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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.

Objectively-Measured Impulsivity and Attention-Deficit/Hyperactivity Disorder (ADHD): Testing Competing Predictions from the Working Memory and Behavioral Inhibition Models of ADHD

“…Commission errors refer to discrete instances in which children respond incorrectly to non-target stimuli, and demonstrate moderate convergent validity with diverse indices of impulsivity (r00.20 to 0.45). These indices include parent ratings (Avila et al 2004;Barkley 1991;Nigg et al 1996;Olson et al 1999), teacher ratings (Barkley 1991;Brewis 2002;Halperin et al 1991;Halperin et al 1988; Klee and Garfinkel 1983), clinical diagnostic interviews (Epstein et al 2003), direct observations of impulsive behavior while completing academic assignments (Barkley 1991), and composite indices of direct observations, parent/ teacher reports, and self-report (Moffitt et al 2011).…”

Heterogeneity in ADHD: Neuropsychological Pathways, Comorbidity and Symptom Domains

“…In dimensional analyses, Epstein et al (2003) found that RT variability was related to both symptoms of hyperactivity/impulsivity and symptoms of inattention, but this study failed to control for the overlap between symptom domains. Clarke et al (2007) did conduct such a control in analyses investigating independent as well as interaction effects in the two symptom domains.…”

The effect of methylphenidate on sustained attention among adolescents with attention-deficit hyperactivity disorder

“…During tasks requiring vigilance, these resources declined, which caused a decrease in performance efficiency (Warm, Parasuraman, & Matthews, 2008). Sustained attention has been found to be the major factor in explaining the difficulties of attention-deficit hyperactivity disorder (ADHD) (to name only a few studies: Epstein et al, 2003;Johnson et al, 2007;Tsal et al, 2005). Investigation into sustained attention increased significantly with the introduction of computerized testing (computerized testing is a part of a testing procedure named: continuous performance tests (CPTs)).…”