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Acute Stimulant Treatment and Reinforcement Increase the Speed of Information Accumulation in Children with ADHD

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Abstract

The current studies utilized drift diffusion modeling (DDM) to examine how reinforcement and stimulant medication affect cognitive task performance in children with ADHD. In Study 1, children with (n = 25; 88 % male) and without ADHD (n = 33; 82 % male) completed a 2-choice discrimination task at baseline (100 trials) and again a week later under alternating reinforcement and no-reinforcement contingencies (400 trials total). In Study 2, participants with ADHD (n = 29; 72 % male) completed a double-blind, placebo-controlled trial of 0.3 and 0.6 mg/kg methylphenidate and completed the same task utilized in Study 1 at baseline (100 trials). Children with ADHD accumulated information at a much slower rate than controls, as evidenced by a lower drift rate. Groups were similar in nondecision time and boundary separation. Both reinforcement and stimulant medication markedly improved drift rate in children with ADHD (ds = 0.70 and 0.95 for reinforcement and methylphenidate, respectively); both treatments also reduced boundary separation (ds = 0.70 and 0.39). Reinforcement, which emphasized speeded accuracy, reduced nondecision time (d = 0.37), whereas stimulant medication increased nondecision time (d = 0.38). These studies provide initial evidence that frontline treatments for ADHD primarily impact cognitive performance in youth with ADHD by improving the speed/efficiency of information accumulation. Treatment effects on other DDM parameters may vary between treatments or interact with task parameters (number of trials, task difficulty). DDM, in conjunction with other approaches, may be helpful in clarifying the specific cognitive processes that are disrupted in ADHD, as well as the basic mechanisms that underlie the efficacy of ADHD treatments.

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Notes

  1. We do not compare baseline (visit 1) DDM parameters to the reinforcement manipulation (visit 2) parameters because of task differences, including the number of trials, length of trials (which changes event rate), and the addition of task stimuli (i.e., reinforcement feedback).

  2. Preliminary screening of the data revealed a subgroup of 6 control group and 3 ADHD group children with atypically high (>3 SDs above the mean) boundary separation. Because of the size of the subgroup, and the fact that this subgroup did not differ from the rest of the sample on obvious variables such as sex, age, IQ, mean RT, or comorbid symptoms, we retained them in the primary analysis. In a supplemental analysis that excluded these participants, children in the ADHD group exhibit significantly higher boundary separation than controls, F(1, 48) = 12.2, p = 0.001, d = 0.97. Other DDM parameters were not characterized by extreme subgroups or outliers.

  3. When the four outliers were included in the analyses, MPH continued to improve drift rate, active MPH vs. placebo F(1, 31) = 21.7, p < 0.001; 0.3 mg/kg vs. 0.6 mg/kg F(1, 31) = 4.5, p = 0.04. However, MPH no longer significantly affected nondecision time, F(1, 31) = 0.60, p = 0.45, or boundary separation, F(1, 31) = 0.01, p = 0.95; 0.3 vs. 0.6 mg/kg ps > 0.25.

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Acknowledgments

This research was funded by grant R01MH069434 to LWH from the National Institute of Mental Health.

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Authors and Affiliations

  1. Department of Psychology, University at Buffalo, SUNY, Buffalo, NY, USA

    Whitney D. Fosco & Larry W. Hawk Jr

  2. Center for Children and Families, University at Buffalo, SUNY, Buffalo, NY, USA

    Larry W. Hawk Jr

  3. Department of Psychology, Syracuse University, Syracuse, NY, USA

    Corey N. White

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  1. Whitney D. Fosco
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Correspondence to Whitney D. Fosco.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Fosco, W.D., White, C.N. & Hawk, L.W. Acute Stimulant Treatment and Reinforcement Increase the Speed of Information Accumulation in Children with ADHD. J Abnorm Child Psychol 45, 911–920 (2017). https://doi.org/10.1007/s10802-016-0222-0

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