The Specificity and Independent Contribution of Inhibition, Working Memory, and Reaction Time Variability in Relation to Symptoms of ADHD and ASD.

Objective: The aim of the present study was to investigate the specificity of inhibition, working memory (WM), and reaction time variability (RTV) in relation to symptoms of ADHD and autism spectrum disorder (ASD). Method: A community-based sample of schoolchildren aged 7 to 9 years (N = 200) completed tasks designed to measure inhibition, WM, and RTV. Results: All neuropsychological functions were related to symptoms of both ADHD and ASD. The results from regression analyses showed that inhibition and RTV were related specifically to ADHD symptoms when controlling for symptoms of ASD. Regarding WM, no specific association with either symptom domain was evident after controlling for the other. Furthermore, independent contributions of inhibition and RTV were found in relation to ADHD symptoms after controlling for ASD symptoms. Conclusion: The present study underscores the relevance of controlling for ADHD symptoms when examining ASD symptoms in relation to neuropsychological functions.

Do Individual Differences in Early Affective and Cognitive Self-Regulation Predict Developmental Change in ADHD Symptoms From Preschool to Adolescence?

OBJECTIVE: The role of heterogeneous self-regulation deficits in ADHD has long been emphasized. Yet, longitudinal studies examining distinct self-regulation processes as prospective predictors of developmental change in ADHD symptoms spanning wide developmental periods are scarce. The aim of the current study was to examine affective and cognitive self-regulation as predictors of developmental change in ADHD symptoms from preschool to adolescence in a sample with one third of the children being at risk for developing an ADHD and/or ODD diagnosis. METHOD: At 5 years laboratory measures for hot and cool executive function (EF) and parental and teacher ratings were used for regulation of positive and negative emotionality. Symptoms of ADHD and ODD were measured at 5 and 13 years using parental and teacher ratings based on the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV). RESULTS: Converging developmental paths in hyperactivity/impulsivity across time were found for those high versus low in early cognitive self-regulation, whereas the development of inattention symptoms diverged across time for those high versus low in early affective self-regulation. CONCLUSION: These results support the idea that different aspects of self-regulation are important for developmental change in the two separate ADHD symptom domains from preschool to adolescence.

Temperament and Cognitive Regulation During the First 3 Years of Life as Predictors of Inattention and Hyperactivity/Impulsivity at 6 Years.

Objective: With a wish to identify early markers of inattention and hyperactivity/impulsivity, we examined effects of temperament and cognitive regulation, during the first 3 years of life, on later inattentive and hyperactive/impulsive behavior. Method: Temperament and cognitive regulation were assessed at 12, 18, 24, and 36 months in 66 typically developing children. Teachers rated inattention and hyperactivity/impulsivity at 6 years. Results: Temperamental activity at all studied time points was predictive of later hyperactive/impulsive behavior, thus appearing as a stable marker thereof. Activity at 12 months was also predictive of inattention, whereas temperamental persistence was correlated with inattention and hyperactivity/impulsivity, but with no independent contributions. No significant relations between cognitive regulation and the outcome measures were found. Conclusion: Our findings add to the scarce literature proposing that markers of inattentive and hyperactive/impulsive behavior in early school age can be found within the first years of life, using parental ratings of child temperament.

The role of sustained attention, maternal sensitivity, and infant temperament in the development of early self-regulation.

This study investigated infant predictors of early cognitive and emotional self-regulation from an intrinsic and caregiving environmental perspective. Sustained attention, reactive aspects of infant temperament, and maternal sensitivity were assessed at 10 months (n = 124) and early self-regulation (including executive functions, EF, and emotion regulation) was assessed at 18 months. The results indicated that sustained attention predicted early EF, which provide empirical support for the hierarchical framework of EF development, advocating early attention as a foundation for the development of cognitive self-regulation. Maternal sensitivity and surgency predicted emotion regulation, in that infants of sensitive mothers showed more regulatory behaviours and a longer latency to distress, whereas high levels of surgency predicted low emotion regulation, suggesting both the caregiving environment and temperament as important in the development of self-regulation. Interaction effects suggested high sustained attention to be a protective factor for children of insensitive mothers, in relation to emotion regulation. In addition, high levels of maternal sensitivity seemed to foster development of emotion regulation among children with low to medium levels of sustained attention and/or surgency. In all, our findings point to the importance of both intrinsic and extrinsic factors in infant development of self-regulation.

Neuropsychological deficits in preschool as predictors of ADHD symptoms and academic achievement in late adolescence.

High levels of ADHD symptoms are related to severe negative outcomes, which underscore the importance of identifying early markers of these behavior problems. The main aim of the present study was therefore to investigate whether neuropsychological deficits in preschool are related to later ADHD symptoms and academic achievement, over and above the influence of early ADHD symptom levels. The present study is unique because it includes a broader range of predictors compared to previous studies and the participants are followed over time for as long as 13 years (i.e., ages 5-18 years). Preschool data included measures of executive functioning and reaction time variability as well as emotional reactivity and emotion regulation of both positive and negative emotions. When controlling for early ADHD symptom levels, working memory, reaction time variability, and regulation of happiness/exuberance were significantly related to inattention whereas regulation of happiness/exuberance and anger reactivity were significantly related to hyperactivity/impulsivity. Furthermore, working memory and reaction time variability in preschool were significantly related to academic achievement in late adolescence beyond the influence of early ADHD symptoms. These findings could suggest that it is possible to screen for early neuropsychological deficits and thereby identify children who are at risk of negative outcomes. Furthermore, our results suggest that interventions need to look beyond executive functioning deficits in ADHD and also target the role of emotional functioning and reaction time variability. The importance of including both the positive and negative aspects of emotional functioning and distinguishing between emotion regulation and emotional reactivity was also demonstrated.

Neuropsychological Functioning and Attachment Representations in Early School Age as Predictors of ADHD Symptoms in Late Adolescence.

This study aimed to examine relations between parent and child attachment representations and neuropsychological functions at age 8, as well as relations between these constructs and ADHD symptoms over a 10-year period. A community-based sample of 105 children (52 boys) participated. Measures of attachment representations and a range of neuropsychological functions were collected at age 8. Parents rated emotion dysregulation and ADHD symptoms at age 8 and ADHD symptoms again at age 18. Significant, although modest, relations were found between disorganized attachment and some aspects of neuropsychological functioning in childhood. When studying outcomes in late adolescence and controlling for early ADHD symptom levels, spatial working memory and disorganized attachment remained significant in relation to both ADHD symptom domains, and one measure of inhibition remained significant for hyperactivity/impulsivity. When examining independent effects, spatial working memory and disorganized attachment were related to inattention, whereas spatial working memory and dysregulation of happiness/exuberance were related to hyperactivity/impulsivity. Our findings showing that disorganized attachment is longitudinally related to ADHD symptoms over and above the influence of both neuropsychological functioning and early ADHD symptom levels highlights the importance of including measures of attachment representations when trying to understand the development of ADHD symptoms. If replicated in more "at-risk" samples, these findings could also suggest that parent-child attachment should be taken into consideration when children are referred for assessment and treatment of ADHD.

Prior participation in the strange situation and overstress jointly facilitate disorganized behaviours: implications for theory, research and practice.

We seek to understand why a relatively high percentage (39%; vs the meta-analytic average, 15-18%) of disorganized/disoriented (D) classifications has accrued in the low-risk Uppsala Longitudinal Study (ULS) study, using experienced D coders. Prior research indicates that D behaviours do not always indicate attachment disorganization stemming from a history of frightening caregiving. We examined the role of two other presumed factors: participation in a previous strange situation and overstress. Our findings indicate that both factors were highly prevalent in the ULS sample and that they jointly predicted higher rates of D. First, participation in a previous strange situation was associated with significantly higher distress displays during the second visit than occurred among previously untested children, suggesting that prior participation in the strange situation had a sensitizing effect on child distress during the second visit. Second, unless separations were cut short in lieu of high distress during the second visit, re-tested children were disproportionately likely (ca 60%) to be classified D. We argue that these findings have important implications for theory, research, and practice. In particular, we conclude that practitioners must refrain from misattributing the appearance of any D behaviors observed to a history of maltreatment.

Is middle childhood attachment related to social functioning in young adulthood?

The aim of the present study (N = 69) was to examine whether middle childhood attachment, measured using the Separation Anxiety Test (Slough, Goyette & Greenberg, 1988), predicts aspects of social functioning (social initiative, prosocial orientation, social anxiety, loneliness) in young adulthood. Insecurity-avoidance at age 8.5 years was, as expected, negatively related to social initiative and prosocial orientation, and was also positively related to social anxiety and loneliness at age 21 years. In addition, insecurity-avoidance contributed to developmental change in social anxiety from middle childhood to young adulthood. Contrary to our expectations, the two security scales were generally unrelated to future social functioning. Taken together, these results extend previous research by showing that insecurity-avoidance is related to social functioning also beyond childhood and adolescence, and that it contributes to developmental change in social functioning over time. The scarcity of prospective links for the attachment security scales points to the need for future studies addressing when and why attachment does not contribute to future social functioning.

The heterogeneity of attention-deficit/hyperactivity disorder symptoms and conduct problems: Cognitive inhibition, emotion regulation, emotionality, and disorganized attachment.

This study examined the contributions of several important domains of functioning to attention-deficit/hyperactivity disorder (ADHD) symptoms and conduct problems. Specifically, we investigated whether cognitive inhibition, emotion regulation, emotionality, and disorganized attachment made independent and specific contributions to these externalizing behaviour problems from a multiple pathways perspective. The study included laboratory measures of cognitive inhibition and disorganized attachment in 184 typically developing children (M age = 6 years, 10 months, SD = 1.7). Parental ratings provided measures of emotion regulation, emotionality, and externalizing behaviour problems. Results revealed that cognitive inhibition, regulation of positive emotion, and positive emotionality were independently and specifically related to ADHD symptoms. Disorganized attachment and negative emotionality formed independent and specific relations to conduct problems. Our findings support the multiple pathways perspective on ADHD, with poor regulation of positive emotion and high positive emotionality making distinct contributions to ADHD symptoms. More specifically, our results support the proposal of a temperamentally based pathway to ADHD symptoms. The findings also indicate that disorganized attachment and negative emotionality constitute pathways specific to conduct problems rather than to ADHD symptoms.

Sustained attention in infancy as a longitudinal predictor of self-regulatory functions.

Previous literature suggests that attention processes such as sustained attention would constitute a developmental foundation for the self-regulatory functions executive functioning and effortful control (e.g., Garon, Bryson, & Smith, 2008; Rothbart, Derryberry, & Posner, 1994). Our main aim was to test this hypothesis by studying whether sustained attention at age 1 year can predict individual differences in self-regulatory functions at age 2 years. Longitudinal data from 66 infants and their parents were included in the study. Sustained attention was assessed during free play at age 1 year; executive functioning, measured using an eye-tracking version of the A-not-B task, and effortful control, measured using parental ratings, were assessed at both age 1 and age 2 years. The results did support a longitudinal prediction of individual differences in 2-year-olds' self-regulatory functions as a function of sustained attention at age 1 year. We also found significant improvement in both executive functioning and effortful control over time, and the two self-regulatory constructs were related in toddlerhood but not in infancy. The study helps increase our understanding of the early development of self-regulatory functions necessary for identifying developmental risks and, in the future, for developing new interventions.

Eighteen-month-olds' ability to make gaze predictions following distraction or a long delay.

The abilities to flexibly allocate attention, select between conflicting stimuli, and make anticipatory gaze movements are important for young children's exploration and learning about their environment. These abilities constitute voluntary control of attention and show marked improvements in the second year of a child's life. Here we investigate the effects of visual distraction and delay on 18-month-olds' ability to predict the location of an occluded target in an experiment that requires switching of attention, and compare their performance to that of adults. Our results demonstrate that by 18 months of age children can readily overcome a previously learned response, even under a condition that involves visual distraction, but have difficulties with correctly updating their prediction when presented with a longer time delay. Further, the experiment shows that, overall, the 18-month-olds' allocation of visual attention is similar to that of adults, the primary difference being that adults demonstrate a superior ability to maintain attention on task and update their predictions over a longer time period.

Individual differences in 10-month-olds' performance on the A-not-B task.

This study used the classical A-not-B task (Piaget, ) to explore individual differences in cognitive flexibility in 10-month-old infants by: (1) examining how differences in search performance during A trials relate to search performance during B trials; (2) studying the relation between temperamental dimensions and A-not-B performance; and (3) investigating differences in search performance between looking and reaching responses within the same task. Forty infants were tested on a fixed-design-version of the A-not-B task, not allowing for training or individual adjustment, but instead eliciting additional search behaviors than the common correct responses in A trials and perseverative errors in B trials. Infants were also rated by their parents on the temperamental scales Activity level and Attention span. The main findings were: (1) performance on A trials affected B trial performance, with infants being more correct on A trials having more incorrect and less 'no search' responses on B trials; (2) activity level, but not attention span, was related to performance on the A-not-B task, with infants performing better on A trials having a lower activity level; and (3) there were a few differences in performance with regard to modality, indicating that responding correctly by looking may be less cognitively demanding than doing so by reaching. This study demonstrated that 10-month-olds show a wide variation of search behaviors on this A-not-B task, resulting in individual differences in performance. These differences are suggested to reflect variation in temperamental activity level as well as maturity of short term/working memory, inhibition and cognitive flexibility.

ADHD symptoms and attachment representations: considering the role of conduct problems, cognitive deficits and narrative responses in non-attachment-related story stems.

The overall aim of the present study was to investigate ADHD symptoms in relation to attachment representations. We used both attachment- and non-attachment-related story stems, which allowed us to investigate whether problems with narrative production can explain the relation between ADHD symptoms and attachment representations. We also investigated the role of cognitive deficits and conduct problems in these relations. The sample consisted of 89 children (27 % girls) between 6 and 10 years old, with an oversampling of children with high levels of ADHD symptoms. ADHD symptoms and conduct problems were rated by parents and teachers. Cognitive functioning was investigated using laboratory tests of inhibition, working memory and sustained attention. Attachment representations were coded as secure, organized insecure and disorganized categories. Narrative responses to non-attachment-related story stems were coded for incoherence and negative content. Results showed that children in the disorganized attachment category had significantly higher levels of ADHD symptoms compared to those in the secure category. Both ADHD symptoms and disorganized attachment were related to incoherence and negative content. Attachment representations were not associated with ADHD symptoms when controlling for negative content in response to non-attachment-related story stems. These results suggest that the associations between attachment security and ADHD are yet to be fully understood. Importantly, a propensity to envisage negative events seems to characterize children with high levels of ADHD symptoms.

Interlinkages between attachment and the Five-Factor Model of personality in middle childhood and young adulthood: a longitudinal approach.

In this paper, we examine concurrent and prospective links between attachment and the Five-Factor Model (FFM) of personality from middle childhood to young adulthood (n = 66). At age 8.5 years, attachment was measured with the Separation Anxiety Test and at 21 years with the Adult Attachment Interview, whereas the personality dimensions were assessed with questionnaires at both time points. The results showed that attachment and personality dimensions are meaningfully related, concurrently and longitudinally. Attachment security in middle childhood was positively related to extraversion and openness, both concurrently and prospectively. Unresolved/disorganized (U/d) attachment was negatively related to conscientiousness and positively related to openness in young adulthood. U/d attachment showed a unique contribution to openness above the observed temporal stability of openness. As attachment security was also associated with openness, the duality of this factor is discussed together with other theoretical considerations regarding attachment theory in relation to the FFM.

Cognitive abilities of street children: low-SES Bolivian boys with and without experience of living in the street.

OBJECTIVES: This study compared results on cognitive tests measuring nonverbal visualization and reasoning, executive functions, and creativity between 36 boys with experience of living in the street and 31 housed yet socioeconomically equivalent boys, in Bolivia. RESULTS: The street children scored significantly higher on the creativity measure, which is discussed in relation to contextual relevance. No significant differences were found on the other cognitive tests. Time elapsed after living in the street and drug use were strongly associated with cognition, while age was not. Both groups scored below average compared to Western norms. The results are discussed in terms of the cultural relevance of the tests and the impact of socioeconomic status, stress, and stimulation on cognition.

Parent-child attachment and executive functioning in relation to ADHD symptoms in middle childhood.

This study investigated attachment representations and executive functioning (i.e., response inhibition and working memory) at age 8½ in relation to ADHD symptoms one year later. Well-validated laboratory measures of both executive functioning and attachment representations were used. Additive, interaction, as well as mediation effects were investigated. The results showed that attachment disorganization and executive functioning were independently related to ADHD symptoms, even when using conduct problems as a covariate. No significant interaction effects were found, and executive functioning was not found to act as a mediator between attachment disorganization and ADHD symptoms. In conclusion, attachment disorganization had a significant effect on ADHD symptoms, independent of both executive functioning and conduct problems, which suggests that the parent-child attachment is a factor that needs to be included if we are to more fully understand the development of ADHD.

Threat-relevance impairs executive functions: negative impact on working memory and response inhibition.

The effects of emotional stimulus content on attention are well-known. In contrast, the impact of emotional information on higher executive control functions is undetermined. To elucidate the role of negative emotion in cognitive control, 56 adult female participants performed a combined working memory and response inhibition task, with threat-relevant (spider and snake) and neutral (flower and mushroom) stimuli. Threat-relevant stimuli impaired performance, by causing prolonged response times to working memory items and increased response inhibition error rate relative to neutral stimuli. The impaired response inhibition was only evident when threat-relevant stimuli co-occurred with working memory matches, in line with a common resource pool view of executive functions and emotion processing. Individual differences in reported fear of spiders were associated with differences of inhibitory control, while fear of snakes was associated with impaired overall accuracy on working memory trials. The results are discussed in relation to the dual-competition framework for interaction between executive functions and emotion (Pessoa, 2009).

Cognitive functioning and family risk factors in relation to symptom behaviors of ADHD and ODD in adolescents.

OBJECTIVE: In this study, the authors investigated whether ADHD and oppositional defiant disorder (ODD) behaviors share associations with problems in cognitive functioning and/or family risk factors in adolescence. This was done by examining independent as well as specific associations of cognitive functioning and family risk factors with ADHD and ODD behaviors. METHOD: A sample of 120 adolescents from the general population was assessed on various cognitive tasks. ADHD and ODD behaviors were measured through parental and teacher ratings based on Diagnostic and Statistical Manual of Mental Disorders (4th edition) criteria. Parents and adolescents provided information regarding measures of family risk factors. RESULTS: The results show that only cognitive functioning was associated with ADHD behaviors, and family risk factors were, independent of cognitive functioning, associated with ODD behaviors. CONCLUSION: These results suggest that cognitive performance bears a specific significance for ADHD behaviors, whereas family risk factors have specific importance for ODD behaviors.

Disorganized attachment and inhibitory capacity: predicting externalizing problem behaviors.

The aim of the present study was to investigate whether attachment insecurity, focusing on disorganized attachment, and the executive function (EF) component of inhibition, assessed at age 5, were longitudinally related to general externalizing problem behaviors as well as to specific symptoms of ADHD and Autism spectrum disorder (ASD), and callous-unemotional (CU) traits. General externalizing problem behaviors were also measured at age 5 to allow for a developmental analysis. Outcome variables were rated by parents and teachers. The sample consisted of 65 children with an oversampling of children with high levels of externalizing behaviors. Attachment was evaluated using a story stem attachment doll play procedure. Inhibition was measured using four different tasks. The results showed that both disorganized attachment and poor inhibition were longitudinally related to all outcome variables. Controlling for initial level of externalizing problem behavior, poor inhibition predicted ADHD symptoms and externalizing problem behaviors, independent of disorganized attachment, whereas for ASD symptoms no predictive relations remained. Disorganized attachment independently predicted CU traits.

Attention demands influence 10- and 12-month-old infants' perseverative behavior.

The present study examined the role of attentional demand on infants' perseverative behavior in a noncommunicative looking version of an A-not-B task. The research aimed at clarifying age-related improvements in the attention process that presumably underlies the development of cognitive control. In a between-subjects design, forty 10-month-olds and forty 12-month-olds were assigned to either a distractor or a no-distractor condition as a means of testing the role of attentional load. The authors used an eye tracker to record infants' looking behavior while they anticipated the reappearance of the target of interest as well as continuously throughout the task. The data demonstrated that 10-month-olds show more perseverative looking than do 12-month-olds and that increased attentional demand leads to more perseverative looking. Correct anticipation, however, was not affected by age or distraction. The results also failed to show that 12-month-olds are better than 10-month-olds at handling the increased attentional demand introduced in the distractor condition, in that the effect of the distractor was not larger for the younger infants. Our results are in line with the theoretical view of cognitive control as dependent on a limited attentional resource, which can explain perseverative behaviors in different tasks and at different ages.