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

  • Mark T. Fillmore (a1), Richard Milich (a1) and Elizabeth P. Lorch (a1)


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.


Corresponding author

Address correspondence and reprint requests to: Mark Fillmore, Department of Psychology, University of Kentucky, Lexington, KY 40506-0044; E-mail:


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Abroms, B. D., & Fillmore, M. T. (2004). Alcohol-induced impairment of inhibitory mechanisms involved in visual search. Experimental and Clinical Psychopharmacology, 12, 243250.
Abroms, B. D., Gottlob, L., & Fillmore, M. T. (2006). Alcohol effects on inhibitory control of attention: Distinguishing between intentional and automatic mechanisms. Psychopharmacology (Berlin), 188, 324334.
Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont, Department of Psychiatry.
Aksan, N., & Kochanska, G. (2004). Links between systems of inhibition from infancy to preschool years. Child Development, 75, 14771490.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 6594.
Barkley, R. A. (2001). The inattentive subtype of ADHD as a distinct disorder. What remains to be done? Clinical Psychology: Science and Practice, 8, 489493.
Barkley, R. (2006). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York: Guilford Press.
Briand, K. A., Larrison, A. L., & Sereno, A. B. (2000). Inhibition of return in manual and saccadic response systems. Perception and Psychophysics, 62, 15121524.
Castellanos, F. X, Giedd, J. N., Marsh, W. L., Hamburger, S. D., Vaituzis, A. C., Dickstein, D. P., et al. (1996). Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. Archives of General Psychiatry, 53, 607616.
Castellanos, F. X., & Tannock, R. (2002). Neuroscience of attention-deficit/hyperactivity disorder. Nature Reviews: Neuroscience, 3, 617628.
Clohessy, A. B., Posner, M. I., Rothbart, M. K., & Vecera, S. P. (1992). The development of inhibition of return in early infancy. Journal of Cognitive Neuroscience, 3, 345350.
Conners, C. K. (1990). Conners Rating Scales manual. New York: Multi-Health Systems.
Diamond, A. (2005). Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): A neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity). Development and Psychopathology, 17, 807825.
Durston, S., Thomas, K. M., Yang, Y., Ulug, A. M., Zimmerman, R. D., & Casey, B. J. (2002). A neural basis for the development of inhibitory control. Developmental Science, 5, F9F16.
Faust, M. E., & Balota, D. A. (1997). Inhibition of return and visuospatial attention in healthy older adults and individuals with dementia of the Alzheimer type. Neuropsychology, 11, 1329.
Fielding, J., Georgiou-Karistianis, N., Bradshaw, J., Millist, L., Churchyard, A. & White, O. (2006). Accelerated time-course of inhibition of return in Huntington's disease. Behavioural Brain Research, 166, 211219.
Fillmore, M. T., Rush, C. R., & Abroms, B. D. (2005). d-Amphetamine-induced enhancement of inhibitory mechanisms involved in visual search. Experimental and Clinical Psychopharmacology, 13, 200208.
Gouzoulis-Mayfrank, E., Arnold, S., & Heekeren, K. (2006). Deficient inhibition of return in schizophrenia—Further evidence from an independent sample. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30, 4249.
Hanisch, C., Radach, R., Holtkamp, K., Herpertz-Dahlmann, B., & Konrad, K. (2006). Oculomotor inhibition in children with and without attention-deficit hyperactivity disorder (ADHD). Journal of Neural Transmission, 113, 671684.
Huang-Pollock, C. L., Carr, T. H., & Nigg, J. T. (2002). Development of selective attention: Perceptual load influences early versus late attentional selection in children and adults. Developmental Psychopathology, 38, 363375.
Huang-Pollock, C. L., Nigg, J. T., & Carr, T. H. (2005). Deficient attention is hard to find: Applying the perceptual load model of selective attention to attention deficit hyperactivity disorder subtypes. Journal of Child Psychology and Psychiatry, 46, 12111218.
Klein, C. H., Raschke, A., & Brandenbusch, A. (2003). Development of pro- and antisaccades in children with attention-deficit hyperactivity disorder (ADHD) and healthy controls. Psychophysiology, 40, 1728.
Klein, R. M. (1988). Inhibitory tagging system facilitates visual search. Nature, 334, 430431.
Klein, R. M. (2000). Inhibition of return. Trends in Cognitive Science, 4, 138147.
Klein, R. M., & MacInnes, W. J. (1999). Inhibition of return is a foraging facilitator in a visual search. Psychological Science, 10, 346352.
Leth-Steensen, C., Elbaz, Z., & Douglas, V. I. (2000). Mean response times, variability and skew in the responding of ADHD children: A response time distributional approach. Acta Psychologica, 104, 167190.
Li, C. R., Chang, H., & Lin, S. (2003). Inhibition of return in children with attention hyperactivity disorder. Experimental Brain Research, 149, 125130.
Logan, G. D. (1994). On the ability to inhibit thought and action: A user's guide to the stop-signal paradigm. In Dagenbach, D. & Carr, T. H. (Eds.), Inhibitory processes in attention, memory, and language (pp. 189239). San Diego, CA: Academic Press.
Logan, G. D., & Cowan, W. B. (1984). On the ability to inhibit thought and action: A theory of an act of control. Psychological Review, 91, 295327.
Logan, G. D., & Irwin, D. E. (2000). Don't look! Don't touch! Inhibitory control of eye and hand movements. Psychonomic Bulletin and Review, 7, 107112.
Lorch, E. P., Berthiaume, K., Milich, R., & van den Broek, P. (2007). Story comprehension impairments in children with ADHD. In Cain, K. & Oakhill, J. (Eds.), Cognitive bases of children's language comprehension difficulties (pp. 128155). New York: Guilford Press.
Lorch, E. P., Sanchez, R., van den Broek, P., Milich, R., Murphy, E. L., Lorch, R., et al. (1999). The relation of story structure properties to recall of television stories in young children with attention deficit hyperactivity disorder and nonreferred peers. Journal of Abnormal Child Psychology, 27, 293309.
Luna, B., Garver, K. E., Urban, T. A., Lazar, N. A., & Sweeney, J. A. (2004). Maturation of cognitive processes from childhood to late adulthood. Child Development, 75, 13571372.
Lupianez, J., Milan, E. G., Tornay, F. J., Madrid, E., & Tudela, P. (1997). Does IOR occur in discrimination tasks? Yes, it does, but later. Perception and Psychophysics, 59, 12411254.
Lupianez, J., Milliken, B., Solano, C., Weaver, B., & Tipper, S. P. (2001). On the strategic modulation of the time course of facilitation and inhibition of return. Quarterly Journal of Experimental Psychology A: Human Experimental Psychology, 54A, 753773.
Lynam, D. R. (1996). The early identification of chronic offenders: Who is the fledgling psychopath? Psychological Bulletin, 120, 209234.
Marzi, C. A. (1999). Neuropsychology of attention. In Denes, G. & Luigi, P. (Eds.), Handbook of clinical and experimental neuropsychology (pp. 509524). Hove: Psychology Press/Erlbaum/Taylor & Francis.
Mayer, A. R., Seidenberg, M., Dorflinger, J. M., & Roa, S. M. (2004). An event-related fMRI study of exogenous orienting: Supporting evidence for the cortical basis of inhibition of return? Journal of Cognitive Neuroscience, 16, 12621271.
Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463488.
Miller, J., Schaffer, R., & Hackley, S. A. (1991). Effects of preliminary information in a go versus no-go task. Acta Psychologia, 76, 241292.
Nigg, J. T. (2006). What causes ADHD? Understanding what goes wrong and why. New York: Guilford Press.
O'Driscoll, G. A., Depatie, L., Holahan, A. V., Savion-Lemieux, T., Barr, R. G., Jolicoeur, , et al. (2005). Executive functions and methylphenidate response in subtypes of attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 14521460.
Oosterlaan, J., & Sergeant, J. A. (1996). Inhibition in ADHD, aggressive, and anxious children: a biologically based model of child psychopathology. Journal of Abnormal Child Psychology, 24, 1937.
Posner, M. I., & Cohen, Y. (1984). Components of visual orienting. In Houma, H. & Bouwhuis, D. G. (Eds.), Attention and performance X: Control of language processes (pp. 531556). Hillsdale, NJ: Erlbaum.
Posner, M. I., Rafal, R. D., Choate, L. S., & Vaughan, J. (1985). Inhibition of return: Neural basis and function. Cognitive Neuropsychology, 2, 211228.
Ro, T., Farne, A., & Chang, E. (2003). Inhibition of return and the human frontal eye fields. Experimental Brain Research, 150, 290296.
Rommelse, N. N. J., Deijen, J. B., Geldof, C. J. A., Witlox, J., Oosterlaan, J., & Sergeant, J. A. (2007). Oculomotor capture in ADHD. Cognitive Neuropsychology, 24, 535549.
Schachar, R. J., & Tannock, R. (1995). A test of four hypotheses for the comorbidity of attention deficit hyperactivity disorder and conduct disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 34, 639648.
Schachar, R., Tannock, R., Marriott, M., & Logan, G. (1995). Deficient inhibitory control in attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 23, 411437.
Schall, J. D. (2004). On the role of frontal eye field in guiding attention and saccades. Vision Research, 44, 14531467.
Schneider, W., Eschman, A., & Zuccolotto, A. (2002). E-Prime user's guide. Pittsburgh, PA: Psychology Software Tools.
Shimojo, S., Hikosaka, O., & Miyauchi, S. (1999). Automatic and controlled attention detected by the line motion effect. In Daniel, G. & Koriat, A. (Eds.), Attention and performance: Vol. 17. Cognitive regulation of performance: Interaction of theory and application (pp. 145163). Cambridge, MA: MIT Press.
Tannock, R. (1998). Attention deficit hyperactivity disorder: Advances in cognitive, neurobiological, and genetic research. Journal of Child Psychology and Psychiatry, 39, 6599.
Weller, E. B., Weller, R. A., Rooney, M. T., & Fristad, M. A. (1999). Children's interview for psychiatric syndromes. Washington, DC: American Psychiatric Association.
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