Differential Diagnosis in Patients with Substance Use Disorder and/or Attention-Deficit/Hyperactivity Disorder Using Continuous Performance Test

Slobodin, Ortal; Blankers, Matthijs; Kapitány-Fövény, Máté; Kaye, Sharlene; Berger, Itai; Johnson, Brian; Demetrovics, Zsolt; Brink, Wim van den; Glind, Geurt van de

doi:10.1159/000506334

Cited by 14 publications

(20 citation statements)

References 58 publications

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“…Ginsberg et al [70] found that inmate males with comorbidity of ADHD and SUD conducted more commission responses than psychiatric patients with ADHD alone. The 4 other studies [62, 66, 71, 77] did not find that the presence of ADHD in individuals with substance use was associated with different commission rates compared with individuals with either SUD or ADHD.…”

Section: Resultsmentioning

confidence: 96%

“…Except for the study of Ginsberg et al [70], which found that inmate males with comorbid ADHD and SUD made more omission errors than psychiatric patients with ADHD alone, no study found differences in the rate of omission errors between patients with comorbid ADHD and SUD and patients with either ADHD [62, 66, 71] or SUD [66, 68].…”

Section: Resultsmentioning

confidence: 99%

“…Table 1 provides an overview of the authors’ names, publication year, sample size, gender distribution, substance type, CPT used, and diagnostic criteria of ADHD and SUD. Cohen’s d effect sizes are reported (Table 2) for the 4 studies that provided sufficient data for these to be calculated [62, 66, 68, 69].…”

Section: Resultsmentioning

confidence: 99%

“…As seen, except for 1 study [66], all sample sizes were limited and ranged between 17 and 72 participants. All studies except 2 [68, 69] included more males than females (52–100% males).…”

Section: Resultsmentioning

confidence: 99%

“…Several studies suggested that patients with comorbid ADHD and SUD may exhibit higher levels of impulsivity compared with either ADHD [62, 63] or SUD [64, 65] alone. However, others failed to find such differences [66]. The aim of this review is to directly examine the quantitative similarities and differences in CPT performance of adults with ADHD, SUD, and their comorbidity to determine if a distinct neurocognitive profile exists for each.…”

Section: Introductionmentioning

confidence: 99%

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The Utility of the CPT in the Diagnosis of ADHD in Individuals with Substance Abuse: A Systematic Review

Slobodin

2020

Eur Addict Res

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Background: Early identification of attention-deficit/hyperactivity disorder (ADHD) in individuals with substance use disorders (SUD) is important because ADHD has an adverse effect on the development and course of SUD. Given the limited validity of self-report measures of ADHD in individuals with SUD, it is important to investigate the utility of the continuous performance test (CPT) in classifying ADHD in adults with SUD. Objective: This review aims to examine the quantitative similarities and differences in CPT performance of adults with ADHD, SUD, and their comorbidity to determine if a distinct neurocognitive profile exists for each. Method: A systematic review of CPT studies that included patients with the comorbidity of ADHD and SUD and a comparison group of one of the disorders alone was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Results: Eight studies were identified with sample sizes ranging from n = 17 to n = 386. The comorbidity of ADHD and SUD was, mostly, not associated with higher rates of commission and omission errors than either disorder alone. However, the comorbidity of ADHD and SUD was more likely to be associated with increased deficits in response time variability compared with individuals with ADHD alone. Conclusions: This review highlights the shortage of large-scale CPT research involving patients with ADHD and SUD. The CPT might be sensitive to attentional deficits, but it lacks specificity for the classification of adult ADHD, SUD, or their comorbidity, and the CPT is thus not useful in discriminating comorbid ADHD and SUD from either disorder alone. Future CPT research should explore whether specific attentional deficits account for the development and persistence of SUD. Such research should also reach beyond traditional CPT measures and include other cognitive and behavioral deficits that were associated with ADHD, such as distractibility and hyperactivity.

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Section: Resultsmentioning

confidence: 96%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Utility of the CPT in the Diagnosis of ADHD in Individuals with Substance Abuse: A Systematic Review

Slobodin

2020

Eur Addict Res

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Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum

et al. 2021

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The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical effort to address limitations of traditional mental disorder diagnoses. These include arbitrary boundaries between disorder and normality, disorder co‐occurrence in the modal case, heterogeneity of presentation within disorders, and instability of diagnosis within patients. This paper reviews the evidence on the validity and utility of the disinhibited externalizing and antagonistic externalizing spectra of HiTOP, which together constitute a broad externalizing superspectrum. These spectra are composed of elements subsumed within a variety of mental disorders described in recent DSM nosologies, including most notably substance use disorders and “Cluster B” personality disorders. The externalizing superspectrum ranges from normative levels of impulse control and self‐assertion, to maladaptive disinhibition and antagonism, to extensive polysubstance involvement and personality psychopathology. A rich literature supports the validity of the externalizing superspectrum, and the disinhibited and antagonistic spectra. This evidence encompasses common genetic influences, environmental risk factors, childhood antecedents, cognitive abnormalities, neural alterations, and treatment response. The structure of these validators mirrors the structure of the phenotypic externalizing superspectrum, with some correlates more specific to disinhibited or antagonistic spectra, and others relevant to the entire externalizing superspectrum, underlining the hierarchical structure of the domain. Compared with traditional diagnostic categories, the externalizing superspectrum conceptualization shows improved utility, reliability, explanatory capacity, and clinical applicability. The externalizing superspectrum is one aspect of the general approach to psychopathology offered by HiTOP and can make diagnostic classification more useful in both research and the clinic.

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ADHD and offending

Young

Cocallis

2021

J Neural Transm

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Differential Diagnosis in Patients with Substance Use Disorder and/or Attention-Deficit/Hyperactivity Disorder Using Continuous Performance Test

Cited by 14 publications

References 58 publications

The Utility of the CPT in the Diagnosis of ADHD in Individuals with Substance Abuse: A Systematic Review

The Utility of the CPT in the Diagnosis of ADHD in Individuals with Substance Abuse: A Systematic Review

Validity and utility of Hierarchical Taxonomy of Psychopathology (HiTOP): II. Externalizing superspectrum

ADHD and offending

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