The correlation between distractor-incorporated continuous performance test and neuropsychological test battery results of children with attention-deficit/hyperactivity disorder

Abstract

Objectives: To investigate the correlation between distractor-incorporated Continuous Performance Test (d-CPT) and Neuropsychological Test Battery (NPT) results of children diagnosed with ADHD. Methods: Study sample consisted of 29 children (mean age 9.17) with a new diagnosis of ADHD according to DSM-5 criteria, recruited from consecutive referrals to two specialty clinics between January to September 2015. Comorbid diagnoses included 17 percent ODD, 7 percent DMDD, 7 percent anxiety disorders. Eighty-three percent of the sample were recently started on methylphenidate (MPH), 10 percent on atomoxetine, 4 percent on SSRIs. MPH was washed out 24 hours prior to testing. Our NPT battery covered a broad spectrum of cognitive functions including Digit Span Learning (DSL), Benton Judgment of Line Orientation (JLO), Complex Figure Test (CFT), Letter and Symbol Cancellation Test (LCT, SCT), Stroop Color Word Test, Trail Making Test (TMT) and Wisconsin Card Sorting Test (WCST). d-CPT test included Attention (omission errors), impulsivity (commission errors), reaction time and hyperactivity (inappropriate response to target stimuli) indices. Spearman’s Correlation was used for statistical analysis. Results: Significant correlations were found for Attentional index with DSL (r = .662, p ≤.001), JLOB (r = .649, p ≤.001), CFT (r = .467, p ≤.05), LCT (r = .039, p ≤.05), SCT (r = .031, p ≤.05), Stoop (r = .046, p ≤.05) and WCST (r = .482, p ≤.05). The correlations were also significant when visual distractors were introduced but were lost with auditory distractors. Impulsivity index was not correlated with any of the NPT batteries. Hyperactivity index was found to be highly correlated with DSL (r =.571, p ≤.05), JLOB (r =.549, p ≤.05), CFT (r = .716, p ≤.001), LCT (r = .769, p ≤.001), (r = .769, p ≤.001), Stoop test (r = .508, p ≤.05), and WCST (r = .535, p ≤.05) and significant correlations were also observed when auditory, visual and combined distractors were introduced. Conclusions: Attention and Hyperactivity indices of d-CPT is found be correlated with other NPTs. Visual distractors enhance correlation significance more than auditory ones. Impulsivity index fails to show correlations; thus caution needs to be exerted when reviewing the results. Hyperactivity index is found most efficient to predict neuropsychological profiles of children with ADHD.