Publication category Archives
Inhibitory deficits and symptoms of attention‐deficit hyperactivity disorder: How are they related to effortful control?
Kostyrka‐Allchorne, K., Wass, S. V., Yusuf, H., Rao, V., Bertini, C., & Sonuga‐Barke, E. J. 2023. British Journal of Developmental Psychology
Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms – inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.
Inhibitory deficits and symptoms of attention‐deficit hyperactivity disorder: How are they related to effortful control?
Kostyrka‐Allchorne, K., Wass, S. V., Yusuf, H., Rao, V., Bertini, C., & Sonuga‐Barke, E. J. 2023. British Journal of Developmental Psychology
Separate studies with clinical and community-based samples have identified an association between symptoms of attention-deficit hyperactivity disorder (ADHD) and inhibitory control deficits and ADHD and weak effortful control. We tested whether differences in effortful control explained the associations between ADHD symptoms and inhibitory control deficits, controlling for conduct problems. In a community sample, parents rated ADHD symptoms, conduct problems, effortful control, surgency and negative affect in 77 4-7-year-olds (47 girls), who performed an inhibitory control task. ADHD symptoms, deficient inhibitory control and low effortful control were correlated. Controlling for conduct problems, path analysis showed the ADHD symptoms – inhibitory control link was mediated statistically by effortful control. This focuses attention on cognitive-energetic factors associated with ADHD-related executive deficits.
Erratum to: Attention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial.
Goodwin, A., Salomone, S., Bolton, P., Charman, T., Jones, E. J., Mason, L., ... & Johnson, M. H. 2017. Trials
Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that can negatively impact on an individual’s quality of life. It is pathophysiologically complex and heterogeneous with different neuropsychological processes being impaired in different individuals. Executive function deficits, including those affecting attention, working memory and inhibitory control, are common. Cognitive training has been promoted as a treatment option, based on the notion that by strengthening the neurocognitive networks underlying these executive processes, ADHD symptoms will also be reduced. However, if implemented in childhood or later, when the full disorder has become well-established, cognitive training has only limited value. INTERSTAARS is a trial designed to test a novel approach to intervention, in which cognitive training is implemented early in development, before the emergence of the disorder. The aim of INTERSTAARS is to train early executive skills, thereby increasing resilience and reducing later ADHD symptoms and associated impairment. Methods/design: Fifty 10–14-month-old infants at familial risk of ADHD will participate in INTERSTAARS. Infants will be randomised to an intervention or a control group. The intervention aims to train early attention skills by using novel eye-tracking technology and gaze-contingent training paradigms. Infants view animated games on a screen and different events take place contingent on where on the screen the infant is looking. Infants allocated to the intervention will receive nine weekly home-based attention training sessions. Control group infants will also receive nine weekly home visits, but instead of viewing the training games during these visits they will view non-gaze-contingent age-appropriate videos. At baseline and post treatment, infant attention control will be assessed using a range of eye-tracking, observational, parent-report and neurophysiological measures. The primary outcome will be a composite of eye-tracking tasks used to assess infant attention skills. Follow-up data will be collected on emerging ADHD symptoms when the infants are 2 and 3 years old. Discussion: This is the first randomised controlled trial to assess the potential efficacy of cognitive training as a prevention measure for infants at familial risk of ADHD. If successful, INTERSTAARS could offer a promising new approach for developing early interventions for ADHD
: Attention training for infants with elevated likelihood of developing ADHD: A proof-of-concept randomised controlled trial
Goodwin, A., Jones, E. J., Salomone, S., Mason, L., Holman, R., Begum-Ali, J., ... & Johnson, M. H. 2021. Translational Psychiatry
Attention-deficit/hyperactivity disorder (ADHD) is first diagnosed during middle childhood, when patterns of difficulty are often established. Pre-emptive approaches that strengthen developing cognitive systems could offer an alternative to post-diagnostic interventions. This proof-of-concept randomised controlled trial (RCT) tested whether computerised gaze-based attention training is feasible and improves attention in infants liable to develop ADHD. Forty-three 9- to 16-month-old infants with a first-degree relative with ADHD were recruited (11/2015-11/2018) at two UK sites and randomised with minimisation by site and sex to receive 9 weekly sessions of either (a) gaze-contingent attention training (intervention; n = 20); or (b) infant-friendly passive viewing of videos (control, n = 23). Sessions were delivered at home with blinded outcome assessments. The primary outcome was a composite of attention measures jointly analysed via a multivariate ANCOVA with a combined effect size (ES) from coefficients at baseline, midpoint and endpoint (Registration: ISRCTN37683928 ). Uptake and compliance was good but intention-to-treat analysis showed no significant differences between 20 intervention and 23 control infants on primary (ES -0.4, 95% CI -0.9 to 0.2; Complier-Average-Causal Effect ES -0.6, 95% CI -1.6 to 0.5) or secondary outcomes (behavioural attention). There were no adverse effects on sleep but a small increase in post-intervention session fussiness. Although feasible, there was no support for short-term effects of gaze-based attention training on attention skills in early ADHD. Longer-term outcomes remain to be assessed. The study highlights challenges and opportunities for pre-emptive intervention approaches to the management of ADHD.
Future preferences and prospection of future of outcomes: Independent yet specific associations with atteniton-defecit/hyperactivity disorder
Kostyrka-Allchorne, K., Cooper, N. R., Wass, S. V., Fenner, B., Gooding, P., Hussain, S., ... & Sonuga-Barke, E. J. 2020. Adolescence
Symptoms of attention-deficit hyperactivity disorder (ADHD) and conduct problems have been associated with heightened temporal discounting of reward value resulting in a preference for immediate over delayed outcomes. We examined the cross-sectional relationship between future preference (including intertemporal choice) and prospection (the ability to bring to mind and imagine the experience of future personally-relevant events and outcomes) in adolescents with a range of ADHD symptoms and aggressive behaviour. Methods
A combination of behavioural tasks and self-reports measured intertemporal decision making, individual differences in preference for future outcomes and experience of prospection in a convenience sample of English adolescents aged 11–17 (n = 64, 43.8% males). Parents rated symptoms of ADHD and aggression.
Results
& Conclusions: Factor analysis identified two factors: “Future Preference” and “Prospection”. Significant negative bivariate correlations were found between ADHD and the scores of both factors and between aggression and Future Preference. A path model confirmed the independent significant association of ADHD with both factors but not with aggression. There was no evidence that Prospection was associated with Future Preference or that it reduced the associations between ADHD symptoms and Future Preference. These results provide further evidence that ADHD is associated with a tendency to prefer immediate over future outcomes. The same association with aggression seemed to be driven by the overlap with ADHD symptoms. We provide some of the first evidence that individuals with high ADHD symptoms have difficulty in prospecting about future episodes. However, this is unrelated to their preference for future outcomes.
Attention training for infants at familial risk of ADHD (INTERSTAARS): study protocol for a randomised controlled trial
Goodwin, A., Salomone, S., Bolton, P., Charman, T., Jones, E. J., Pickles, A., ... & Johnson, M. H. 2016. Trials
Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that can
negatively impact on an individual’s quality of life. It is pathophysiologically complex and heterogeneous with
different neuropsychological processes being impaired in different individuals. Executive function deficits, including
those affecting attention, working memory and inhibitory control, are common. Cognitive training has been promoted
as a treatment option, based on the notion that by strengthening the neurocognitive networks underlying these
executive processes, ADHD symptoms will also be reduced. However, if implemented in childhood or later, when the
full disorder has become well-established, cognitive training has only limited value. INTERSTAARS is a trial designed to
test a novel approach to intervention, in which cognitive training is implemented early in development, before the
emergence of the disorder. The aim of INTERSTAARS is to train early executive skills, thereby increasing resilience and
reducing later ADHD symptoms and associated impairment.
Methods/design: Fifty 10–14-month-old infants at familial risk of ADHD will participate in INTERSTAARS. Infants
will be randomised to an intervention or a control group. The intervention aims to train early attention skills
by using novel eye-tracking technology and gaze-contingent training paradigms. Infants view animated games
on a screen and different events take place contingent on where on the screen the infant is looking. Infants
allocated to the intervention will receive nine weekly home-based attention training sessions. Control group
infants will also receive nine weekly home visits, but instead of viewing the training games during these visits
they will view non-gaze-contingent age-appropriate videos. At baseline and post treatment, infant attention
control will be assessed using a range of eye-tracking, observational, parent-report and neurophysiological
measures. The primary outcome will be a composite of eye-tracking tasks used to assess infant attention skills.
Follow-up data will be collected on emerging ADHD symptoms when the infants are 2 and 3 years old.
Discussion: This is the first randomised controlled trial to assess the potential efficacy of cognitive training as
a prevention measure for infants at familial risk of ADHD. If successful, INTERSTAARS could offer a promising
new approach for developing early interventions for ADHD.