The ADHD response-inhibition deficit as measured by the stop task: replication with DSM-IV combined type, extension, and qualification

Abstract

Although response inhibition has been proposed as a core element of child attention-deficit hyperactivity disorder (ADHD), the literature is heavily reliant on studies using DSM-III-R diagnostic criteria, older methods of measuring response inhibition, samples of boys, and failing to control thoroughly for comorbid problems--both as diagnoses and as subclinical variation. The present study replicated a deficit in response inhibition in the ADHD combined type (DSM-IV, American Psychiatric Association, 1994) using samples matched on age and sex. The study replicated an effect size of approximately d = .6 in boys with ADHD, and observed an even larger effect size for girls, although the Sex x Group interaction was nonsignificant. Children with ADHD also had problems with response output, shown by variable responding. Excluding comorbid conduct disorder, reading disorder, generalized anxiety disorder, obsessive-compulsive disorder, major depression, and posttraumatic stress disorder from the sample did not alter the results. Correlations indicated that response inhibition was associated with both attentional problems and reading level. Covarying for reading problems did not eliminate the ADHD group effect, but the association of response inhibition with reading clearly requires further examination. Overall, the study supported the role of response inhibition in the DSM-IV ADHD combined type, but with key qualifications as to degree of specificity in reference both to comorbid problems and other executive functions.