The DOI matches its Crossref record; 30 of the 31 references it cites were found in a registry or an index.
Relations Between Continuous Performance Test Performance Measures and ADHD Behaviors
Abstract
The Conners' Continuous Performance Test (CPT) is a neuropsychological task that has repeatedly been shown to differentiate ADHD from normal groups. Several variables may be derived from the Conners' CPT including errors of omission and commission, mean hit reaction time(RT), mean hit RT standard error, d', and beta. What each CPT parameter actually assesses has largely been based upon clinical assumptions and the face validity of each measure (e.g., omission errors measure inattention, commission errors measure impulsivity). This study attempts to examine relations between various CPT variables and phenotypic behaviors so as to better understand the various CPT variables. An epidemiological sample of 817 children was administered the Conners' CPT. Diagnostic interviews were conducted with parents to determine ADHD symptom profiles for all children. Children diagnosed with ADHD had more variable RTs, made more errors of commission and omission, and demonstrated poorer perceptual sensitivity than nondiagnosed children. Regarding specific symptoms, generalized estimating equations (GEE) and ANCOVAs were conducted to determine specific relationships between the 18 DSM-IV ADHD symptoms and 6 CPT parameters. CPT performance measures demonstrated significant relationships to ADHD symptoms but did not demonstrate symptom domain specificity according to a priori assumptions. Overall performance on the two signal detection measures, d' and beta, was highly related to all ADHD symptoms across symptom domains. Further, increased variability in RTs over time was related to most ADHD symptoms. Finally, it appears that at least 1 CPT variable, mean hit RT, is minimally related to ADHD symptoms as a whole, but does demonstrate some specificity in its link with symptoms of hyperactivity.
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“In a study examining whether RTV was specifically correlated with individual ADHD symptoms (e.g., short attention span), significant relations were observed between RTV and all 18 ADHD symptoms, suggesting no specificity between RTVand specific ADHD behaviors [55].”
From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [55]
In the citing paper
“sustained attention abilities predict objective and subjective reports of classroom behavior (Brocki, Tillman, & Bohlin, 2010; Epstein et al., 2003; Rapport et al., 1987), academic performance (Molina et al., 2009; Rapport et al., 1994), special education placement, and comorbid learning disabilities (Faraone et al., 1993).”
From Improving Outcomes for Youth with ADHD: A Conceptual Framework for Combined Neurocognitive and Skill-Based Treatment Approaches (2014) · cites this paper as Epstein et al., 2003
In the citing paper
“Epstein and colleagues (Epstein et al., 2003) reported variability in d’, lnβ, and RT to be strongly associated across multiple ADHD symptom domains.”
From The influences of environmental enrichment, cognitive enhancement, and physical exercise on brain development: Can we alter the developmental trajectory of ADHD? (2011) · cites this paper as Epstein et al., 2003
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“In general, correlations between omission errors and measures of inattention or commission errors and measures of impulsivity have been low to moderate and have not always been domain specific ( Barkley, 1991 ).”
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“In contrast, the precision indicators indicated by Epstein et al. (2003) that are given by the number of CHs (general accuracy), OEs (associated with attention issues) and CEs (impulsivity and hyperactivity) could not lead to improvements with the VG.”
Additional language learning in ADHD: a call for research
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“…deficits in only two of the three attention networks in individuals with ADHD, in alertness (sustained attention, e.g., Berlin et al., 2004; Epstein et al., 2003) and executive control, but not in the orienting network (Berger & Posner, 2000; Coll-Martín et al., 2021; Johnson et al., 2008,…”
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Letter Reversals, Default Mode, and Childhood ADHD
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“Epstein et al. (2011) investigated RTV in 51 children and controls, utilizing five neuropsychological tasks, including a Choice Discrimination Task, Child Attentional Network Task, Go/No task, Stop Signal, and N-back task. They demonstrated greater RTV across all five tasks, as measured by the ex-Gaussian indicator ta…”
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“However, it is equally plausible that the phenotype identified in our Nlgn3 R451C mice in the rCPT is not indicative of an ADHD-like performance deficit (Epstein et al., 2003), where these drugs may prove most effective.”
Poh, X. W. W., Lim, S. S. Y., Chew, Y. Y., Lim-Ashworth, N., & Lim, C. G. (2024) · Singapore Medical Journal · doi:10.4103/singaporemedj.smj-2024-132 · Cited by 2
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“…to inattention symptoms but also to hyperactivity/impulsivity symptoms (Tamm et al., 2012), and one study reported significant relationships between response-time variability and each of the 18 ADHD symptoms established by the American Psychiatric Association (APA., 2013; Epstein et al., 2003).”
BackgroundNejati, V., Akram, J., Borhani, K., & Fathabadi, J. (2024) · Developmental Neuropsychology · doi:10.1080/87565641.2024.2425925 · Cited by 2
“In line with this result, impaired sustained attention has been described earlier using CPT with non-emotional stimuli (Epstein et al., 2003; Nejati et al., 2016).”
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“…hyperactivity-impulsivity scores being related to larger, more negative N2 amplitudes when response inhibition is required. suggesting excessive engagement of the behavioral inhibition system in anxiety (Epstein et al., 2003; Gray & McNaughton, 2000; Grillon et al., 2017; Quay, 1997; Sylwan, 2004).”
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“, avoid errors of omission) while inhibiting nontarget responses (errors of commission).(7) Executive function was assessed with the Wisconsin Card Sorting Test (WCST), in which participants must match cards according to prior trials stored in working memory and then activate regions of the frontal lobe to “setshift”…”
MethodYang, G. P., Liu, J., Xu, F., & Liu, Z. (2012) · International Conference on Consumer Electronics, Communications and Networks (CECNet) · doi:10.1109/cecnet.2012.6201980 · Cited by 2
“A series of numbers or characters are showed on a computer monitor as stimulants in a CPT, subjects are required to make response to certain target, the reaction results are used to evaluate attention deficit [3].”
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Delay discounting as a measure of impulsivity.
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“Results from these early studies prompted subsequent clinical research using CPT with psychiatric populations to measure neuropsychological impairment in individuals with attention deficits (Epstein et al., 2003).”
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“104 Identifying signi fi cant group interactions in RT variability and commission errors, as opposed to group × task interactions, suggests that these impairments are independent of face processing in individuals with ADHD.”
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“However, studies of reaction time in ADHD involving Go/No-Go or continuous performance tasks have not demonstrated the same utility either in predicting developmental pathways or in differentiating ADHD from TD samples (Epstein et al., 2003).”
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“These observations contradict the assumption that CCPT is a predictor of ADHD symptoms (Epstein et al., 2003) and aligns with findings to the contrary (Baggio et al., 2020).”
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Metadata
- Authors
- Epstein, J. N., Erkanli, A., Conners, C. K., Klaric, J., Costello, J. E., & Angold, A.
- Affiliations
- Duke University (US)
- Corresponding author
- Epstein, Jeffery N.
- ORCID
- Epstein, Jeffery N.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2003-10
- Volume
- 31
- Issue
- 5
- Pages
- 543-554
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- OpenAlex
- W1539412734
- Cited by
- 520
- References
- 31
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 16 · 2023: 18 · 2022: 14 · 2021: 10 · 2020: 27 · 2019: 22 · 2018: 31 · 2017: 16 · 2016: 34 · 2015: 35 · 2014: 42 · 2013: 28 · 2012: 35
- FWCI
- 5.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, Conners' Continuous Performance Test, inattention, impulsivity, hyperactivity, reaction time variability, omission errors, commission errors, perceptual sensitivity, children
- MeSH terms
- Algorithms, Attention Deficit Disorder with Hyperactivity, Child, Humans, Neuropsychological Tests, Reaction Time, Severity of Illness Index, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders
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