Differential Effects of Methylphenidate on Working Memory in ADHD Children with and without Comorbid Anxiety

Tannock, Rosemary; Ickowicz, Abel; Schachar, Russell

doi:10.1097/00004583-199507000-00012

Cited by 275 publications

(196 citation statements)

References 22 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…ADHD is frequently seen in comorbidity and t h e proper identification and treatment of coexistent d i s o rders is thought to positively modify the pro gn o s i s 6 . There is an extensive data on the higher prevalence of anxiety disorders in ADHD patients w h e n c o m p a red to general population (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Souza

Pinheiro²,

Mattos

2005

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

For many years, childhood anxiety was considered a benign and transitory disorder with a good o u tcome. More recent studies, however, show this b elief was wro n g 1 . Anxiety disorders are now considered chronic and pervasive and their prevalence increases throughout adolescence 2 . These children show a generalized anxious feeling with excessive w o rries about their parents, school tests, future events and visits to a doctor or past behavior. They a re also distressed about their competence, behavior and performance in different settings such as school, sports and social relationships and experience physical distress with flushing, rapid heart b e a t , headache, insomnia, agitation, muscles cramps a n d u r i n a ry urg e n c y. Young children might also show separation anxiety, which is a very particular feeling of distress, along with worries about separating f ro m parents or other close ones. These symptoms are usually expressed by refusing to go to school and inability to perf o rm social functions. Some anxious children develop specific fears with avoidance behaviors and social impairment. Obsessive-compulsive disorder can also be diagnosed in children.Anxiety disorders are one of the most studied fields of comorbid conditions with attention deficit hyperactivity disorder (ADHD). Several studies documented a high prevalence of comorbidity in child ren and adolescents suffering from ADHD (Ta b l e 1). There are two Brazilian studies re p o rting pre v alence rates similar to those described in intern a t i onal literature. Also, when using strict diagnostic criteria, there is no diff e rence in the prevalence rates ABSTRACT -Objective: To evaluate the prevalence of anxiety disorders in a clinical referred sample of child ren and adolescents with attention deficit/hyperactivity disorder (ADHD). M e t h o d : 78 children and adolescents with ADHD according to DSM-IV criteria were investigated with a semi-structured interview (P-CHIPS), complemented by clinical interviews with the children or adolescents and their parents. Their IQ was calculated with neuropsychological testing. Results: A high prevalence of anxiety disorders (23.05%) was found in the sample. Generalized anxiety disorder was the most prevalent disorder (12,8%), followed by social phobia (3,84%) and separation anxiety disorder (3,8%). Two children showed more than one anxiety disord e r. C o n c l u s i o n : C h i l d ren and adolescents with ADHD seem to be more prone to have comorbid anxiety disorders, at least in clinical samples referred to specialized units.KEY WORDS: ADHD, attention deficit hyperactivity disorder, anxiety, comorbidity.Transtorno de ansiedade em amostra de pacientes com déficit de atenção e hiperatividade RESUMO -O b j e t i v o: Avaliar a presença de transtornos de ansiedade numa amostra clínica referida de crianças e adolescentes com transtorno do déficit de atenção e hiperatividade (TDAH). M é t o d o:78 crianças c o m TDAH de acordo com os critérios da DSM-IV foram avaliadas através de entrevista semi-estruturada...

show abstract

Section: Discussionmentioning

confidence: 99%

Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Souza

Pinheiro²,

Mattos

2005

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Pliszka (1992) reported that ADHD subjects with comorbid anxiety had a significantly poorer response to stimulant medication than those without anxiety, suggesting they might represent children who develop secondary inattentiveness, or perhaps a different type of ADHD. The effects of MPH on working memory and behavior in anxious and nonanxious children with ADHD have been investigated (Tannock et al, 1995a). They found that MPH improved working memory in the nonanxious group but not in the comorbidly anxious group.…”

Section: Comorbidity and Adhdmentioning

confidence: 99%

Synaptic Gating and ADHD: A Biological Theory of Comorbidity of ADHD and Anxiety

Lévy

2004

Neuropsychopharmacol

View full text Add to dashboard Cite

To derive a biologically based theory of comorbidity in Attention Deficit Hyperactivity Disorder (ADHD). Theoretical concepts and empirical studies were reviewed to determine whether the behavioral inhibition concept provided an understanding of biological processes involved in comorbidity in ADHD. Empirical studies of ADHD have shown comorbidity of ADHD and anxiety, while studies of behavioral inhibition tend to suggest independent disruptive and anxiety traits. This paradox can be resolved by an understanding of the dynamics of mesolimbic dopamine (DA) systems, where reward and delay of reinforcement are determined by tonic/phasic DA relationships, resulting in impulsive 'fearless' responses when impaired. On the other hand, comorbid anxiety is related to impaired synaptic processes, which selectively gate fear (or aggressive) responses from the amygdala at the accumbens. Monosynaptic convergence between prefrontal, hippocampal, and amygdala projection neurons at the accumbens allows the operation of a synaptic gating mechanism between prefrontal cortex (PFC), hippocampus, and amygdala. Impairment of this mechanism by lowered PFC inhibition allows greater amygdala input, and anxiety-related processes more impact, over the accumbens. In conclusion, a dual theory incorporating long-term tonic/phasic mesolimbic DA relationships and secondly impairment of PFC and hippocampal inputs to synaptic gating of anxiety at the accumbens has implications for comorbidity in ADHD, as well as for possible pharmacological interventions, utilizing either stimulant or axiolytic interventions. The use of DA partial agonists may also be of interest.

show abstract

“…Working memory deficits are well-documented in ADHD (Pennington & Ozonoff, 1996;Stevens, Quittner, Zuckerman, & Moore, 2002;Tannock, Ickowicz, & Schachar, 1995). Also, recent research has explored time perception deficits of children with ADHD relative to normal controls (Barkley et al, 1997;Barkley, Edwards, Laneri, Fletcher, & Metevia, 2001;Castellanos & Tannock, 2002;Kerns, McInerney, & Wilde, 2001;Kerns & Price, 2001;West et al, 2000).…”

mentioning

confidence: 99%

Time Perception: Does It Distinguish ADHD and RD Children in a Clinical Sample?

McGee

Brodeur

Symons

et al. 2004

J Abnorm Child Psychol

View full text Add to dashboard Cite

This study used a double-dissociation design to evaluate whether children with ADHD demonstrated specific deficits relative to children with Reading Disorders. Recent theory suggests that ADHD children have deficits in time perception and working memory, whereas RD children have deficits in phonological decoding. The performance of 113 clinic-referred children aged 6-11 was examined using measures of working memory, phonological processing, and time perception. Respondents completed two time production tasks in which they were to judge when 30-s had elapsed, and another in which they were asked to estimate the duration of the Conners' CPT (CCPT). Time Perception and phonological processing variables were submitted to a 2 × 2 ANCOVA (ADHD vs. RD), covarying for age, SES, IQ, and working memory. Children with ADHD were more likely to overestimate the time taken for the CCPT than children without ADHD, but no group differences were found on the 30-s estimation tasks. Children with RD did not display deficits in time estimation, but showed deficits in auditory phonological processing. The lack of interaction effects supported an "etiological subtype" over the "phenocopy" model of ADHD and RD. No group differences were detected using the CCPT. Although our previous studies did not find an order effect for the Conners' CPT in a 1-hr battery, a fatigue effect was evident with a 1.5-hr battery. The implications for Barkley's behavioral inhibition theories (R. Barkley, 1997) are discussed.

show abstract

Differential Effects of Methylphenidate on Working Memory in ADHD Children with and without Comorbid Anxiety

Cited by 275 publications

References 22 publications

Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Anxiety disorders in an attention-deficit/hyperactivity disorder clinical sample

Synaptic Gating and ADHD: A Biological Theory of Comorbidity of ADHD and Anxiety

Time Perception: Does It Distinguish ADHD and RD Children in a Clinical Sample?

Contact Info

Product

Resources

About