Abstract
BackgroundThis study investigated cognitive and emotional functioning in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and disruptive, impulse-control, and conduct disorders (DICCD).MethodsThirty patients with ADHD, 26 with DICCD, 22 with ADHD+DICCD were recruited from the outpatient department of Shanghai Changning Mental Health Center, plus 20 healthy controls (HC). Differences between the groups in cognitive and emotional functioning were examined using Golden’s Stroop and Emotional Stroop tests. For Emotional Stroop Mean reaction time (RT) of positive word (POS) and negative word (NEG) with color congruence (C) or incongruence (I) were recorded as POS-C, POS-I, NEG-C and NEG-I, respectively.ResultsFor Golden’s interference scores (IGs), both errors and RTs in the ADHD group were higher than in the other groups. Longer mean RTs of POS-C, POS-I, NEG-C and neural word (NEU) of the ADHD group, and NEG-I of ADHD+DICCD and DICCD groups were observed compared to HC. After 12 weeks of methylphenidate treatment, differences between ADHD subgroups and HC on Golden’s Stroop RT disappeared, but differences in Golden’s Stroop errors and Emotional Stroop mean RTs remained. The ADHD+DICCD group showed longer mean RTs in NEG-C, NEG-I and NEU of the Emotional Stroop test than the ADHD group.ConclusionsOur study shows that regardless of emotional responding, deficit in cognitive control is the core symptom of ADHD. However, emotionally biased stimuli may cause response inhibitory dysfunction among DICCD with callous-unemotional traits, and the comorbidity of ADHD and DICCD tends to account for the negative emotional response characteristic of DICCD. These deficits may be eliminated by medication treatment in ADHD, but not the ADHD with comorbid DICCD. Our results support the notion that ADHD with comorbid DICCD is more closely related to DICCD than to ADHD.
Highlights
This study investigated cognitive and emotional functioning in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and disruptive, impulse-control, and conduct disorders (DICCD)
Emotional Stroop test showed that the mean reaction time (RT) of negative word (NEG)-C, NEG-I and neural word (NEU) of ADHD+DICCD were
The subscales were able to distinguish between ADHD, DICCD and comorbidity
Summary
This study investigated cognitive and emotional functioning in children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and disruptive, impulse-control, and conduct disorders (DICCD). Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children and adolescents that comprises core symptoms of high levels of inattention, motor hyperactivity, and impulsivity [1]. ADHD ranks among the highest of children’s mental disorders, with a prevalence of 6.26% in China, with difficulties often continuing into adulthood [2]. It is estimated that comorbid disruptive, impulsecontrol, and conduct disorders (DICCD) occurs in 20 to 78% of cases [3, 4]. The treatment difficulty in ADHD is currently still unresolved, resulting in poor prognosis of the disorder. These issues have so far not received adequate attention. The low rate of treatment and high rate of missed diagnosis of ADHD have become a serious public health problem worldwide
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