Relations between Continuous Performance Test performance measures and ADHD behaviors

Department of Psychiatry, Duke University Medical Center, Durham, North Carolina 27705, USA.
Journal of Abnormal Child Psychology (Impact Factor: 3.48). 11/2003; 31(5):543-54. DOI: 10.1023/A:1025405216339
Source: PubMed

ABSTRACT The Conners' Continuous Performance Test (CPT) is a neuropsychological task that has repeatedly been shown to differentiate ADHD from normal groups. Several variables may be derived from the Conners' CPT including errors of omission and commission, mean hit reaction time(RT), mean hit RT standard error, d', and beta. What each CPT parameter actually assesses has largely been based upon clinical assumptions and the face validity of each measure (e.g., omission errors measure inattention, commission errors measure impulsivity). This study attempts to examine relations between various CPT variables and phenotypic behaviors so as to better understand the various CPT variables. An epidemiological sample of 817 children was administered the Conners' CPT. Diagnostic interviews were conducted with parents to determine ADHD symptom profiles for all children. Children diagnosed with ADHD had more variable RTs, made more errors of commission and omission, and demonstrated poorer perceptual sensitivity than nondiagnosed children. Regarding specific symptoms, generalized estimating equations (GEE) and ANCOVAs were conducted to determine specific relationships between the 18 DSM-IV ADHD symptoms and 6 CPT parameters. CPT performance measures demonstrated significant relationships to ADHD symptoms but did not demonstrate symptom domain specificity according to a priori assumptions. Overall performance on the two signal detection measures, d' and beta, was highly related to all ADHD symptoms across symptom domains. Further, increased variability in RTs over time was related to most ADHD symptoms. Finally, it appears that at least 1 CPT variable, mean hit RT, is minimally related to ADHD symptoms as a whole, but does demonstrate some specificity in its link with symptoms of hyperactivity.

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Available from: Elizabeth Jane Costello, Mar 31, 2015
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    • "Four types of responses were also recorded: hit (a target appeared and the participant responded), omission (a target appeared and the participant failed to respond), correct inhibition (a distractor appeared and the participant did not respond) and false alarm (a distractor appeared and the participant responded). Omissions reflect inattention where as false alarms reflect hyperactivity–impulsivity (Barkley, 1991; Epstein et al., 2003). These two types of errors were calculated in percentage according to the total number of targets or distractors (omission = number of omissions/number of targets × 100; false alarm = number of false alarms/number of distractors × 100). "
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    ABSTRACT: Chronic exposure to methylmercury (MeHg), lead (Pb) and polychlorinated biphenyls (PCBs) has been associated with a range of attention deficits in children, but it is not known whether selective spatial attention is also altered. We modified the classic Posner paradigm, which assesses visuospatial attention, to also assess vigilance and impulsivity. This paradigm is based on the well-documented findings that a target will be detected more quickly if a visual cue indicates beforehand where it will appear, and more slowly if the cue indicates a false spatial location. In our task, visual distractors were introduced, in addition to the classic Posner trials, to assess impulsivity, and a central smiley face, whose eye-movement cued the location of the targets, to measure spatial attention. This task was administered to 27 school-age Inuit children (mean age=11.2years) from Nunavik (Arctic Quebec, Canada), in which pre- and postnatal exposures to environmental contaminants had been documented from birth. After controlling for the impact of confounding variables, multivariable regressions revealed that prenatal exposures to PCBs and Pb were significantly associated with greater inattention and impulsivity, respectively, while current exposure to Pb was significantly associated with longer reaction times. Although a significant correlation was observed between cord blood PCB concentration and decreased visuospatial performance, no significant association was found after adjustment for confounders. No effect was found for Hg exposures. These results suggest that our adapted Posner paradigm is sensitive in detecting a range of attention deficits in children exposed to environmental contaminants; implications for future studies are discussed. Copyright © 2015. Published by Elsevier Inc.
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    • "Another limitation of the current study is that parent-report measures were used instead of performance-based tasks to assess attention problems. Studies have shown that both parent and teacher ratings of attention problems tend to show small and somewhat inconsistent correlations with performance-based indices of attention and executive functioning (Epstein et al. 2003; Toplak et al. 2013 "
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    • "Among the diverse models of attention, studies of childhood ADHD frequently focus on four attention-related processes: orienting/alertness , selective/focused attention , divided attention, and vigilance/ sustained attention. Converging evidence indicates that approximately 33% to 55% of children with ADHD demonstrate vigilance/ sustained attention deficits; however, performance on vigilance/sustained attention tasks is correlated weakly to moderately with parent and teacher ratings of core ADHD symptoms (Epstein et al., 2003) and objectively observed classroom attention (Barkley, 1991). Deficient sustained attention, however, is associated with poorer academic performance , lower grades and standardized test scores, and higher rates of special education placement and comorbid learning disabilities (Rapport, Denney, DuPaul, & Gardner, 1994). "
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