title: Cognitive-motivational deficits in ADHD: development of a classification system.
abstract: The classification systems developed so far to detect attention deficit/hyperactivity disorder (ADHD) do not have high sensitivity and specificity. We have developed a classification system based on several neuropsychological tests that measure cognitive-motivational functions that are specifically impaired in ADHD children. A total of 240 (120 ADHD children and 120 healthy controls) children in the age range of 6-9 years and 32 Oppositional Defiant Disorder (ODD) children (aged 9 years) participated in the study. Stop-Signal, Task-Switching, Attentional Network, and Choice Delay tests were administered to all the participants. Receiver operating characteristic (ROC) analysis indicated that percentage choice of long-delay reward best classified the ADHD children from healthy controls. Single parameters were not helpful in making a differential classification of ADHD with ODD. Multinominal logistic regression (MLR) was performed with multiple parameters (data fusion) that produced improved overall classification accuracy. A combination of stop-signal reaction time, posterror-slowing, mean delay, switch cost, and percentage choice of long-delay reward produced an overall classification accuracy of 97.8%; with internal validation, the overall accuracy was 92.2%. Combining parameters from different tests of control functions not only enabled us to accurately classify ADHD children from healthy controls but also in making a differential classification with ODD. These results have implications for the theories of ADHD.
authors.affiliation: Centre of Behavioural and Cognitive Sciences, University of Allahabad, India. rash_cogsci@yahoo.com
authors.forename: Rashmi
authors.initials: R
authors.lastname: Gupta
authors.forename: Bhoomika R
authors.initials: BR
authors.lastname: Kar
authors.forename: Narayanan
authors.initials: N
authors.lastname: Srinivasan
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000145:classification* / Q000523:psychology; D002648:Child; D002755:Choice Behavior; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D009483:Neuropsychological Tests; D012201:Reward