title: Processing of continuously provided punishment and reward in children with ADHD and the modulating effects of stimulant medication: an ERP study.
abstract: OBJECTIVE
  Current models of ADHD suggest abnormal reward and punishment sensitivity, but the exact mechanisms are unclear. This study aims to investigate effects of continuous reward and punishment on the processing of performance feedback in children with ADHD and the modulating effects of stimulant medication.
  
  
  METHODS
  15 Methylphenidate (Mph)-treated and 15 Mph-free children of the ADHD-combined type and 17 control children performed a selective attention task with three feedback conditions: no-feedback, gain and loss. Event Related Potentials (ERPs) time-locked to feedback and errors were computed.
  
  
  RESULTS
  All groups performed more accurately with gain and loss than without feedback. Feedback-related ERPs demonstrated no group differences in the feedback P2, but an enhanced late positive potential (LPP) to feedback stimuli (both gains and losses) for Mph-free children with ADHD compared to controls. Feedback-related ERPs in Mph-treated children with ADHD were similar to controls. Correlational analyses in the ADHD groups revealed that the severity of inattention problems correlated negatively with the feedback P2 amplitude and positively with the LPP to losses and omitted gains.
  
  
  CONCLUSIONS
  The early selective attention for rewarding and punishing feedback was relatively intact in children with ADHD, but the late feedback processing was deviant (increased feedback LPP). This may explain the often observed positive effects of continuous reinforcement on performance and behaviour in children with ADHD. However, these group findings cannot be generalised to all individuals with the ADHD, because the feedback-related ERPs were associated with the severity of the inattention problems. Children with ADHD-combined type with more inattention problems showed both deviant early attentional selection of feedback stimuli, and deviant late processing of non-reward and punishment.
authors.affiliation: Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands. y.groen@rug.nl
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Groen
authors.forename: Oliver
authors.initials: O
authors.lastname: Tucha
authors.forename: Albertus A
authors.initials: AA
authors.lastname: Wijers
authors.forename: Monika
authors.initials: M
authors.lastname: Althaus
mesh_terms: D001288:Attention / Q000187:drug effects; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D016022:Case-Control Studies; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D004578:Electron Spin Resonance Spectroscopy; D005071:Evoked Potentials / Q000187:drug effects; D030141:Feedback, Psychological / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D011678:Punishment; D011930:Reaction Time / Q000187:drug effects; D012054:Reinforcement, Psychology; D012201:Reward
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate
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