Behavioral Inhibition Deficits Research Articles

Handbook of Disruptive Behavior Disorders

Back to table of contents Previous article Next article Book Forum: Disorders of Childhood and BeyondFull AccessHandbook of Disruptive Behavior DisordersTRUCE T. ORDOÑA, M.D., TRUCE T. ORDOÑASearch for more papers by this author, M.D., Davenport, IowaPublished Online:1 Mar 2001https://doi.org/10.1176/appi.ajp.158.3.512-aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail Approximately three-fourths of all psychopathological disorders of childhood and adolescence are the disruptive disorders: attention deficit hyperactivity disorder (ADHD), conduct disorder, and oppositional defiant disorder. Bringing together 53 authors from Canada, New Zealand, Australia, the Netherlands, and the United States, this volume culls from more than 2,600 references a very comprehensive dissection of these disorders.Including one of the late Dennis Cantwell’s last papers, this exhaustive collection of studies is both thoughtful and refreshingly pragmatic. One actually senses, after putting down this book, that there is hope out there because we now have a clearer understanding of problems long viewed as puzzling and frustrating.To those among us who do strictly clinical, nonresearch work, a lot of the data confirm what we already know. They underline the importance of the concept that it takes a village to raise a child. Toward this end, it is crucial to examine the respective causal contributions of the child, the parents, and the social environment to the child’s behavioral and cognitive problems. This belief window colors whether the child is viewed as needing help or as just bad and thus colors how the village bands together to invest in shaping the child or giving up on the child and going into punitive mode.Russell Barkley’s chapter summarizing theories of ADHD deserves special attention. His model of the impairments in executive functions thought to be associated with the deficits in behavioral inhibition that characterize ADHD is both clear and instrumental in the understanding and formulation of treatment strategies for the disorder.Because we know that pediatricians and family physicians are usually the first-line initiators of pharmacological treatments of disruptive disorders, it would be highly advisable for them to read the chapter by Schachar and Ickowicz. This one could have easily been subtitled “Everything You Have Always Wanted to Know About Child Psychopharmacology But Were Afraid To Ask.” It is thorough, scholarly, and blunt. It might not be a bad idea to summarize this chapter to hand out to families and agencies involved with such children.Edited by Herbert C. Quay and Anne E. Hogan. New York, Kluwer Academic/Plenum, 1999, 695 pp, $125.00. FiguresReferencesCited byDetailsCited ByNone Volume 158Issue 3 March 2001Pages 512-a-513 Metrics History Published online 1 March 2001 Published in print 1 March 2001

Evaluation of sensorimotor training in children with ADHD.

Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.

EVALUATION OF SENSORIMOTOR TRAINING IN CHILDREN WITH ADHD

Reduced ability to regulate motor behavior seems to be an essential aspect of Attention-Deficit Hyperactivity Disorder (ADHD) and may reflect deficits in behavioral response inhibition. In this respect, pragmatic clinical experience over the last two decades, in daily practice, training of motor control has played an important role within multimodal treatment approaches, although an adequate proof of its efficacy is still lacking. Therefore, to examine the efficacy of sensorimotor training, 12 children with ADHD (two groups of six) were treated with both sensorimotor training and (as control) cognitive behavioral training using a within-subject cross-over design. Each treatment had a duration of 4 months (20 sessions), yielding a total of 40 sessions for the completed cross-over design. Results showed that Sensorimotor Training improved sensorimotor coordination slightly, while Cognitive Behavioral Training ameliorated cognitive impulse control. Hyperactivity and anxious-depressive/aggressive behavior were markedly reduced by Sensorimotor Training but not by Cognitive Behavioral Training. In conclusion, a combined treatment may be recommended since compensation and regulation of inhibitory deficits in ADHD come into play within the framework of both kinds of training.

Behavioral inhibition deficits in juvenile psychopaths

Although many studies have shown that delinquents are impaired on certain executive function tasks related to frontal lobe functioning, whether psychopaths present with such impairments is still controversial. Lapierre et al. [1995. Neuropsychologia 33:139–151] have investigated a more specific hypothesis of orbitofrontal deficits in psychopaths and found that psychopathic criminals are impaired on tasks involving behavioral inhibition and olfactory discrimination. The present study sought to replicate these results with juvenile psychopaths 14 to 18 years of age. As expected, psychopaths were found to be significantly impaired on behavioral inhibition tasks. However, psychopathic and nonpsychopathic inmates performed similarly on measures related to the dorsolateral area of the frontal lobe. Also, no significant intergroup difference was noted on the olfactory discrimination task. Although an orbitofrontal deficit in psychopathy remains possible, it is suggested to explain results through a functional inhibition deficit that is not specifically related to orbitofrontal processing. Aggr. Behav. 26:413–424, 2000. © 2000 Wiley-Liss, Inc.

Behavioral inhibition deficits in juvenile psychopaths

Behavioral inhibition deficits in juvenile psychopaths

Premorbid Prevalence of ADHD and Development of Secondary ADHD After Closed Head Injury

To determine premorbid prevalence of attention-deficit hyperactivity disorder (ADHD) in children with moderate and severe closed head injury (CHI), to determine incidence of ADHD 1 year after injury, and to characterize children who develop ADHD by demographic, neuropsychiatric, and outcome variables. Ninety-nine children who had severe and moderate CHI were followed up for 1 year. Premorbid and 1-year postinjury psychiatric status were ascertained by parent and child structured interviews and questionnaires measuring affective lability, aggression, apathy, and social judgment. Premorbid prevalence of ADHD was 0.20, significantly higher than in a reference population (0.045). Fifteen of the remaining 80 children (0.19) developed full ADHD criteria (except for age of onset) by the end of the first year. Children who developed secondary ADHD (S-ADHD) had significantly greater premorbid psychosocial adversity, posttraumatic affective lability and aggression, posttraumatic psychiatric comorbidity, and overall disability than children who did not develop S-ADHD. There is an excess prevalence of premorbid ADHD among children who present with moderate and severe CHI. Children with high psychosocial adversity are more likely to develop S-ADHD after CHI. S-ADHD has criteria in common with personality change due to CHI, a deficit in behavioral inhibition being the major overlapping feature.

Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD.

Attention deficit hyperactivity disorder (ADHD) comprises a deficit in behavioral inhibition. A theoretical model is constructed that links inhibition to 4 executive neuropsychological functions that appear to depend on it for their effective execution: (a) working memory, (b) self-regulation of affect-motivation-arousal, (c) internalization of speech, and (d) reconstitution (behavioral analysis and synthesis). Extended to ADHD, the model predicts that ADHD should be associated with secondary impairments in these 4 executive abilities and the motor control they afford. The author reviews evidence for each of these domains of functioning and finds it to be strongest for deficits in behavioral inhibition, working memory, regulation of motivation, and motor control in those with ADHD. Although the model is promising as a potential theory of self-control and ADHD, far more research is required to evaluate its merits and the many predictions it makes about ADHD.

Relative contributions of pituitary -Adrenal hormones to the ontogeny of behavioral inhibition in the rat

Recent investigations revealed that adrenalectomized (ADX) rat pups exhibit deficits in behavioral inhibition. Furthermore, administration of exogenous corticosterone (CORT) restores behavioral inhibition in ADX pups. Although these studies suggest that CORT has an important role in the development of behavioral inhibition, the relative behavioral effects of elevated pituitary hormone secretion induced by ADX are not known. Therefore, experiments were conducted to assess the potential behavioral effects of elevated adrenocorticotropin (ACTH) secretion induced by ADX and to further evaluate the contribution of endogenous CORT to the development of behavioral inhibition. In Experiment 1., we verified that 10-day-old ADX rats exhibit high levels of plasma ACTH throughout the preweaning period associated with the development of behavioral inhibition. In Experiment 2, 10-day-old pups were hypophysectomized (HYPOX) and ADX and were compared behaviorally to sham-operated controls on day 14. When tested in the presence of an anesthetized unfamiliar adult male rat, HYPOX + ADX pups exhibited low levels of freezing accompanied by ultrasonic vocalizations. These pups also had reduced concentrations of plasma ACTH and CORT. In Experiment 3, 10-day-old pups were HYPOX and tested for behavioral inhibition on day 14. In comparison to sham-operated controls, HYPOX rats exhibited significantly lower levels of freezing and had reduced plasma concentrations of ACTH and CORT. Results demonstrate clearly that deficits in freezing occur even in the presence of low plasma ACTH concentrations. Therefore, elevated secretion of pituitary hormones is not a major factor that contributes to the ADX-induced deficits in behavioral inhibition. In addition, results considerably strengthen the contention that endogenous adrenal steroids have a prominent role in the development of neural pathways regulating the expression of behavioral inhibition.

Inhibitory deficits in rats rendered “mentally retarded” by early brain damage

Young rats with lesions to the parietal cortex, globus pallidus, or median raphe have previously been reported to be deficient in learning a wide variety of laboratory tasks. The purpose of the current study was to determine whether weanling rats with similarly placed lesions (or with hippocampal or amygdaloid lesions) would subsequently manifest a global deficit in behavioral inhibition (as evidenced by abnormalities on activity, extinction, spontaneous alternation, go/no-go discrimination, passive avoidance, spatial reversal, and visual reversal tests), and whether the degree of this inhibitory deficit would correlate with an independent assessment of learning ability (as gauged by performance on three distinct detour problems). The parietal and median raphe groups showed losses on at least six of the seven tests of inhibition, whereas the remaining groups showed losses on no more than three tests. However, the correlations between overall inhibition scores and learning scores did not exceed.43. Based on a key cluster analysis, two factors were extracted from the data on the inhibition tests. Inhibition related to Factor I (which was strongly associated with learning ability) appeared to underlie the suppression of an initially preferred response in the face of nonreinforcement or punishment. Inhibition related to Factor II appeared to underlie the suppression of an approach response to the negative cue in approach-avoidance and go/no-go discrimination situations. These results are discussed in relation to certain theories of intelligence and mental retardation.