The relation between executive functions, error-related brain activity, and ADHD symptoms in clinically evaluated school-aged children

“A three-component solution based on the larger sample (Soto et al., 2022) was specified a priori to derive separate estimates of working memory, inhibitory control, and set shifting based on theory and previous empirical work (e.g., Miyake et al., 2000).”

“…that cognitive control overlaps significantly with specific facets of executive function, particularly the core “lower-level” executive functions that appear first developmentally (working memory and response inhibition, followed by set shifting; Diamond, 2013; Karr et al., 2018; Nigg, 2017).”

“…(a) the empirical and theorized relations between anxiety and both error-related neural activity and executive functions (Derakshan et al., 2009; Eysenck et al., 2007; Meyer, 2016; Wong et al., 2013); (b) the multicomponent nature of inhibitory control (e.g., Alderson, Rapport, Sarver, et al.,…”

“Ocular artifacts (i.e., eye blinks and eye movement) were corrected following the steps outlined in Gratton et al. (1983).”

“ERN is generated in the anterior cingulate cortex (ACC; Mathewson et al., 2005; van Veen & Carter, 2002), a brain region implicated in conflict and outcome monitoring (Botvinick et al., 2004).”

“The ERN is characterized by a negative deflection about 50 to 100 ms after an individual makes an error, and is most readily observed at frontocentral scalp locations (Falkenstein et al., 1991; Gehring et al., 1993; Gehring, Liu, et al., 2012).”

“…and (b) school-aged children’s executive functioning/cognitive control abilities also follow different developmental trajectories (Best et al., 2009; Best & Miller, 2010), with working memory and inhibitory control reflecting unique executive functions in early childhood (Lerner & Lonigan, 2014)…”

“Power analysis for the conditional effects models was conducted using Monte Carlo simulation (Schoemann et al., 2017).”

“The ERN is characterized by a negative deflection about 50 to 100 ms after an individual makes an error, and is most readily observed at frontocentral scalp locations (Falkenstein et al., 1991; Gehring et al., 1993; Gehring, Liu, et al., 2012).”

“…seeking assessment for behavior and emotional concerns that have been linked with executive function/cognitive control (e.g., Kofler et al., 2019; Snyder, 2013), it is possible that the diverse clinical symptom presentation complicated our ability to detect relations between the ERN/Pe and…”

“…impurity was controlled by computing Bartlett maximum likelihood component scores based on inter-correlations among all 7 executive function tests (Distefano et al., 2009), which parsed the 3 working memory, 2 inhibitory control, and 2 set-shifting tasks into 3 component scores (35.31% of…”

“…that cognitive control overlaps significantly with specific facets of executive function, particularly the core “lower-level” executive functions that appear first developmentally (working memory and response inhibition, followed by set shifting; Diamond, 2013; Karr et al., 2018; Nigg, 2017).”

“The Pe typically follows the ERN and is marked by a slow positive wave occurring centroparietally on the scalp between about 200 and 400 ms after an individual makes an error (Falkenstein et al., 1991; Overbeek et al., 2005).”

“ERN is generated in the anterior cingulate cortex (ACC; Mathewson et al., 2005; van Veen & Carter, 2002), a brain region implicated in conflict and outcome monitoring (Botvinick et al., 2004).”

“In contrast, the ERN appears to reflect more passive monitoring processes that do not overlap meaningfully with the active, top-down processes that characterize cognitive control/executive function (Boen et al., 2022; Nieuwenhuis et al., 2001; O’Connell et al., 2007).”

“…et al., 2017); and (b) school-aged children’s executive functioning/cognitive control abilities also follow different developmental trajectories (Best et al., 2009; Best & Miller, 2010), with working memory and inhibitory control reflecting unique executive functions in early childhood (Lerner…”

“…on tests that were developed to assess gross neuropsychological functioning and questionnaire-based assessments of executive function/cognitive control processes that show poor correspondence with specific tests of these cognitive processes (for reviews, see Snyder et al., 2015; Soto et al., 2020).”

“Similarly, working memory and inhibitory control reflect distinct abilities around the age of school entry, while set shifting only emerges as a distinct executive function in older school-aged children (Karr et al., 2018; Lerner & Lonigan, 2014).”

“…(Pe) , have been proposed to reflect cognitive control mechanisms given that errors represent a breakdown in performance that is detected and subsequently acted upon using performance monitoring processes (Cavanagh & Shackman, 2015; Falkenstein, 2004; Gehring et al., 2012; Overbeek et al., 2005).”

“…between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013; Kaiser et al., 2020); and (c) medium to large magnitude relations between executive functions and ADHD symptoms ( d = 0.60–1.40; Kasper et al., 2012; Kofler et al., 2019; Willcutt et al., 2005; Wright et al., 2014).”

“…(Pe) , have been proposed to reflect cognitive control mechanisms given that errors represent a breakdown in performance that is detected and subsequently acted upon using performance monitoring processes (Cavanagh & Shackman, 2015; Falkenstein, 2004; Gehring et al., 2012; Overbeek et al., 2005).”

“…inhibitory control is consistent with most prior work finding that the Pe is related to performance metrics from inhibition tasks in adults (Chang et al., 2014; Hajcak, McDonald, et al., 2003; Mathewson et al., 2005) and children (Kim et al., 2016; Overbye et al., 2019; c.f. Grammer et al., 2018).”

“1 Executive function deficits are theorized to play an etiological role in several forms of psycho-pathology, and are considered to play a prominent/primary role in the development and behavioral expression of ADHD (e.g., Rapport et al., 2013).”

“Inhibitory control abilities are characterized by the active and goal-directed withholding or stopping of a response that relies on deliberate and conscious control processes (Alderson, Rapport & Kofler, 2007; Mirabella, 2021).”

“…between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013; Kaiser et al., 2020); and (c) medium to large magnitude relations between executive functions and ADHD symptoms ( d = 0.60–1.40; Kasper et al., 2012; Kofler et al., 2019; Willcutt et al., 2005; Wright et al., 2014).”

“In contrast, the relation between the Pe and anxiety is more variable (Hajcak et al., 2004; Ladouceur et al., 2006; McDermott et al., 2009).”

“In contrast, the ERN appears to reflect more passive monitoring processes that do not overlap meaningfully with the active, top-down processes that characterize cognitive control/executive function (Boen et al., 2022; Nieuwenhuis et al., 2001; O’Connell et al., 2007).”

“…between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013; Kaiser et al., 2020); and (c) medium to large magnitude relations between executive functions and ADHD symptoms ( d = 0.60–1.40; Kasper et al., 2012; Kofler et al., 2019; Willcutt et al., 2005; Wright et al., 2014).”

“Cognitive control , a closely related construct, refers to mental processes that enable the continuous adjustment of behaviors in accordance with actively changing goals and task demands to optimize performance (Botvinick & Cohen, 2014; Nigg, 2017).”

“…prior work suggests that an ERN is detectable regardless of whether an individual recognizes that they made an error, whereas the Pe is most pronounced following trials where an individual has conscious awareness of the error (Endrass et al., 2007; Nieuwenhuis et al., 2001; O’Connell et al., 2007).”

“…between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013; Kaiser et al., 2020); and (c) medium to large magnitude relations between executive functions and ADHD symptoms ( d = 0.60–1.40; Kasper et al., 2012; Kofler et al., 2019; Willcutt et al., 2005; Wright et al., 2014).”

“…is warranted given (a) the empirical and theorized relations between anxiety and both error-related neural activity and executive functions (Derakshan et al., 2009; Eysenck et al., 2007; Meyer, 2016; Wong et al., 2013); (b) the multicomponent nature of inhibitory control (e.g., Alderson,…”

“Based on prior research indicating directional, if not causal, effects of executive functioning on ADHD behavioral symptom frequency/severity (e.g., Kofler et al., 2010; Rapport et al., 2009), the executive functions were modeled as predictors of ADHD symptoms.”

“Given evidence supporting the reliability and validity of these ERPs as individual difference markers (Riesel et al., 2013; Weinberg et al., 2012), there is a need for studies using (a) construct valid executive function/cognitive control batteries completed separately from the task used to capture…”

“Following Meyer et al. (2017), the ERN and Pe were computed as unstandardized residualized difference scores (average voltage for correct trials regressed out of average voltage for error trials) to reflect the difference wave between correct and erroneous responses, 3 separately for the ERN (R 2 =…”

“Based on prior research indicating directional, if not causal, effects of executive functioning on ADHD behavioral symptom frequency/severity (e.g., Kofler et al., 2010; Rapport et al., 2009), the executive functions were modeled as predictors of ADHD symptoms.”

“In contrast, the relation between the Pe and anxiety is more variable (Hajcak et al., 2004; Ladouceur et al., 2006; McDermott et al., 2009).”

“Notably, the current study is cross-sectional, inhibiting our ability to test competing models regarding the direction of effects (i.e., reversing arrows does not distinguish plausible models; Thoemmes, 2015).”

“Event-related potentials (ERPs) are a useful tool for assessing cognitive processes because they are a direct measure of brain activity and have demonstrated clinical utility in predicting both risk for and developmental trajectories of psychopathology (Hajcak et al., 2019).”

“Given evidence supporting the reliability and validity of these ERPs as individual difference markers (Riesel et al., 2013; Weinberg et al., 2012), there is a need for studies using (a) construct valid executive function/cognitive control batteries completed separately from the task used to capture…”

“In contrast, the relation between the Pe and anxiety is more variable (Hajcak et al., 2004; Ladouceur et al., 2006; McDermott et al., 2009).”

“However, as with the ERN/ Pe-executive function findings in the developmental/cognitive literatures, results from these ADHD studies are mixed (for reviews, see Meyer & Hajcak, 2019; Shiels & Hawk, 2010).”

“In contrast, a more recent meta-analysis found the Pe to be blunted in ADHD groups compared to non-ADHD groups ( d = −0.39), while no significant group differences were found in the ERN ( d = 0.21; Kaiser et al., 2020).”

“…between executive functions and the ERN and Pe ( η 2 =.19–.25, r = .27–.72; Coleman et al., 2018; Grammer et al., 2018; Larson & Clayson, 2011; Mathewson et al., 2005; Miller et al., 2012); (b) medium relations between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013;…”

“…(Pe) , have been proposed to reflect cognitive control mechanisms given that errors represent a breakdown in performance that is detected and subsequently acted upon using performance monitoring processes (Cavanagh & Shackman, 2015; Falkenstein, 2004; Gehring et al., 2012; Overbeek et al., 2005).”

“Teacher-reported ADHD symptoms were selected a priori given evidence that teacher-reported ADHD symptoms are more strongly associated with executive function task performance (Cho et al., 2011; Wang et al., 2015) and more predictive of ADHD diagnosis (Tripp et al., 2006).”

“…control includes evidence that the ERN is associated with accuracy-speed tradeoffs (Gehring et al., 1993) and that a larger ERN is related to greater post-error slowing in adults during response inhibition tasks (Hirsh & Inzlicht, 2010; for review, see Cavanagh & Shackman, 2015).”

“…was selected because (a) such methods have been shown to provide higher construct stability relative to confirmatory/reflective approaches (Willoughby et al., 2016); and (b) estimating executive functioning at the construct-level rather than measure-level was expected to maximize…”

“…on tests that were developed to assess gross neuropsychological functioning and questionnaire-based assessments of executive function/cognitive control processes that show poor correspondence with specific tests of these cognitive processes (for reviews, see Snyder et al., 2015; Soto et al., 2020).”

“Similarly, working memory and inhibitory control reflect distinct abilities around the age of school entry, while set shifting only emerges as a distinct executive function in older school-aged children (Karr et al., 2018; Lerner & Lonigan, 2014).”

“For example, the ERN continues to increase into early adulthood and the Pe matures earlier in development (Downes et al., 2017).”

“…medium to large relations between executive functions and the ERN and Pe ( η 2 =.19–.25, r = .27–.72; Coleman et al., 2018; Grammer et al., 2018; Larson & Clayson, 2011; Mathewson et al., 2005; Miller et al., 2012); (b) medium relations between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68;…”

“Inhibitory control abilities are characterized by the active and goal-directed withholding or stopping of a response that relies on deliberate and conscious control processes (Alderson, Rapport & Kofler, 2007; Mirabella, 2021).”

“A minimum of six commission errors during the EEG go/no-go task was required for ERP extraction, as recommended (Meyer et al., 2014), and all participants in the current sample met this threshold ( M = 29.77, SD = 9.02; range = 10–50).”

“…functions and the ERN and Pe ( η 2 =.19–.25, r = .27–.72; Coleman et al., 2018; Grammer et al., 2018; Larson & Clayson, 2011; Mathewson et al., 2005; Miller et al., 2012); (b) medium relations between the ERN and Pe and ADHD symptoms ( d = 0.21–0.68; Geburek et al., 2013; Kaiser et al., 2020);…”

“…findings contribute to a fairly large body of mixed evidence in which about half of the studies find that a greater ERN and/or Pe is related to fewer ADHD symptoms and the other half find no such relations (Herrmann et al., 2009; Marquardt et al., 2018; Rommel et al., 2019; Wiersema et al., 2009).”

“…studies found that individuals with ADHD exhibit a blunted (i.e., significantly reduced) ERN compared to controls ( d = 0.50), but that a blunted Pe may be detectable only during certain types of inhibition tasks such as the go/no-go task used in the current study ( d = 0.68; Geburek et al., 2013).”

“Briefly, working memory involves the active, top-down manipulation of information held in short-term memory through interrelated functions of updating, dual-processing, and temporal/serial reordering (Fosco et al., 2020).”

“In particular, an increased ERN is frequently reported in children with anxiety disorders, and has been proposed to be a biomarker of anxiety (Meyer, 2016).”

“Finally, set shifting involves cognitive flexibility in shifting back and forth between mental sets or tasks (Irwin et al., 2019; Miyake et al., 2000).”

“…are inconsistent with studies finding relations between a larger ERN and better working memory and inhibitory control (Coleman et al., 2018; Miller et al., 2012; Overbye et al., 2019), as well as better overall cognitive control/executive function (Larson & Clayson, 2011; Meyer & Klein, 2018).”

“…better inhibitory control is consistent with most prior work finding that the Pe is related to performance metrics from inhibition tasks in adults (Chang et al., 2014; Hajcak, McDonald, et al., 2003; Mathewson et al., 2005) and children (Kim et al., 2016; Overbye et al., 2019; c.f. Grammer et…”

“…capturing aspects of inhibitory control that are linked with anxiety symptoms and/or other behavioral expressions rather than ADHD symptoms (e.g., Lutz et al., 2021), particularly given evidence that anxiety may serve as a protective factor for children with ADHD in at least some domains (Chan…”

“Task performance was monitored at all times by the examiner, who was stationed just outside of the testing room (out of the child’s view) to provide a structured setting while minimizing performance improvements associated with examiner demand characteristics (Gomez & Sanson, 1994).”

“…with anxiety symptoms and/or other behavioral expressions rather than ADHD symptoms (e.g., Lutz et al., 2021), particularly given evidence that anxiety may serve as a protective factor for children with ADHD in at least some domains (Chan et al., 2022; Klymkiw et al., 2020; Maric et al., 2018).”

“Within-subjects ANOVAs with trial type (error, correct) were conducted to confirm that error-related ERPs were elicited/captured by the task.”

“Indeed, Boen et al. (2022) suggested such a distinction as a potential mechanism underlying the differing developmental trajectories of the ERN and Pe.”

“…with anxiety symptoms and/or other behavioral expressions rather than ADHD symptoms (e.g., Lutz et al., 2021), particularly given evidence that anxiety may serve as a protective factor for children with ADHD in at least some domains (Chan et al., 2022; Klymkiw et al., 2020; Maric et al., 2018).”

“…findings contribute to a fairly large body of mixed evidence in which about half of the studies find that a greater ERN and/or Pe is related to fewer ADHD symptoms and the other half find no such relations (Herrmann et al., 2009; Marquardt et al., 2018; Rommel et al., 2019; Wiersema et al., 2009).”

“Teacher-reported ADHD symptoms were selected a priori given evidence that teacher-reported ADHD symptoms are more strongly associated with executive function task performance (Cho et al., 2011; Wang et al., 2015) and more predictive of ADHD diagnosis (Tripp et al., 2006).”

“Although our sample size was similar to most prior work on this topic (e.g., Grammer et al., 2018; Marquardt et al., 2018; 2018Miller et al., 2012; cf. Meyer & Klein, 2018 ; Rommel et al. Importantly, the current study recruited a clinically heterogeneous sample.”

“Our results are inconsistent with studies finding relations between a larger ERN and better working memory and inhibitory control (Coleman et al., 2018; Miller et al., 2012; Overbye et al., 2019), as well as better overall cognitive control/executive function (Larson & Clayson, 2011; Meyer & Klein,…”

“…while behavioral data in some ERN studies found that fewer errors on inhibition tasks were associated with a larger ERN in children and adolescents (Lo et al., 2017; Mehra et al., 2022; Overbye et al., 2019), others did not find this relation (Gorday & Meyer, 2018; Grammer et al., 2018; Kim et…”

“…data in some ERN studies found that fewer errors on inhibition tasks were associated with a larger ERN in children and adolescents (Lo et al., 2017; Mehra et al., 2022; Overbye et al., 2019), others did not find this relation (Gorday & Meyer, 2018; Grammer et al., 2018; Kim et al., 2016).”

“…data in some ERN studies found that fewer errors on inhibition tasks were associated with a larger ERN in children and adolescents (Lo et al., 2017; Mehra et al., 2022; Overbye et al., 2019), others did not find this relation (Gorday & Meyer, 2018; Grammer et al., 2018; Kim et al., 2016).”

“…data in some ERN studies found that fewer errors on inhibition tasks were associated with a larger ERN in children and adolescents (Lo et al., 2017; Mehra et al., 2022; Overbye et al., 2019), others did not find this relation (Gorday & Meyer, 2018; Grammer et al., 2018; Kim et al., 2016).”

“In other words, the Pe may represent top-down regulation of ongoing behavioral processes, while the ERN may be reflective of more automatic bottom-up processes that would be less affected by effortful cognitive control/executive function processes (Wells et al., 2019).”

“…with anxiety symptoms and/or other behavioral expressions rather than ADHD symptoms (e.g., Lutz et al., 2021), particularly given evidence that anxiety may serve as a protective factor for children with ADHD in at least some domains (Chan et al., 2022; Klymkiw et al., 2020; Maric et al., 2018).”

“…previous evidence of (a) medium to large relations between executive functions and the ERN and Pe ( η 2 =.19–.25, r = .27–.72; Coleman et al., 2018; Grammer et al., 2018; Larson & Clayson, 2011; Mathewson et al., 2005; Miller et al., 2012); (b) medium relations between the ERN and Pe and ADHD…”

“Teacher-reported ADHD symptoms were selected a priori given evidence that teacher-reported ADHD symptoms are more strongly associated with executive function task performance (Cho et al., 2011; Wang et al., 2015) and more predictive of ADHD diagnosis (Tripp et al., 2006).”

“Although our sample size was similar to most prior work on this topic (e.g., Grammer et al., 2018; Marquardt et al., 2018; 2018Miller et al., 2012; cf. Meyer & Klein, 2018 ; Rommel et al. Importantly, the current study recruited a clinically heterogeneous sample.”

“Similar results are seen in ADHD/Control between-group studies in the ERN (for review see Meyer & Hajcak, 2019), while a reduced Pe in ADHD groups appears to be a more consistent finding (Kaiser et al., 2020; McLoughlin et al., 2022).”

“Moreover, the aggregation of multiple executive functions into a single metric is expected to contribute to between-study heterogeneity, given the range of possible executive functions and corresponding indices that might be included in aggregate measures (Marsh et al., 2023).”

“In this study, we focused on the Pe, which as a later (as opposed to earlier) ERP component after the commission of an error, may be more closely related to higher-order cognitive processing stages (Marsh et al., 2023).”