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Response Style Differences in the Inattentive and Combined Subtypes of Attention-Deficit/Hyperactivity Disorder

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Abstract

This study examined potential differences between the inattentive and combined ADHD subtypes using laboratory tasks assessing behavioral inhibitory processes. Seventy-five children completed two tasks of behavioral inhibition believed to isolate different processes: the cued reaction time task (CRT), a basic inhibition task, and the go/no-go task (GNG), a complex inhibition task that incorporates motivational contingencies. Three groups of participants were identified, including ADHD/Inattentive (n = 17), ADHD/Combined (n = 37), and comparison (n = 21). Results indicated that rather than showing behavioral inhibition deficits, the ADHD/I children appeared overly inhibited, as evidenced by slower reaction times across the two tasks and significantly higher errors of omission in the GNG task. Additionally, the ADHD/I children did not demonstrate cue dependency effects on the CRT task, suggesting that they were failing to incorporate relevant information before making a response. The sluggish and inhibited performance of the ADHD/I group challenges the idea that it is a subtype of ADHD.

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References

  • Abroms, B. D., Fillmore, M. T., & Marczinski, C. A. (2003). Alcohol-induced impairment of behavioral control: Effects on the alteration and suppression of prepotent responses. Journal of Studies on Alcohol, 64, 687–695.

    PubMed  Google Scholar 

  • Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington: University of Vermont Department of Psychiatry.

    Google Scholar 

  • American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Baeyens, D., Roeyers, H., & Vande Walle, J. (2006). Subtypes of attention-deficit/hyperactivity disorder (ADHD): Distinct or related disorders across measurement levels? Child Psychiatry and Human Development, 36, 403–417.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Barkley, R. A. (2001). The inattentive type of ADHD as a distinct disorder: What remains to be done. Clinical Psychology: Science and Practice, 8, 489–493.

    Article  Google Scholar 

  • Barkley, R. A. (2006). Attention-deficit hyperactivity disorder, 3rd ed.: A handbook for diagnosis and treatment. New York, NY: Guilford Press.

    Google Scholar 

  • Barr, C. L., Wigg, K. G., Bloom, S., Schachar, R., Tannock, R., Roberts, W., et al. (2000). Further evidence from haplotype analysis for linkage of the dopamine D4 receptor gene and ADHD. American Journal of Medical Genetics, 96, 262–267.

    Article  PubMed  Google Scholar 

  • Bauermeister, J. J., Barkley, R. A., & Martinez, J. V. (2005). Time estimation and performance on reproduction tasks in subtypes of children with attention deficit hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 34, 151–162.

    Article  PubMed  Google Scholar 

  • Carlson, C. L., & Mann, M. (2000). Attention-deficit/hyperactivity disorder, predominately inattentive subtype. Child and Adolescent Psychiatric Clinics of North America, 9, 499–510.

    PubMed  Google Scholar 

  • Carlson, C. L., & Mann, M. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, primarily inattentive type. Journal of Clinical Child and Adolescent Psychology, 31, 123–129.

    Article  PubMed  Google Scholar 

  • Carr, L. A., Nigg, J. T., & Henderson, J. M. (2006). Attentional versus motor inhibition in adults with attention deficit/hyperactivity disorder. Neuropsychology, 4, 430–441.

    Article  Google Scholar 

  • Castellanos, F. X., Sonuga-Barke, E. J. S., Milham, M. P., & Tannock, R. (2006). Characterizing cognition in ADHD: Beyond executive dysfunction. Trends in Cognitive Sciences, 10, 117–123.

    Article  PubMed  Google Scholar 

  • Castellanos, F. X., & Tannock, R. (2002). Neuroscience of attention-deficit/hyperactivity disorder: The search for endophenotypes. Nature Reviews: Neuroscience, 3, 617–628.

    PubMed  Google Scholar 

  • Conners, C. K. (1997). Conners’ rating scales—revised: Technical manual. North Tonawanda, NY: Multi-Health Systems.

    Google Scholar 

  • Daly, G., Hawi, Z., Fitzgerald, M., & Gill, M. (1999). Mapping susceptibility loci in attention deficit hyperactivity disorder: Preferential transmission of parental alleles at DAT1, DBH and DRD5 to affected children. Molecular Psychiatry, 4, 192–196.

    Article  PubMed  Google Scholar 

  • Diamond, A. (2005). Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention deficit/hyperactivity (with hyperactivity). Development and Psychopathology, 17, 807–825.

    Article  PubMed  Google Scholar 

  • Durston, S., Davidson, M. C., Mulder, M. J., Spicer, J. A., Galvan, A., Tottenham, N., et al. (2007). Neural and behavioral correlates of expectancy violations in attention-deficit hyperactivity disorder. Journal of Child Psychology and Psychiatry, 48, 881–889.

    Article  PubMed  Google Scholar 

  • Epstein, J. N., Johnson, D. E., Varia, I. M., & Conners, C. K. (2001). Neuropsychological assessment of response inhibition in adults with ADHD. Journal of Clinical and Experimental Neuropsychology, 23, 362–371.

    PubMed  Google Scholar 

  • Faraone, S. V., Biederman, J., Weber, W., & Russell, R. L. (1998). Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: Results from a clinically referred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 185–193.

    Article  PubMed  Google Scholar 

  • Fillmore, M. T., Marczinski, C. A., & Bowman, A. M. (2005). Acute tolerance to alcohol effects on inhibitory and activational mechanisms of behavioral control. Journal of Studies on Alcohol, 66, 663–672.

    PubMed  Google Scholar 

  • Flory, K., Milich, R., Lorch, E. P., Hayden, A. N., Strange, C., & Welsh, R. (2006). Online story comprehension among children with ADHD: Which core deficits are involved? Journal of Abnormal Child Psychology, 34, 853–865.

    Article  PubMed  Google Scholar 

  • Gray, J. A. (1991). The neuropsychology of temperament. In J. Strelau, & A. Angleitner (Eds.) Explorations in temperament: International perspectives on theory and measurement (pp. 105–128). Plenum: New York, NY.

    Google Scholar 

  • Hartman, C. A., Willcutt, E. G., Rhee, S. H., & Pennington, B. F. (2004). The relation between sluggish cognitive tempo and DSM-IV ADHD. Journal of Abnormal Child Psychology, 32, 491–503.

    Article  PubMed  Google Scholar 

  • Hartung, C. M., Milich, R., Lynam, D. R., & Martin, C. A. (2002). Understanding the relations among gender, disinhibition, and disruptive behavior in adolescents. Journal of Abnormal Psychology, 111, 659–664.

    Article  PubMed  Google Scholar 

  • Hinshaw, S. P. (2001). Is the inattentive type of ADHD a separate disorder? Clinical Psychology: Science and Practice, 8, 498–501.

    Article  Google Scholar 

  • Hinshaw, S. P. (2002). Preadolescent girls with attention-deficit/hyperactivity disorder: I. Background characteristics, comorbidity, cognitive and social functioning, and parenting practices. Journal of Consulting and Clinical Psychology, 70, 1086–1098.

    Article  PubMed  Google Scholar 

  • Huang-Pollock, C. L., Mikami, A. Y., Pfiffner, L., & McBurnett, K. (2007). ADHD subtype differences in motivational responsivity but not inhibitory control: Evidence from a reward-based variation of the stop signal paradigm. Journal of Clinical Child and Adolescent Psychology, 36, 127–136.

    Article  PubMed  Google Scholar 

  • Iaboni, F., Douglas, V. I., & Baker, A. G. (1995). Effects of reward and response costs on inhibition in ADHD children. Journal of Abnormal Psychology, 104, 232–240.

    Article  PubMed  Google Scholar 

  • Iaboni, F., Douglas, V. I., & Ditto, B. (1997). Psychophysiological response of ADHD children to reward and extinction. Psychophysiology, 34, 116–123.

    Article  PubMed  Google Scholar 

  • Lahey, B. B. (2001). Should the combined and predominantly inattentive types of ADHD be considered distinct and unrelated disorders? Not now, at least. Clinical Psychology: Science and Practice, 8, 494–497.

    Article  Google Scholar 

  • Lahey, B. B., Pelham, W. E., Loney, J., Lee, S. S., & Willcutt, E. (2005). Instability of the DSM-IV Subtypes of ADHD From Preschool Through Elementary School. Archives of General Psychiatry, 62, 896–902.

    Article  PubMed  Google Scholar 

  • Lijffijt, M., Kenemans, J. L., Verbaten, M. N., & van Engeland, H. (2005). A meta-analytic review of stopping performance in attention-deficit/hyperactivity disorder: Deficient inhibitory motor control? Journal of Abnormal Psychology, 114, 216–222.

    Article  PubMed  Google Scholar 

  • Logan, G. D. (1994). On the ability to inhibit thought and action: A users’ guide to the stop signal paradigm. In D. Dagenbach, & T. H. Carr (Eds.) Inhibitory processes in attention, memory, and language (pp. 189–239). Toronto: Academic.

    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.

    Article  Google Scholar 

  • Logan, G. D., & Irwin, D. E. (2000). Don’t look! Don’t touch! Inhibitory control of eye and hand movements. Psychonomic Bulletin & Review, 7, 107–112.

    Google Scholar 

  • Lorch, E. P., Sanchez, R. P., van den Broek, P., Milich, R., Murphy, E. L., Lorch, R. F., et al. (1999). The relation of story structure properties to recall of television stories in young children with attention-deficit hyperactivity disorder and nonreferred peers. Journal of Abnormal Child Psychology, 27, 293–309.

    Article  PubMed  Google Scholar 

  • Luman, M., Oosterlaan, J. A., & Sergeant, J. (2005). The impact of reinforcement contingencies on AD/HD: A review and theoretical appraisal. Clinical Psychology Review, 25, 183–213.

    Article  PubMed  Google Scholar 

  • MacCoon, D. G., Wallace, J. F., & Newman, J. P. (2004). Self-regulation: Context-appropriate balanced attention. In K. D. Vohs, & R. F. Baumeister (Eds.) Handbook of self-regulation: Research, theory, and applications (pp. 422–444). New York, NY: Guilford Press.

    Google Scholar 

  • Maedgen, J., & Carlson, C. L. (2000). Social functioning and emotional regulation in the attention deficit hyperactivity disorder subtypes. Journal of Clinical Child Psychology, 29, 30–42.

    Article  PubMed  Google Scholar 

  • Marczinski, C. A., & Fillmore, M. T. (2003). Preresponse cues reduce the impairing effects of alcohol on the execution and suppression of responses. Experimental and Clinical Psychopharmacology, 11, 110–117.

    Article  PubMed  Google Scholar 

  • Marshall, R. M., Hynd, G. W., Handwerk, M. J., & Hall, J. (1997). Academic underachievement in ADHD subtypes. Journal of Learning Disabilities, 30, 635–642.

    PubMed  Google Scholar 

  • McBurnett, K., Pfiffner, L. J., Willcutt, E., Tamm, L., Lerner, M., Ottolini, Y. L., et al. (1999). Experimental cross-validation of DSM-IV types of attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 17–24.

    Article  PubMed  Google Scholar 

  • Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463–488.

    Article  Google Scholar 

  • Milich, R., Hartung, C. M., Martin, C. A., & Haigler, E. D. (1994). Behavioral disinhibition and underlying processes in adolescents with disruptive behavior disorders. In D. K. Routh (Ed.) Disruptive behavior disorders in childhood (pp. 109–138). New York: Plenum.

    Google Scholar 

  • Newman, J. P., & Kosson, D. (1996). Passive avoidance learning in psychopathic and nonpsychopathic children. Journal of Abnormal Psychology, 95, 2257–2263.

    Google Scholar 

  • Newman, J. P., & Wallace, J. F. (1993). Diverse pathways to deficient self-regulation: Implications for disinhibitory psychopathology in children. Clinical Psychology Review, 13, 699–720.

    Article  Google Scholar 

  • Nichols, S. L., & Waschbusch, D. A. (2004). A review of the validity of laboratory cognitive tasks used to assess symptoms of ADHD. Child Psychiatry and Human Development, 34, 297–315.

    Article  PubMed  Google Scholar 

  • Nigg, J. T. (2000). On inhibition/disinhibition in developmental psychopathology: Views from cognitive and personality psychology and a working inhibition taxonomy. Psychological Bulletin, 126, 200–246.

    Article  Google Scholar 

  • Nigg, J. T. (2001). Is ADHD an inhibitory disorder? Psychological Bulletin, 127, 571–598.

    Article  PubMed  Google Scholar 

  • Nigg, J. T. (2006). What causes ADHD?: Understanding what goes wrong and why. New York, NY: Guilford Press.

    Google Scholar 

  • Nigg, J. T., Blaskey, L. G., Huang-Pollock, C. L., & Rappley, M. D. (2002). Neuropsychological executive functions and DSM-IV ADHD subtypes. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 59–66.

    Article  Google Scholar 

  • O'Driscoll, D. A., Depatie, L., Holahan, A. V., Savion-Lemieux, T., Barr, R. G., Jolicoeur, C., et al. (2005). Executive functions and methylphenidate response in subtypes of Attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 1452–1460.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Patterson, C., & Newman, J. P. (1993). Reflectivity and learning from aversive events: Toward a psychological mechanism for the syndromes of disinhibition. Psychological Review, 100, 716–736.

    Article  PubMed  Google Scholar 

  • Pelham, W. E. (2001). Are ADHD/I and ADHD/C the same or different? Does it matter? Clinical Psychology: Science and Practice, 8, 502–506.

    Article  Google Scholar 

  • Pennington, B. E., & Ozonoff, S. (1996). Executive functions and developmental psychopathology. Journal of Child Psychology and Psychiatry, 37, 51–87.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Pliszka, S. R., Hatch, J. P., Bocherding, S. H., & Rogeness, G. A. (1993). Classical conditioning in children with attention deficit hyperactivity disorder (ADHD) and anxiety disorders: A test of Quay’s model. Journal of Abnormal Child Psychology, 21, 411–523.

    Article  PubMed  Google Scholar 

  • Pfiffner, L. J., Mikami, A. Y., Huang-Pollock, C. L., Easterlin, B., Zalecki, C., & McBurnett, K. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1041–1050.

    Article  PubMed  Google Scholar 

  • Quay, H. (1988). The behavioral reward and inhibition system in childhood behavior disorder. Elmsford, NY: Pergamon.

    Google Scholar 

  • Quay, H. C. (1997). Inhibition and attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 25, 7–13.

    Article  PubMed  Google Scholar 

  • Rey, J. M., Schrader, E., & Morris-Yates, A. (1992). Parent-child agreement on children’s behaviours reported by the Child Behavior Checklist (CBCL). Journal of Adolescence, 15, 219–230.

    Article  PubMed  Google Scholar 

  • Riccio, C. A., Homack, S., Jarratt-Pizzitola, K., & Wolfe, M. E. (2006). Differences in academic and executive function domains among children with ADHD predominantly inattentive and combined types. Archives of Clinical Neuropsychology, 21, 657–667.

    Article  PubMed  Google Scholar 

  • Rommelse, N. N. J., Altink, M. E., Sonneville, L. M. J., Buschgens, C. J. M., Buitelaar, J., Oosterlaan, J., et al. (2007). Are motor inhibition and cognitive flexibility dead ends in ADHD? Journal of Abnormal Child Psychology, 35, 957–967.

    Article  PubMed  Google Scholar 

  • Rowe, D. C., Stever, C., & Gard, J. M. C. (1998). The relation of the dopamine transporter gene (DAT1) to symptoms of internalizing disorders in children. Behavior Genetics, 28, 215–225.

    Article  PubMed  Google Scholar 

  • Smoller, J. W., Biederman, J., Arbeitman, L., Doyle, A. E., Fagerness, J., Perlis, R. H., et al. (2006). Association between the 5HT1B receptor gene (HTR1B) and the inattentive subtype of ADHD. Biological Psychiatry, 59, 460–467.

    Article  PubMed  Google Scholar 

  • Solanto, M. V., Gilbert, S. N., Raj, A., Zhu, J., Pope-Boyd, S., Stepak, B., et al. (2007). Neurocognitive functioning in AD/HD, predominantly inattentive and combined subtypes. Journal of Abnormal Child Psychology, 35, 729–744.

    Article  PubMed  Google Scholar 

  • Weiss, M. D., Worling, D. E., & Wasdell, M. B. (2003). A chart review study of the Inattentive and Combined Types of ADHD. Journal of Attention Disorders, 7, 1–9.

    Article  PubMed  Google Scholar 

  • Weller, E. B., Weller, R. A., Rooney, M. T., & Fristad, M. A. (1999). ChIPS. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Wilens, T., Pelham, W., Stein, M., Conners, C., Abikoff, H., Atkins, M., et al. (2003). ADHD treatment with once-daily OROS methylphenidate: Interim 12-month results from a long-term open-label study. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 424–433 (April).

    Article  Google Scholar 

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Acknowledgments

This research was supported by the National Institute on Drug Abuse grants DA021027 and DA005312.

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Authors and Affiliations

  1. Department of Psychology, University of Kentucky, 202A Kastle Hall, Lexington, KY, 40506-0044, USA

    Karen J. Derefinko, Zachary W. Adams, Richard Milich, Mark T. Fillmore & Elizabeth P. Lorch

  2. Department of Psychological Sciences, Purdue University, West Lafayette, IN, USA

    Donald R. Lynam

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  1. Karen J. Derefinko
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  2. Zachary W. Adams
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  3. Richard Milich
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  6. Donald R. Lynam
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Correspondence to Richard Milich.

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Derefinko, K.J., Adams, Z.W., Milich, R. et al. Response Style Differences in the Inattentive and Combined Subtypes of Attention-Deficit/Hyperactivity Disorder. J Abnorm Child Psychol 36, 745–758 (2008). https://doi.org/10.1007/s10802-007-9207-3

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