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A Meta-Analytic Study of Event Rate Effects on Go/No-Go Performance in Attention-Deficit/Hyperactivity Disorder
Open accessAbstract
Background According to the state regulation deficit model, event rate (ER) is an important determinant of performance of children with attention-deficit/hyperactivity disorder (ADHD). Fast ER is predicted to create overactivation and produce errors of commission, whereas slow ER is thought to create underactivation marked by slow and variable reaction times (RT) and errors of omission.Methods To test these predictions, we conducted a systematic search of the literature to identify all reports of comparisons of ADHD and control individuals' performance on Go/No-Go tasks published between 2000 and 2011. In one analysis, we included all trials with at least two event rates and calculated the difference between ER conditions. In a second analysis, we used metaregression to test for the moderating role of ER on ADHD versus control differences seen across Go/No-Go studies.Results There was a significant and disproportionate slowing of reaction time in ADHD relative to controls on trials with slow event rates in both meta-analyses. For commission errors, the effect sizes were larger on trials with fast event rates. No ER effects were seen for RT variability. There were also general effects of ADHD on performance for all variables that persisted after effects of ER were taken into account.Conclusions The results provide support for the state regulation deficit model of ADHD by showing the differential effects of fast and slow ER. The lack of an effect of ER on RT variability suggests that this behavioral characteristic may not be a marker of cognitive energetic effects in ADHD.
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“The evidence of hypo-activation of the ANS during cognitive tasks described in this review is consistent with previous findings of greater RTV (Kofler et al., 2013) and response errors in ADHD, which are exacerbated when task stimuli are presented at a slower event rate (Metin et al., 2012).”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Metin et al., 2012
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“Further support for this comes from evidence of increased intra-individual reaction time variability (RTV) across a range of experimental paradigms (see Kofler et al., 2013, for a metaanalysis), particularly during monotonous cognitive tasks (Metin et al., 2012).”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Metin et al., 2012
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“The findings of ANS hypoarousal are also consistent with evidence of poorer performance when cognitive tasks have a slow event rate (Metin et al., 2012;Wiersema et al., 2006) and suggest that lower ANS activity may be one factor that contributes to poorer performance of people with ADHD when tasks require sustained attention and response regulation.”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Metin et al., 2012
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“Several studies have directly tested this performance pattern hypothesis and found their results to be supportive to the model predictions (Wiersema et al., 2006; Metin et al., 2012).”
From A Review of Heterogeneity in Attention Deficit/Hyperactivity Disorder (ADHD) (2019) · cites this paper as Metin et al., 2012
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“suggest that these factors help to offset impaired arousal regulation in ADHD.”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Metin et al., 2012
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Bellato, A., Wiersema, J. R., & Groom, M. J. (2023) · Autism and child psychopathology series · doi:10.1007/978-3-031-41709-2_3 · Cited by 11
Self-citationOjuri, B., Deronda, A. C., Plotkin, M. R., Mostofsky, S. H., & Rosch, K. S. (2024) · Journal of Attention Disorders · doi:10.1177/10870547241237242 · Cited by 11
“ADHD is associated with lower inhibition accuracy (i.e., ability to withhold a response) on go/no-go (GNG) tasks (Manoli et al., 2021; Metin et al., 2012; Wright et al., 2014) and speed of inhibition on stop signal tasks (Huizenga et al., 2009; Lijffijt et al., 2005; Lipszyc & Schachar, 2010).”
BackgroundDriesen, M., Rijmen, J., Hulsbosch, A., Danckaerts, M., Wiersema, J. R., & der Oord, S. V. (2023) · Contemporary Educational Psychology · doi:10.1016/j.cedpsych.2023.102214 · Cited by 10
Self-citationThe effect of anodal transcranial direct current stimulation on multi-limb coordination performance
Leenus, D. J. F., Cuypers, K., Vanvlijmen, D., & Meesen, R. (2015) · Neuroscience · doi:10.1016/j.neuroscience.2014.12.053 · Cited by 10
“Previously it was reported that there is an increase in reaction time (time slowing effect) correlated with the efficacy of the response inhibition (constraint inhibition) (van Gaal et al., 2009; Metin et al., 2012).”
BackgroundLiefferinge, D. V., Sonuga-Barke, E. J. S., Broeck, N. V., der Oord, S. V., Lemiere, J., & Danckaerts, M. (2016) · Child Neuropsychology · doi:10.1080/09297049.2016.1170798 · Cited by 12
Self-citationReward Processing Deficits During a Spatial Attention Task in Patients With ADHD: An fMRI Study
Metin, B., Tas, Z. C., Çebi, M., Büyükaslan, A., Soysal, A. Ş., Hatıloglu, D., & Tarhan, N. (2017) · Journal of Attention Disorders · doi:10.1177/1087054717703188 · Cited by 11
Self-citationMotor actions across psychiatric disorders: a research domain criteria (RDoC) perspective
Osborne, K. J., Walther, S., & Mittal, V. A. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102511 · Cited by 9
Brown, L. E., Tallon, M. M., Bellgrove, M. A., Rudaizky, D., Kendall, G. E., Boyes, M. E., & MYERS, B. J. (2025) · Child Psychiatry & Human Development · doi:10.1007/s10578-025-01815-5 · Cited by 12
State regulation in adults scoring high versus low on ADHD symptomatology: A pupillometry study.
Drescher, L. H., Boehler, C. N., & Wiersema, J. R. (2021) · Neuropsychology · doi:10.1037/neu0000738 · Cited by 9
“In the past decades, a growing body of research has provided support for the state regulation deficit (SRD) account of ADHD (Johnson et al., 2009; Metin et al., 2012; Sergeant, 2000; Sonuga-Barke et al., 2010; van der Meere, 2005).”
BackgroundMethodResultInfluentialSelf-citationWhat to expect and when to expect it: an fMRI study of expectancy in children with ADHD symptoms
van Hulst, B. M., de Zeeuw, P., Rijks, Y., Neggers, S. F. W., & Durston, S. (2016) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-016-0921-7 · Cited by 10
“Both metrics have been linked to attentional lapses [40, 41] and could explain why we did not find differences in cognitive control.”
BackgroundThapaliya, G., Carnell, S., Mostofsky, S. H., & Rosch, K. S. (2023) · Pediatric Obesity · doi:10.1111/ijpo.13001 · Cited by 9
“Greater commission error rate (ComRate) and RT variability in children with ADHD have been extensively described.(15,43) Although there is heterogeneity within the ADHD group,(44,45) our findings suggest that this is not related to weight status.”
BackgroundMohamed, S. M. H., Börger, N. A., Geuze, R. H., & van der Meere, J. J. (2016) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803395.2016.1167174 · Cited by 10
“State regulation was manipulated by three event rates with interstimulus interval of 2000, 4200, and 8200 ms. Interstimulus intervals were derived from the only available meta-analysis on event rate effects on task performance (Metin et al., 2012).”
MethodTomlinson, R. C., Weigard, A. S., Sripada, C., Jonides, J., Klump, K. L., Burt, S. A., & Hyde, L. W. (2025) · Journal of Psychopathology and Clinical Science · doi:10.1037/abn0001043 · Cited by 10
Lauth-Lebens, M., & Lauth, G. W. (2020) · Lernen und Lernstörungen · doi:10.1024/2235-0977/a000284 · Cited by 8
The Impact of Sleep Deprivation on Continuous Performance Task Among Young Men With ADHD
Dan, O., Cohen, A., Asraf, K., Saveliev, I., & Haimov, I. (2020) · Journal of Attention Disorders · doi:10.1177/1087054719897811 · Cited by 7
“Consistent with these findings, several meta-analyses have pointed out that although individuals with ADHD do not necessarily demonstrate an overall slowness of response compared with individuals without ADHD, their reaction times are much less stable (Metin et al., 2012).”
ResultSchutter, D. J. L. G., & Kenemans, J. L. (2022) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780192898340.013.15 · Cited by 6
The Evolving ADHD Phenotype in the Externalizing Context
Nigg, J. T. (2026) · American Journal of Psychiatry · doi:10.1176/appi.ajp.20251165 · Cited by 7
Devor, T., Einziger, T., Ben-Shachar, M. S., Klein, C., Auerbach, J. G., & Berger, A. (2025) · Psychophysiology · doi:10.1111/psyp.14764 · Cited by 5
“…of inhibitory control, evidenced by both increased SSRT (Crosbie et al. 2013; Lipszyc and Schachar 2010) and a higher rate of commission errors (i.e., incorrect responses to a stop stimulus in tasks involving response inhibition, such as the go/no-go task; Kuntsi et al. 2010; Metin et al. 2012).”
Zhang, R., & Wang, Z. (2023) · Aggressive Behavior · doi:10.1002/ab.22110 · Cited by 4
Rijmen, J., & Wiersema, J. R. (2024) · Neuropsychologia · doi:10.1016/j.neuropsychologia.2024.108961 · Cited by 6
Self-citationRoutier, L., Querné, L., Fontaine, C., Berquin, P. C., & Moing, A. G. L. (2024) · European Journal of Paediatric Neurology · doi:10.1016/j.ejpn.2024.05.016 · Cited by 4
Superbia-Guimarães, L., Bader, M., & Camos, V. (2023) · PLoS ONE · doi:10.1371/journal.pone.0282896 · Cited by 4
Kurokami, T., Kobayashi, H., Nakajima, M., Mikami, M., & Koeda, T. (2022) · Brain and Development · doi:10.1016/j.braindev.2022.07.002 · Cited by 3
Münger, M., Sele, S., Candrian, G., Müller, A. F., & Jäncke, L. (2022) · International Journal of Psychophysiology · doi:10.1016/j.ijpsycho.2022.11.003 · Cited by 3
Drescher, L. H., Boehler, C. N., & Wiersema, J. R. (2023) · Acta Psychologica · doi:10.1016/j.actpsy.2023.103877 · Cited by 4
Self-citationKatabi, G., & Shahar, N. (2024) · Translational Psychiatry · doi:10.1038/s41398-023-02717-7 · Cited by 4
Wetzel, N., Widmann, A., Schöllkopf, U., Prigge, M., & Krauel, K. (2022) · PsyArXiv (OSF Preprints) · doi:10.31234/osf.io/q3c9e · Cited by 2
Haque, H., Hirvonen, J., Wang, S. H., Simola, J., Morales‐Muñoz, I., Cowley, B. U., Palva, J. M., & Palva, S. (2022) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2022.12.14.519751 · Cited by 3
Rijmen, J., Senoussi, M., & Wiersema, J. R. (2025) · Journal of Attention Disorders · doi:10.1177/10870547251357074 · Cited by 3
“Research along these lines has shown that ADHD may be associated with both hypo-and hyper-arousal depending on the requirements of the context (for a meta-analysis, see Metin et al., 2012).”
Self-citationWagner, D., & Eastwood, J. D. (2025) · PLoS ONE · doi:10.1371/journal.pone.0332505 · Cited by 2
“Metin et al. [30] conducted a meta-analysis of studies examining event rate effects using a type of CPT (the Go/No-Go paradigm) in ADHD.”
Shen, F., & Zhou, H. (2025) · Frontiers in Pharmacology · doi:10.3389/fphar.2025.1726716 · Cited by 2
Do Childhood Emotional Lability and ADHD Symptoms Have Shared Neuropsychological Roots?
Liefferinge, D. V., Sonuga-Barke, E. J. S., Danckaerts, M., Broeck, N. V., & der Oord, S. V. (2021) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-020-09859-8 · Cited by 3
Self-citationZhou, Q., & Luo, Y. (2022) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2022.104262 · Cited by 2
ImGo: A Novel Tool for Behavioral Impulsivity Assessment Based on Go/NoGo Tasks
Šašinka, Č., Lacko, D., Čeněk, J., Popelka, S., Ugwitz, P., Řádová, H., Fabianová, M., Šašinková, A., Brancik, J. V., & Jankovská, M. (2021) · Psychological Reports · doi:10.1177/00332941211040431 · Cited by 2
“Previous research has identified potential relationships of impulsivity, for example with personality disorders (Coffey et al., 2011), mental disorders (Enticott et al., 2008), attention disorders (Metin et al., 2012), interference control (Aichert et al., 2012) or intelligence (Lynam et al., 1993).”
BackgroundResultInfluentialSuzuki, K. (2022) · Brain and Development · doi:10.1016/j.braindev.2022.08.006 · Cited by 2
Differences in self-concept among persons with high and low prevalence of ADHD symptoms
Perifanou, A. (2020) · DiVA at Umeå University (Umeå University) · Cited by 2
Metadata
- Authors
- Metin, B., Roeyers, H., Wiersema, J. R., van der Meere, J., & Sonuga-Barke, E.
- Affiliations
- Ghent University (BE)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 72
- Issue
- 12
- Pages
- 990-996
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2130750988
- Cited by
- 121
- References
- 57
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 10 · 2023: 10 · 2022: 10 · 2021: 9 · 2020: 11 · 2019: 10 · 2018: 4 · 2017: 6 · 2016: 12 · 2015: 8 · 2014: 12 · 2013: 3
- FWCI
- 0.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- ePrints Soton (University of Southampton) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, other-oa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- Vlaamse regering
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, event rate, go/no-go task, reaction time, reaction time variability, commission errors, omission errors, children
- MeSH terms
- Algorithms, Attention Deficit Disorder with Hyperactivity, Choice Behavior, Humans, Psychomotor Performance, Reaction Time
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