Response Inhibition, Response Execution, and Emotion Regulation among Children with Attention-Deficit/Hyperactivity Disorder

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in response inhibition, response execution, and emotion regulation. However, the nature of the associations among these deficits remains unclear. Thus, this study examines these associations using a multi-method design. One hundred sixty-six children (aged 5-13 years; 66.3% male; 75 with ADHD) completed two conditions (i.e., neutral and fear) of an emotional go/no-go task. Parasympathetic-based regulation was indexed via respiratory sinus arrhythmia (RSA), and sympathetic-based reactivity was indexed via cardiac pre-ejection period (PEP). Overall, children exhibited more difficulty with response execution (i.e., more omission errors, fewer correct go responses) and less difficulty with response inhibition (i.e., fewer commission errors, more correct no-go responses) during the fear condition than the neutral condition. Children with ADHD displayed more difficulty with response execution during the fear condition compared to typically developing youth. Additionally, children with ADHD displayed parasympathetic-based dysregulation (i.e., RSA increase from baseline) and reduced sympathetic-based reactivity (i.e., PEP lengthening) compared to typically developing youth across task conditions. In sum, children with ADHD demonstrate greater difficulty with response execution during emotionally salient contexts, as well as parasympathetic-based emotion dysregulation. Future work should examine these associations longitudinally with the aim of predicting impairment and treatment response in youth with ADHD.

Keywords: Attention-deficit/hyperactivity disorder; Autonomic nervous system; Emotion regulation; Response execution; Response inhibition.

Fig. 1A and Fig. 1B.

Go/No-Go Performance (A: Correct Go Responses; B: Correct No-Go Responses) according to task (i.e., neutral vs. fear) and by group (i.e., typically developing vs. ADHD) A. The interaction of task condition by group was significant (F=4.40, p=.04, η_p²=.03);Children with ADHD demonstrated significantly fewer correct go responses during the fear condition (M=3.47, S.E.=1.94) compared to typically developing youth (M=12.70, S.E.=1.63; F=7.50, p=.007, η_p²=.05), no group-based differences were observed during the neutral condition (F=.95, p=.33, η_p²=.006). B. The interaction of task condition by group was significant (F=5.50, p=.02, η_p²=.03); Children with ADHD demonstrated significantly more correct no-go responses during the fear condition (M=24.54, S.E.=1.19) compared to typically developing youth (M=20.30, S.E.=1.00; F=4.21, p=.04, η_p²=.03), while no significant group differences were observed during the neutral condition (F=1.14, p=.29, η_p²=.007).

Fig. 2A and Fig. 2B.

Psychophysiological Reactivity (A: RSA reactivity; B: PEP reactivity) according to task (i.e., neutral vs. fear) and by group (i.e., typically developing vs. ADHD) A. Mean change scores in respiratory sinus arrhythmia (RSA) from baseline to each of the task conditions by group. The interaction of condition by group was significant (F=4.46, p=.04, η_p²=.03), children with ADHD displayed reduced PNS-based regulation (i.e., RSA augmentation; M=.76, S.E.=.21) during the neutral condition compared to typically developing youth (i.e., RSA withdrawal M= −.36, S.E.=.18; F=9.47, p=.002, η_p²=.06), while no significant group-based differences were demonstrated during the fear condition (F=2.31, p=13, η_p²=.01). B. Mean change scores in pre-ejection period from baseline to each of the task conditions by group. Interaction of task condition by group for PEP reactivity was not significant but is represented in order to evaluate RSA reactivity. The interaction of condition by group was non-significant (F=.28, p=.56, η_p²=.002), the main effect of group was significant (F=10.37, p=.002, η_p²=.06), children with ADHD exhibited reductions in SNS-based activity (i.e., PEP lengthening; M=8.10 S.E=1.82), while typically developing youth displayed increases in SNS-based activity (i.e, PEP shortening; M= −2.10, S.E.=1.53).