Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial

IntroductionApproximately 48–54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targ...

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Main Authors: Nicole B. Groves, Elizabeth S. M. Chan, Carolyn L. Marsh, Fatou Gaye, Emma M. Jaisle, Michael J. Kofler
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-12-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1034722/full
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author Nicole B. Groves
Elizabeth S. M. Chan
Carolyn L. Marsh
Fatou Gaye
Emma M. Jaisle
Michael J. Kofler
author_facet Nicole B. Groves
Elizabeth S. M. Chan
Carolyn L. Marsh
Fatou Gaye
Emma M. Jaisle
Michael J. Kofler
author_sort Nicole B. Groves
collection DOAJ
description IntroductionApproximately 48–54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation.MethodsThis preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8–13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls).ResultsResults of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1–2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2–4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings.DiscussionTo determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT03324464].
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spelling doaj.art-d7f12f5cd1024a7594edb1e8a4f2d8ad2022-12-22T03:47:45ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402022-12-011310.3389/fpsyt.2022.10347221034722Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trialNicole B. Groves0Elizabeth S. M. Chan1Carolyn L. Marsh2Fatou Gaye3Emma M. Jaisle4Michael J. Kofler5Department of Psychology, Florida State University, Tallahassee, FL, United StatesDepartment of Psychology, Florida State University, Tallahassee, FL, United StatesDepartment of Psychology, Florida State University, Tallahassee, FL, United StatesDepartment of Psychology, Florida State University, Tallahassee, FL, United StatesDepartment of Psychology, Florida International University, Miami, FL, United StatesDepartment of Psychology, Florida State University, Tallahassee, FL, United StatesIntroductionApproximately 48–54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation.MethodsThis preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8–13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls).ResultsResults of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1–2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2–4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings.DiscussionTo determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT03324464].https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1034722/fullattention-deficit/hyperactivity disorder (ADHD)emotion regulationworking memoryinhibitory controlexecutive function
spellingShingle Nicole B. Groves
Elizabeth S. M. Chan
Carolyn L. Marsh
Fatou Gaye
Emma M. Jaisle
Michael J. Kofler
Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
Frontiers in Psychiatry
attention-deficit/hyperactivity disorder (ADHD)
emotion regulation
working memory
inhibitory control
executive function
title Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
title_full Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
title_fullStr Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
title_full_unstemmed Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
title_short Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial
title_sort does central executive training and or inhibitory control training improve emotion regulation for children with attention deficit hyperactivity disorder a randomized controlled trial
topic attention-deficit/hyperactivity disorder (ADHD)
emotion regulation
working memory
inhibitory control
executive function
url https://www.frontiersin.org/articles/10.3389/fpsyt.2022.1034722/full
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