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Hyperactivity in Boys with Attention-Deficit/Hyperactivity Disorder (ADHD): A Ubiquitous Core Symptom or Manifestation of Working Memory Deficits?

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Abstract

Hyperactivity is currently considered a core and ubiquitous feature of attention-deficit/hyperactivity disorder (ADHD); however, an alternative model challenges this premise and hypothesizes a functional relationship between working memory (WM) and activity level. The current study investigated whether children’s activity level is functionally related to WM demands associated with the domain-general central executive and subsidiary storage/rehearsal components using tasks based on Baddeley’s (Working memory, thought, and action. New York: Oxford University Press 2007) WM model. Activity level was objectively measured 16 times per second using wrist- and ankle-worn actigraphs while 23 boys between 8 and 12 years of age completed control tasks and visuospatial/phonological WM tasks of increasing memory demands. All children exhibited significantly higher activity rates under all WM relative to control conditions, and children with ADHD (n = 12) moved significantly more than typically developing children (n = 11) under all conditions. Activity level in all children was associated with central executive but not storage/rehearsal functioning, and higher activity rates exhibited by children with ADHD under control conditions were fully attenuated by removing variance directly related to central executive processes.

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Notes

  1. Prefrontal cortical hypo-activation refers to deficient task-related changes in arousal.

  2. Children with ADHD were previously shown to exhibit significant WM deficits relative to typically developing children in CE and both working memory subsystems using these paradigms (Rapport et al. 2008a).

  3. Successful interaction with the Paint program requires central executive processes such as focused attention and interaction with long-term memory, as well as limited phonological and visuospatial storage/rehearsal processes.

  4. Site placement contrasts for each task revealed that non-dominant hand movement was greater than left and right foot movement across most conditions (i.e., NH > LF = RF). The pattern of results across conditions for the three actigraph recording sites, however, did not differ significantly from those reported for TES in the Results.

  5. The relationship between phonological storage/rehearsal functioning and activity level at set size 5 (R 2 = 0.21) was significant at p = 0.03.

  6. Phonological and visuospatial storage/rehearsal composite scores were also used in the analysis initially but did not share significant variance with C1 and C2 activity level.

  7. Tsujii et al. 2007 found these differences only during the afternoon hours.

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  1. Department of Psychology, University of Central Florida, Orlando, FL, USA

    Mark D. Rapport, Jennifer Bolden, Michael J. Kofler, Dustin E. Sarver & Joseph S. Raiker

  2. Department of Psychology, Oklahoma State University, Stillwater, OK, USA

    R. Matt Alderson

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  1. Mark D. Rapport
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Rapport, M.D., Bolden, J., Kofler, M.J. et al. Hyperactivity in Boys with Attention-Deficit/Hyperactivity Disorder (ADHD): A Ubiquitous Core Symptom or Manifestation of Working Memory Deficits?. J Abnorm Child Psychol 37, 521–534 (2009). https://doi.org/10.1007/s10802-008-9287-8

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