Forming first impressions of children: the role of attention-deficit/hyperactivity disorder symptoms and emotion dysregulation.

BACKGROUND: Previous research on peer status of children with attention-deficit/hyperactivity disorder (ADHD) has focused on already-established peer groups, rendering the specific social behaviors that influence peers' initial impressions largely unknown. Recently, theorists have argued that emotion dysregulation is a key aspect of ADHD, with empirical work finding relations between emotion dysregulation and social outcomes. Therefore, the current study focuses on the initial interactions among children varying in ADHD symptoms duringh a novel playgroup, proposing that emotion dysregulation displayed during the playgroup may serve as a possible pathway between ADHD symptoms and peers' initial negative impressions. METHODS: Participants were 233 elementary-age children ranging from 8 to 10 years old (M = 8.83, 70% male). Parents and teachers rated children's ADHD symptoms and related impairment; 51% of the children met criteria for an ADHD diagnosis. Then, children participated with unfamiliar peers in a three-hour playgroup that included three structured and two unstructured tasks. After the tasks, children and staff rated each child on social outcomes. Coders unaware of child's diagnostic status watched videos of the groups and rated each child's global emotion dysregulation during each task. RESULTS: Using multiple raters and methods, ADHD severity was associated with more negative peer ratings, through observed emotion dysregulation. Results were consistent for both parent and teacher ratings of ADHD severity as well as for both peer ratings of likeability and staff ratings of perceived peer likeability. CONCLUSIONS: When focusing on improving peers' initial impressions of children with ADHD symptoms, emotion dysregulation may be a valuable target for intervention.

Rural and urban substance use differences: Effects of the transition to college.

BACKGROUND: With approximately 20% of Americans residing in rural communities, substance use differences is an important topic for appropriate use of resources, policy decisions, and the development of prevention and intervention programs. OBJECTIVES: The current study examined differences in alcohol, tobacco, and marijuana use among students from rural and urban backgrounds across the transition to college. METHODS: Participants were 431 (48% male) undergraduate students from a large, public southeastern university who provided yearly alcohol, tobacco, and marijuana use data during freshman, sophomore, and junior years. RESULTS: Prevalence of alcohol, tobacco, and marijuana use was lower during early college years, and females were less likely to use tobacco and marijuana. Results indicated that rural individuals were less likely to use alcohol and marijuana than their urban counterparts as freshmen, but rose to meet the rates of urban students by junior year. In contrast, no rural/urban differences in tobacco were noted, although rural minorities were more likely to endorse tobacco use across all years. Finally, perceived peer use of each substance was a significant predictor of future use of that substance for all years. CONCLUSION: This is the first study to explore rural/urban, gender, and racial differences in substance use across the college transition. Results suggest that there are subgroups of individuals at specific risk who may benefit not only from feedback regarding the influence of perceived peer use in college, but also from a deeper understanding of how cultural norms maintain their substance use behaviors over time.

Bidirectional Relations of Impulsive Personality and Alcohol Use Across Three Waves of Data Collection.

OBJECTIVE: To explore the bidirectional relations between alcohol use and three impulsive personality traits, to advance understanding of risk processes. PARTICIPANTS: 525 college students (mean age = 18.95 years) recruited in August 2008 and 2009 and followed up annually for three years. METHODS: Personality and past/current substance use were assessed. RESULTS: T2 sensation seeking mediated the predictive relationship between T1 and T3 alcohol use, and T2 alcohol use mediated the predictive relationship between T1 and T3 sensation seeking. In addition, T2 alcohol problems mediated the predictive relationship between T1 alcohol use and T3 negative urgency. CONCLUSIONS: Findings support a bidirectional relationship between sensation seeking and alcohol use, and drinking anticipates drinking problems, which predict increases in negative urgency. For some individuals, there appears to be an ongoing process of increased risk in the form of increases in both drinking and high-risk personality traits.

Longitudinal and reciprocal relations between delay discounting and crime.

Theorists argue that self-control failure is the underlying cause of criminal behavior, with previous research linking poor self-control to delinquency and drug use. The path from self-control to crime is well-established, but less is known about whether criminal behavior contributes to self-control deficits over time. We investigated bi-directional relations between self-control assessed via a delay discounting task and self-reported crime over a three-year period. During their first, second (73.38% retention rate), and third (63.12% retention rate) years of college, 526 undergraduates completed a delay discounting task and reported on their criminal behavior. In order to maximize variability, participants with conduct problems were overrecruited, comprising 23.1% of the final sample. As expected, more discounting of hypothetical monetary rewards significantly predicted future property crime across a one and two-year period, even when controlling for initial levels of both. This study also demonstrated evidence of a bi-directional relationship; violent crime predicted higher rates of delay discounting one year later. These results suggest that bi-directional relations exist between self-control and types of crime.

How do negative emotions impair self-control? A neural model of negative urgency.

Self-control often fails when people experience negative emotions. Negative urgency represents the dispositional tendency to experience such self-control failure in response to negative affect. Neither the neural underpinnings of negative urgency nor the more general phenomenon of self-control failure in response to negative emotions are fully understood. Previous theorizing suggests that an insufficient, inhibitory response from the prefrontal cortex may be the culprit behind such self-control failure. However, we entertained an alternative hypothesis: negative emotions lead to self-control failure because they excessively tax inhibitory regions of the prefrontal cortex. Using fMRI, we compared the neural activity of people high in negative urgency with controls on an emotional, inhibitory Go/No-Go task. While experiencing negative (but not positive or neutral) emotions, participants high in negative urgency showed greater recruitment of inhibitory brain regions than controls. Suggesting a compensatory function, inhibitory accuracy among participants high in negative urgency was associated with greater prefrontal recruitment. Greater activity in the anterior insula on negatively-valenced, inhibitory trials predicted greater substance abuse one month and one year after the MRI scan among individuals high in negative urgency. These results suggest that, among people whose negative emotions often lead to self-control failure, excessive reactivity of the brain's regulatory resources may be the culprit.

Dysregulated negative emotional reactivity as a predictor of chronic peer victimization in childhood.

This study examined the relations of dysregulated negative emotional reactivity, emotional distress, and chronic peer victimization in childhood. A model was proposed whereby dysregulated reactivity was directly and indirectly related to concurrent peer victimization through victimization-related emotional distress. The model further proposed that dysregulated reactivity directly incrementally predicted longitudinal peer victimization above and beyond the effect of concurrent victimization. Two hundred thirteen 9- to 13-year-old children and their parents completed measures of dysregulated reactivity and victimization experiences at baseline and 6-month follow-up. Children also related narratives of personal victimization experiences at baseline that were coded to assess victimization-related emotional distress. Model testing strongly supported the direct association of dysregulated reactivity with concurrent victimization and incremental predictive effects of dysregulated reactivity on peer victimization over time. Model testing also provided support for an indirect effect of dysregulated reactivity on concurrent peer victimization through victimization-related emotional distress. This study demonstrated the powerful role that dysregulated negative emotional reactivity plays in the development of chronic peer victimization over time.

The effect of impulsivity and drinking motives on alcohol outcomes in college students: a 3-year longitudinal analysis.

Objective: Substance use is a public health concern and cross-sectional studies have found that impulsivity and drinking motives influence substance use in emerging adults. Despite these findings, longitudinal studies with nuanced measures of impulsivity and drinking motives are needed. Participants: The current study investigated the three-year relationship between impulsivity-related traits, drinking motives, sex, and drinking outcomes in a sample of 509 college students (47.47% male; 81% White). Methods: The effects of impulsivity traits and drinking motives on problematic drinking outcomes were evaluated using linear mixed effects models. Results: The results confirmed the hypothesized relationship between traits of impulsivity, drinking motives, and alcohol outcomes over time. Further, sex significantly interacted with drinking motives longitudinally in its relationship with alcohol use outcomes. Conclusions: These results indicate that intervention efforts may need to be tailored to specific individual attributes to target direct correlates of alcohol use behavior to increase effectiveness.

Examining the stress response and recovery among children with migraine.

OBJECTIVE: This study compared physiological differences between children diagnosed with migraine and their healthy peers. METHOD: Physiological measures were obtained at baseline, after discussing an emotional stressor, and after a 5-min recovery period in 21 children with pediatric migraine and 32 healthy peers. Comparisons were also made on psychological measures investigating anxiety. RESULTS: Children with migraine exhibited a significantly higher pulse rate compared to comparison children at rest, and higher diastolic blood pressure and higher low-frequency/high-frequency ratio after a 5-min recovery from an emotional stressor. Additionally, when anxiety was entered as a covariate, group differences after the 5-min recovery period were no longer significant. CONCLUSIONS: Results suggest that relative to comparison children, children with migraine exhibit some physiological elevation at rest, as well as a prolonged physiological recovery period after an emotional stressor. Group differences after the 5-min recovery period suggest that children with migraine experience delayed sympathetic hyperarousal and prolonged sympathovagal imbalance. The treatment implications of these findings are discussed.

Developmental changes in attention and comprehension among children with attention deficit hyperactivity disorder.

Changes in visual attention and story comprehension for children (N = 132) with attention deficit hyperactivity disorder (ADHD) and comparison peers were examined. Between the ages of 7 and 9 (Phase 1) and approximately 21 months later (Phase 2), children viewed 2 televised stories: 1 in the presence of toys and 1 in their absence. Both groups of children showed developmental increases in visual attention and stable group differences over time. Deficits in comprehension among children with ADHD, however, increased over time. Whereas comparison children's recall of factual and causal information increased over time in both viewing conditions, children with ADHD showed no developmental improvement in recall of factual information in the toys-present condition and no improvement in recall of causal relations in either viewing condition.

Inhibitory deficits in children with attention-deficit/hyperactivity disorder: intentional versus automatic mechanisms of attention.

Application of theoretically based tasks to the study of the development of selective attention has led to intriguing new findings concerning the role of inhibitory mechanisms. This study examined inhibitory mechanisms using a countermanding task and an inhibition of return task to compare deficits in intentionally, versus reflexively, controlled inhibition of attention in children with attention deficit hyperactivity disorder. Fifty children with attention-deficit/hyperactivity disorder (ADHD) were classified into one of three subtypes: predominantly inattentive (ADHD/PI), combined (ADHD/C), and those children with ADHD/C who also met criteria for comorbid oppositional defiant disorder (ADHD/C + ODD). The groups were compared to a comparison group of children (n = 21). The countermanding task showed that the ADHD groups required more time to inhibit responses and this impairment did not differ among subtypes. With respect to reflexively controlled inhibition, compared with controls ADHD/C and ADHD/C + ODD groups showed impaired reflexive inhibition, whereas the ADHD/PI group was considerably less impaired. The findings highlight a dissociation between the two forms of inhibitory deficits among children with the inattentive subtype, and raise the possibility that the efficient operation of reflexive inhibitory mechanisms might be necessary for the development of effective intentional control of inhibition.

Increased sensitivity to the disinhibiting effects of alcohol in adults with ADHD.

The acute impairing effects of alcohol on inhibitory control have been well documented in healthy drinkers. By contrast, little is known about alcohol effects in individuals with disorders characterized by poor impulse control, such as those with attention-deficit/hyperactivity disorder (ADHD). Alcohol could produce greater inhibitory impairment in these individuals. The present study tested this hypothesis in adults with ADHD (n=10) and controls (n=12) using the cued go/no-go task. The task requires quick responses to go targets and suppression of responses to no-go targets following the presentation of cues. Prior research on healthy adults has shown that valid cues can protect against alcohol impairment (Marczinski & Fillmore, 2003). Performance was tested under 3 doses of alcohol: 0.65 g/kg, 0.45 g/kg, and 0.0 g/kg (placebo). Alcohol dose-dependently increased inhibitory failures in controls in the invalid, but not the valid, cue condition. By contrast, those with ADHD displayed significant alcohol impairment regardless of cue condition. Thus, unlike controls, valid cues offered little protection from the disinhibiting effects of alcohol in drinkers with ADHD, suggesting an increased sensitivity to alcohol impairment of inhibitory control.

Parent--child joint picture-book reading among children with ADHD.

OBJECTIVE: Children with AD/HD exhibit two disparate areas of difficulty: disrupted interactions with parents and significant problems in story comprehension. This study links these two difficulties by examining parent-child joint picture-book reading to determine whether there were diagnostic group differences in parent and child storytelling. METHOD: Parents of 25 children with ADHD and 39 comparison children (mean age = 7.5 years) told their children a story based on a wordless picture-book, and children then retold the story to an examiner from memory. RESULTS: Parents in both groups told stories of similar length and complexity and demonstrated similar affective and responsive quality. The length of the child's retell of the parent's story did not differ across groups but children with ADHD included fewer goal-based events. CONCLUSIONS: RESULTS are discussed in terms of implications for enhancing the quality and frequency of parent-child storytelling among children with ADHD.

Simulated driving performance of adults with ADHD: comparisons with alcohol intoxication.

Previous research has demonstrated that adults with attention deficit/hyperactivity disorder (ADHD) are more likely to experience driving-related problems, which suggests that they may exhibit poorer driving performance. However, direct experimental evidence of this hypothesis is limited. The current study involved 2 experiments that evaluated driving performance in adults with ADHD in terms of the types of driving decrements typically associated with alcohol intoxication. Experiment 1 compared the simulated driving performance of 15 adults with ADHD to 23 adult control participants, who performed the task both while sober and intoxicated. Results showed that sober adults with ADHD exhibited decrements in driving performance compared to sober controls, and that the profile of impairment for the sober ADHD group did in fact resemble that of intoxicated drivers at the blood alcohol concentration level for legally impaired driving in the United States. Driving impairment of the intoxicated individuals was characterized by greater deviation of lane position, faster and more abrupt steering maneuvers, and increased speed variability. Experiment 2 was a dose-challenge study in which 8 adults with ADHD and 8 controls performed the driving simulation task under 3 doses of alcohol: 0.65g/kg, 0.45g/kg, and 0.0g/kg (placebo). Results showed that driving performance in both groups was impaired in response to alcohol, and that individuals with ADHD exhibited generally poorer driving performance than did controls across all dose conditions. Together the findings provide compelling evidence to suggest that the cognitive and behavioral deficits associated with ADHD might impair driving performance in such a manner as to resemble that of an alcohol intoxicated driver. Moreover, alcohol might impair the performance of drivers with ADHD in an additive fashion that could considerably compromise their driving skill even at blood alcohol concentrations below the legal limit.

Response style differences in the inattentive and combined subtypes of attention-deficit/hyperactivity disorder.

This study examined potential differences between the inattentive and combined ADHD subtypes using laboratory tasks assessing behavioral inhibitory processes. Seventy-five children completed two tasks of behavioral inhibition believed to isolate different processes: the cued reaction time task (CRT), a basic inhibition task, and the go/no-go task (GNG), a complex inhibition task that incorporates motivational contingencies. Three groups of participants were identified, including ADHD/Inattentive (n = 17), ADHD/Combined (n = 37), and comparison (n = 21). Results indicated that rather than showing behavioral inhibition deficits, the ADHD/I children appeared overly inhibited, as evidenced by slower reaction times across the two tasks and significantly higher errors of omission in the GNG task. Additionally, the ADHD/I children did not demonstrate cue dependency effects on the CRT task, suggesting that they were failing to incorporate relevant information before making a response. The sluggish and inhibited performance of the ADHD/I group challenges the idea that it is a subtype of ADHD.

Heavy, Problematic College Drinking Predicts Increases in Impulsivity.

OBJECTIVE: Impulsigenic personality traits are among the many factors demonstrated to predict drinking behavior among late adolescents. The current study tested the opposite possibility, that during the emerging adulthood developmental period, problematic drinking behavior predicts increases in impulsigenic traits. This possibility is important because such traits increase risk for multiple forms of dysfunction. METHOD: Using a prospective design, we studied the personality traits and drinking behavior of 458 traditional college freshmen over one year. RESULTS: We found that drinking problems predicted increases in urgency (the tendency to act rashly when highly emotional), lack of planning (the tendency to act without forethought), and lack of perseverance (difficulty maintaining focus on a task). CONCLUSIONS: Maladaptive personality change may be one mechanism that increases risk transdiagnostically for some individuals who drink problematically during college. Increases in impulsigenic traits predictable from problem drinking put individuals at risk for not only more drinking, but a host of other negative outcomes.

Neural mechanisms of the rejection-aggression link.

Social rejection is a painful event that often increases aggression. However, the neural mechanisms of this rejection-aggression link remain unclear. A potential clue may be that rejected people often recruit the ventrolateral prefrontal cortex's (VLPFC) self-regulatory processes to manage the pain of rejection. Using functional MRI, we replicated previous links between rejection and activity in the brain's mentalizing network, social pain network and VLPFC. VLPFC recruitment during rejection was associated with greater activity in the brain's reward network (i.e. the ventral striatum) when individuals were given an opportunity to retaliate. This retaliation-related striatal response was associated with greater levels of retaliatory aggression. Dispositionally aggressive individuals exhibited less functional connectivity between the ventral striatum and the right VLPFC during aggression. This connectivity exerted a suppressing effect on dispositionally aggressive individuals' greater aggressive responses to rejection. These results help explain how the pain of rejection and reward of revenge motivate rejected people to behave aggressively.

The effects of thematic importance on story recall among children with attention deficit hyperactivity disorder and comparison children.

This study examined the recall of televised stories for younger (4-6 years) and older (7-9 years) children with and without attention deficit hyperactivity disorder (ADHD) under two different viewing conditions (toys present/toys absent). Each child watched two Rugrats television programs, once with toys present and once with toys absent. Immediately after viewing a program, the child completed a free recall of the observed story. Comparison children's recall increased more than ADHD children's as importance level increased, and comparison children recalled more information overall than children with ADHD. When toys were present, children with ADHD retold less coherent stories than comparison children, as indexed by smaller correlations between the story units recalled and the order of these units in the story. In summary, children with ADHD demonstrated multiple difficulties in story comprehension. These findings add to our understanding of the differences in higher-order cognitive processing abilities between children with ADHD and comparison children, and suggest important areas of focus in designing more effective academic interventions for children with ADHD.

Social rejection magnifies impulsive behavior among individuals with greater negative urgency: An experimental test of urgency theory.

Impulsivity is a multifaceted trait with substantial implications for human well-being. One facet of impulsivity is negative urgency, the tendency to act impulsively in response to negative affect. Correlational evidence suggests that negative affect magnifies impulsive behavior among individuals with greater negative urgency, yet causal evidence for this core pillar of urgency theory is lacking. To fill this gap in the literature, participants (N = 363) were randomly assigned to experience social rejection (a situation shown to induce negative affect) or acceptance. Participants then reported their subjective negative affect, completed a behavioral measure of impulsivity, and reported their negative urgency. Among individuals with relatively high and average negative urgency, social rejection increased their impulsive behavior through greater experiences of negative affect. These indirect effects were not observed among individuals relatively low in negative urgency. These findings suggest that negative urgency exists at the nexus of urgent dispositions and situations that elicit negative affect, which offers novel support for urgency theory. (PsycINFO Database Record

Physical aggressiveness and gray matter deficits in ventromedial prefrontal cortex.

What causes individuals to hurt others? Since the famous case of Phineas Gage, lesions of the ventromedial prefrontal cortex (VMPFC) have been reliably linked to physically aggressive behavior. However, it is unclear whether naturally-occurring deficits in VMPFC, among normal individuals, might have widespread consequences for aggression. Using voxel based morphometry, we regressed gray matter density from the brains of 138 normal female and male adults onto their dispositional levels of physical aggression, verbal aggression, and sex, simultaneously. Physical, but not verbal, aggression was associated with reduced gray matter volume in the VMPFC and to a lesser extent, frontopolar cortex. Participants with less gray matter density in this VMPFC cluster were much more likely to engage in real-world violence. These findings suggest that even granular deficits in normal individuals' VMPFC gray matter can promote physical aggression.

Cross-lagged relations between motives and substance use: Can use strengthen your motivation over time?

Motives for substance use have garnered considerable attention due to the strong predictive utility of this construct, both in terms of use and problems associated with use. The current study examined the cross-lagged relations between alcohol use and motives, and marijuana use and motives over three yearly assessment periods in a large sample (N=526, 48% male) of college students. The relations between substance use and motives were assessed at each time point, allowing for the examination of these inter-relations over time. Results indicated different trends based on the type of substance. For alcohol use, cross-lagged trends were found between freshman and sophomore year for coping, social, and conformity motives with cross-lagged relations between enhancement motives and alcohol use across all years. However, outside of enhancement motives, cross-lagged relations were not found between sophomore and junior year. In contrast, cross-lagged effects were found for marijuana use and coping, enhancement, and expansion motives between sophomore and junior year, but not freshman year. These results suggest that people's expectations that drinking or smoking marijuana makes activities more reinforcing and helps them cope with distress may perpetuate use. In turn, use itself may enhance these expectations over time. Results have direct implications for treatment, with recommended focus on motives, behavior activation, and healthy coping skills in order to interrupt the cycle of substance use.