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Hot executive functioning (EF) – EF under emotionally or motivationally salient conditions – is a putative etiology of attention-deficit/hyperactivity disorder (ADHD), disruptive behavior problems (DBPs), and their related impairments. Despite two decades of research, the present study is the first review of the construct in youth ADHD, with a particular focus on the role of task design, age, and DBPs, as well as relevant conceptual and methodological considerations. While certain hot EF tasks have been investigated extensively (e.g., choice impulsivity), substantial inconsistency in measurement of the broader construct remains, severely limiting conclusions. Future research should a) consider the extent to which various hot EF tasks relate to one another, a higher order factor, and other related constructs; b) further investigate task design, particularly the elicitation of emotion or motivation and its anticipated effect on EF; and c) incorporate multiple levels of analysis to validate similarities and differences among tasks with regard to the affective experiences and cognitive demands they elicit. With improved measurement and conceptual clarity, hot EF has potential to advance the literature on etiological pathways to ADHD, DBPs and associated impairments and, more broadly, may represent a useful tool for understanding the influence of emotion and motivation on cognition. [ABSTRACT FROM AUTHOR]

Short-term memory (STM) impairments are common among youth with attention-deficit/hyperactivity disorder (ADHD), but not inherent to the disorder. Little is known about predictors driving heterogeneity in STM among youth with ADHD. Prior work (i.e., Ward et al., 2015) has shown that parasympathetic nervous system functioning may play a role explaining this heterogeneity. The current study sought to replicate and extend this study with a diverse sample of 285 children (N = 143 clinically recruited with ADHD) ages 6 to 12 years. Parents reported on child psychopathology and youth completed a visual spatial STM task while psychophysiological data (i.e., heart rate, respiration rate, skin conductance) were recorded, then derived to relevant parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., electrodermal activity [EDA]) indexes. Youth with ADHD exhibited lower STM, lower resting RSA, and task-based RSA increase from baseline compared to typically developing peers. RSA moderated the association between STM and ADHD, such that low STM was associated with ADHD in the context of RSA increase from baseline. This was in contrast to Ward and colleagues (2015), which reported that low STM was associated with ADHD in the context of RSA withdrawal from baseline. When analyses were limited to youth with ADHD only, EDA moderated the association between STM and ADHD symptoms, such that low STM performance was associated with elevated symptoms in the context of EDA augmentation from baseline. Findings are discussed in comparison to the original study, and possible explanations for discrepancies in results are explored. Future research directions are proposed. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is the most commonly diagnosed mental health disorder in childhood, however, there is well-established heterogeneity in both the presentation of ADHD symptoms and secondary characteristics across the literature. Existing Diagnostic and Statistical Manual of Mental Disorders (DSM-5) nosology has been ineffective in explaining such heterogeneity in terms of both pathophysiology and clinical trajectories. The current study investigated ADHD heterogeneity via a biologically-based, data-driven approach (k-Means algorithm). Specifically, unique biological profiles (derived from patterns of parasympathetic and sympathetic functioning) were identified and utilized as predictors of clinical presentations. Two hundred eighty-nine participants (167 youth with ADHD), ages 5 to 13 years, completed an emotion-based task while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., electrodermal activity [EDA]) activity were obtained. Overall, results suggest that three distinct biological profiles among youth with ADHD are evident, with biological profiles differing in regulation and arousal levels during emotionally evocative contexts: (Profile 1) underregulated, hyperaroused (negative contexts only), (Profile 2) typically regulated, underaroused, and (Profile 3) overregulated (positive contexts only), hyperaroused. Results are supported by several dopaminergic- and reward-based theories, integrating differing concepts across the literature, and adds biological support for existing models. Behaviorally, results may translate into differing clinical presentations, however, further work is needed. In general, youth with ADHD are heterogenous in autonomic functioning, which could have implications for synthesizing across differing theories within the literature, predicting clinical presentations, and developing targeted treatments. [ABSTRACT FROM AUTHOR]

Psychostimulants are commonly prescribed medications for youth with attention-deficit/hyperactivity disorder (ADHD). Limited studies have evaluated how psychostimulants (e.g., methylphenidate [MPH]) impact autonomic nervous system (ANS) indexes among youth with ADHD. Understanding the effects of MPH on autonomic functioning is essential, given that youth with ADHD have been shown to experience atypical autonomic functioning (i.e., reduced activity across both sympathetic and parasympathetic branches) compared to typically developing youth. The current study investigated how a specific psychostimulant, Osmotic Release Oral System [OROS] MPH, impacts parasympathetic (indexed by respiratory sinus arrhythmia [RSA]) and sympathetic (indexed by electrodermal activity [EDA]) functioning among youth with ADHD via a within-subjects, double-masked, cross-over design. Two hundred fifty-six participants (157 youth with ADHD), ages 5 to 13 years, completed a two-minute resting baseline task while electrocardiograph and electrodermal data were obtained. Youth with ADHD completed the resting baseline task twice, 3 weeks apart, once during active medication and once during placebo conditions (counterbalanced). Typically developing youth were assessed without medication or placebo. Youth with ADHD during the placebo condition exhibited reduced RSA and EDA compared to typically developing youth. In contrast, youth with ADHD during the medication condition did not differ significantly from typically developing youth with respect to either RSA nor EDA. As such, OROS MPH appears to normalize RSA and EDA levels among youth with ADHD to levels comparable to typically developing youth. Future studies including indexes of the ANS among youth with ADHD are urged to consider the impact of MPH. [ABSTRACT FROM AUTHOR]

Although inattention is a key symptom subdomain of attention-deficit/hyperactivity disorder (ADHD), the mechanisms underlying this subdomain and related symptoms remain unclear. There is a need for more granular approaches that allow for greater specificity in linking disruptions in specific domains of cognitive performance (e.g., executive function and reward processing) with behavioral manifestations of ADHD. Such approaches may inform the development of more targeted therapeutic interventions. Here, we describe the results of a pilot study of elementary-aged children (ages 6–12years) with ADHD (n =50) and typically developing children (n =48) utilizing a cognitive science task designed to target two dissociable mechanisms of attentional selection: a goal-driven mechanism (i.e., reward/value-driven) and a salience-driven mechanism. Participants were asked to optimally extract and combine information about stimulus salience and value to maximize rewards. While results of this pilot study are ambiguous due to the small sample size and limited number of task trials, data suggest that neither participants with ADHD nor typically developing participants performed optimally to maximize rewards, though typically developing participants were somewhat more successful at the task (i.e., more likely to report high-value targets) regardless of task condition. Further, the manuscript examines several follow-up questions regarding group differences in task response times and group differences in task performance as related to sustained attention across the duration of the task. Finally, the manuscript examines follow-up questions related to heterogeneity in the ADHD group (i.e., age, DSM 5 presentation, and comorbid diagnosis) in predicting task performance. [ABSTRACT FROM AUTHOR]

Two primary methods of quantifying executive functioning include self- or other-reports (i.e., questionnaire-based EF) and cognitive test performance (i.e., task-based EF). Despite their lack of concordance with one another and relatively inconsistent associations with attention-deficit/hyperactivity disorder (ADHD) symptoms, both approaches have been utilized in attempts to advance our understanding of the role of EF in symptoms of ADHD. The current study is the first to incorporate a direct assessment of behavior (i.e., actigraphy) to further clarify the relation between EF and hyperactivity using a multi-method approach in a sample of children with a range of ADHD symptoms. Fifty-two children between the ages of 8 and 12 completed a testing session during which performance on working memory and inhibition computerized tasks, as well as actigraphy data, were collected. Additionally, parent reports of hyperactivity/impulsivity, working memory, and inhibition were obtained. As expected, questionnaire-based measures of working memory and inhibition were strongly associated with parent-reported hyperactivity/impulsivity, whereas only the latter was associated significantly with mechanically assessed movement. In contrast, task-based working memory performance was more strongly associated with parent-reported hyperactivity/impulsivity relative to task-based inhibition. Further, both task-based working memory and task-based inhibition were similarly associated with mechanically-assessed movement. Finally, compared to questionnaire-based EF, both measures of task-based EF accounted for more variance in objectively-assessed movement. Collectively, these results highlight the measurement issues in the present literature, the importance of careful task and questionnaire design, and the value that alternative approaches (e.g., actigraphy) may provide with respect to advancing our understanding of EF. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder characterized by symptoms of inattention, hyperactivity, and/or impulsivity, as well as executive dysfunction. Recent work underlines the importance in understanding the role of emotion reactivity and regulatory deficits in the context of the disorder. One study (i.e., Musser et al. 2011) utilized a positive and negative emotion induction and suppression task, as well as indexes of autonomic nervous system reactivity, to examine emotional functioning in youth with ADHD. This study revealed inflexible parasympathetic-based regulation across emotion conditions among youth with ADHD compared to typically developing youth. The present study sought to replicate and extend these findings to a clinically recruited, diverse sample, while also examining sympathetic functioning. Two hundred fifty-nine participants (160 youth with ADHD), aged 5 to 13, completed the task utilized in Musser et al. 2011, while indexes of parasympathetic (i.e., respiratory sinus arrhythmia [RSA]) and sympathetic (i.e., pre-ejection period [PEP] and electrodermal activity [EDA]) reactivity were obtained. ADHD was associated with significantly elevated parasympathetic (i.e., augmented RSA) and sympathetic (as indexed by EDA) reactivity. Overall, results replicate and extend Musser et al. 2011, revealing sympathetic-linked disruptions in emotion reactivity and parasympathetic-linked disruptions in emotion regulation among youth with ADHD. Future studies of behavioral therapies for ADHD should consider the efficacy of adding an emotion regulation skills training component. [ABSTRACT FROM AUTHOR]

Objective: Youth with attention-deficit/hyperactivity disorder (ADHD), characterized by symptoms of inattention and hyperactivity, often experience challenges with emotion regulation (ER) and/or emotional lability/negativity (ELN).1-3 Prior work has shown that difficulties with ER and ELN among young children contribute to lower academic achievement.4-6 To date, research examining associations between ADHD and academic achievement have primarily focused on the roles of inattentive symptoms and executive functioning.7-8 However, preliminary work among youth with ADHD suggests significant associations between disruptions in emotional functioning and poor academic outcomes.9-10 The current study will examine associations between ER, ELN, and specific subdomains of academic achievement (i.e., reading, spelling, math) among youth with and without ADHD. Participants and Methods: Forty-six youth (52% male; Mage=9.52 years; 76.1% Hispanic/Latino; 21 with ADHD) and their parents were recruited as part of an ongoing study. Parents completed the Disruptive Behavior Disorders Rating Scale11 and Emotion Regulation Checklist12 about their child. Youth completed the Wechsler Abbreviated Scale of Intelligence-II13 and three subtests [Spelling (SP), Numerical Operations (NO), Word Reading (WR)] of the Wechsler Individual Achievement Test-III.14 Univariate analysis of variance assessed differences in emotional functioning and academic achievement among youth with and without ADHD. Correlation and regression analyses were conducted to examine the association between emotional factors and the three subtests of academic achievement. Results: Youth with ADHD exhibited significantly higher ELN (M =30.7, SD =8.7) compared to their peers (M =23.2, SD =5.8), when controlling for child age, sex, and diagnoses of conduct disorder and/or oppositional defiant disorder [ F (1,41)=8.96, p <.01, ŋp 2=.18]. With respect to ER, youth with (M =24.8, SD =4.2) and without ADHD (M =25.8, SD =4.3) did not differ [ F (1,41)=.51, p =.48]. Surprisingly, within this sample, ADHD diagnostic status was not significantly associated with performance on any of the academic achievement subtests [WR: F (1,41)=.29, p =.59; NO: F (1,41)=.91, p =.35; SP: F (1,41)=2.14, p =.15]. Among all youth, ER was significantly associated with WR (r =.31, p =.04) and SP (r =.35, p =.02), whereas ELN was associated with performance on NO (r =-.30, p =.04). When controlling for child age, sex, IQ, and ER within the full sample, higher ELN was associated with lower scores on the NO subtest (b =-.56, SE=.26, p =.04). The associations between higher ER and WR scores (b =1.12, SE=.51, p =.03), as well as higher ER and SP scores (b =1.47, SE=.56, p =.01), were significant when controlling for child age and sex, but not ELN and IQ (p =.73 and p =.64, respectively). Conclusions: As expected, youth with ADHD had higher ELN, although they did not differ from their peers in terms of ER. Results identified distinct associations between ER and higher reading/spelling performance, as well as ELN and lower math performance across all youth. Thus, findings suggest that appropriate emotional coping skills may be most important for reading and spelling, while emotional reactivity appears most salient to math performance outcomes. In particular, ELN may be a beneficial target for intervention, especially with respect to improvement in math problem-solving skills. Future work should account for executive functioning skills, expand the academic achievement domains to include fluency and more complex academic skills, and assess longitudinal pathways within a larger sample. [ABSTRACT FROM AUTHOR]

Children with attention deficit/hyperactivity disorder (ADHD) display alterations in both emotion reactivity and regulation. One mechanism underlying such alternations may be reduced coherence among emotion systems (i.e., autonomic, facial affect). The present study sought to examine this. One hundred children (50 with ADHD combined presentation), 7-11 years of age (62% male, 78% White), completed an emotion induction and suppression task. This task was coded for facial affect behavior across both negative and positive emotion eliciting task conditions. Electrocardiogram and impedance cardiography data were acquired throughout the task. Time-linked coherence of facial affect behavior and autonomic reactivity and regulation were examined during the induction conditions using hierarchical linear modeling. Although ADHD and typically developing children did not differ with respect to rates of facial affect behavior displayed (all Fs < 2.09, ps > .29), the ADHD group exhibited reduced coherence between facial affect behavior and an index of parasympathetic functioning (i.e., respiratory sinus arrhythmia), γ10 = -0.03, SE = 0.02, t(138) = -1.96, p = .05. In contrast, children in the control group displayed a significant, positive, γ10 = 0.06, SE = 0.01, t(138) = 4.07, p < .001, association between facial affect behavior and respiratory sinus arrhythmia. Children with ADHD may receive conflicting emotional signals at the levels of facial affective behavior and parasympathetic functioning when compared to typically developing youth. Weakened coherence among these emotion systems may be an underlying mechanism of emotion dysregulation in ADHD. Implications for etiology and treatment are discussed. [ABSTRACT FROM AUTHOR]

Despite evidence that ADHD is associated with disruptions in emotion regulation, few studies have examined the biological correlates of emotion dysregulation among children with this disorder. Prior work has pointed to roles of the parasympathetic and sympathetic nervous system, as indexed via respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP), respectively. Work in typically developing populations suggests that parenting behavior and parental emotion expression may shape the development of these systems. To date, a single study has examined the independent and interactive roles of autonomic nervous system functioning and parent emotion expression in youth with ADHD. This study seeks to extend that work. 86 children (42 with ADHD), aged 8-12 years, and a parent completed a parent-child interaction task, while electrocardiography and impedance cardiography data were recorded to derive RSA and PEP. Parent and child emotion word use (positive and negative valence) were coded from recordings of the task. Parents of youth with ADHD used fewer positive emotion words throughout the task. Additionally, throughout the task, children with ADHD engaged in excessive RSA withdrawal from baseline. Further, the association between RSA reactivity and ADHD diagnosis was moderated by parent positive emotion word use. Specifically, those with RSA augmentation and parents displaying high positive affect across the task conditions were least likely to have an ADHD diagnosis. If replicated and extended, these results support the use of interventions specifically designed to increase parental modeling of positive emotions, while simultaneously focusing on building emotion regulation skills in youth with ADHD. [ABSTRACT FROM AUTHOR]

Attention-deficit/hyperactivity disorder (ADHD) is associated with disruptionsin reward sensitivity and regulatory processes. However, it is unclear whether thesedisruptions are better explained by comorbid disruptive behavior disorder (DBD)symptomology. This study sought to examine this question using multiple levels ofanalysis (i.e., behavior, autonomic reactivity). One hundred seventeen children (aged 6 to 12 years; 72.6% male; 69 with ADHD) completed theBalloon-Analogue Risk Task (BART) to assess external reward sensitivity behaviorally.Sympathetic-based internal reward sensitivity and parasympathetic-based regulationwere indexed via cardiac pre-ejection period (PEP) and respiratory sinus arrhythmia(RSA), respectively. Children with ADHD exhibited reduced internal reward sensitivity (i.e.,lengthened PEP; F(1,112)=4.01, p=0.047) compared to healthy controls and werecharacterized by greater parasympathetic-based dysregulation (i.e., reduced RSAaugmentation F(1,112)=10.12, p=0.002). However, follow-up analyses indicated theADHD effect was better accounted for by comorbid DBD diagnoses; that is, childrenwith ADHD and comorbid ODD were characterized by reduced internal rewardsensitivity (i.e., lengthened PEP; t=2.47, p=0.046) and by parasympathetic-baseddysregulation (i.e., reduced RSA augmentation; t=3.51, p=0.002) in response to rewardwhen compared to typically developing youth. Furthermore, children with ADHD and comorbid CD exhibited greater behaviorally-based external reward sensitivity (i.e.,more total pops; F(3,110)= 5.96, p=0.001) compared to children with ADHD only (t=3.87, p=0.001) and children with ADHD and ODD (t=3.56, p=0.003). Results suggest that disruptions in sensitivity to reward may be betteraccounted for, in part, by comorbid DBD.Key Words: attention-deficit/hyperactivity disorder, autonomic nervous system,disruptive behavior disorders, reward sensitivityPowered. [ABSTRACT FROM AUTHOR]

Background High maternal prepregnancy body mass index ( BMI) has been associated with increased risk of offspring attention-deficit/hyperactivity disorder ( ADHD). However, whether this effect is attributable to maternal or familial level confounds has been little examined. Methods The present study sought to examine these associations, utilizing data from the medical records of a health care system which treats 350,000 patients annually and a sibling-comparison design in a sample of 4,682 children born to 3,645 mothers. Results When examining the overall maternal effect, a linear association was observed between maternal prepregnancy BMI and child ADHD [ b = 0.04, 95% confidence interval (95% CI) = 0.02-0.06, p = .0003], such that a one-unit (i.e. 1 kg/m2) increase in prepregnancy BMI was associated with a 4% increase in the odds of ADHD (exp b = 1.04). However, when the model was reparameterized to take full advantage of the sibling design to allow for the examination of both maternal and child-specific effects, the child-specific prepregnancy BMI effect was not reliably different from zero ( b = −0.08, 95% CI = −0.23 to 0.06, p = .24). In contrast, at the maternal-level, average prepregnancy BMI was a reliably non-zero predictor of child ADHD ( b = 0.04, 95% CI = 0.02-0.06, p < .0001) with each one-unit increase in maternal prepregnancy BMI associated with a 4.2% increase in the odds of ADHD (exp b = 1.04, 95% CI = 1.02-1.06). Conclusions The association between maternal prepregnancy BMI and offspring ADHD may be better accounted for by familial or maternal confounds rather than a direct causal effect of BMI. [ABSTRACT FROM AUTHOR]

The authors note two errors in this article. In the reference section, Musser et al. (2014) was mistakenly used whereas the following entry should have been used. [ABSTRACT FROM AUTHOR]

This erratum reports an error in Musser, E. D., Backs, R. W., Schmitt, C. F., Ablow, J. C., Measelle, J. R., & Nigg, J. T. (2011). Emotion regulation via the autonomic nervous system in children with attention-deficit/hyperactivity disorder (ADHD). [ABSTRACT FROM AUTHOR]

Unlabelled: In the transition from childhood to adolescence, attention-deficit/hyperactivity disorder (ADHD) developmental trajectories diverge. Family environment, as indexed by parental expressed emotion, may moderate these trajectories. 388 children with ADHD and 127 controls were assessed using multi-informant, multimethod diagnostic procedures at up to 3 time points 1 year apart in an accelerated longitudinal design spanning ages 7-13 years. Latent-class growth analysis was used to identify developmental trajectories for parent- and teacher-rated ADHD and oppositional-defiant disorder (ODD) symptoms within the ADHD sample. Parental expressed emotion, criticism, and emotional overinvolvement were coded from a 5-min speech sample at 2 time points, 1 year apart, for 208 of these children and compared among ADHD trajectory groups.Results: Parent-rated hyperactivity yielded a 4-class trajectory solution in latent-class growth analysis; teacher-rated inattention yielded a 3-trajectory solution. Teacher-rated ODD also yielded 3-trajectory solution. A parent-rated high persistent hyperactive group was more likely than the other ADHD groups to have parents with stable high criticism (34.6%, p < .001), with ODD symptoms controlled. A teacher-identified high ODD-worsening group was more likely to experience high criticism, particularly the initial time point; (87.5%, p < .001), with hyperactivity controlled. Parental criticism, an index of the family environment, is uniquely associated with divergent developmental trajectories among children with ADHD in addition to those associated with ODD symptoms. Lay summary: For many children, ADHD symptoms decrease as they transition to adolescence. Family environmental factors, such as parental criticism, may help explain for whom symptom remission is less likely. [ABSTRACT FROM AUTHOR]

Background Peripheral epigenetic marks hold promise for understanding psychiatric illness and may represent fingerprints of gene-environment interactions. We conducted an initial examination of CpG methylation variation in children with or without attention-deficit/hyperactivity disorder ( ADHD). Methods Children age 7-12 were recruited, screened, evaluated and assigned to ADHD or non- ADHD groups by defined research criteria. Two independent age-matched samples were examined, a discovery set ( n = 92, all boys, half control, half ADHD) and a confirmation set ( n = 20, half ADHD, all boys). 5-methylcytosine levels were quantified in salivary DNA using the Illumina 450 K HumanMethylation array. Genes for which multiple probes were nominally significant and had a beta difference of at least 2% were evaluated for biological relevance and prioritized for confirmation and sequence validation. Gene pathways were explored and described. Results Two genes met the criteria for confirmation testing, VIPR2 and MYT1L; both had multiple probes meeting cutoffs and strong biological relevance. Probes on VIPR2 passed FDR correction in the confirmation set and were confirmed through bisulfite sequencing. Enrichment analysis suggested involvement of gene sets or pathways related to inflammatory processes and modulation of monoamine and cholinergic neurotransmission. Conclusions Although it is unknown to what extent CpG methylation seen in peripheral tissue reflect transcriptomic changes in the brain, these initial results indicate that peripheral DNA methylation markers in ADHD may be promising and suggest targeted hypotheses for future study in larger samples. [ABSTRACT FROM AUTHOR]

Early environmental influences are increasingly of interest in understanding ADHD as a neurodevelopmental condition, particularly in light of recognition that gene by environment interplay are likely involved in this condition. Breastfeeding duration predicts cognitive development, as well as development of brain white matter connectivity, in areas similar to those seen in ADHD. Prior studies show an association between breastfeeding and ADHD but without adequate evaluation of ADHD. A case control cohort of 474 children aged 7-13 years was examined, 291 with well characterized ADHD (71.5 % male) and the rest typically developing controls (51.9 % male). Mothers retrospectively reported on breast feeding initiation and duration. Initiation of breastfeeding was not associated with child ADHD, but shorter duration of breastfeeding was associated with child ADHD with a medium effect size (d = 0.40, p < 0.05); this effect held after covarying a broad set of potential confounders, including child oppositional defiant and conduct problems and including maternal and paternal ADHD symptoms. Effects were replicated across both parent and teacher ratings of child ADHD symptoms. Shorter duration of breastfeeding is among several risk factors in early life associated with future ADHD, or else longer duration is protective. The direction of this effect is unknown, however. It may be that some children are more difficult to breastfeed or that breastfeeding provides nutrients or other benefits that reduce future chance of ADHD. [ABSTRACT FROM AUTHOR]

IMPORTANCE Psychiatric nosology is limited by behavioral and biological heterogeneity within existing disorder categories. The imprecise nature of current nosologic distinctions limits both mechanistic understanding and clinical prediction. We demonstrate an approach consistent with the National Institute of Mental Health Research Domain Criteria initiative to identify superior, neurobiologically valid subgroups with better predictive capacity than existing psychiatric categories for childhood attention-deficit/hyperactivity disorder (ADHD). OBJECTIVE To refine subtyping of childhood ADHD by using biologically based behavioral dimensions (ie, temperament), novel classification algorithms, and multiple external validators. DESIGN, setting. AND PARTICIPANTS A total of437 clinically well-characterized, community-recruited children, with and without ADHD, participated in an ongoing longitudinal study. Baseline data were used to classify children into subgroups based on temperament dimensions and examine external validators including physiological and magnetic resonance imaging measures. One-year longitudinal follow-up data are reported for a subgroup of the ADHD sample to address stability and clinical prediction. MAIN OUTCOMES AND MEASURES Parent/guardian ratings of children on a measure of temperament were used as input features in novel community detection analyses to identify subgroups within the sample. Groups were validated using 3 widely accepted external validators: peripheral physiological characteristics (cardiac measures of respiratory sinus arrhythmia and pre-ejection period), central nervous system functioning (via resting-state functional connectivity magnetic resonance imaging), and clinical outcomes (at 1-year longitudinal follow-up). RESULTS The community detection algorithm suggested 3 novel types of ADHD, labeled as mild (normative emotion regulation), surgent (extreme levels of positive approach-motivation), and irritable (extreme levels of negative emotionality, anger, and poor soothability). Types were independent of existing clinical demarcations including DSM-5 presentations or symptom severity. These types showed stability over time and were distinguished by unique patterns of cardiac physiological response, resting-state functional brain connectivity, and clinical outcomes 1 year later. CONCLUSIONS AND relevance Results suggest that a biologically informed temperament-based typology, developed with a discovery-based community detection algorithm, provides a superior description of heterogeneity in the ADHD population than does any current clinical nosologic criteria. This demonstration sets the stage for more aggressive attempts at a tractable, biologically based nosology. [ABSTRACT FROM AUTHOR]

Background: To determine whether familial transmission is shared between autism spectrum disorders and attention-deficit/hyperactivity disorder, we assessed the prevalence, rates of comorbidity, and familial transmission of both disorders in a large population-based sample of children during a recent 7 year period. Methods: Study participants included all children born to parents with the Kaiser Permanente Northwest (KPNW) Health Plan between 1 January 1998 and 31 December 2004 (n = 35,073). Children and mothers with physician-identified autism spectrum disorders (ASD) and/or attention-deficit/hyperactivity disorder (ADHD) were identified via electronic medical records maintained for all KPNW members. Results: Among children aged 6-12 years, prevalence was 2.0% for ADHD and 0.8% for ASD; within those groups, 0.2% of the full sample (19% of the ASD sample and 9.6% of the ADHD sample) had co-occurring ASD and ADHD, when all children were included. When mothers had a diagnosis of ADHD, first born offspring were at 6-fold risk of ADHD alone (OR = 5.02, p < .0001) and at 2.5-fold risk of ASD alone (OR = 2.52, p < .01). Results were not accounted for by maternal age, child gestational age, child gender, and child race. Conclusions: Autism spectrum disorders shares familial transmission with ADHD. ADHD and ASD have a partially overlapping diathesis. [ABSTRACT FROM AUTHOR]

The article discusses a study which examined whether emotion reactivity and regulation can lead to heterogeneity in attention-deficit/hyperactivity disorder (ADHD). The study featured children with ADHD as well as varying levels of prosocial behavior who were required to perform induction or suppression tasks. According to the authors, the study indicated that ADHD is heterogeneous in terms of physiological demonstrations of emotion and regulation.

Despite growing interest in conceptualizing ADHD as involving disrupted emotion regulation, few studies have examined the physiological mechanisms related to emotion regulation in children with this disorder. This study examined parasympathetic and sympathetic nervous system reactivity via measures of respiratory sinus arrhythmia (RSA) and cardiac pre-ejection period (PEP) in children with ADHD ( n = 32) and typically developing controls ( n = 34), using a novel emotion task with four conditions: negative induction, negative suppression, positive induction, and positive suppression of affect. Both groups showed strong task-response effects in RSA. However, typically developing children showed systematic variation in parasympathetic activity (RSA) depending on both emotion valence (more activation for negative emotion, reduced activation for positive emotion) and task demand (more activation for suppression than induction). In contrast, children with ADHD displayed a stable pattern of elevated parasympathetic activity (RSA) across all task conditions compared to baseline. No group differences in sympathetic activity (PEP) were observed. It is concluded ADHD in childhood is associated with abnormal parasympathetic mechanisms involved in emotion regulation. [ABSTRACT FROM AUTHOR]

A key underlying process that may contribute to attention-deficit/hyperactivity disorder (ADHD) involves alterations in reward evaluation, including assessing the relative value of immediate over delayed rewards. This study examines whether children with ADHD discount the value of delayed rewards to a greater degree than typically developing children using a delay discounting task. Children aged 7-9 years diagnosed with ADHD and controls completed a task in which they chose between a hypothetical $10 available after a delay (7, 30, 90 and 180 days) versus various amounts available immediately. ADHD participants discounted more steeply than controls. However, this effect did not survive covarying of IQ. ADHD is associated with a steeper delay gradient when contemplating hypothetical later rewards, but not independently of IQ. The interplay of cognitive processing and IQ with reward evaluation in ADHD requires further exploration. [ABSTRACT FROM AUTHOR]

Notice of Retraction and Replacement. Karalunas et al. Subtyping attention-deficit/hyperactivity disorder using temperament dimensions toward biologically based nosologic criteria. JAMA Psychiatry. 2014;71(9):1015-1024 [ABSTRACT FROM AUTHOR]

Attention deficit hyperactivity disorder (ADHD) is emblematic of unresolved heterogeneity in psychiatric disorders-the variation in biological, clinical, and psychological correlates that impedes progress on etiology. One approach to this problem is to characterize subgroups using measures rooted in biological or psychological theory, consistent with the National Institute of Mental Health's research domain criteria initiative. Within ADHD, a promising application involves using emotion trait profiles that can address the role of irritability as a complicating feature for ADHD. Here, a new sample of 186 children with ADHD was evaluated using community detection analysis to determine if meaningful subprofiles existed and if they replicated those previously identified. The new sample and a prior sample were pooled for evaluation of (a) method dependence, (b) longitudinal assessment of the stability of classifications, and (c) clinical prediction 2 years later. Three temperament profiles were confirmed within the ADHD group: one with normative emotional functioning ("mild"), one with high surgency ("surgent"), and one with high negative affect ("irritable"). Profiles were similar across statistical clustering approaches. The irritable group had the highest external validity: It was moderately stable over time and it enhanced prospective prediction of clinical outcomes beyond standard baseline indicators. The irritable group was not reducible to ADHD + oppositional defiant disorder, ADHD + disruptive mood dysregulation disorder, or other patterns of comorbidity. Among the negative affect domains studied, trait proneness to anger uniquely contributed to clinical prediction. Results extend our understanding of chronic irritability in psychiatric disorders and provide prospects for a fresh approach to assessing ADHD heterogeneity focused on the distinction between ADHD with and without anger/irritability. (PsycINFO Database Record (c) 2019 APA, all rights reserved). [ABSTRACT FROM AUTHOR]