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Reaction time performance in ADHD: improvement under fast-incentive condition and familial effects


Reaction time (RT) variability is one of the strongest findings to emerge in cognitive-experimental research of attention deficit hyperactivity disorder (ADHD). We set out to confirm the association between ADHD and slow and variable RTs and investigate the degree to which RT performance improves under fast event rate and incentives. Using a group familial correlation approach, we tested the hypothesis that there are shared familial effects on RT performance and ADHD.


A total of 144 ADHD combined-type probands, 125 siblings of the ADHD probands and 60 control participants, ages 6–18, performed a four-choice RT task with baseline and fast-incentive conditions.


ADHD was associated with slow and variable RTs, and with greater improvement in speed and RT variability from baseline to fast-incentive condition. RT performance showed shared familial influences with ADHD. Under the assumption that the familial effects represent genetic influences, the proportion of the phenotypic correlation due to shared familial influences was estimated as 60–70%.


The data are inconsistent with models that consider RT variability as reflecting a stable cognitive deficit in ADHD, but instead emphasize the extent to which energetic or motivational factors can have a greater effect on RT performance in ADHD. The findings support the role of RT variability as an endophenotype mediating the link between genes and ADHD.

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*Address for correspondence: J. Kuntsi, Ph.D., MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, De Crespigny Park (Box P080), London SE5 8AF, UK. (Email:
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T. Banaschewski , D. Brandeis , H. Heinrich , B. Albrecht , E. Brunner & A. Rothenberger (2003). Association of ADHD and conduct disorder – brain electrical evidence for the existence of a distinct subtype. Journal of Child Psychology and Psychiatry and Allied Disciplines 44, 356376.

M. A. Bellgrove , Z. Hawi , A. Kirley , M. Fitzgerald , M. Gill & I. H. Robertson (2005 a). Association between dopamine transporter (DAT1) genotype, left-sided inattention, and an enhanced response to methylphenidate in attention-deficit hyperactivity disorder. Neuropsychopharmacology 30, 22902297.

M. A. Bellgrove , Z. Hawi , A. Kirley , M. Gill & I. H. Robertson (2005 b). Dissecting the attention deficit hyperactivity disorder (ADHD) phenotype: sustained attention, response variability and spatial attentional asymmetries in relation to dopamine transporter (DAT1) genotype. Neuropsychologia 43, 18471857.

O. G. Berwid , E. A. Curko Kera , D. J. Marks , A. Santra , H. A. Bender & J. M. Halperin (2005). Sustained attention and response inhibition in young children at risk for Attention Deficit/Hyperactivity Disorder. Journal of Child Psychology and Psychiatry and Allied Disciplines 46, 12191229.

N. Borger & J. van der Meere (2000). Motor control and state regulation in children with ADHD: a cardiac response study. Biological Psychology 51, 247267.

K. Brookes , X. Xu , W. Chen , K. Zhou , B. Neale , N. Lowe , R. Anney , B. Franke , M. Gill , R. Ebstein , J. Buitelaar , P. Sham , D. Campbell , J. Knight , P. Andreou , M. Altink , R. Arnold , F. Boer , C. Buschgens , L. Butler , H. Christiansen , L. Feldman , K. Fleischman , E. Fliers , R. Howe-Forbes , A. Goldfarb , A. Heise , I. Gabriels , I. Korn-Lubetzki , L. Johansson , R. Marco , S. Medad , R. Minderaa , F. Mulas , U. Muller , A. Mulligan , K. Rabin , N. Rommelse , V. Sethna , J. Sorohan , H. Uebel , L. Psychogiou , A. Weeks , R. Barrett , I. Craig , T. Banaschewski , E. Sonuga-Barke , J. Eisenberg , J. Kuntsi , I. Manor , P. McGuffin , A. Miranda , R. D. Oades , R. Plomin , H. Roeyers , A. Rothenberger , J. Sergeant , H. C. Steinhausen , E. Taylor , M. Thompson , S. V. Faraone & P. Asherson (2006). The analysis of 51 genes in DSM-IV combined type attention deficit hyperactivity disorder: association signals in DRD4, DAT1 and 16 other genes. Molecular Psychiatry 11, 934953.

L. Burd , M. G. Klug , M. J. Coumbe & J. Kerbeshian (2003). Children and adolescents with attention deficit-hyperactivity disorder: 1. Prevalence and cost of care. Journal of Child Neurology 18, 555561.

F. X. Castellanos , E. J. Sonuga-Barke , A. Scheres , A. Di Martino , C. Hyde & J. R. Walters (2005). Varieties of attention-deficit/hyperactivity disorder-related intra-individual variability. Biological Psychiatry 57, 14161423.

F. X. Castellanos & R. Tannock (2002). Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes. Nature Reviews. Neuroscience 3, 617628.

J. C. DeFries & D. W. Fulker (1985). Multiple regression analysis of twin data. Behavior Genetics 15, 467473.

R. Drechsler , D. Brandeis , M. Foldenyi , K. Imhof & H. C. Steinhausen (2005). The course of neuropsychological functions in children with attention deficit hyperactivity disorder from late childhood to early adolescence. Journal of Child Psychology and Psychiatry and Allied Disciplines 46, 824836.

S. V. Faraone , J. Biederman , D. Mennin , R. Russell & M. T. Tsuang (1998). Familial subtypes of attention deficit hyperactivity disorder: a 4-year follow-up study of children from antisocial-ADHD families. Journal of Child Psychology and Psychiatry and Allied Disciplines 39, 10451053.

S. V. Faraone & A. E. Doyle (2000). Genetic influences on attention deficit hyperactivity disorder. Current Psychiatry Reports 2, 143146.

S. V. Faraone , M. C. Monuteaux , J. Biederman , S. L. Cohan & E. Mick (2003). Does parental ADHD bias maternal reports of ADHD symptoms in children? Journal of Consulting and Clinical Psychology 71, 168175.

S. V. Faraone , R. H. Perlis , A. E. Doyle , J. W. Smoller , J. J. Goralnick , M. A. Holmgren & P. Sklar (2005). Molecular genetics of attention-deficit/hyperactivity disorder. Biological Psychiatry 57, 13131323.

T. Ford , R. Goodman & H. Meltzer (2003). The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders. Journal of the American Academy of Child and Adolescent Psychiatry 42, 12031211.

L. S. Goldman , M. Genel , R. J. Bezman & P. J. Slanetz (1998). Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Journal of the American Medical Association 279, 11001107.

R. Goodman (1997). The Strengths and Difficulties Questionnaire: a research note. Journal of Child Psychology and Psychiatry and Allied Disciplines 38, 581586.

I. I. Gottesman & T. D. Gould (2003). The endophenotype concept in psychiatry: etymology and strategic intentions. American Journal of Psychiatry 160, 636645.

I. I. Gottesman & J. Shields (1973). Genetic theorizing and schizophrenia. British Journal of Psychiatry 122, 1530.

H. Heinrich , G. H. Moll , H. Dickhaus , V. Kolev , J. Yordanova & A. Rothenberger (2001). Time-on-task analysis using wavelet networks in an event-related potential study on attention-deficit hyperactivity disorder. Clinical Neurophysiology 112, 12801287.

C. Klein , K. Wendling , P. Huetter & M. Peper (2006). Intra-subject variability in attention-deficit hyperactivity disorder (ADHD). Biological Psychiatry 60, 10881097.

K. Konrad , S. Gauggel , A. Manz & M. Scholl (2000). Lack of inhibition: a motivational deficit in children with attention deficit/hyperactivity disorder and children with traumatic brain injury. Child Neuropsychology 6, 286296.

J. Kuntsi , P. Andreou , J. Ma , N. A. Borger & J. J. van der Meere (2005). Testing assumptions for endophenotype studies in ADHD: reliability and validity of tasks in a general population sample. BMC Psychiatry 5, 40.

J. Kuntsi , G. McLoughlin & P. Asherson (2006 a). Attention deficit hyperactivity disorder. Neuromolecular Medicine 8, 461484.

J. Kuntsi , J. Oosterlaan & J. Stevenson (2001). Psychological mechanisms in hyperactivity: I. Response inhibition deficit, working memory impairment, delay aversion, or something else? Journal of Child Psychology and Psychiatry and Allied Disciplines 42, 199210.

J. Kuntsi & J. Stevenson (2001). Psychological mechanisms in hyperactivity: II. The role of genetic factors. Journal of Child Psychology and Psychiatry and Allied Disciplines 42, 211219.

C. Leth-Steensen , Z. King Elbaz & V. I. Douglas (2000). Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach. Acta Psychologica 104, 167190.

D. Li , P. C. Sham , M. J. Owen & L. He (2006). Meta-analysis shows significant association between dopamine system genes and attention deficit hyperactivity disorder (ADHD). Human Molecular Genetics 15, 22762284.

S. K. Loo , E. Specter , A. Smolen , C. Hopfer , P. D. Teale & M. L. Reite (2003). Functional effects of the DAT1 polymorphism on EEG measures in ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 42, 986993.

D. J. Mason , G. W. Humphreys & L. Kent (2005). Insights into the control of attentional set in ADHD using the attentional blink paradigm. Journal of Child Psychology and Psychiatry and Allied Disciplines 46, 13451353.

D. J. Mason , G. W. Humphreys & L. S. Kent (2003). Exploring selective attention in ADHD: visual search through space and time. Journal of Child Psychology and Psychiatry and Allied Disciplines 44, 11581176.

J. T. Nigg (2005). Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Biological Psychiatry 57, 14241435.

J. T. Nigg , L. G. Blaskey , J. A. Stawicki & J. Sachek (2004). Evaluating the endophenotype model of ADHD neuropsychological deficit: results for parents and siblings of children with ADHD combined and inattentive subtypes. Journal of Abnormal Psychology 113, 614625.

J. Oosterlaan & J. A. Sergeant (1998). Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children. Behavioural Brain Research 94, 3343.

A. Scheres , J. Oosterlaan & J. A. Sergeant (2001). Response execution and inhibition in children with AD/HD and other disruptive disorders: the role of behavioural activation. Journal of Child Psychology and Psychiatry and Allied Disciplines 42, 347357.

J. Sergeant (2000). The cognitive-energetic model: an empirical approach to attention-deficit hyperactivity disorder. Neuroscience and Biobehavioral Reviews 24, 712.

J. A. Sergeant , H. Geurts , S. Huijbregts , A. Scheres & J. Oosterlaan (2003). The top and the bottom of ADHD: a neuropsychological perspective. Neuroscience and Biobehavioral Reviews 27, 583592.

M. Slusarek , S. Velling , D. Bunk & C. Eggers (2001). Motivational effects on inhibitory control in children with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry 40, 355363.

E. Taylor , B. Everitt , G. Thorley , R. Schachar , M. Rutter & M. Wieselberg (1986 a). Conduct disorder and hyperactivity: II. A cluster analytic approach to the identification of a behavioural syndrome. British Journal of Psychiatry 149, 768777.

E. Taylor , R. Schachar , G. Thorley & M. Wieselberg (1986 b). Conduct disorder and hyperactivity: I. Separation of hyperactivity and antisocial conduct in British child psychiatric patients. British Journal of Psychiatry 149, 760767.

A. Thapar , J. Holmes , K. Poulton & R. Harrington (1999). Genetic basis of attention deficit and hyperactivity. British Journal of Psychiatry 174, 105111.

R. Wiersema , J. van der Meere , H. Roeyers , R. Van Coster & D. Bayens (2006). Event rate and event-related potentials in ADHD. Journal of Child Psychology and Psychiatry and Allied Disciplines 47, 560567.

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