Top

Published in:

Open Access 01-12-2021 | Disturbance of the Social Behaviour | Research article

Cognitive control and emotional response in attention-deficit/ hyperactivity disorder comorbidity with disruptive, impulse-control, and conduct disorders

Authors: Yuncheng Zhu, Li Liu, Daoliang Yang, Haifeng Ji, Tianming Huang, Lianxue Xue, Xixi Jiang, Kaiyun Li, Lily Tao, Qing Cai, Yiru Fang

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

This study investigated cognitive and emotional functioning in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and disruptive, impulse-control, and conduct disorders (DICCD).

Methods

Thirty patients with ADHD, 26 with DICCD, 22 with ADHD+DICCD were recruited from the outpatient department of Shanghai Changning Mental Health Center, plus 20 healthy controls (HC). Differences between the groups in cognitive and emotional functioning were examined using Golden’s Stroop and Emotional Stroop tests. For Emotional Stroop Mean reaction time (RT) of positive word (POS) and negative word (NEG) with color congruence (C) or incongruence (I) were recorded as POS-C, POS-I, NEG-C and NEG-I, respectively.

Results

For Golden’s interference scores (IGs), both errors and RTs in the ADHD group were higher than in the other groups. Longer mean RTs of POS-C, POS-I, NEG-C and neural word (NEU) of the ADHD group, and NEG-I of ADHD+DICCD and DICCD groups were observed compared to HC. After 12 weeks of methylphenidate treatment, differences between ADHD subgroups and HC on Golden’s Stroop RT disappeared, but differences in Golden’s Stroop errors and Emotional Stroop mean RTs remained. The ADHD+DICCD group showed longer mean RTs in NEG-C, NEG-I and NEU of the Emotional Stroop test than the ADHD group.

Conclusions

Our study shows that regardless of emotional responding, deficit in cognitive control is the core symptom of ADHD. However, emotionally biased stimuli may cause response inhibitory dysfunction among DICCD with callous-unemotional traits, and the comorbidity of ADHD and DICCD tends to account for the negative emotional response characteristic of DICCD. These deficits may be eliminated by medication treatment in ADHD, but not the ADHD with comorbid DICCD. Our results support the notion that ADHD with comorbid DICCD is more closely related to DICCD than to ADHD.

Shaw P, Sudre G. Adolescent attention-deficit/hyperactivity disorder: understanding teenage symptom trajectories. Biol Psychiatry. 2020;14(20):31673–5.

Zhu Y, Jiang X, Ji W. The mechanism of Cortico-Striato-Thalamo-cortical Neurocircuitry in response inhibition and emotional responding in attention deficit hyperactivity disorder with comorbid disruptive behavior disorder. Neurosci Bull. 2018;34(3):566–72. https://doi.org/10.1007/s12264-018-0214-x.CrossRefPubMedPubMedCentral

Reale L, Bartoli B, Cartabia M, Zanetti M, Costantino MA, Canevini MP, et al. Comorbidity prevalence and treatment outcome in children and adolescents with ADHD. Eur Child Adolesc Psychiatry. 2017;26(12):1443–57. https://doi.org/10.1007/s00787-017-1005-z.CrossRefPubMed

Frick PJ, Nigg JT. Current issues in the diagnosis of attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder. Annu Rev Clin Psychol. 2012;8(1):77–107. https://doi.org/10.1146/annurev-clinpsy-032511-143150.CrossRefPubMed

American Psychiatric Association: Diagnostic criteria from DSM-IV: American Psychiatric Pub; 1994.

Healy C, Brannigan R, Dooley N, Coughlan H, Clarke M, Kelleher I, et al. Childhood and adolescent psychotic experiences and risk of mental disorder: a systematic review and meta-analysis. Psychol Med. 2019;49(10):1589–99. https://doi.org/10.1017/S0033291719000485.CrossRefPubMed

American Psychiatric Association: Diagnostic and statistical manual of mental disorders, (DSM-5®): American Psychiatric Pub; 2013.CrossRef

Zhu Y, Yang D, Ji W, Huang T, Xue L, Jiang X, et al. The relationship between Neurocircuitry dysfunctions and attention deficit hyperactivity disorder: a review. Biomed Res Int. 2016;2016(10):3821579.PubMedPubMedCentral

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: DSM-V: American Psychiatric Association; 2013.CrossRef

10.

Barkley RA. Differential diagnosis of adults with ADHD: the role of executive function and self-regulation. J Clin Psychiatry. 2010;71(7):e17.CrossRef

11.

Diamond A. Executive functions. Annu Rev Psychol. 2013;64(1):135–68. https://doi.org/10.1146/annurev-psych-113011-143750.CrossRefPubMed

12.

Hwang S, Nolan ZT, White SF, Williams WC, Sinclair S, Blair RJ. Dual neurocircuitry dysfunctions in disruptive behavior disorders: emotional responding and response inhibition. Psychol Med. 2016;46(7):1485–96. https://doi.org/10.1017/S0033291716000118.CrossRefPubMedPubMedCentral

13.

Hoogman M, Bralten J, Hibar DP, Mennes M, Zwiers MP, Schweren LSJ, et al. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry. 2017;4(4):310–9. https://doi.org/10.1016/S2215-0366(17)30049-4.CrossRefPubMedPubMedCentral

14.

Blair RJ, Veroude K, Buitelaar JK. Neuro-cognitive system dysfunction and symptom sets: a review of fMRI studies in youth with conduct problems. Neurosci Biobehav Rev. 2016;26(16):30078–1.

15.

Zelazo PD. Executive function and psychopathology: a neurodevelopmental perspective. Annu Rev Clin Psychol. 2020;16(1):431–54. https://doi.org/10.1146/annurev-clinpsy-072319-024242.CrossRefPubMed

16.

Bari A, Robbins TW. Inhibition and impulsivity: behavioral and neural basis of response control. Prog Neurobiol. 2013;108:44–79. https://doi.org/10.1016/j.pneurobio.2013.06.005.CrossRefPubMed

17.

Goldstein S, Naglieri JA. Handbook of executive functioning. Ann Phys Rehabil Med. 2014;56(7):618.

18.

Krain AL, Wilson AM, Arbuckle R, Castellanos FX, Milham MP. Distinct neural mechanisms of risk and ambiguity: a meta-analysis of decision-making. Neuroimage. 2006;32(1):477–84. https://doi.org/10.1016/j.neuroimage.2006.02.047.CrossRefPubMed

19.

Sonuga-Barke EJ, Dalen L, Remington B. Do executive deficits and delay aversion make independent contributions to preschool attention-deficit/hyperactivity disorder symptoms? J Am Acad Child Adolesc Psychiatry. 2003;42(11):1335–42. https://doi.org/10.1097/01.chi.0000087564.34977.21.CrossRefPubMed

20.

Sonuga-Barke EJ. Causal models of attention-deficit/hyperactivity disorder: from common simple deficits to multiple developmental pathways. Biol Psychiatry. 2005;57(11):1231–8. https://doi.org/10.1016/j.biopsych.2004.09.008.CrossRefPubMed

21.

Noordermeer SD, Luman M, Oosterlaan J. A systematic review and meta-analysis of neuroimaging in oppositional defiant disorder (ODD) and conduct disorder (CD) taking attention-deficit hyperactivity disorder (ADHD) into account. Neuropsychol Rev. 2016;26(1):44–72. https://doi.org/10.1007/s11065-015-9315-8.CrossRefPubMedPubMedCentral

22.

Noordermeer SDS, Luman M, Buitelaar JK, Hartman CA, Hoekstra PJ, Franke B, et al. Neurocognitive deficits in attention-deficit/hyperactivity disorder with and without comorbid oppositional defiant disorder. J Atten Disord. 2020;24(9):1317–29. https://doi.org/10.1177/1087054715606216.CrossRefPubMed

23.

Golubchik P, Weizman A. The possible effect of methylphenidate treatment on empathy in children diagnosed with attention-deficit/hyperactivity disorder, both with and without comorbid oppositional defiant disorder. J Child Adolesc Psychopharmacol. 2017;27(5):429–32. https://doi.org/10.1089/cap.2016.0111.CrossRefPubMed

24.

Petrovic P, Castellanos FX. Top-down dysregulation-from ADHD to emotional instability. Front Behav Neurosci. 2016;10:70.

25.

Frogner L, Andershed AK, Andershed H. Psychopathic personality works better than CU traits for predicting fearlessness and ADHD symptoms among children with conduct problems. J Psychopathol Behav Assess. 2018;40(1):26–39. https://doi.org/10.1007/s10862-018-9651-0.CrossRefPubMedPubMedCentral

26.

Jiang X, Liu L, Ji H, Zhu Y. Association of Affected Neurocircuitry with Deficit of response inhibition and delayed gratification in attention deficit hyperactivity disorder: a narrative review. Front Hum Neurosci. 2018;12:506. https://doi.org/10.3389/fnhum.2018.00506.CrossRefPubMedPubMedCentral

27.

Poon K. Hot and cool executive functions in adolescence: development and contributions to important developmental outcomes. Front Psychol. 2018;8:2311. https://doi.org/10.3389/fpsyg.2017.02311.CrossRefPubMedPubMedCentral

28.

Jiang X, Liu L, Ji H, Gao J, Zhang M, Zhu Y, et al. Response inhibition and emotional responding in attention-deficit/hyperactivity disorder with comorbid disruptive, impulse-control, and conduct disorders. Nan Fang Yi Ke Da Xue Xue Bao. 2019;39(1):30–4. https://doi.org/10.12122/j.issn.1673-4254.2019.01.05.CrossRefPubMed

29.

Jiang X, Zhu Y, Fang Y. Response inhibition and emotional regulation in the patients with attention-deficit/hyperactivity disorder and comorbidity of disruptive, impulse-control, and conduct disorders. Psychiatry Investig. 2019;16(11):872–4. https://doi.org/10.30773/pi.2019.0101.CrossRefPubMedPubMedCentral

30.

Grizzle R. Wechsler intelligence scale for children. 4th ed. US: Springer; 2011.

31.

Goyette CH, Conners CK, Ulrich RF. Normative data on revised Conners parent and teacher rating scales. J Abnorm Child Psychol. 1978;6(2):221–36. https://doi.org/10.1007/BF00919127.CrossRefPubMed

32.

Gordon HA, Rucklidge JJ, Blampied NM, Johnstone JM. Clinically significant symptom reduction in children with attention-deficit/hyperactivity disorder treated with micronutrients: an open-label reversal design study. J Child Adolesc Psychopharmacol. 2015;25(10):783–98. https://doi.org/10.1089/cap.2015.0105.CrossRefPubMedPubMedCentral

33.

Dahdah MN, Bennett M, Prajapati P, Parsons TD, Sullivan E, Driver S. Application of virtual environments in a multi-disciplinary day neurorehabilitation program to improve executive functioning using the Stroop task. NeuroRehabilitation. 2017;41(4):721–34. https://doi.org/10.3233/NRE-172183.CrossRefPubMed

34.

Golden CJ. A manual for the clinical and experimental use of the Stroop color and word test. Stoelting. 1978.

35.

Chan E, Fogler JM, Hammerness PG. Treatment of attention-deficit/hyperactivity disorder in adolescents: a systematic review. Jama. 2016;315(18):1997–2008. https://doi.org/10.1001/jama.2016.5453.CrossRefPubMed

36.

Faraone SV. The pharmacology of amphetamine and methylphenidate: relevance to the neurobiology of attention-deficit/hyperactivity disorder and other psychiatric comorbidities. Neurosci Biobehav Rev. 2018;87:255–70. https://doi.org/10.1016/j.neubiorev.2018.02.001.CrossRefPubMedPubMedCentral

37.

Zhang DD, Zhang YQ, Zhang XH. Prefrontal AMPA receptors are involved in the effect of methylphenidate on response inhibition in rats. Acta Pharmacol Sin. 2018;39(4):607–15. https://doi.org/10.1038/aps.2017.138.CrossRefPubMed

38.

Euler F, Sterzer P, Stadler C. Cognitive control under distressing emotional stimulation in adolescents with conduct disorder. Aggress Behav. 2014;40(2):109–19. https://doi.org/10.1002/ab.21508.CrossRefPubMed

39.

Kalnin AJ, Edwards CR, Wang Y, Kronenberger WG, Hummer TA, Mosier KM, et al. The interacting role of media violence exposure and aggressive-disruptive behavior in adolescent brain activation during an emotional Stroop task. Psychiatry Res. 2011;192(1):12–9. https://doi.org/10.1016/j.pscychresns.2010.11.005.CrossRefPubMed

40.

Hoogman M, Bralten J, Hibar DP, Mennes M, Zwiers MP, Schweren LS, et al. Subcortical brain volume differences in participants with attention deficit hyperactivity disorder in children and adults: a cross-sectional mega-analysis. Lancet Psychiatry. 2017;16(17):30049–4.

41.

Bellagamba F, Addessi E, Focaroli V, Pecora G, Maggiorelli V, Pace B, et al. False belief understanding and "cool" inhibitory control in 3-and 4-years-old Italian children. Front Psychol. 2015;6:872.CrossRef

42.

Shuai L, Wang YF. Executive function characteristic in boys with attention deficit hyperactivity disorder comorbid disruptive behavior disorders. Beijing Da Xue Xue Bao. 2007;39(3):241–6.PubMed

43.

Yarmolovsky J, Szwarc T, Schwartz M, Tirosh E, Geva R. Hot executive control and response to a stimulant in a double-blind randomized trial in children with ADHD. Eur Arch Psychiatry Clin Neurosci. 2017;267(1):73–82. https://doi.org/10.1007/s00406-016-0683-8.CrossRefPubMed

44.

Masi G, Milone A, Manfredi A, Brovedani P, Pisano S, Muratori P. Combined pharmacotherapy-multimodal psychotherapy in children with disruptive behavior disorders. Psychiatry Res. 2016;238:8–13. https://doi.org/10.1016/j.psychres.2016.02.010.CrossRefPubMed

45.

Schiffer B, Pawliczek C, Mu Ller B, Forsting M, Gizewski E, Leygraf N, et al. Neural mechanisms underlying cognitive control of men with lifelong antisocial behavior. Psychiatry Res. 2014;222(1–2):43–51. https://doi.org/10.1016/j.pscychresns.2014.01.008.CrossRefPubMed

46.

Pasini A, Sinibaldi L, Paloscia C, Douzgou S, Pitzianti MB, Romeo E, et al. Neurocognitive effects of methylphenidate on ADHD children with different DAT genotypes: a longitudinal open label trial. Eur J Paediatr Neurol. 2013;17(4):407–14. https://doi.org/10.1016/j.ejpn.2013.02.002.CrossRefPubMed

47.

Huss M, Duhan P, Gandhi P, Chen CW, Spannhuth C, Kumar V. Methylphenidate dose optimization for ADHD treatment: review of safety, efficacy, and clinical necessity. Neuropsychiatr Dis Treat. 2017;13:1741–51. https://doi.org/10.2147/NDT.S130444.CrossRefPubMedPubMedCentral

48.

Rosch KS, Fosco WD, Pelham WE Jr, Waxmonsky JG, Bubnik MG, Hawk LW Jr. Reinforcement and stimulant medication ameliorate deficient response inhibition in children with attention-deficit/hyperactivity disorder. J Abnorm Child Psychol. 2016;44(2):309–21. https://doi.org/10.1007/s10802-015-0031-x.CrossRefPubMedPubMedCentral

49.

Waschbusch DA, Carrey NJ, Willoughby MT, King S, Andrade BF. Effects of methylphenidate and behavior modification on the social and academic behavior of children with disruptive behavior disorders: the moderating role of callous/unemotional traits. J Clin Child Adolesc Psychol. 2007;36(4):629–44. https://doi.org/10.1080/15374410701662766.CrossRefPubMed

50.

World Health Organization. International Classification of Diseases and Related Health Problems, 10th revision. Geneva: World Health Organization; 1992.

51.

Brammer WA, Lee SS. Impairment in children with and without ADHD: contributions from oppositional defiant disorder and callous-unemotional traits. J Atten Disord. 2012;16(7):535–43. https://doi.org/10.1177/1087054711403709.CrossRefPubMed

52.

Xu M, Jiang W, Du Y, Li Y, Fan J. Executive function features in drug-naive children with oppositional defiant disorder. Shanghai Arch Psychiatry. 2017;29(4):228–36. https://doi.org/10.11919/j.issn.1002-0829.216104.CrossRefPubMed

53.

Herpers PCM, Klip H, Rommelse NNJ, Taylor MJ, Greven CU, Buitelaar JK. Taxometric analyses and predictive accuracy of callous-unemotional traits regarding quality of life and behavior problems in non-conduct disorder diagnoses. Psychiatry Res. 2017;253:351–9. https://doi.org/10.1016/j.psychres.2017.04.004.CrossRefPubMed

Title: Cognitive control and emotional response in attention-deficit/ hyperactivity disorder comorbidity with disruptive, impulse-control, and conduct disorders
Authors: Yuncheng Zhu
Li Liu
Daoliang Yang
Haifeng Ji
Tianming Huang
Lianxue Xue
Xixi Jiang
Kaiyun Li
Lily Tao
Qing Cai
Yiru Fang
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Disturbance of the Social Behaviour
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03221-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Cognitive control and emotional response in attention-deficit/ hyperactivity disorder comorbidity with disruptive, impulse-control, and conduct disorders

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

A systematic review and meta-analysis of group peer support interventions for people experiencing mental health conditions

Prevalence of post-traumatic stress disorders and associated factors one month after the outbreak of the COVID-19 among the public in southwestern China: a cross-sectional study

Longitudinal influence of COVID-19-related stress on sexual compulsivity symptoms in Chinese undergraduates

A novel model to predict mental distress among medical graduate students in China

Longitudinal changes in personal recovery in individuals with psychotic disorders through hospitalisation in a psychiatric ward: preliminary findings

Prevalence and risk factors for seclusion and restraint in old-age psychiatry inpatient units