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ATTENTION DEFICIT ATTENTION DEFICIT HYPERACTIVITY HYPERACTIVITY
DISORDERDISORDER
Further explained Further explained
ComorbiditiesComorbidities
CDCD ODDODD
MMR LD ADHD PDD-NOS HFAMMR LD ADHD PDD-NOS HFA
PKU PKU CHTCHT
Developmental pathwayDevelopmental pathway
depression/anxiety depression/anxiety
Childhood Adulthood ADHDChildhood Adulthood ADHD impulsivityimpulsivity CD CD
Core symptoms persistCore symptoms persist MPH treatmentMPH treatment
DIAGNOSTIC MEASURESDIAGNOSTIC MEASURES
QuestionnairesQuestionnaires (Semi) Structured Interviews(Semi) Structured Interviews DIAGNOSIS BY HEARSAYDIAGNOSIS BY HEARSAY PARENT + TEACHERPARENT + TEACHER Third observational condition??Third observational condition??
Important cognitive theoriesImportant cognitive theories
response inhibition hypothesisresponse inhibition hypothesis Barkley (1997) Barkley (1997) Psychological Bulletin, 121Psychological Bulletin, 121,, 65-9465-94 (frontal) paper and pencil tests(frontal) paper and pencil tests delayed responding testsdelayed responding tests stop taskstop task
Delayed response testDelayed response testProfile control childProfile control child
trial time in seconds after stimulustrial time in seconds after stimulus
1 2 3 4 5 6 7 81 2 3 4 5 6 7 8 1 x 1 x 2 x2 x 3 x3 x 4 x4 x 5 x5 x 6 x6 x 7 x7 x
Profile child with ADHDProfile child with ADHD
trial time in seconds after stimulustrial time in seconds after stimulus 1 2 3 4 5 6 7 81 2 3 4 5 6 7 8 1 x 1 x 2 x2 x 3 x3 x 4 x4 x 5 x5 x 6 x6 x 7 x7 x
Delay Aversion TheoryDelay Aversion Theory
Sonuga Barke et al. (1992) - Sonuga Barke et al. (1992) - Journal of Child Journal of Child
Psychology and Psychiatry, 33Psychology and Psychiatry, 33, 387-398, 387-398
Sonuga Barke (2002) - Sonuga Barke (2002) - Behavioural Brain Behavioural Brain Research, 130Research, 130, 29-36, 29-36
extra effort
no extra effort
optimal state non-optimal state
Perf
orm
an
ce
Actual state vs. required (target) state – effort allocationActual state vs. required (target) state – effort allocation
Theory of state regulationTheory of state regulation
Signal rate Signal rate
05101520253035404550
fast slow
ADHDControlsothers
extra effort
no extra effort
optimal state non-optimal state
Perf
orm
an
ce
Actual state vs. required (target) state – effort allocationActual state vs. required (target) state – effort allocation
Theory of state regulationTheory of state regulation
Physiological costs
Heart rate variability
P300 amplitude
fMRI
NRT is a neural sheet draped over the lateral/anterior aspects of the thalamus
NRT is the functional interface between the arousal and attention systems
Receives axonal collaterals from corticothalamic, thalamocortical and reticular formation projections
Nucleus Reticularis Thalami
Portas et al. 1998, J. of Neuroscience, 18
Go No-Go testGo No-Go test
7,2
7,4
7,6
7,8
8
8,2
Mo
d.
Ind
ex (
ln)
Fast Slow
test condition
Heart rate variability (0.10 Hz )
ADHD
Controls
ERPsERPs Tracking of covert information processingTracking of covert information processing Excellent temporal resolution Excellent temporal resolution More direct assessment of energetic More direct assessment of energetic
mechanismsmechanisms