Çelik Hidayet Ece Arat, Küçükgöncü Suat, Erdoğan Ayşe, Özerdem Ayşegül
Maltepe University Faculty of Medicine, Department of Psychiatry, İstanbul, Turkey.
Dokuz Eylül University, Institutes of Health Sciences, Department of Neuroscience, İzmir, Turkey.
Noro Psikiyatr Ars. 2023 Feb 26;60(1):3-8. doi: 10.29399/npa.28192. eCollection 2023.
Among the executive functions affected in attention deficit hyperactivity disorder (ADHD), inhibitory control is one of the primary areas of impairment, characterized by components that include response inhibition and interference control. Determining the impaired inhibitory control components will be useful in the differential diagnosis and treatment of ADHD. The present study aimed to investigate response inhibition and interference control abilities of adults with ADHD.
The study included 42 adults diagnosed with ADHD and 43 healthy controls. The stop-signal task (SST) and Stroop test were used for assessing the response inhibition and interference control, respectively. Multivariate analysis of covariance was used for comparing the ADHD and healthy control groups in terms of their SST and Stroop test scores, wherein the age and education level of the participants were taken as covariables. The relationship between SST and Stroop Test and Barratt Impulsiveness Scale-11 (BIS-11) was tested by Pearson correlation analysis. Mann-Whitney U test was used for comparing the test scores between those who were administered with psychostimulants among the adults with ADHD and those who were not.
Response inhibition was observed to be impaired in adults with ADHD compared with the healthy controls, whereas no difference regarding interference control was observed. As per the Barratt Impulsiveness Scale-11 (BIS-11), a weak and moderately negative relationship was found between the stop signal delay and the attentional, motor, non-planning scores, and total scores and a weak positive relationship was found between the stop-signal reaction time and the attentional, motor, non-planning scores, and total scores. A significant improvement was observed in the response inhibition skills of the adults with ADHD who had received methylphenidate treatment compared to those who had not, and the former also showed lower impulsivity levels as measured by the BIS-11.
It should be noted that response inhibition and interference control, which are considered under the umbrella of inhibitory control, may exhibit different characteristics in adult individuals diagnosed with ADHD and this is important for differential diagnosis. An improvement was observed in the response inhibition of adults with ADHD caused by psychostimulant treatment, which was associated with positive outcomes that were also noticeable by the patients. Understanding the underlying neurophysiological mechanisms of the condition would further facilitate the development of appropriate treatments.
在注意力缺陷多动障碍(ADHD)所影响的执行功能中,抑制控制是主要受损领域之一,其特征包括反应抑制和干扰控制等成分。确定受损的抑制控制成分将有助于ADHD的鉴别诊断和治疗。本研究旨在调查患有ADHD的成年人的反应抑制和干扰控制能力。
该研究纳入了42名被诊断为ADHD的成年人和43名健康对照者。分别使用停止信号任务(SST)和斯特鲁普测验来评估反应抑制和干扰控制。多变量协方差分析用于比较ADHD组和健康对照组在SST和斯特鲁普测验分数方面的差异,其中将参与者的年龄和教育水平作为协变量。通过Pearson相关分析检验SST和斯特鲁普测验与巴拉特冲动性量表-11(BIS-11)之间的关系。使用曼-惠特尼U检验比较ADHD成年人中接受精神兴奋剂治疗者与未接受治疗者之间的测验分数。
与健康对照组相比,观察到患有ADHD的成年人的反应抑制受损,而在干扰控制方面未观察到差异。根据巴拉特冲动性量表-11(BIS-11),发现停止信号延迟与注意力、运动、非计划性分数及总分之间存在微弱且中等程度的负相关,停止信号反应时间与注意力、运动、非计划性分数及总分之间存在微弱的正相关。与未接受治疗的ADHD成年人相比,接受哌甲酯治疗的ADHD成年人的反应抑制技能有显著改善,并且前者在BIS-11测量中也表现出较低的冲动水平。
应当注意的是,在抑制控制范畴下的反应抑制和干扰控制在被诊断为ADHD的成年个体中可能表现出不同特征,这对于鉴别诊断很重要。观察到精神兴奋剂治疗可改善ADHD成年人的反应抑制,这与积极结果相关,患者也能明显注意到这些结果。了解该病症潜在的神经生理机制将进一步促进合适治疗方法的开发。