of feigned ADHD is of importance. This review briefly describes the research on this topic with an emphasis on the approaches available for detection of feigned ADHD (i.e., self-report questionnaires, personality inventories, cognitive tests used in routine neuropsychological assessment and tests specifically designed for detecting feigned cognitive dysfunction). Promising approaches and measures are available for identifying feigned ADHD but there is an immediate need for further research.

Variants of the SLC6A3 (DAT1) polymorphism affect performance monitoring-related cortical evoked potentials that are associated with ADHD

Although the 10-repeat (10R) variant of the dopamine transporter gene (DAT1 or SLC6A3) is suggested to be a risk allele for Attention Deficit Hyperactivity Disorder (ADHD) no relationships between DAT1 and measures of cognition in children with ADHD have yet been demonstrated. We studied neurophysiological correlates of performance monitoring during a feedback-based learning task by measuring cortical event-related potentials (ERPs) in a group of 65 10-13-year-old children half of whom were diagnosed as ADHD. The first part of the study investigates correlations between parent-reported behaviour problems and several performance monitoring components, while the second part investigates the relationship between DAT1 and these components. Specifically ADHD problems correlated significantly with an error-related positivity (Pe) and a feedback-anticipatory negativity (the SPN). Only these two components discriminated between the DAT1 10/10R and 9R carriers. The 10/10R carriers showed a smaller Pe to errors and a smaller SPN in anticipation of negative feedback, particularly with learning.

Oxytocin enhances orienting to social information in a selective group of high-functioning male adults with autism spectrum disorder

OBJECTIVE The study investigated the effects of nasally administered oxytocin on neurophysiological orienting to empathy-evoking pictures in normally intelligent male adults with and without an autism spectrum disorder (ASD). It further investigated whether these effects might be moderated by the individuals approach and avoidance tendencies. METHODS All subjects participated in a randomised double-blind placebo controlled crossover trial where either oxytocin (OXT) or placebo was administered preceding the viewing of affective pictures.The pictures, selected from the International Affective Picture System (IAPS), represented a systematic variation of pleasant, unpleasant and neutral scenes with and without humans. Both cardiac (ECR) and cortical (LPP) evoked orienting responses were measured and both were enhanced for the pictures with humans, in particular for the unpleasant ones. RESULTS No significant group differences were found, nor were there any treatment effects. Moderator analysis, however, demonstrated that OXT did enhance orienting to affective pictures with humansin male adults with ASD who are easily distressed when seeing others in stressful situations and in healthy males who are highly sensitive to anticipated punishment and criticism or have a low drive for goal achievement. CONCLUSION Individual differences in stress-related avoidance tendencies should be taken into account when considering OXT as a treatment of social deficiencies in autism.

Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review

As attention–deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed developmental disorders in childhood, effective yet safe treatment options are highly important. Recent research introduced physical exercise as a potential treatment option, particularly for children with ADHD. The aim of this review was to systematically analyze potential acute and chronic effects of cardio and non-cardio exercise on a broad range of functions in children with ADHD and to explore this in adults as well. Literature on physical exercise in patients with ADHD was systematically reviewed based on categorizations for exercise type (cardio versus non-cardio), effect type (acute versus chronic), and outcome measure (cognitive, behavioral/socio-emotional, and physical/(neuro)physiological). Furthermore, the methodological quality of the reviewed papers was addressed. Cardio exercise seems acutely beneficial regarding various executive functions (e.g., impulsivity), response time and several physical measures. Beneficial chronic effects of cardio exercise were found on various functions as well, including executive functions, attention and behavior. The acute and chronic effects of non-cardio exercise remain more questionable but seem predominantly positive too. Research provides evidence that physical exercise represents a promising alternative or additional treatment option for patients with ADHD. Acute and chronic beneficial effects of especially cardio exercise were reported with regard to several cognitive, behavioral, and socio-emotional functions. Although physical exercise may therefore represent an effective treatment option that could be combined with other treatment approaches of ADHD, more well-controlled studies on this topic, in both children and adults, are needed.

Processing of Continuously Provided Punishment and Reward in Children with ADHD and the Modulating Effects of Stimulant Medication: An ERP Study

Objectives Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication. Methods 15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditions: no-feedback, gain and loss. Event Related Potentials (ERPs) time-locked to feedback and errors were computed. Results All groups performed more accurately with gain and loss than without feedback. Feedback-related ERPs demonstrated no group differences in the feedback P2, but an enhanced late positive potential (LPP) to feedback stimuli (both gains and losses) for Mph-free children with ADHD compared to controls. Feedback-related ERPs in Mph-treated children with ADHD were similar to controls. Correlational analyses in the ADHD groups revealed that the severity of inattention problems correlated negatively with the feedback P2 amplitude and positively with the LPP to losses and omitted gains. Conclusions The early selective attention for rewarding and punishing feedback was relatively intact in children with ADHD, but the late feedback processing was deviant (increased feedback LPP). This may explain the often observed positive effects of continuous reinforcement on performance and behaviour in children with ADHD. However, these group findings cannot be generalised to all individuals with the ADHD, because the feedback-related ERPs were associated with the severity of the inattention problems. Children with ADHD-combined type with more inattention problems showed both deviant early attentional selection of feedback stimuli, and deviant late processing of non-reward and punishment.

Sex Differences in Orienting to Pictures with and without Humans: Evidence from the Cardiac Evoked Response (ECR) and the Cortical Long Latency Parietal Positivity (LPP)

Objective This study investigated the effect of social relevance in affective pictures on two orienting responses, i.e. the evoked cardiac response (ECR), and a long latency cortical evoked potential (LPP) and whether this effect would differ between males and females. Assuming that orienting to affective social information is fundamental to experiencing affective empathy, associations between self-report measures of empathy and the two orienting responses were investigated. Method ECRs were obtained from 34 female and 30 male students, and LPPs from 25 female and 27 male students viewing 414 pictures from the International Affective Picture System. Pictures portrayed pleasant, unpleasant and neutral scenes with and without humans. Results Both the ECR and LPP showed the largest response to pictures with humans in unpleasant situations. For both measures, the responses to pictures with humans correlated with self-report measures of empathy. While we found a greater male than female responsiveness to the pictures without humans in the ECR, a greater female than male responsiveness was observed in the LPP response to pictures with humans. Conclusion and Significance The sensitivity of these orienting responses to social relevance and their differential contribution to the prediction of individual differences underline the validity of their combined use in clinical studies investigating individuals with social disabilities.

Sluggish Cognitive Tempo and Its Neurocognitive, Social and Emotive Correlates: A Systematic Review of the Current Literature

ObjectivesSince the elimination of items associated with Sluggish Cognitive Tempo (SCT) during the transition from DSM-III to DSM-IV from the diagnostic criteria of Attention-deficit Hyperactivity Disorder (ADHD), interest in SCT and its associated cognitive as well as emotional and social consequences is on the increase. The current review discusses recent findings on SCT in clinical as well as community based ADHD populations. The focus is further on clinical correlates of SCT in populations different from ADHD, SCT’s genetic background, SCT’s association with internalizing and other behavioral comorbidities, as well as SCT’s association with social functioning and its treatment efficacy.MethodA systematic review of empirical studies on SCT in ADHD and other pathologies in PsycInfo, SocIndex, Web of Science and PubMed using the key terms “Sluggish Cognitive Tempo”, “Cognitive Tempo”, “Sluggish Tempo” was performed. Thirty-two out of 63 studies met inclusion criteria and are discussed in the current review.Results/ConclusionFrom the current literature, it can be concluded that SCT is a psychometrically valid construct with additive value in the clinical field of ADHD, oppositional defiant disorder (ODD), internalizing disorders and neuro-rehabilitation. The taxonomy of SCT has been shown to be far from consistent across studies; however, the impact of SCT on individuals’ functioning (e.g., academic achievement, social interactions) seems remarkable. SCT has been shown to share some of the genes with ADHD, however, related most strongly to non-shared environmental factors. Future research should focus on the identification of adequate SCT measurement to promote symptom tailored treatment and increase studies on SCT in populations different from ADHD.