ebook_ADHD2019_engl.

24 Rohde, Buitelaar, Gerlach & Faraone by suppressing or altering intended actions that are no longer required or appro- priate. Adequate response inhibition thus enables people to properly adapt to changes in the environment. 42 Impaired response inhibition is central to theoreti- cal models of ADHD. 43 Barkley 37 and others have argued for response inhibition as a central deficit of ADHD in that it affects top-down multiple executive func- tions, including working memory, self-regulation, internalization of speech and reconstitution. On average individuals with ADHD inhibit their responses more slowly than controls, as reflected in longer stop-signal reaction times and higher error rates. A meta-analysis reported a medium effect-size of 0.62 for the case- -control difference in stop-signal reaction time. 44 In addition, a large community study showed that ADHD symptoms in children and adolescents are associated with worse response inhibition and slower response latency. 45 Response inhibition deficits in ADHD are also observed at the level of the brain. When brain activation is assessed during the administation of response inhi- bition tasks in the MRI scanner (in socalled functional MRI or fMRI studies), Box 2.1 REVIEW OF EXECUTIVE FUNCTION AND REWARD PROCESSING DEFICITS IN ADHA Key single deficit theories y y Attention deficit 35 y y Non-optimal energetic state, in particular activation 36 y y Behavioral inhibition 37 y y Delay-aversion 38 Dual pathway theories Executive functioning deficit (“cold cognition”) and reward processing deficit (“hot cognition”) 39 Triple pathway theories Executive functioning deficit, reward processing deficit, timing deficit 40 Link in this https://www.youtube.com/ watch?v=sPFmKu2S5XY