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Heterogeneity in development of aspects of working memory predicts longitudinal attention deficit hyperactivity disorder symptom change.
Open accessAbstract
The role of cognitive mechanisms in the clinical course of neurodevelopmental disorders is poorly understood. Attention Deficit Hyperactivity Disorder (ADHD) is emblematic in that numerous alterations in cognitive development are apparent, yet how they relate to changes in symptom expression with age is unclear. To resolve the role of cognitive mechanisms in ADHD, a developmental perspective that takes into account expected within-group heterogeneity is needed. METHOD: The current study uses an accelerated longitudinal design and latent trajectory growth mixture models in a sample of children ages 7-13 years carefully characterized as with (n = 437) and without (n = 297) ADHD to (a) identify heterogeneous developmental trajectories for response inhibition, visual spatial working memory maintenance, and delayed reward discounting and (b) to assess the relationships between these cognitive trajectories and ADHD symptom change. RESULTS: Best-fitting models indicated multiple trajectory classes in both the ADHD and typically developing samples, as well as distinct relationships between each cognitive process and ADHD symptom change. Developmental change in response inhibition and delayed reward discounting were unrelated to ADHD symptom change, while individual differences in the rate of visual spatial working memory maintenance improvement predicted symptom remission in ADHD. CONCLUSION: Characterizing heterogeneity in cognitive development will be crucial for clarifying mechanisms of symptom persistence and recovery. Results here suggest working memory maintenance may be uniquely related to ADHD symptom improvement. (PsycINFO Database Record
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“Together, these findings suggest that only a small minority of children with ADHD have impairments in both working memory and inhibitory control, and thus appear to support models conceptualizing them as relatively independent impairments in ADHD.”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [74]
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“For example, most longitudinal studies have linked improvements in working memory, or executive functioning more generally, with remission of ADHD symptoms (e.g., 74).”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [74]
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“Working memory deficits are present in the majority of children with ADHD and have been shown to covary longitudinally and experimentally with ADHD behavioral symptoms (e.g., Karalunas et al., 2017; Kofler et al., 2018).”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Karalunas et al., 2017
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“Combined with longitudinal and experimental evidence (e.g., Karalunas et al., 2017; Rapport et al., 2009; Patros et al., 2017), the evidence base at this time implicates working memory as a core mechanism that is involved, at least in part, in the phenotypic expression of ADHD behavioral symptoms.”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Karalunas et al., 2017
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“This concurrent and predictive validity evidence includes experimental and longitudinal linkages between EF performance tests, objective and subjective measures of inattention, hyperactivity, impulsivity, emotion recognition, reading skills, math performance, social skills, organizational skills, parent-child relationship quality, and activities of daily living (Karalunas et al., 2017; Wells et al”
From Assessment of executive functions in school-aged children: A narrative review (2022) · cites this paper as Karalunas et al., 2017
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“Karalunas et al. (74) also found that only 13% of children with ADHD have stable impairments in both inhibition and working memory (vs. 44% who have stable working memory but not inhibition deficits, and only 5% who have stable inhibition deficits but not working memory deficits).”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [74]
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“Although these effect sizes are not directly comparable because they reflect performance changes vs. between group differences, this finding is consistent with evidence that only 5-11% of children with ADHD have inhibition deficits without co-occurring working memory deficits (9, 74) and calls into question the extent to which children with ADHD have deficits in inhibitory control versus perform”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [74]
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“Working memory deficits are present in the majority of children with ADHD and have been shown to covary longitudinally and experimentally with ADHD behavioral symptoms (e.g., Karalunas et al., 2017; Kofler et al., 2018).”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Karalunas et al., 2017
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“Furthermore, highly similar results were reported in recent heterogeneity studies reporting that 62%−85% of children with ADHD were classified as impaired in working memory (Fosco et al., in press; Karalunas et al., 2017; Kofler, Irwin et al., 2019).”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Karalunas et al., 2017
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“When controlling for ASD symptoms, the evidence is mixed as to whether or not youth with ADHD continue to display deficits on set shifting tests.68,89”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [89]
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Metadata
- Authors
- Karalunas, S. L., Gustafsson, H. C., Dieckmann, N. F., Tipsord, J., Mitchell, S. H., & Nigg, J. T.
- Affiliations
- Oregon Health & Science University (US)
- ORCID
- Venue
- Journal of Abnormal Psychology
- Published
- 2017-08
- Volume
- 126
- Issue
- 6
- Pages
- 774-792
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- PMC
- PMC5657320
- OpenAlex
- W2742297264
- Cited by
- 104
- References
- 97
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 7 · 2023: 18 · 2022: 20 · 2021: 14 · 2020: 17 · 2019: 6 · 2018: 9 · 2017: 1
- FWCI
- 7.41
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Abnormal Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R37 MH059105, K23 MH108656)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- attention deficit hyperactivity disorder, working memory maintenance, visuospatial working memory, response inhibition, delay discounting, symptom remission, symptom change, within-group heterogeneity, children, developmental trajectories
- MeSH terms
- Adolescent, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Impulsive Behavior, Inhibition, Psychological, Male, Memory, Short-Term, Neuropsychological Tests, Reward, Space Perception, Case-Control Studies
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