Assessing Frustration Tolerance in Children with Attention-Deficit/Hyperactivity Disorder: Use of Two Novel Behavioral Paradigms

• In Event: 1-205 - Advances in Neurobiological Conceptualizations of Pediatric Irritability

Integrative Statement

Irritability is a common and problematic form of emotion dysregulation in children with Attention-Deficit/Hyperactivity Disorder (ADHD). Irritability is a “mood state characterized by a low threshold for frustration” where frustration is “an affective response to blocked goal attainment”, and is probed using frustrating behavioral paradigms.
There has been limited empirical research examining the clinical, behavioral and physiological correlates of frustration tolerance in children with ADHD. Therefore, this talk will present data from two novel behavioral paradigms assessing frustration in children with ADHD: the Frustration Go/NoGo (Frustration GNG) and the Mirror Tracing Persistence Task (MTPT).
Participants, ages 8-12 years, for the Frustration GNG included: 38 TDCs, 30 children with ADHD and 31 children with ADHD plus comorbid ODD, anxiety or depression (i.e., Comorbid). The Frustration GNG is a classic Go/No-Go paradigm with performance-based incentives delivered across three blocks; however, it includes a “frustrative” second block involving 50% “rigged” Go trials. The primary dependent variable is commission error rate, and frustration is assessed via self-report of affect at four points during the task (baseline and after each block).
Participants, ages 8-12 years, for the MTPT included: 55 TDCs, 37 ADHD, and 32 Comorbid children. In the MTPT, participants trace the outline of 3 stars (Easy, Hard, Very Hard) using the computer mouse. To elicit frustration, all the controls on the mouse are reversed. If the participant stops for more than 2 seconds or goes outside the shape, a buzzer sounds and the cursor is reset to the beginning. Participants can quit the Very Hard Star anytime but are told that their prize depends on task performance. The primary dependent variable is latency to quit on the Very Hard Star, and self-reported frustration is measured at baseline, pre-Very Hard Star and post-Very Hard Star.
For the Frustration GNG, across the sample, results revealed an increase in self-reported frustration, t(99)=-10.90, p<.001, from baseline to the end of block 2, and an increase in commission error rate, t(99)=-3.03, p=.003, from block 1 to block 2. Further, child self-reported irritability was associated with change in frustration from baseline to block 2 (r=.272, p=.008). A 3Group x 2Sex x 3Block repeated measures ANCOVA with age as a covariate showed a significant Group x Sex x Block interaction for commission error rate, F(4,184)=2.51, p=.043. Post-hoc tests indicated that ADHD girls showed the greatest increase in commission error rate with frustration (p=.002, d=1.12), followed by TDC boys (p=.02, d=.47) and Comorbid boys (p=.05, d=.43). In the frustration block, the ADHD girls showed the highest commission error rate (28%).
For the MTPT, across the sample, results showed an increase in frustration from baseline to post-Very Hard Star, t(123)=-11.98,p≤.001, but there were no group differences in change in frustration. Covarying for age, there was a main effect of Group, F(2,120)=7.58,p=.001, on latency to quit such that ADHD (p=.002) and Comorbid (p=.025) participants had a shorter latency to quit than TDCs. Across the sample, child-reported irritability was positively associated with change in frustration (r=.232,p=.010) and negatively associated with latency to quit (r=-.242,p=.007).

Authors

• Karen E. Seymour, Kennedy Krieger Institute
  Presenting Author

• Keri Shiels Rosch, Kennedy Krieger Institute, Johns Hopkins University
  Non-Presenting Author

• Da-Yea Song, Kennedy Krieger Institute
  Non-Presenting Author

• Stewart H Mostofsky, Kennedy Krieger Institute
  Non-Presenting Author