ARTICLES
Dichotic Listening and Response Inhibition in Children With Comorbid Anxiety Disorders and ADHD

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ABSTRACT

Objective

To compare children with comorbid anxiety disorders (ANX) and attention-deficit hyperactivity disorder (ADHD) with children with either pure disorder and normal controls on 2 cognitive measures to elucidate the cognitive basis of this comorbidity.

Method

Four groups of children aged 8 to 12 years (n = 64 total) were assessed: ANX, ADHD, both conditions (comorbid group), and neither condition (normal control group). Groups were compared on 2 cognitive measures: a measure of auditory emotional perception (dichotic listening task) and a measure of response inhibition (stop task), chosen for their relative specificity for ANX and ADHD, respectively, in previous studies.

Results

Multivariate analyses of variance revealed significant group differences on the dichotic listening task (p < .05), with the comorbid group differing from the control group on emotion targets (p < .01) and the ADHD group differing from the control group on word targets (p < .05). On the stop task, the ADHD group appeared slower than the other diagnostic groups on both go and stop-signal reaction times, but differences were not significant.

Conclusions

In this study, children with comorbid ANX and ADHD showed reduced auditory emotion recognition relative to controls but did not show response inhibition deficits. Thus they appeared cognitively distinct from children with either pure disorder.

Section snippets

Cognitive Features of ADHD

There is growing evidence that ADHD is associated with an impairment in inhibitory control (Barkley, 1994, Schachar and Logan, 1990, Schachar et al., 1993, Pennington and Ozonoff, 1996). Inhibitory control refers to the ability to quickly stop an ongoing action and thought in accordance with sudden changes in the immediate environment (Logan, 1985). It is one of the “executive” functions or higher-order cognitive processes that are involved in the planning and regulation of action and thought (

Subjects

Sixty-four children aged 8 to 12 years participated in the study: 15 meeting diagnostic criteria for at least one anxiety disorder (ANX), 15 meeting a diagnosis of ADHD, 18 with both disorders (ANX+ADHD), and 16 who were free of psychiatric or learning problems and constituted a normal control group. Clinical subjects were selected from children with either ADHD or ANX or both, diagnosed by semistructured interview in 2 specialty clinics in the outpatient department of psychiatry of an urban

Dichotic Listening Task

All data were analyzed using the Statistical Package for the Social Sciences (SPSS) software. Group means and standard deviations were determined for correct responses for each target word and each target emotion for each ear on the dichotic listening task (the words bower and tower and the emotions happy and sad). To account for variable rates of false alarms among groups, we then calculated a sensitivity index (MacMillan and Creelman, 1991). All subsequent analyses were done using the

DISCUSSION

Expected differences were found on the dichotic listening task for ear, task, target, and overall lateralization (i.e., words preferentially perceived in right ear; emotions in left ear), confirming that it is a valid instrument to use in this population.

Group differences on this task were clearly significant, but not identical with those reported previously. Anxious subjects' performance on the task did not differ significantly from that of normal controls, either on words or emotions, whereas

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    The authors gratefully acknowledge the financial support of the Ontario Mental Health Foundation.

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