Autonomic correlates of attention-deficit/hyperactivity disorder and oppositional defiant disorder in preschool children.

Abstract

Numerous studies have revealed autonomic underarousal in conduct-disordered adolescents and antisocial adults. It is unknown, however, whether similar autonomic markers are present in at-risk preschoolers. In this study, the authors compared autonomic profiles of 4- to 6-year-old children with attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD; n = 18) with those of age-matched controls (n = 20). Children with ADHD and ODD exhibited fewer electrodermal responses and lengthened cardiac preejection periods at baseline and during reward. Although group differences were not found in baseline respiratory sinus arrhythmia, heart rate changes among ADHD and ODD participants were mediated exclusively by parasympathetic withdrawal, with no independent sympathetic contribution. Heart rate changes among controls were mediated by both autonomic branches. These results suggest that at-risk preschoolers are autonomically similar to older externalizing children.

Affective Decision-Making and Externalizing Behaviors: The Role of Autonomic Activity

“…The strengths of the study include the examination of affective decision-making and sex differences in relation to ANS activity and externalizing behaviors, and an evaluation of the generalizability of findings involving autonomic correlates of ADHD and ODD symptoms to impoverished, inner-city children, which can inform intervention efforts aimed at potentially malleable risk factors (Crowell et al 2006;Raine et al 2001). For instance, it is likely that the alteration of one's environment (e.g., contextual disadvantage, parental stress, marital conflict) can shape and modulate psychophysiological processes and subsequent behavior problems.…”

“…Spectral densities were calculated in 30 s epochs. The log of RSA was used to index parasympathetic functioning, which is a common transformation used to normalize spectral analytic data (Crowell et al 2006). …”

“…The lack of association between EF and affective decision-making further supports the distinction between cold and hot cognition (Kerr and Zelazo 2004) and suggests that these abilities may rely on different areas of the prefrontal cortex. Last, given that controlling for IQ and family income did not change the findings, the child's ability to understand the tasks and family SES likely did not unduly influence the results.The strengths of the study include the examination of affective decision-making and sex differences in relation to ANS activity and externalizing behaviors, and an evaluation of the generalizability of findings involving autonomic correlates of ADHD and ODD symptoms to impoverished, inner-city children, which can inform intervention efforts aimed at potentially malleable risk factors (Crowell et al 2006;Raine et al 2001). For instance, it is likely that the alteration of one's environment (e.g., contextual disadvantage, parental stress, marital conflict) can shape and modulate psychophysiological processes and subsequent behavior problems.…”

“…Accordingly, our goal in the present study was to test a conceptual model linking ADHD and ODD symptoms with ANS and affective decision-making (shown to be partially dependent on orbitofrontal and amygdala functioning; Bechara et al 1999) to examine whether differential processes underlie symptoms characteristic of ADHD subtypes and ODD. This conceptual model is based on three lines of work and includes research conducted by Beauchaine and colleagues examining ANS functioning among children with ADHD and ODD (Crowell et al 2006), by Blair and colleagues examining decision making and reversal learning among individuals with psychopathy (e.g., Blair 2005;Fisher and Blair 1998), and by Damasio, Bechara, and colleagues investigating the somatic marker hypothesis (Bechara and Bar-On 2006;Damasio 1994). The present study can be distinguished from previous work in two primary ways: (1) we applied our conceptual model to both ADHD subtypes and ODD symptoms in children, and (2) we relied more specifically on the somatic marker hypothesis (Bechara and Bar-On 2006;Damasio 1994) rather than reinforcement expectancy models of amygdalaorbitofrontal interaction (Blair 2004).…”

“…For instance, preschool children with ADHD and ODD exhibit attenuated SNS, but not PNS activity (Beauchaine et al 2007;Crowell et al 2006). In middle childhood and adolescence, ODD and CD are associated with attenuated SNS and PNS activity (Beauchaine et al , 2007, which suggests that PNS activity may come "online" during middle childhood and SNS deficiencies may emerge before reductions in PNS activity.…”