Characterizing Underlying Cognitive Components of ADHD Presentations and Co-morbid Diagnoses: A Diffusion Decision Model Analysis

J Atten Disord. 2022 Mar;26(5):706-722. doi: 10.1177/10870547211020087. Epub 2021 Jun 4.

Abstract

Objective: To Explore whether subtypes and comorbidities of attention-deficit hyperactivity disorder (ADHD) induce distinct biases in cognitive components involved in information processing.

Method: Performance on the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was compared between 150 children (aged 7 to 10) with ADHD, grouped by DSM-5 presentation (ADHD-C, ADHD-I) or co-morbid diagnoses (anxiety, oppositional defiant disorder [ODD], both, neither), and 60 children without ADHD. Diffusion decision modeling decomposed performance into cognitive components.

Results: Children with ADHD had poorer information integration than controls. Children with ADHD-C were more sensitive to changes in presentation modality (auditory/visual) than those with ADHD-I and controls. Above and beyond these results, children with ADHD+anxiety+ODD had larger increases in response biases when targets became frequent than children with ADHD-only or with ADHD and one comorbidity.

Conclusion: ADHD presentations and comorbidities have distinct cognitive characteristics quantifiable using DDM and IVA-CPT. We discuss implications for tailored cognitive-behavioral therapy.

Keywords: ADHD; cognitive testing; comorbidity; computational psychiatry; diffusion decision model.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anxiety Disorders
  • Attention Deficit Disorder with Hyperactivity* / complications
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Attention Deficit Disorder with Hyperactivity* / epidemiology
  • Attention Deficit and Disruptive Behavior Disorders / complications
  • Attention Deficit and Disruptive Behavior Disorders / diagnosis
  • Attention Deficit and Disruptive Behavior Disorders / epidemiology
  • Child
  • Cognition
  • Comorbidity
  • Humans