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Do Executive Deficits and Delay Aversion Make Independent Contributions to Preschool Attention-Deficit/Hyperactivity Disorder Symptoms?
Open accessAbstract
Objective To test whether deficits in executive function and delay aversion make independent contributions to levels of attention-deficit/hyperactivity disorder (ADHD) symptoms exhibited by preschool children.Method One hundred fifty-six children between 3 and 5.5 years old (78 girls and 78 boys) selected from the community completed an age-appropriate battery of tests measuring working memory, set shifting, planning, delay of gratification, and preference for delayed rewards. Parents completed a clinical interview about their children's ADHD symptoms.Results Analysis of test performance revealed two factors: executive dysfunction and delay aversion. Multivariate analysis demonstrated that when other factors (i.e., age, IQ, and conduct problems) were controlled, executive dysfunction and delay aversion each made significant independent contributions to predictions of ADHD symptoms.Conclusions Preschool ADHD symptoms are psychologically heterogeneous. Executive dysfunction and delay aversion may represent two distinct and early appearing neurodevelopmental bases for ADHD symptoms.
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“and that this deficit is independent of deficits in inhibitory control.”
From Multiple deficits in ADHD: executive dysfunction, delay aversion, reaction time variability, and emotional deficits (2013) · cites this paper as Sonuga-Barke, Dalen, & Remington, 2003
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“Several studies (e.g., Dalen, Sonuga-Barke, Hall, & Remington, 2004; Solanto et al., 2001; Sonuga-Barke, Dalen, & Remington, 2003) have found that ADHD is significantly related to delay aversion”
From Multiple deficits in ADHD: executive dysfunction, delay aversion, reaction time variability, and emotional deficits (2013) · cites this paper as Sonuga-Barke, Dalen, & Remington, 2003
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“However, there is now considerable justification suggesting that multiple developmental and pathophysiological pathways inform ADHD symptomatology (Fair et al., 2012; Nigg et al., 2004; Sonuga-Barke et al., 2003).”
From Reward circuit connectivity relates to delay discounting in children with attention-deficit/hyperactivity disorder (2013) · cites this paper as Sonuga-Barke et al., 2003
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“The distinctiveness of both pathways was demonstrated by Solanto et al. (2001) and Sonuga-Barke et al. (2003), who showed that inhibitory deficits and delay aversion independently contributed to the prediction of ADHD symptoms.”
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“In short, EC can be assessed through direct neuropsychological assessments as well as adults' reports, with evidence that the two forms of assessment are robustly correlated (Espy et al., 2011; Sonuga-Barke, Dalen & Remington, 2003).”
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“…correlates, like academic achievement (e.g., Brock et al., 2009; Willoughby et al., 2011), symptoms www.frontiersin.org May 2014 | Volume 5 | Article 447 | 1 of ADHD and behavioral problems, as well as social competence (Sonuga-Barke et al., 2003; Dalen et al., 2004; Smith-Donald et al., 2007).”
BackgroundResultWhat motivates individuals with ADHD? A qualitative analysis from the adolescent’s point of view
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“In one direction, altered motivational drives might invoke ADHD symptoms, as they might prevent individuals with ADHD to fully engage in tasks, resulting into more hyperactivity/impulsivity and inattention [37, 48, 49].”
BackgroundSelf-citationDelay and inhibition as early predictors of ADHD symptoms in third grade.
Campbell, S. B., & von Stauffenberg, C. (2009) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-008-9270-4 · Cited by 90
“Thus, consistent with prior research, early cognitive functioning and externalizing problems were robust predictors of later problems regulating attention and impulses (e.g., Campbell et al. 1994; Sonuga-Barke et al. 2003 ).”
BackgroundResultInfluentialThe Impact of Financial Reward Contingencies on Cognitive Function Profiles in Adult ADHD
Marx, I., Höpcke, C., Berger, C., Wandschneider, R., & Herpertz, S. C. (2013) · PLoS ONE · doi:10.1371/journal.pone.0067002 · Cited by 52
“As measures of cognitive functioning in the executive and non-executive domain are uncorrelated but are both associated with ADHD symptoms, which has been demonstrated particularly in the domain of motivation/emotion [22–24], these measures permit for the definition of distinct neuropsychological subgroups of patients…”
BackgroundEmotion Dysregulation in Attention Deficit Hyperactivity Disorder
Shaw, P., Stringaris, A. K., Nigg, J. T., & Leibenluft, E. (2016) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.140102 · Cited by 53
Transcranial Direct Current Stimulation Improves Reward Processing in Children With ADHD
Nejati, V., Khorrami, A. S., & Nitsche, M. A. (2020) · Journal of Attention Disorders · doi:10.1177/1087054720923094 · Cited by 49
“…disorder (ADHD) cannot tolerate delays because of impaired time perception, representing an executive function and respective negative emotions associated with waiting, which cannot be easily controlled, which involves motivational factors (Sonuga-Barke, 2003; Sonuga-Barke et al. 2003).”
BackgroundHolst, Y., & Thorell, L. B. (2017) · Journal of Attention Disorders · doi:10.1177/1087054713506264 · Cited by 46
Sjöwall, D., Backman, A., & Thorell, L. B. (2014) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-014-9942-1 · Cited by 52
“With regard to independent effects, both cognitive and motivation-based regulation were shown to have independent effects in relation to symptoms of inattention, which is in line with a previous preschool study (Sonuga-Barke et al. 2003).”
BackgroundResultStevens, M. C. G., Pearlson, G. D., Calhoun, V. D., & Bessette, K. L. (2017) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2017.09.005 · Cited by 49
Wåhlstedt, C. (2009) · Child Neuropsychology · doi:10.1080/09297040802524198 · Cited by 46
“Moreover, these genetic findings have been complemented by behavioral results showing a linear relation between inhibitory function and ADHD symptom severity in children (eg, Sonuga-Barke, Dalen, Dalen, & Remington, 2002 ; Sonuga-Barke, Dalen, & Remington, 2003 ).”
ResultBitsakou, P., Antrop, I., Wiersema, J. R., & Sonuga-Barke, E. J. S. (2006) · Journal of Neuroscience Methods · doi:10.1016/j.jneumeth.2005.06.031 · Cited by 45
Self-citationPatros, C. H. G., Alderson, R. M., Lea, S. E., Tarle, S. J., Kasper, L. J., & Hudec, K. L. (2015) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.12.016 · Cited by 43
“…Size Ordering Task, which requires children to temporarily store and mentally re-order a list of items by size (Sjowall et al., 2013), the Noisy Book Task, Find a Phone Task, and Digit Span task used in previous studies (Sjowall et al., 2013; Sonuga-Barke et al., 2003, 2010) likely placed minimal”
Methodvan den Bergh, F. S., Spronk, M., Ferreira, L. M. T., Bloemarts, E., Groenink, L., Olivier, B., & Oosting, R. S. (2006) · Behavioural Brain Research · doi:10.1016/j.bbr.2006.08.003 · Cited by 43
Delay aversion: Effects of 7-OH-DPAT, 5-HT1A/1B-receptor stimulation and d-cycloserine
van den Bergh, F. S., Bloemarts, E., Groenink, L., Olivier, B., & Oosting, R. S. (2006) · Pharmacology Biochemistry and Behavior · doi:10.1016/j.pbb.2006.11.007 · Cited by 42
Mies, G. W., Ma, I., de Water, E., Buitelaar, J. K., & Scheres, A. (2018) · Cortex · doi:10.1016/j.cortex.2018.05.018 · Cited by 41
Ortiz, N., Parsons, A., Whelan, R., Brennan, K., Agan, M., O'Connell, R., Bramham, J., & Garavan, H. (2015) · Acta Neurobiologiae Experimentalis · doi:10.55782/ane-2015-2038 · Cited by 40
“Additionally, it appears that delay aversion may make an independent contribution to ADHD symptoms that is distinct from response inhibition and other executive functions (Sonuga-Barke et al. 2003).”
BackgroundDovis, S., Van der Oord, S., Huizenga, H. M., Wiers, R. W., & Prins, P. J. M. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-014-0612-1 · Cited by 39
“, see [22]; but also see [76]).”
A critical appraisal of the role of neuropsychological deficits in preschool ADHD
Sjöwall, D., & Thorell, L. B. (2018) · Child Neuropsychology · doi:10.1080/09297049.2018.1447096 · Cited by 43
“…investigating the overlap between different neuropsychological deficits, the results of the present study are in line with those from previous studies (Sonuga-Barke et al., 2010, 2003), in that executive deficits and delay-related behaviors both contributed independently to the explained variance.”
ResultNeural Correlates of the Dual-Pathway Model for ADHD in Adolescents
Shen, C., Luo, Q., Jia, T., Zhao, Q., Desrivières, S., Quinlan, E. B., Banaschewski, T., Millenet, S., Bokde, A. L. W., Büchel, C., et al. (2020) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2020.19020183 · Cited by 40
Salari, R., Bohlin, G., Rydell, A., & Thorell, L. B. (2016) · Child Psychiatry & Human Development · doi:10.1007/s10578-016-0664-1 · Cited by 39
Cognitive-Motivational Deficits In ADHD: Development of a Classification System
Gupta, R., Kar, B. R., & Srinivasan, N. (2010) · Child Neuropsychology · doi:10.1080/09297049.2010.524152 · Cited by 35
“Deficits in both processes are thought to give rise to the manifestation of ADHD (Sonuga-Barke et al., 2003).”
BackgroundResultBari, A., & Robbins, T. W. (2011) · Current topics in behavioral neurosciences · doi:10.1007/7854_2010_102 · Cited by 37
“2009) but both measures, taken together, are able to accurately classify almost 90% of children with ADHD (Sonuga-Barke et al. 2003).”
BackgroundResultScholtens, S., Diamantopoulou, S., Tillman, C. M., & Rydell, A. (2011) · Journal of Attention Disorders · doi:10.1177/1087054711417398 · Cited by 40
Júlvez, J., Forns, M., Ribas‐Fitó, N., Torrent, M., & Sunyer, J. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2010.03.013 · Cited by 35
“The current research focuses on the study of ADHD symptoms among younger age groups, specifically preschoolers [21,31,41,46,48].”
La mesure des fonctions exécutives chez les enfants d'âge préscolaire.
Monette, S., & Bigras, M. (2008) · Canadian Psychology/Psychologie canadienne · doi:10.1037/a0014000 · Cited by 33
Scholtens, S., Rydell, A., Bohlin, G., & Thorell, L. B. (2014) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-014-9854-0 · Cited by 34
“The clinical features of ADHD are increasingly being recognized as representing the extreme end of normal traits, rather than a distinct category (e.g., Bauermeister et al. 2007; Kraemer et al. 2004; Larsson et al. 2012; Sonuga-Barke et al. 2003).”
BackgroundPauli-Pott, U., Schloß, S., Ruhl, I., Skoluda, N., Nater, U. M., & Becker, K. (2017) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2017.09.002 · Cited by 31
Neuropsychological Assessment and The Paradox of ADHD
Koziol, L. F., & Stevens, M. C. G. (2012) · Applied Neuropsychology Child · doi:10.1080/21622965.2012.694764 · Cited by 36
“For instance, several studies have reinforced the use of cognitive tests in differentiating ADHD-related primary impairment with cognitive control and delay aversion (Nigg et al, 2005 ; Solanto et al, 2001 ; Sonuga-Barke, Dalen, & Remington, 2003 ).”
BackgroundMies, G. W., de Water, E., Wiersema, J. R., & Scheres, A. (2018) · Child Neuropsychology · doi:10.1080/09297049.2018.1508563 · Cited by 33
Ward, A. R., Alarcón, G., Nigg, J. T., & Musser, E. D. (2015) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-015-0054-3 · Cited by 32
“executive function has revealed substantial neuropsychological heterogeneity in wellcharacterized samples of children with ADHD, implicating multiple developmental pathways to the disorder (Nigg et al. 2005; Sonuga-Barke et al. 2003; Willcutt et al. 2005) and indicating a need for examination of ADHD-related impairmen…”
Background
Metadata
- Authors
- Sonuga-Barke, E. J. S., Dalen, L., & Remington, B.
- Affiliations
- Economic and Social Research Council (GB)
- Corresponding author
- Sonuga-Barke, Edmund J.S.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2003-11
- Volume
- 42
- Issue
- 11
- Pages
- 1335-1342
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W2007093632
- Cited by
- 233
- References
- 48
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 6 · 2023: 3 · 2022: 5 · 2021: 8 · 2020: 12 · 2019: 2 · 2018: 12 · 2017: 10 · 2016: 14 · 2015: 16 · 2014: 12 · 2013: 12 · 2012: 14
- FWCI
- 6.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Funders
- Economic and Social Research Council
- 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, preschool children, executive dysfunction, delay aversion, delay of gratification, working memory, set-shifting, planning
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Preschool, Cognition Disorders, Female, Humans, Male, Neuropsychological Tests, Severity of Illness Index, Diagnostic and Statistical Manual of Mental Disorders
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