Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder
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The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.
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In the authors' previous study of ADHD, increased CRN amplitude, average ERN amplitude, and decreased ΔERN, as well as decreased Pe amplitude and decreased ΔPe, were found.
“We also found in our study of ADHD an increased CRN amplitude, average ERN amplitude, and decreased ERN minus CRN (ΔERN), as well as a decreased Pe amplitude and decreased Pe minus Pc (ΔPe) (Liu et al. 2020).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Liu et al. 2020
The Results (§3.2.1–3.2.2; page unavailable) report smaller ERN-minus-CRN (ΔERN) and Pe-minus-Pc (ΔPe) effects in children and adolescents with ADHD than in healthy controls. They do not establish the claimed increases in CRN and average ERN amplitudes or a decrease in Pe amplitude individually; the reported group main effects were not significant. (LLM, conf=0.85)
Experimental — accuracy not yet measuredThe finding of an enlarged CRN in ADHD is consistent with the hypothesis that ADHD is associated with a delayed maturation of the CRN.
“Our finding of an enlarged CRN in ADHD requires replication in other large pediatric ADHD samples and is consistent with the hypothesis that ADHD is associated with a delayed maturation of the CRN (Boen et al. 2022; Liu et al. 2020; Overbye et al. 2019; Tamnes et al. 2013).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Liu et al. 2020
The Results (§3.2.1; page unavailable) report that CRN became smaller with age, and the Discussion (§4; page unavailable) suggests a developmental delay in ADHD for other performance-monitoring measures. The paper does not specifically establish delayed CRN maturation in ADHD or report an enlarged CRN in its ADHD group. The citing authors describe the enlarged CRN as their own finding, not Liu et al.'s. (LLM, conf=0.83)
Experimental — accuracy not yet measuredAge and sex matching of the HC were less exact than in our previous studies of ADHD and OCD.
“Age and sex matching of the HC were less exact than in our previous studies of ADHD and OCD because the ADHD group had a male majority and the OCD group a female majority (Hanna et al. 2026; Liu et al. 2020).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Liu et al. 2020
The main ERP findings were present in our two previous studies of ADHD and OCD.
“No corrections were made for multiple statistical comparisons, although the main ERP findings were present in our two previous studies of ADHD and OCD (Hanna et al. 2026; Liu et al. 2020).”
From Reaction Time Variability and Electrophysiological Indices of Performance Monitoring in Youths With Attention-Deficit/Hyperactivity Disorder and Obsessive-Compulsive Disorder (2026) · cites this paper as Liu et al. 2020
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Bellato, A., Norman, L., Idrees, I., Ogawa, C. Y., Waitt, A., Zuccolo, P. F., Tye, C., Radua, J., Groom, M. J., & Shephard, E. (2021) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2021.10.018 · Cited by 49 · see citing works
Boen, R., Quintana, D. S., Ladouceur, C. D., & Tamnes, C. K. (2022) · Psychophysiology · doi:10.1111/psyp.14003 · Cited by 40 · see citing works
Hanna, G. L., Liu, Y., Hanna, B. S., Arnold, P. D., & Gehring, W. J. (2026) · Psychophysiology · doi:10.1111/psyp.70403
“Seven patients with a lifetime diagnosis of ADHD were included in the present study but not in the Liu et al. (2020) study, whereas 15 patients with lifetime diagnoses of both ADHD and OCD were included in the Hanna et al. (2026) study but not in the present study.”
InfluentialSelf-citation
- Authors
- Liu, Y., Hanna, G. L., Hanna, B. S., Rough, H. E., Arnold, P. D., & Gehring, W. J.
- Affiliations
- University of Michigan (US)
- University of Calgary (CA)
- Corresponding author
- Liu, Yanni
- Venue
- Brain Sciences
- Publisher
- MDPI AG
- Published
- 2020-02-02
- Volume
- 10
- Issue
- 2
- Pages
- 79
- ISSN
- 2076-3425 (ISSN-L)
- PMC
- PMC7071615
- OpenAlex
- W3003369528
- Cited by
- 22
- References
- 11
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 5 · 2021: 6 · 2020: 3
- FWCI
- 2.92
- Type
- journal article
- Language
- en
- Open access
- gold
- dx.doi.org
- Licence
- Locations
- Brain Sciences (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institute of Mental Health (R01 MH101493)
- 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, performance monitoring, error-related negativity, error positivity, reaction time variability, post-error slowing, P300, N2 component, developmental trajectories, children and adolescents, EEG correlates
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