Characterizing cognition in ADHD: beyond executive dysfunction.
The hypothesis that Attention-Deficit/Hyperactivity Disorder (ADHD) reflects a primary inhibitory executive function deficit has spurred a substantial literature. However, empirical findings and methodological issues challenge the etiologic primacy of inhibitory and executive deficits in ADHD. Based on accumulating evidence of increased intra-individual variability in ADHD, we reconsider executive dysfunction in light of distinctions between 'hot' and 'cool' executive function measures. We propose an integrative model that incorporates new neuroanatomical findings and emphasizes the interactions between parallel processing pathways as potential loci for dysfunction. Such a reconceptualization provides a means to transcend the limits of current models of executive dysfunction in ADHD and suggests a plan for future research on cognition grounded in neurophysiological and developmental considerations.
Castellanos
F Xavier
FX
Institute for Pediatric Neuroscience, NYU Child Study Center, 215 Lexington Avenue, New York, NY 10016, USA. castef01@med.nyu.edu
Sonuga-Barke
Edmund J S
EJ
Milham
Michael P
MP
Tannock
Rosemary
R
D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000503:physiopathology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D009044:Motor Cortex / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000503:physiopathology