Details

Autor(en) / Beteiligte

• Sidol, Craig

Titel

The Effects of Comorbid Internalizing and Externalizing Symptoms on Performance of Hot and Cool Executive Functions in Children with ADHD

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2017

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed disorders in childhood. Although research suggests strong associations between the disorder and deficits in hot and cool executive functions (EFs) at a group level, deficits among individual children with ADHD are not universal. One potential moderator of executive dysfunction may be the presence of a comorbid internalizing or externalizing symptoms. This study examined the association between EFs and comorbid internalizing and externalizing symptoms among children with ADHD. It was hypothesized that 1) higher levels of externalizing behaviors will relate to poor performance on "hot" EF tasks among individuals with ADHD, 2) higher levels of internalizing behaviors will relate to poor performance on "cool" EF tasks among individuals with ADHD, 3) higher levels of internalizing symptoms will moderate the relationship between externalizing symptoms and poor performance on "hot" EF tasks whereby children with higher levels of internalizing and externalizing symptoms will demonstrate better performance on "hot" EF tasks than observed among individuals with ADHD and high levels of externalizing alone. Eighty-four (7-12 years old) participated in the study. "Hot" EFs were assessed through use of the Child Version of the Iowa Gambling Task (CIGT) to measure risk-taking behavior in decision making and a Delay Discounting Task (DDT) to measure discounting gradient or preference for immediate rewards. "Cool" EFs were assessed with a Computerized Spatial Span task (CSST) to measure spatial working memory and a Stop Signal task (SST) to measure response inhibition. To examine each hypothesis, separate linear mixed models were conducted to evaluate if higher levels of comorbid symptoms related to performance on EF tasks. Results indicated that externalizing symptoms were not associated with "hot" EF performance and that internalizing symptoms were not associated with "cool" EF performance. Additionally, internalizing symptoms did not moderate the relationship between externalizing symptoms and "hot" EF performance. Factors related to the design of this study may have contributed to the lack of association between comorbid symptoms and EF task performance. For example, our sample had a low rate of individuals with actual comorbid internalizing (9%) or externalizing diagnoses (27%) Additionally, it is possible that the neuropsychology tests we used in the study were not effective at measuring either "hot" or "cool EF. Specifically, our "hot" EF tasks did not include a monetary reward to increase motivational saliency and the "cool" EF tasks provided computerized feedback, as opposed to feedback from an examiner, which may not have incited anxiety during the testing. Finally, internalizing symptoms may be better measured through self-report rather than relying solely on parent report. Relying on parent-report may have impacted our measurement of internalizing symptoms thereby preventing us from detecting relationships between comorbid internalizing symptoms and "cool" EF. Future research should recruit samples of children with significant problems in the internalizing and externalizing domain.