Recent Innovations in Psychology

Recent Innovations in Psychology

Comparison of Anti-saccade, Inhibitory Control and Sustained Attention in College Students with Attention-Deficit/Hyperactivity Disorder and Normal Peers

Document Type : Original Article

Authors
Siamak Dadashi 1
Ezzatollah Ahmadi 2
Mohammad Motallebzadeh 3
Pariya Khandaghi 4
1 Ph.D in Cognitive Neuroscience, University of Tabriz, Tabriz, Iran
2 Associate Professor, Department of Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
3 MSc. Student in General Psychology, Azarbaijan Shahid Madani University, Tabriz, Iran
4 BSc. Student in Psychology, University College of Nabi Akram, Tabriz, Iran
10.22034/rip.2024.482940.1064
Abstract
Although the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) states that the symptoms of Attention Deficit/Hyperactivity Disorder (ADHD) are the same in adults as they are in children, clinical observations suggest that adults have more diverse deficits than children in higher-level executive functions. This study compares anti-saccade, inhibitory control and sustained attention in college students with ADHD and normal peers. A causal-comparative design was employed, and the Adult ADHD Self-Report Scale (ASRS) was used for screening purposes. From among the students at one of Tabriz's higher education institutions, 30 students with ADHD and 30 normal students were selected through purposive sampling. The data were collected using the Anti-Saccade Task (AST) and the Continuous Performance Test- 2nd edition (CPT-II). The results of the multivariate analysis of variance demonstrated a statistically significant difference in antisaccade, inhibitory control, and sustained attention between the adult ADHD group and the normal group (P < 0.001). The findings indicate that students with ADHD exhibit deficiencies in anti-saccade, inhibitory control, and sustained attention, which can result in diminished academic and occupational performance.
Keywords
anti-saccade
attention-deficit/hyperactivity disorder
inhibitory control
sustained attention

Subjects

References

Agha, S. S., Riglin, L., Carbury, R., Blakey, R., Shakeshaft, A., Thapar, A. K., ... & Langley, K. (2024). Young adult ADHD symptoms in the general population and neurocognitive impairment. Journal of attention disorders, 28(1), 89-98. https://doi.org/10.1177/10870547231201870

American Psychiatric Association Division of Research. (2013). Highlights of changes from dsm-iv to dsm-5: Somatic symptom and related disorders. Focus, 11(4), 525-527. https://doi.org/10.1176/appi.focus.11.4.525

Ashoor Zadeh, E., Mousavi Nasab, S. M. H., & Towhidi. A. (2022). Psychometric characteristics of inhibition component of executive functions: Comparing normal people with clinical disorders. Advances in Cognitive Sciences, 24 (2) ,99-112 (In Persian). http://dx.doi.org/10.30514/ICSS.24.2.99

Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological bulletin, 121(1), 65. https://doi.org/10.1037/0033-2909.121.1.65

Brandeis, D., Banaschewski, T., Baving, L., Georgiewa, P., Blanz, B., Schmidt, M. H., ... &Scheuerpflug, P. (2002). Multicenter P300 brain mapping of impaired attention to cues in hyperkinetic children. Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), 990-998. https://doi.org/10.1097/00004583-200208000-00018

Coe, B. C., & Munoz, D. P. (2017). Mechanisms of saccade suppression revealed in the anti-saccade task. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1718), 20160192. https://doi.org/10.1098/rstb.2016.0192

Cubillo, A., Halari, R., Smith, A., Taylor, E., & Rubia, K. (2012). A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. cortex, 48(2), 194-215. https://doi.org/10.1016/j.cortex.2011.04.007

Duval, F., Erb, A., Mokrani, M. C., Weiss, T., & Carcangiu, R. (2021). First‐Dose Methylphenidate‐Induced Changes in the Anti‐Saccade Task Performance and Outcome in Adults with Attention‐Deficit/Hyperactivity Disorder. Psychiatric Research and Clinical Practice, 3(4), 146-152. https://doi.org/10.1176/appi.prcp.20210010

Feifel, D., Farber, R. H., Clementz, B. A., Perry, W., &Anllo-Vento, L. (2004). Inhibitory deficits in ocular motor behavior in adults with attention-deficit/hyperactivity disorder. Biological psychiatry, 56(5), 333-339. https://doi.org/10.1016/j.biopsych.2004.06.019 

Fernandez-Ruiz, J., Hakvoort Schwerdtfeger, R. M., Alahyane, N., Brien, D. C., Coe, B. C., & Munoz, D. P. (2020). Dorsolateral prefrontal cortex hyperactivity during inhibitory control in children with ADHD in the antisaccade task. Brain Imaging and Behavior, 14, 2450-2463. https://doi.org/10.1007/s11682-019-00196-3

Fullen, T., Jones, S. L., Emerson, L. M., & Adamou, M. (2020). Psychological treatments in adult ADHD: a systematic review. Journal of Psychopathology and Behavioral Assessment, 42(3), 500-518. https://psycnet.apa.org/doi/10.1007/s10862-020-09794-8

Gow, R. V., Rubia, K., Taylor, E., Vallee-Tourangeau, F., Matsudaira, T., Ibrahimovic, A., &Sumich, A. (2012). Abnormal centroparietal ERP response in predominantly medication-naive adolescent boys with ADHD during both response inhibition and execution. Journal of Clinical Neurophysiology, 29(2), 181-189. https://doi.org/10.1097/wnp.0b013e31824e1025 

Hadas, I., Hadar, A., Lazarovits, A., Daskalakis, Z. J., & Zangen, A. (2021). Right prefrontal activation predicts ADHD and its severity: A TMS-EEG study in young adults. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 111, 110340. https://doi.org/10.1016/j.pnpbp.2021.110340

Hadianfard, H., Najarian, B., Shokrkon, H., Mehrabizadeh, M. (2001). Construction and validation of the Farsi version of The Continuous Performance Test. Journal of Psychology, 416(4), 388-404 (In Persian). URL: https://www.sid.ir/fileserver/jf/61513791604.pdf

Klein, C. H., Raschke, A., & Brandenbusch, A. (2003). Development of pro–and antisaccades in children with attention–deficit hyperactivity disorder (ADHD) and healthy controls. Psychophysiology, 40(1), 17-28. https://doi.org/10.1111/1469-8986.00003

Klein, C., & Ettinger, U. (Eds.). (2019). Eye movement research: An introduction to its scientific foundations and applications. Springer Nature. https://doi.org/10.1007/978-3-030-20085-5   

Linhartová, P., Širůček, J., Ejova, A., Barteček, R., Theiner, P., & Kašpárek, T. (2021). Dimensions of impulsivity in healthy people, patients with borderline personality disorder, and patients with attention-deficit/hyperactivity disorder. Journal of attention disorders, 25(4), 584-595. https://doi.org/10.1177/1087054718822121

Machida, K., Barry, E., Mulligan, A., Gill, M., Robertson, I. H., Lewis, F. C., ... & Johnson, K. A. (2022). Which measures from a sustained attention task best predict ADHD group membership?. Journal of Attention Disorders, 26(11), 1471-1482. https://doi.org/10.1177/10870547221081266

Mirsky, J. B., Heuer, H. W., Jafari, A., Kramer, J. H., Schenk, A. K., Viskontas, I. V., ... & Boxer, A. L. (2011). Anti-saccade performance predicts executive function and brain structure in normal elders. Cognitive and Behavioral Neurology, 24(2), 50-58. https://doi.org/10.1097/WNN.0b013e318223f6c6

Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology, 41(1), 49-100. https://doi.org/10.1006/cogp.1999.0734

Mokhtari, H., Rabiei, M., & Salimi, S. H. (2015). Psychometric Properties of the Persian Version of Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale. Iranian Journal of Psychiatry and Clinical Psychology, 21(3), 244-253 (In Persian). URL: https://ijpcp.iums.ac.ir/article-1-2472-en.html

Munoz, D. P., & Everling, S. (2004). Look away: the anti-saccade task and the voluntary control of eye movement. Nature Reviews Neuroscience, 5(3), 218-228. https://doi.org/10.1038/nrn1345

Munoz, D. P., Armstrong, I. T., Hampton, K. A., & Moore, K. D. (2003). Altered control of visual fixation and saccadic eye movements in attention-deficit hyperactivity disorder. Journal of neurophysiology, 90(1), 503-514. https://doi.org/10.1152/jn.00192.2003

Rubia, K. (2018). Cognitive neuroscience of attention deficit hyperactivity disorder (ADHD) and its clinical translation. Frontiers in human neuroscience, 12, 100. https://doi.org/10.3389/fnhum.2018.00100

Servera, M., Sáez, B., & Rodríguez, T. I. (2023). Assessment of sustained attention in high-performance and attention deficit/hyperactivity disorder (ADHD) children with a vigilance task. Anales de Psicología/Annals of Psychology, 39(2), 223-230. https://doi.org/10.6018/analesps.477731

Stins, J. F., Tollenaar, M. S., Slaats-Willemse, D. I., Buitelaar, J. K., Swaab-Barneveld, H., Verhulst, F. C., ... &Boomsma, D. I. (2005). Sustained attention and executive functioning performance in attention-deficit/hyperactivity disorder. Child neuropsychology, 11(3), 285-294. https://doi.org/10.1080/09297040490916938

Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary (3rd ed.). Oxford University Press. URL: https://psycnet.apa.org/record/2006-04736-000

Tremblay, L. K., Hammill, C., Ameis, S. H., Bhaijiwala, M., Mabbott, D. J., Anagnostou, E., ... & Schachar, R. J. (2020). Tracking inhibitory control in youth with ADHD: a multi-modal neuroimaging approach. Frontiers in Psychiatry, 11, 00831. https://doi.org/10.3389/fpsyt.2020.00831

Tsal, Y., Shalev, L., & Mevorach, C. (2005). The diversity of attention deficits in ADHD: The prevalence of four cognitive factors in ADHD versus controls. Journal of learning disabilities, 38(2), 142-157. https://doi.org/10.1177/00222194050380020401

Tucha, L., Fuermaier, A. B., Koerts, J., Buggenthin, R., Aschenbrenner, S., Weisbrod, M., ... &Tucha, O. (2017). Sustained attention in adult ADHD: time-on-task effects of various measures of attention. Journal of neural transmission, 124, 39-53. https://doi.org/10.1007/s00702-015-1426-0 

Tucha, L., Tucha, O., Walitza, S., Sontag, T. A., Laufkötter, R., Linder, M., & Lange, K. W. (2009). Vigilance and sustained attention in children and adults with ADHD. Journal of attention disorders, 12(5), 410-421. https://doi.org/10.1177/1087054708315065

Wiersema, R., Van Der Meere, J., Antrop, I., &Roeyers, H. (2006). State regulation in adult ADHD: an event-related potential study. Journal of clinical and experimental neuropsychology, 28(7), 1113-1126. https://doi.org/10.1080/13803390500212896

References
Agha, S. S., Riglin, L., Carbury, R., Blakey, R., Shakeshaft, A., Thapar, A. K., ... & Langley, K. (2024). Young adult ADHD symptoms in the general population and neurocognitive impairment. Journal of attention disorders, 28(1), 89-98. https://doi.org/10.1177/10870547231201870
American Psychiatric Association Division of Research. (2013). Highlights of changes from dsm-iv to dsm-5: Somatic symptom and related disorders. Focus, 11(4), 525-527. https://doi.org/10.1176/appi.focus.11.4.525
Ashoor Zadeh, E., Mousavi Nasab, S. M. H., & Towhidi. A. (2022). Psychometric characteristics of inhibition component of executive functions: Comparing normal people with clinical disorders. Advances in Cognitive Sciences, 24 (2) ,99-112 (In Persian). http://dx.doi.org/10.30514/ICSS.24.2.99
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychological bulletin, 121(1), 65. https://doi.org/10.1037/0033-2909.121.1.65
Brandeis, D., Banaschewski, T., Baving, L., Georgiewa, P., Blanz, B., Schmidt, M. H., ... &Scheuerpflug, P. (2002). Multicenter P300 brain mapping of impaired attention to cues in hyperkinetic children. Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), 990-998. https://doi.org/10.1097/00004583-200208000-00018
Coe, B. C., & Munoz, D. P. (2017). Mechanisms of saccade suppression revealed in the anti-saccade task. Philosophical Transactions of the Royal Society B: Biological Sciences, 372(1718), 20160192. https://doi.org/10.1098/rstb.2016.0192
Cubillo, A., Halari, R., Smith, A., Taylor, E., & Rubia, K. (2012). A review of fronto-striatal and fronto-cortical brain abnormalities in children and adults with Attention Deficit Hyperactivity Disorder (ADHD) and new evidence for dysfunction in adults with ADHD during motivation and attention. cortex, 48(2), 194-215. https://doi.org/10.1016/j.cortex.2011.04.007
Duval, F., Erb, A., Mokrani, M. C., Weiss, T., & Carcangiu, R. (2021). First‐Dose Methylphenidate‐Induced Changes in the Anti‐Saccade Task Performance and Outcome in Adults with Attention‐Deficit/Hyperactivity Disorder. Psychiatric Research and Clinical Practice, 3(4), 146-152. https://doi.org/10.1176/appi.prcp.20210010
Feifel, D., Farber, R. H., Clementz, B. A., Perry, W., &Anllo-Vento, L. (2004). Inhibitory deficits in ocular motor behavior in adults with attention-deficit/hyperactivity disorder. Biological psychiatry, 56(5), 333-339. https://doi.org/10.1016/j.biopsych.2004.06.019 
Fernandez-Ruiz, J., Hakvoort Schwerdtfeger, R. M., Alahyane, N., Brien, D. C., Coe, B. C., & Munoz, D. P. (2020). Dorsolateral prefrontal cortex hyperactivity during inhibitory control in children with ADHD in the antisaccade task. Brain Imaging and Behavior, 14, 2450-2463. https://doi.org/10.1007/s11682-019-00196-3
Fullen, T., Jones, S. L., Emerson, L. M., & Adamou, M. (2020). Psychological treatments in adult ADHD: a systematic review. Journal of Psychopathology and Behavioral Assessment, 42(3), 500-518. https://psycnet.apa.org/doi/10.1007/s10862-020-09794-8
Gow, R. V., Rubia, K., Taylor, E., Vallee-Tourangeau, F., Matsudaira, T., Ibrahimovic, A., &Sumich, A. (2012). Abnormal centroparietal ERP response in predominantly medication-naive adolescent boys with ADHD during both response inhibition and execution. Journal of Clinical Neurophysiology, 29(2), 181-189. https://doi.org/10.1097/wnp.0b013e31824e1025 
Hadas, I., Hadar, A., Lazarovits, A., Daskalakis, Z. J., & Zangen, A. (2021). Right prefrontal activation predicts ADHD and its severity: A TMS-EEG study in young adults. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 111, 110340. https://doi.org/10.1016/j.pnpbp.2021.110340
Hadianfard, H., Najarian, B., Shokrkon, H., Mehrabizadeh, M. (2001). Construction and validation of the Farsi version of The Continuous Performance Test. Journal of Psychology, 416(4), 388-404 (In Persian). URL: https://www.sid.ir/fileserver/jf/61513791604.pdf
Klein, C. H., Raschke, A., & Brandenbusch, A. (2003). Development of pro–and antisaccades in children with attention–deficit hyperactivity disorder (ADHD) and healthy controls. Psychophysiology, 40(1), 17-28. https://doi.org/10.1111/1469-8986.00003
Klein, C., & Ettinger, U. (Eds.). (2019). Eye movement research: An introduction to its scientific foundations and applications. Springer Nature. https://doi.org/10.1007/978-3-030-20085-5   
Linhartová, P., Širůček, J., Ejova, A., Barteček, R., Theiner, P., & Kašpárek, T. (2021). Dimensions of impulsivity in healthy people, patients with borderline personality disorder, and patients with attention-deficit/hyperactivity disorder. Journal of attention disorders, 25(4), 584-595. https://doi.org/10.1177/1087054718822121
Machida, K., Barry, E., Mulligan, A., Gill, M., Robertson, I. H., Lewis, F. C., ... & Johnson, K. A. (2022). Which measures from a sustained attention task best predict ADHD group membership?. Journal of Attention Disorders, 26(11), 1471-1482. https://doi.org/10.1177/10870547221081266
Mirsky, J. B., Heuer, H. W., Jafari, A., Kramer, J. H., Schenk, A. K., Viskontas, I. V., ... & Boxer, A. L. (2011). Anti-saccade performance predicts executive function and brain structure in normal elders. Cognitive and Behavioral Neurology, 24(2), 50-58. https://doi.org/10.1097/WNN.0b013e318223f6c6
Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “frontal lobe” tasks: A latent variable analysis. Cognitive psychology, 41(1), 49-100. https://doi.org/10.1006/cogp.1999.0734
Mokhtari, H., Rabiei, M., & Salimi, S. H. (2015). Psychometric Properties of the Persian Version of Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale. Iranian Journal of Psychiatry and Clinical Psychology, 21(3), 244-253 (In Persian). URL: https://ijpcp.iums.ac.ir/article-1-2472-en.html
Munoz, D. P., & Everling, S. (2004). Look away: the anti-saccade task and the voluntary control of eye movement. Nature Reviews Neuroscience, 5(3), 218-228. https://doi.org/10.1038/nrn1345
Munoz, D. P., Armstrong, I. T., Hampton, K. A., & Moore, K. D. (2003). Altered control of visual fixation and saccadic eye movements in attention-deficit hyperactivity disorder. Journal of neurophysiology, 90(1), 503-514. https://doi.org/10.1152/jn.00192.2003
Rubia, K. (2018). Cognitive neuroscience of attention deficit hyperactivity disorder (ADHD) and its clinical translation. Frontiers in human neuroscience, 12, 100. https://doi.org/10.3389/fnhum.2018.00100
Servera, M., Sáez, B., & Rodríguez, T. I. (2023). Assessment of sustained attention in high-performance and attention deficit/hyperactivity disorder (ADHD) children with a vigilance task. Anales de Psicología/Annals of Psychology, 39(2), 223-230. https://doi.org/10.6018/analesps.477731
Stins, J. F., Tollenaar, M. S., Slaats-Willemse, D. I., Buitelaar, J. K., Swaab-Barneveld, H., Verhulst, F. C., ... &Boomsma, D. I. (2005). Sustained attention and executive functioning performance in attention-deficit/hyperactivity disorder. Child neuropsychology, 11(3), 285-294. https://doi.org/10.1080/09297040490916938
Strauss, E., Sherman, E. M. S., & Spreen, O. (2006). A compendium of neuropsychological tests: Administration, norms, and commentary (3rd ed.). Oxford University Press. URL: https://psycnet.apa.org/record/2006-04736-000
Tremblay, L. K., Hammill, C., Ameis, S. H., Bhaijiwala, M., Mabbott, D. J., Anagnostou, E., ... & Schachar, R. J. (2020). Tracking inhibitory control in youth with ADHD: a multi-modal neuroimaging approach. Frontiers in Psychiatry, 11, 00831. https://doi.org/10.3389/fpsyt.2020.00831
Tsal, Y., Shalev, L., & Mevorach, C. (2005). The diversity of attention deficits in ADHD: The prevalence of four cognitive factors in ADHD versus controls. Journal of learning disabilities, 38(2), 142-157. https://doi.org/10.1177/00222194050380020401
Tucha, L., Fuermaier, A. B., Koerts, J., Buggenthin, R., Aschenbrenner, S., Weisbrod, M., ... &Tucha, O. (2017). Sustained attention in adult ADHD: time-on-task effects of various measures of attention. Journal of neural transmission, 124, 39-53. https://doi.org/10.1007/s00702-015-1426-0 
Tucha, L., Tucha, O., Walitza, S., Sontag, T. A., Laufkötter, R., Linder, M., & Lange, K. W. (2009). Vigilance and sustained attention in children and adults with ADHD. Journal of attention disorders, 12(5), 410-421. https://doi.org/10.1177/1087054708315065
Wiersema, R., Van Der Meere, J., Antrop, I., &Roeyers, H. (2006). State regulation in adult ADHD: an event-related potential study. Journal of clinical and experimental neuropsychology, 28(7), 1113-1126. https://doi.org/10.1080/13803390500212896

  • Receive Date 11 October 2024
  • Revise Date 02 November 2024
  • Accept Date 21 November 2024
  • First Publish Date 05 December 2024