The effects of anxiety on continuous performance test functioning in an ADHD clinic sample

Abstract

Several research studies have reported that the performance of children with attention deficit hyperactivity disorder (ADHD) on continuous performance tests (CPTs) is affected by comorbid anxiety. However, the specific anxiety domains/symptoms that affect CPT performance as well as the particular CPT performance measures have been inconsistent across studies. The present study examines CPT performance in 158 ADHD clinic-referred children using measures derived from signal detection theory. Regression analyses are conducted to examine whether any of the anxiety domains from the Revised Children's Manifest Anxiety Scale (RCMAS) account for variance on CPT performance measures. The main finding of these analyses is that physiological anxiety appears to increase response inhibition, whereas cognitive anxiety appears to decrease response inhibition. This finding suggests that physiological anxiety alone may be responsible for increased response inhibition/decreased impulsivity in children with comorbid anxiety. These results are interpreted in the context of Gray's model of a behavioral inhibition system

References

Biederman, J. , Faraone, S. V. , Keenan, K. , Stemgard, R. , & Tsuang, M.T. (1991). Familial association between attention deficit disorder and anxiety disorders. American Journal of Psychiatry , 148 (2), 251-256.

Conners, C. K. (1994). The Conners Continuous Performance Test Toronto: Multi-Health Systems, Inc.

Corkum, P. V. , & Siegel, L. S. (1993). Is the continuous performance task a valuable research tool for use with children with attention-deficit-hyperactivity disorder? Journal of Child Psychology and Psychiatry, 34 (7), 1217-1239.

Fischer, M. , Newby, R. F. , & Gordon, M. ( 1995 ). Who are the false negatives on continuous performance tests ? Journal of Clinical Child Psychology, 24 (4), 427-433.

Gordon, M. (1987). The Gordon Diagnostic System. DeWitt, NY: Gordon Systems, Inc.

Gray, J. A. (1982). The Neuropsychology of Anxiety. Oxford: Oxford University Press.

Gray, J. A. (1987). The psychology of fear and stress New York: Cambridge University Press.

Horn, W.F. , Wagner, A.E. , & Ialongo, N. ( 1989). Sex differences in school aged children with pervasive attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 17, 109-125.

Jensen, P. S. , Traylor, J. , Xenakis, S. N. , & Davis, H. (1988). Child psychopathology rating scales and interrater agreement: Vol. I. Parents' gender and psychiatric symptoms. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 442-450.

10.

Livingston, R. L. , Dykman, R. A. , & Ackerman, P. T. (1990). The frequency and significance of additional self-reported psychiatric diagnoses in children with attention deficit disorder . Journal of Abnormal Child Psychology, 18 (5), 465-478.

11.

Moretti, M. M. , Fine, S. , Haley, G. , & Marriage, K. (1985). Childhood and adolescent depression: Child-report versus parent-report information . Journal of the American Academy of Child Psychiatry, 24, 298-302.

12.

O'Dougherty, M. , Neuchterlein, K. H. , & Drew, B. ( 1984). Hyperactive and hypoxic children: Signal detection, sustained attention, and behavior. Journal of Abnormal Psychology , 92 (2), 4-28.

13.

Pliszka, S. R. (1989). Effect of anxiety on cognition, behavior, and stimulant response in ADHD. Journal of the American Academy of Child and Adolescent Psychiatry , 28 (6), 882-887.

14.

Pliszka, S. R. (1992). Comorbidity of attention-deficit hyperactivity disorder and overanxious disorder. Journal of the American Academy of Child and Adolescent Psychiatry , 31 (2), 197-203.

15.

Quay, H. C. (1988). Attention deficit disorder and the behavioral inhibition system: The relevance of the neuropsychological theory of Jeffrey A. Gray. In L. M. Bloomingdale & J. Sergeant (Eds.), Attention deficit disorder: Criteria, cognition, and intervention . Oxford, England: Pergamon Press .

16.

Quay, H. C. (1997). Inhibition and attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 25, 7-13.

17.

Reynolds, C. R. , & Richmond, B. O. (1978). Factor structure and construct validity of "What I Think and Feel": The Revised Children's Manifest Anxiety Scale. Journal of Personality Assessment, 43, 281-283.

18.

Sandberg, S. T. , Wieselberg, M. , & Shaffer, D. ( 1980). Hyperkinetic and conduct problem children in a primary school population: Some epidemiological considerations. Journal of Child Psychology, Psychiatry and Allied Disciplines, 21, 293-311.

19.

Schachar, R. J. , Tannock, R. , & Logan, G. ( 1993). Inhibitory control, impulsiveness, and attention deficit hyperactivity disorder. Clinical Psychology Review, 13, 721-739.

20.

Sostek, A. J. , Buchsbaum, M. S. , & Rapoport, J. L. (1980). Effects of amphetamine on vigilance performance in normal and hyperactive children. Journal of Abnormal Child Psychology, 8 (4), 491-500.

21.

Steptoe, A. & Kearsley, N. (1990). Cognitive and somatic anxiety. Behaviour Research and Therapy, 28, 75-81.

22.

Swanson, H. L. (1983). A developmental study of vigilance in learning-disabled and nondisabled children. Journal of Abnormal Child Psychology, 11 (3), 415-429.

23.

Tannock, R. , Ickowicz, A. , & Schachar, R. ( 1995). Differential effects of methylphenidate on working memory in ADHD children with and without comorbid anxiety. Journal of the American Academy of Child & Adolescent Psychiatry, 34 (7), 886-896.

24.

Tarnowski, K. J. , Prinz, R. J. , & Nay, S. M. (1986). Comparative analysis of attentional deficits in hyperactive and learning-disabled children. Journal of Abnormal Psychology, 95 (4), 341-345.