From Behavior to Cognition to the Brain and Back: What Have We Learned From Functional Imaging Studies of Attention Deficit Hyperactivity Disorder?

摘要

Theoretical accounts of the core symptoms and cognitive problems in attention deficit hyperactivity disorder (ADHD) nearly all address aspects of self-regulation in some form (1). Self-regulation-or cognitive control, in contemporary terms-is characterized as the ability to suppress inappropriate actions in favor of appropriate ones. This issue of The American Journal of Psychiatry includes three articles that report unique patterns of brain activity in ADHD using functional magnetic resonance imaging and versions of cognitive control tasks across dif- ferent ages. Examples of cognitive control in these studies are shown in instances where overriding an action to an expected target in favor of an unexpected nontarget in an oddball or goo-go paradigm occurs-reported in this issue of the Journal by Smith and colleagues and Pliszka and colleagues-or when switching attention from one salient stimulus attribute (color) to another (shape) occurs-reported in this issue of the Journal by Tamm and colleagues.These studies underscore the importance of tracking developmental changes in cognitive processes implicated in ADHD, acknowledging individual differences in ADHD, and moving away from empirical studies to more theoretical and testable models of the disorder.