The ecological validity of delay aversion and response inhibition as measures of impulsivity in AD/HD: a supplement to the NIMH multimodal treatment study of AD/HD.
Impulsivity is a primary symptom of the combined type of Attention Deficit/Hyperactivity Disorder (AD/HD). The Stop Signal Paradigm is premised upon a primary deficit in inhibitory control in AD/HD, whereas the Delay Aversion Hypothesis, by contrast, conceptualizes impulsivity in AD/HD, not as an inability to inhibit a response, but rather as a choice to avoid delay. This study compared the ecological validity of the Stop Signal Task (SST) and Choice-Delay Task (C-DT) measure of delay aversion, with respect to their relative utility in discriminating AD/HD children from normal control participants, and their correlations with classroom observations and with ratings of impulsivity and other core AD/HD symptoms on the Conners and SNAP-IV checklists. The tasks exhibited modest discriminant validity when used individually and excellent discriminant validity when used in combination. The C-DT correlated with teacher ratings of impulsivity, hyperactivity, and conduct problems, and with observations of gross motor activity, physical aggression, and an AD/HD composite score. The SST correlated with the observations only. These results suggest that delay aversion is associated with a broad range of AD/HD characteristics whereas inhibitory failure seems to tap a more discrete dimension of executive control.
Solanto
M V
MV
Division of Child and Adolescent Psychiatry, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, New York, USA. mary_solanto-gardner@mssm.edu
Abikoff
H
H
Sonuga-Barke
E
E
Schachar
R
R
Logan
G D
GD
Wigal
T
T
Hechtman
L
L
Hinshaw
S
S
Turkel
E
E
D000704:Analysis of Variance; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000523:psychology*; D002140:California; D016022:Case-Control Studies; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D007175:Impulsive Behavior / Q000175:diagnosis / Q000523:psychology*; D007266:Inhibition, Psychological; D008297:Male; D009519:New York City; D011581:Psychological Tests / Q000592:standards; D011792:Quebec; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity