Relations Between Continuous Performance Test Performance Measures and ADHD Behaviors

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


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
    • "We first examined whether individuals who exerted greater listening effort (mean taskevoked pupil response) exhibited greater vigilance on a behavioral measure of reaction time (RT) variability that was obtained from a standardized continuous performance test (CPT). In particular, previous research has demonstrated that RTs in response to changing interstimulus intervals (ISIs) on the CPT are more variable with increasing distractibility and with attention deficit disorders (Advokat, Martino, Hill, & Gouvier, 2007;Epstein et al., 2003). Secondly, we predicted that individuals who exhibited greater listening effort (larger pupil responses) would demonstrate auditory-and attention-related neural activity to a greater degree in response to unexpected transitions in experimental epochs (i.e., quiet rest, rest with background noise, and word-in-noise recognition). "
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    ABSTRACT: Background/Study Context: Vigilance refers to the ability to sustain and adapt attentional focus in response to changing task demands. For older adults with hearing loss, vigilant listening may be particularly effortful and variable across individuals. This study examined the extent to which neural responses to sudden, unexpected changes in task structure (e.g., from rest to word recognition epochs) were related to pupillometry measures of listening effort. Methods: Individual differences in the task-evoked pupil response during word recognition were used to predict functional magnetic resonance imaging (MRI) estimates of neural responses to salient transitions between quiet rest, noisy rest, and word recognition in unintelligible, fluctuating background noise. Participants included 29 older adults (M = 70.2 years old) with hearing loss (pure tone average across all frequencies = 36.1 dB HL [hearing level], SD = 6.7).Results: Individuals with a greater average pupil response exhibited a more vigilant pattern of responding on a standardized continuous performance test (response time variability across varying interstimulus intervals r(27) = .38, p = .04). Across participants there was widespread engagement of attention- and sensory-related cortices in response to transitions between blocks of rest and word recognition conditions. Individuals who exhibited larger task-evoked pupil dilation also showed even greater activity in the right primary auditory cortex in response to changes in task structure.Conclusion: Pupillometric estimates of word recognition effort predicted variation in activity within cortical regions that were responsive to salient changes in the environment for older adults with hearing loss. The results of the current study suggest that vigilant attention is increased amongst older adults who exert greater listening effort.
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    • "On the AULA, children do sustained attention and response inhibition exercises while various auditory and visual distractors are presented. On CPTs – whether sustained attention/vigilance or sustained attention/inhibition – children with attention deficits exhibit: longer and more variable reaction times, and lower sensitivity (d') (Epstein et al., 2003; Hooks, Milich, & Pugzles-Lorch, 1994; Losier, McGrath, & Klein, 1996; Oades, 2000; Stins et al., 2005; Swaab- Barneveld et al., 2000) than children with typical development. Children with attention deficit make more omission errors and commission only when it comes to sustained attention/inhibition. "
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    ABSTRACT: The purpose of this study was to analyze the DiViSA’s predictive validity in school-age children. To do so, two groups of school-age children were compared: one with low school achievement ( N = 1,174), and one with typical development ( N = 1,426). The obtained results show that: (1) in all grades, children with poor school performance exhibited lower levels of attention and task organization, greater hastiness, and made more commission errors; (2) the combination of variables that best differentiated between groups was not the same in all grades; (3) level of organization improved with age in the low-school-achievement group, and did not in the typical-development group; (4) the data regarding sensitivity (81% to 93%) and specificity (79% to 90%), for the first time computed for each grade separately, support the test’s predictive validity in the grades we evaluated. The discussion focuses on the DiViSA test’s usefulness in diagnosing attention problems. It is the first computerized test to include separate scores for: (a) how children complete the task (organization) and (2) the source of their errors (distraction or hastiness).
    No preview · Article · Dec 2015
    • "Moreover, disrupted impulse control has been observed in psychiatric disorders such as attention-deficit/hyperactivity disorder (Epstein et al., 2003, 2006), antisocial or borderline personality disorders (Dougherty et al., 1999; Swann et al., 2009a), and bipolar disorder (Swann et al., 2003, 2009b). Thus, elucidating the neural basis of impulse control would be an important contribution to modern society. "
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    ABSTRACT: Poor impulse control is a debilitating condition observed in various psychiatric disorders and could be a risk factor for drug addiction, criminal involvement, and suicide. The rat infralimbic cortex (IL), located in the ventral portion of the medial prefrontal cortex, has been implicated in impulse control. To elucidate the neurophysiological basis of impulse control, we recorded single unit activity in the IL of a rat performing a 3-choiceserial reaction time task (3-CSRTT) and 2-choice task (2-CT), which are animal models for impulsivity. The inactivation of IL neuronal activity with an injection of muscimol (0.1μg /side) disrupted impulse control in the 3-CSRTT. More than 60% (38/56) of isolated IL units were linked to impulse control, while approximately 30% of all units were linked to attentional function in the 3-CSRTT. To avoid confounding motor-related units with the impulse control-related units, we further conducted the 2-CT in which the animals' motor activities were restricted during recording window. More than 30% (14/44) of recorded IL units were linked to impulse control in the 2-CT. Several types of impulse control-related units were identified. Only 16% of all units were compatible with the results of the muscimol experiment, which showed a transient decline in the firing rate immediately before the release of behavioral inhibition. This is the first study to elucidate the neurophysiological basis of impulse control in the IL and to propose that IL neurons control impulsive actions in a more complex manner than previously considered.
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