The interplay of delay aversion, timing skills, and impulsivity in children experiencing attention-deficit/hyperactivity disorder (ADHD) symptoms

Abstract

Impulsive behaviours occurring as a central deficit in connection with attention-deficit/hyperactivity disorder (ADHD) are associated with social and academic impairment in children. Whereas impulsivity was shown to be related to both delay aversion and deficient timing skills, the mutual relation between the latter two has hardly been investigated. The present study therefore examined the interplay of delay aversion, timing skills, and impulsivity in a sample of eighty-eight children aged between seven and fourteen, twenty-one of them diagnosed with ADHD. Children participated in a delay aversion and a tapping task, while parents reported about their impulsiveness. The results showed that both delay aversion and deficient timing skills were related to impulsivity. Contrasting prior assumptions, delay aversion and timing skills were also shown to be related, even when controlling for impulsivity. Implications for interventions aiming to reduce children’s impulsivity as well as methodological considerations regarding whether to view ADHD as a category or a continuum are discussed.

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    To measure delay aversion, participants were instructed to indicate answers to simple math tasks with a button press. The computer accepted the answer with varying delay. During the delay, the number of button presses and their mean duration was recorded. An index calculated as the product of the number of button presses and their duration indicated delay aversion.

References

  1. Antrop I, Stock P, Verté S, Wiersema JR, Baeyens D, Roeyers H (2006) ADHD and delay aversion: the influence of non-temporal stimulation on choice for delayed rewards. J Child Psychol Psychiatry 47(11):1152–1158. https://doi.org/10.1111/j.1469-7610.2006.01619.x

    Article  PubMed  Google Scholar 

  2. APA (2000) DSM-IV-TR: diagnostic and statistical manual of mental disorders, text revision. (American Psychiatric Association, Ed.). American Psychiatric Association, Washington

  3. APA (2013) Diagnostic and statistical manual of mental disorders (DSM-5) (Fifth Vers). American Psychiatric Association Publishing, Arlington

    Google Scholar 

  4. Barkley RA (2002) Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. J Clin Psychiatry 63(Suppl12):10–15

    PubMed  Google Scholar 

  5. Barkley RA (2006) Attention-deficit/hyperactivity disorder: a handbook for diagnosis and treatment, 3rd edn. Guildford Press, New York

    Google Scholar 

  6. Biederman J, Faraone SV, Milberger S, Al E (1996) A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 53(5):437–446. https://doi.org/10.1001/archpsyc.1996.01830050073012

    CAS  Article  PubMed  Google Scholar 

  7. Biederman J, Mick E, Faraone SV (2000) Age-dependent decline of symptoms of attention deficit hyperactivity disorder: impact of remission definition and symptom type. Am J Psychiatry 157(5):816–818. https://doi.org/10.1176/appi.ajp.157.5.816

    CAS  Article  PubMed  Google Scholar 

  8. Bitsakou P, Antrop I, Wiersema JR, Sonuga-Barke EJS (2006) Probing the limits of delay intolerance: preliminary young adult data from the Delay Frustration Task (DeFT). J Neurosci Methods 151(1):38–44. https://doi.org/10.1016/j.jneumeth.2005.06.031

    Article  PubMed  Google Scholar 

  9. Bitsakou P, Psychogiou L, Thompson M, Sonuga-Barke EJS (2009) Delay aversion in attention deficit/hyperactivity disorder: an empirical investigation of the broader phenotype. Neuropsychologia 47(2):446–456. https://doi.org/10.1016/j.neuropsychologia.2008.09.015

    Article  PubMed  Google Scholar 

  10. Block RA, Zakay D, Hancock PA (1999) Developmental changes in human duration judgments: a meta-analytic review. Dev Rev 19(1):183–211. https://doi.org/10.1006/drev.1998.0475

    Article  Google Scholar 

  11. Castellanos FX, Tannock R (2002) Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nat Rev Neurosci 3(8):617–628. https://doi.org/10.1038/nrn896

    CAS  Article  PubMed  Google Scholar 

  12. Coghill DR, Sonuga-Barke EJS (2012) Annual Research Review: categories versus dimensions in the classification and conceptualisation of child and adolescent mental disorders—implications of recent empirical study. J Child Psychol Psychiatry 53(5):469–489. https://doi.org/10.1111/j.1469-7610.2011.02511.x

    Article  PubMed  Google Scholar 

  13. Coghill DR, Seth S, Matthews K (2014) A comprehensive assessment of memory, delay aversion, timing, inhibition, decision making and variability in attention deficit hyperactivity disorder: advancing beyond the three-pathway models. Psychol Med 44(9):1989–2001. https://doi.org/10.1017/S0033291713002547

    CAS  Article  PubMed  Google Scholar 

  14. Cortese S, Ferrin M, Brandeis D, Buitelaar J, Daley D, Dittmann RW et al (2015) Cognitive training for Attention-Deficit/Hyperactivity Disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. J Am Acad Child Adolesc Psychiatry 54(3):164–174. https://doi.org/10.1016/j.jaac.2014.12.010

    Article  PubMed  PubMed Central  Google Scholar 

  15. DeYoung CG, Rueter AR (2017) Impulsivity as a personality trait. In: Vohs KD, Baumeister RF (eds) Handbook of self regulation: Research, theory, and applications, 3rd edn. Guildford Publications, New York, pp 345–363

    Google Scholar 

  16. Döpfner M, Görtz-Dorten A (2008) Diagnostik-System für Psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV, DISYPS-II [Diagnostic system for psychiatric disorders in childhood and adolescence according to ICD-10 and DSM-IV, DISYPS-II]. Huber, Bern

    Google Scholar 

  17. Douglas VI, Parry PA (1983) Effects of reward on delayed reaction time task performance of hyperactive children. J Abnorm Child Psychol 11(2):313–326. https://doi.org/10.1007/BF00912094

    CAS  Article  PubMed  Google Scholar 

  18. Downing G (1965) The preparation of teachers for schools in culturally deprived neighborhoods (The Bridge Project). Final Report. Flushing, NY

  19. Drake C, Jones MR, Baruch C (2000) The development of rhythmic attending in auditory sequences: attunement, referent period, focal attending. Cognition 77(3):251–288. https://doi.org/10.1016/S0010-0277(00)00106-2

    CAS  Article  PubMed  Google Scholar 

  20. Fahrenberg J, Myrtek M (1996) Ambulatory assessment: computer-assisted psychological and psychophysiological methods in monitoring and field studies. Hogrefe & Huber, Seattle

    Google Scholar 

  21. Fahrenberg J, Myrtek M, Pawlik K, Perrez M (2007) Ambulatory assessment—monitoring behavior in daily life settings. Eur J Psychol Assess 23(4):206–213. https://doi.org/10.1027/1015-5759.23.4.206

    Article  Google Scholar 

  22. Fischer B, Hartnegg K (2004) On the development of low-level auditory discrimination and deficits in dyslexia. Dyslexia 10(2):105–118. https://doi.org/10.1002/dys.268

    Article  PubMed  Google Scholar 

  23. Haslam N, Williams B, Prior M, Haslam R, Graetz B, Sawyer M (2006) The latent structure of Attention-Deficit/Hyperactivity Disorder: a taxometric analysis. Aust N Z J Psychiatry 40(8):639–647. https://doi.org/10.1080/j.1440-1614.2006.01863.x

    Article  PubMed  Google Scholar 

  24. Hays JR, Smith AL (1980) Comparison of WISC-R and culture fair intelligence test scores for three ethnic groups of juvenile delinquents. Psychol Rep 46(3):931–934. https://doi.org/10.2466/pr0.1980.46.3.931

    CAS  Article  PubMed  Google Scholar 

  25. Huang J, Yang B, Zou X, Jing J, Pen G, McAlonan GM, Chan RCK (2012) Temporal processing impairment in children with attention-deficit-hyperactivity disorder. Res Dev Disabil 33(2):538–548. https://doi.org/10.1016/j.ridd.2011.10.021

    Article  PubMed  Google Scholar 

  26. Huang-Pollock CL, Mikami AY, Pfiffner L, McBurnett K (2009) Can executive functions explain the relationship between attention deficit hyperactivity disorder and social adjustment? J Abnorm Child Psychol 37(5):679–691. https://doi.org/10.1007/s10802-009-9302-8

    Article  PubMed  Google Scholar 

  27. Jensen PS, Eaton Hoagwood K, Roper M, Arnold LE, Odbert C, Crowe M et al (2004) The services for children and adolescents–parent interview: development and performance characteristics. J Am Acad Child Adolesc Psychiatry 43(11):1334–1344. https://doi.org/10.1097/01.chi.0000139557.16830.4e

    Article  PubMed  Google Scholar 

  28. Körner R, Betz T (2012) Die empirische Bestimmung der sozialen Herkunft und des Migrationshintergrunds von Kindern. Das Erhebungsinstrument der standardisierten Elternbefragung. Ergebnisbericht aus dem Projekt EMiL. [The empirical determination of the social origin and the migration background of children. The survey instrument of the standardised parent interview. Result report of the project EMiL]. Frankfurt a. M

  29. Kuntsi J, Oosterlaan J, Stevenson J (2001) Psychological mechanisms in hyperactivity: response inhibition deficit, working memory impairment, delay aversion, or something else? J Child Psychol Psychiatry 42(2):199–210

    CAS  Article  Google Scholar 

  30. Lampert T, Kroll L, Müters S, Stolzenberg H (2013) Messung des sozioökonomischen Status in der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1) [Assessment of the socioeconomic statis in a study on adult health in Germany]. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz 56(5):631–636. https://doi.org/10.1007/s00103-012-1663-4

    CAS  Article  PubMed  Google Scholar 

  31. LeFever GB, Villers MS, Morrow AL (2002) Parental perceptions of adverse educational outcomes among children diagnosed and treated for ADHD: a call for improved school/provider collaboration. Psychol Schools 39(1):63–71. https://doi.org/10.1002/pits.10000

    Article  Google Scholar 

  32. Levy F, Hay DA, McStephen M, Wood C, Waldman I (1997) Attention-deficit hyperactivity disorder: a category or a continuum? Genetic analysis of a large-scale twin study. J Am Acad Child Adolesc Psychiatry 36(6):737–744

    CAS  Article  Google Scholar 

  33. Marcus DK, Barry TD (2011) Does attention-deficit/hyperactivity disorder have a dimensional latent structure? A taxometric analysis. J Abnorm Psychol 120(2):427–442. https://doi.org/10.1037/a0021405

    Article  PubMed  PubMed Central  Google Scholar 

  34. Martel MM, Nigg JT, von Eye A (2008) How do trait dimensions map onto ADHD symptom domains? J Abnorm Child Psychol 37(3):337. https://doi.org/10.1007/s10802-008-9255-3

    Article  Google Scholar 

  35. McAuley JD, Jones MR, Holub S, Johnston HM, Miller NS (2006) The time of our lives: life span development of timing and event tracking. J Exp Psychol Gen 135(3):348–367. https://doi.org/10.1037/0096-3445.135.3.348

    Article  PubMed  Google Scholar 

  36. Monuteaux MC, Faraone SV, Herzig K, Navsaria N, Biederman J (2005) ADHD and dyscalculia: evidence for independent familial transmission. J Learn Disabil 38(1):86–93. https://doi.org/10.1177/00222194050380010701

    Article  PubMed  Google Scholar 

  37. Noreika V, Falter CM, Rubia K (2013) Timing deficits in attention-deficit/hyperactivity disorder (ADHD): evidence from neurocognitive and neuroimaging studies. Neuropsychologia 51(2):235–266. https://doi.org/10.1016/j.neuropsychologia.2012.09.036

    Article  PubMed  Google Scholar 

  38. Polderman TJC, Boomsma DI, Bartels M, Verhulst FC, Huizink AC (2010) A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatr Scand 122(4):271–284. https://doi.org/10.1111/j.1600-0447.2010.01568.x

    Article  PubMed  Google Scholar 

  39. Rubia K, Taylor A, Taylor E, Sergeant JA (1999) Synchronization, anticipation, and consistency in motor timing of children with dimensionally defined attention deficit hyperactivity behaviour. Percept Mot Skills 89(3 suppl):1237–1258. https://doi.org/10.2466/pms.1999.89.3f.1237

    CAS  Article  PubMed  Google Scholar 

  40. Rubia K, Noorloos J, Smith A, Gunning B, Sergeant JA (2003) Motor timing deficits in community and clinical boys with hyperactive behavior: the effect of methylphenidate on motor timing. J Abnorm Child Psychol 31(3):301–313. https://doi.org/10.1023/A:1023233630774

    Article  PubMed  Google Scholar 

  41. Rubia K, Smith A, Taylor E (2007) Performance of children with attention deficit hyperactivity disorder (ADHD) on a test battery of impulsiveness. Child Neuropsychol 13(3):276–304. https://doi.org/10.1080/09297040600770761

    Article  PubMed  Google Scholar 

  42. Rubia K, Halari R, Christakou A, Taylor E (2009) Impulsiveness as a timing disturbance: neurocognitive abnormalities in attention-deficit hyperactivity disorder during temporal processes and normalization with methylphenidate. Philos Trans R Soc B Biol Sci 364(1525):1919–1931

    CAS  Article  Google Scholar 

  43. Salum GA, Sonuga-Barke E, Sergeant JA, Vandekerckhove J, Gadelha A, Moriyama TS et al (2014) Mechanisms underpinning inattention and hyperactivity: neurocognitive support for ADHD dimensionality. Psychol Med 44(15):3189–3201

    CAS  Article  Google Scholar 

  44. Shaw P, Gilliam M, Liverpool M, Weddle C, Malek M, Sharp W et al (2011) Cortical development in typically developing children with symptoms of hyperactivity and impulsivity: support for a dimensional view of attention deficit hyperactivity disorder. Am J Psychiatry 168(2):143–151. https://doi.org/10.1176/appi.ajp.2010.10030385

    Article  PubMed  Google Scholar 

  45. Shih LYL, Kuo W-J, Yeh T-C, Tzeng OJL, Hsieh J-C (2009) Common neural mechanisms for explicit timing in the sub-second range. NeuroReport 20(10). http://journals.lww.com/neuroreport/Fulltext/2009/07010/Common_neural_mechanisms_for_explicit_timing_in.1.aspx

    Article  Google Scholar 

  46. Solanto MV, Abikoff H, Sonuga-Barke E, Schachar R, Logan GD, Wigal T et al (2001) The ecological validity of delay aversion and response inhibition as measures of impulsivity in AD/HD: a supplement to the NIMH multimodal treatment study of AD/HD. J Abnorm Child Psychol 29(3):215–228. https://doi.org/10.1023/A:1010329714819

    CAS  Article  PubMed  Google Scholar 

  47. Sonuga-Barke EJS (2002) Psychological heterogeneity in AD/HD—a dual pathway model of behaviour and cognition. Behav Brain Res 130(1–2):29–36. https://doi.org/10.1016/S0166-4328(01)00432-6

    Article  PubMed  Google Scholar 

  48. Sonuga-Barke EJS, Saxton T, Hall M (1998) The role of interval underestimation in hyperactive children’s failure to suppress responses over time. Behav Brain Res 94(1):45–50. https://doi.org/10.1016/S0166-4328(97)00168-X

    CAS  Article  PubMed  Google Scholar 

  49. Sonuga-Barke EJS, Bitsakou P, Thompson M (2010) Beyond the dual pathway model: evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 49(4):345–355. https://doi.org/10.1016/j.jaac.2009.12.018

    Article  PubMed  Google Scholar 

  50. Stawski RS, MacDonald SWS, Sliwinski MJ (2015) Measurement burst design. In: The encyclopedia of adulthood and aging. Wiley, New York. https://doi.org/10.1002/9781118521373.wbeaa313

  51. Teicher MH, Anderson CM, Polcari A, Glod CA, Maas LC, Renshaw PF (2000) Functional deficits in basal ganglia of children with attention-deficit/hyperactivity disorder shown with functional magnetic resonance imaging relaxometry. Nat Med 6(4):470

    CAS  Article  Google Scholar 

  52. Toplak ME, Tannock R (2005a) Tapping and anticipation performance in attention deficit hyperactivity disorder. Percept Mot Skills 100(3):659–675. https://doi.org/10.2466/pms.100.3.659-675

    CAS  Article  PubMed  Google Scholar 

  53. Toplak ME, Tannock R (2005b) Time perception: modality and duration effects in attention-deficit/hyperactivity disorder (ADHD). J Abnorm Child Psychol 33(5):639–654. https://doi.org/10.1007/s10802-005-6743-6

    Article  PubMed  Google Scholar 

  54. Tripp G, Alsop B (2001) Sensitivity to reward delay in children with Attention Deficit Hyperactivity Disorder (ADHD). J Child Psychol Psychiatry 42(5):691–698. https://doi.org/10.1111/1469-7610.00764

    CAS  Article  PubMed  Google Scholar 

  55. Trull TJ, Ebner-Priemer U (2013) Ambulatory assessment. Annu Rev Clin Psychol 9(1):151–176. https://doi.org/10.1146/annurev-clinpsy-050212-185510

    Article  PubMed  Google Scholar 

  56. Valera EM, Spencer RMC, Zeffiro TA, Makris N, Spencer TJ, Faraone SV et al (2010) Neural substrates of impaired sensorimotor timing in adult attention-deficit/hyperactivity disorder. Biol Psychiat 68(4):359–367. https://doi.org/10.1016/j.biopsych.2010.05.012

    Article  PubMed  Google Scholar 

  57. Walg M, Oepen J, Prior H (2012) Adjustment of time perception in the range of seconds and milliseconds: the nature of time-processing alterations in children with ADHD. J Atten Disorders 19(9):755–763. https://doi.org/10.1177/1087054712454570

    Article  Google Scholar 

  58. Weiß RH, Weiß B (2006) CFT 20-R. Grundintelligenztest Skala 2 - Revision - [CFT 20-R. Basic intelligence scale 2 - Revision-]. Hogrefe Verlag, Göttingen

  59. WHO (1992) ICD-10 classifications of mental and behavioural disorder: clinical descriptions and diagnostic guidelines. World Health Organization, Geneva

    Google Scholar 

  60. Zelaznik HN, Vaughn AJ, Green JT, Smith AL, Hoza B, Linnea K (2012) Motor timing deficits in children with Attention-Deficit/Hyperactivity Disorder. Hum Mov Sci 31(1):255–265. https://doi.org/10.1016/j.humov.2011.05.003

    Article  PubMed  Google Scholar 

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Acknowledgements

We thank all research assistants of this project for their work.

Funding

This research was part of a larger project analysing correlates of decision-making in children with ADHD at the Center for Individual Development and Adaptive Education of Children at Risk (IDeA) in Frankfurt/Main, Germany, funded by the Hessian Initiative for the Development of Scientific and Economic Excellence (LOEWE). This research was furthermore funded by the LEAD Graduate School & Research Network [GSC1028], a project of the Excellence Initiative of the German federal and state governments.

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Appendix: Supplementary analyses

Appendix: Supplementary analyses

Interplay of delay aversion, timing skills and other ADHD symptoms

To test whether inattention and hyperactivity were related to delay aversion and timing skills, additional two-tailed partial correlation analyses were calculated. Controlling for age and ADHD diagnosis, the analyses showed that inattention and delay aversion were unrelated (r = .14, p = .23), while hyperactivity and delay aversion were related (r = .22, p = .049). Additionally, controlling for age and ADHD diagnosis, inattention and timing skills were unrelated (r = − .068, p = .55), while also hyperactivity and timing skills were (r = −.093, p = .42). Finally, delay aversion and timing skills were related when controlling for inattention, age, and ADHD diagnosis (r = − .23, p = .045), while they were not when controlling for hyperactivity, age, and ADHD diagnosis (r = − .21, p = .66).

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Blume, F., Kuehnhausen, J., Reinelt, T. et al. The interplay of delay aversion, timing skills, and impulsivity in children experiencing attention-deficit/hyperactivity disorder (ADHD) symptoms. ADHD Atten Def Hyp Disord 11, 383–393 (2019). https://doi.org/10.1007/s12402-019-00298-4

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Keywords

  • ADHD symptoms
  • Dimensionality
  • Delay aversion
  • Timing skills
  • Impulsivity