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2009, Vol. 23, No. 2, 265–269
0894-4105/09/$12.00 DOI:10.1037/a0014553
BRIEF REPORT
Contraction of Time in Attention-Deficit Hyperactivity Disorder
David L. Gilden and Laura R. Marusich
The University of Texas at Austin
Attention-deficit hyperactivity disorder (ADHD) has been associated with anomalies in dopamine
systems. Recent advances in the understanding of the core cognitive deficits in ADHD suggest that
dopamine dysfunction might be expressed through shortened time scales in reward-based learning. Here
this perspective is extended by the conjecture that temporal span in working memory systems might
generally be shortened. As a test of this conjecture the authors focus on the implicit memory system
involved in rhythmic movement, assessing the minimum tempo at which rhythmic feeling can be
sustained in adults with diagnosed ADHD and in a control group of normal adults. The authors found that
people with ADHD do in fact have a rhythm cut-off that is faster in tempo than those without ADHD.
This finding is consistent with the idea that impaired dopamine dynamics have systemic consequences for
cognitive function, essentially recalibrating the clock that sets the time scale for the subjective experience
of temporal events.
Keywords: attention deficit, timing, dopamine, musical performance, l/f noise
Attention-deficit hyperactivity disorder (ADHD) is a syndrome
that impacts cognitive functions essential to the moment-to-mo-
ment apprehension of and response to the environment. An influ-
ential cognitive theory of ADHD identifies impairments in the
executive control of inhibition as being a principal deficit (Barkley,
1997). Inhibitory control is operationalized through tasks that
require the withholding of response: so-called Go/No-Go methods.
In one version of the methodology (Conners, 1995), the dependent
measures have been standardized to serve as a diagnostic tool. Yet
Go/No-Go methods generally fail to generate consistent group
differences based on ADHD diagnosis (Castellanos, Sonuga-
Barke, Milham, & Tannock, 2006; Edwards et al., 2007). Never-
theless, one prediction of the inhibitory control theory, that ADHD
would lead to deficits in temporal aspects of working memory
(Barkley, 1997), has led to a number of interesting findings re-
garding the perception of time and the planning of behavior, delay
aversion being most notable (Sonuga-Barke, Saxton, & Hall,
1998). The notion that time perception might be altered by ADHD
is supported by neuroimaging evidence of volumetric reductions
(Castellanos et al., 2002; Valera, Faraone, Murray, & Seidman,
2007) in areas known to control and regulate timing: prefrontal
cortex (Mangels, Ivry, & Shimizu, 1998; Smith, Taylor, Lidzba, &
Rubia, 2003) and cerebellum (Ivry & Spencer, 2004; Mangels et
al., 1998). Yet, direct psychophysical assessments of time percep-
tion have also failed to yield consistent group differences.
Timing behavior is generally assessed in ADHD populations
through explicit tests in which the participant must focus attention on
the passage of time per se. These tests are quite diverse and include
anticipating a future event scheduled some few seconds or minutes in
the future (Rubia, Taylor, & Taylor, 1999; Smith, Taylor, Rogers,
Newman, & Rubia, 2002; Sonuga-Barke et al., 1998), synchro-
nized tapping with an external signal (Rubia et al., 1999), discrim-
inating between two given durations (Rubia et al., 1999; Smith
et al., 2002; Toplak & Tannock, 2005), or generating a few
instances of a given interval (Barkley, Murphy, & Bush, 2001;
Kerns, McInerney, & Wilde, 2001; Smith et al., 2002). The results
of these studies have varied in terms of whether people with
ADHD showed timing biases toward shorter intervals, but ADHD
timing behavior consistently shows more variability than that of
controls. Such a result, however, provides little information about
timing mechanisms in ADHD because greater variability is uni-
versally found in ADHD cognitive assessment (Castellanos &
Tannock, 2002).
What is required here are implicit tests where timing behavior is
allowed to emerge as a byproduct of an activity that proceeds
without refined judgment and discrimination. There is an implicit
aspect of timing behavior that is universally experienced and
eminently suitable for psychophysical assessment: the feeling that
emerges when we experience rhythm. Such feelings are a prime
example of Gestalt; the whole (rhythm) is greater than the sum of
the parts (individual time intervals). When we feel rhythm the
experience is of the feeling; the actual intervals that create the
feeling recede into the background. In this sense the data of
interest, the intervals so marked, arise implicitly. We refer to this
foreground/background distinction when we inquire if a person is
feeling rhythm. Having drawn the distinction, it must be remarked
that its relevance to ADHD cognition is not obvious. There are
manifestly many musicians who have ADHD; musical or dancing
ineptitude is not part of the symptom cluster of ADHD.
David L. Gilden and Laura R. Marusich, Department of Psychology, The
University of Texas at Austin.
Financial Support for this research was provided by National Institutes
of Mental Health Grant R01-MH58606 and National Science Foundation
Grants BCS-0226449 and BCS-0744989.
Correspondence concerning this article should be addressed to David L.
Gilden, 1 University Station A8000, Austin, TX 78712. E-mail: gilden@psy
.utexas.edu
265
Neuropsychology
© 2009 American Psychological Association
266
BRIEF REPORT
That there may be a connection between ADHD and rhythmic
expression is suggested by evidence that dopamine pathways
are affected in ADHD (Volkow et al., 2007), and that dopamine
neurons are tuned to event salience, a key stimulus attribute in
the initiation of reward-based learning. Sagvolden et al. (2005)
have argued that loss of salience might be functionally expressed
by a reward system that is developmentally attuned to shortened
delays. At this level of explanation, the symptoms of ADHD (short
attention span, hyperactivity, impulsivity) are merely the macro-
scopic outcomes of steep delay-of-reinforcement gradients. In this
article we conjecture that time scale shortening in conditioned
learning may have consequences generally for the organization of
behavior, and in particular for the repetitive behavior experienced
as rhythmic movement.
The production of rhythm is a human capacity about which quite
a bit is already known. Practical musical performance mandates
the construction of metronomes that reflect true human capacities
in timekeeping, and most metronomes have a limiting largo setting
at 40 beats per minute (bpm), an interbeat interval of 1.5 seconds.
This is practically the slowest setting at which music can be
counted. Our conjecture is that rhythmic feeling may be subject to
a shorter limiting interval in ADHD. The suggestion is not that
people with ADHD cannot feel rhythm, but that there would be no
need to build a metronome that extends to 40 bpm if the intended
user has ADHD. A smaller pendulum with a shorter maximum
period would suffice.
ADHD) whose task was simply to produce a steady train of
drumbeats at various tempi. In each tempo condition the partici-
pant drummed with a synchronizing signal for 16 beats and then
continued without the signal for another 60 beats. Most of the
pertinent facts about rhythm are deducible from simply noting
whether the performances appear stable or whether they wander
about. At tempi faster than 40 bpm the performances are mani-
festly stable; their associated time series seem to have a well-
defined mean and variance. Performances at tempi slower than 40
bpm lack this apparent stability, showing a pronounced tendency
to meander. Meandering is a specific kind of losing one’s way that
is characteristic of a random walk process.
Random walks are generated by an imperfect copying mecha-
nism that has the recursive form: X(t 1) *X(t) ε (t), where
determines the rate at which successive copies lose their corre-
lation over generations, and ε is the random step that drives the
walk to meander. This relation provides an important insight into
drumming performances at tempi a little slower than the 40-bpm
metronome limit. Consider the options available to a drummer who
is asked to perform so slowly that he or she cannot feel the beat.
How does such a person know when to strike the drum when the
implicit body knowledge, the feel, is missing? One strategy is to
use the recollection of the most recent interval as a guide for when
it would be judicious to next strike the drum. This strategy natu-
rally generates the recursive pattern observed in the random walk.
From the point of view of an observer of drumming performance,
inferences about whether somebody else is feeling rhythm comes
down to deciding whether the performance indicates the recursive
use of explicit memories.
Statistics that are sensitive to recursion are quite different from
those that have been typically used to measure timing behavior.
Most assessments of the human capacity to produce regular pulses
are made at tempi well within the range of rhythmic feel (Allan,
1979; Wearden, 1991), and the sole focus has been on overall
accuracy as measured by the coefficient of variation, (standard
deviation)/mean. When drumming performance is stable both the
mean and standard deviation are well-defined in the sense that they
do not themselves change during the performance. In this case, the
coefficient of variation is a true measure of relative error. How-
ever, in meandering performances the mean drifts, and this makes
the interpretation of the coefficient of variation problematic. As-
sessments made at very slow tempi require statistics that do not
assume a stable mean but rather quantify the tendency to drift.
Such statistics focus on how well past performance predicts future
performance. Meandering performance tends to be less accurate
but more predictable than stable performance.
The most common statistic used in psychology to capture pre-
dictive accuracy is correlation. In time series analysis the concept
of correlation generalizes to the autocorrelation function, the cor-
relation of the series with a copy of itself that has been displaced 1,
2, . . ., k, trials. The autocorrelation function has demonstrated
utility in the assessment of rhythmic tapping (Madison, 2001).
Related to the autocorrelation function is its Fourier twin, the
power spectrum. The power spectrum is especially useful here
because it employs trial wavelength rather than trial separation to
partition the correlations, and drumming performance is more
easily described in terms of wavelength. In the power spectrum
global features such as hills and valleys are resolved at the long
wavelengths (low frequencies) while the inevitable beat-to-beat
Theoretical Issues in the Assessment of Rhythmic Feel
A recorded drumming performance is literally a succession of
marked moments in time: beats. The succession of intervals be-
tween beats forms a time series that may be used to assess the
feeling of rhythm. Examples of drumming performance displayed
as interbeat-interval time series are illustrated in Figure 1. These
data were produced by a normal adult (one not diagnosed with
Figure 1. Time series of successive interval estimates are shown for non-
synchronized drum beating. Target tempos of 15, 30, 40, 60, and 120 bpm
(target time intervals of 4, 2, 1.5, 1, and 0.5 seconds, respectively). Loss of
rhythm is implied by wandering estimates at tempo slower than 40 bpm.
92861832.001.png
BRIEF REPORT
267
variation is resolved at the short wavelengths (high frequencies).
Spectral representations are commonly used in the analysis of
stable timekeeping (Gilden, Thornton, & Mallon, 1995; Lemoine,
Torre, & Delignieres, 2006).
Beyond correlation are statistics that measure nonlinear aspects
of prediction. The sample entropy (Richman & Moorman, 2000) is
one such statistic that has proven worth as a clinical tool in
diagnosing cardiomypathy through wandering heartbeat (Norris,
Stein, Cao, & Morris, 2006), and promises to be quite useful in
assessing rhythmic feel. The sample entropy measures the ten-
dency for micropatterns in the time series to repeat. Formally, the
sample entropy is an average conditional probability; given that X
was followed by Y in the past, how likely is it that an event
resembling X will be followed by an event resembling Y. Signals
that drift generally have lower entropy than signals that fluctuate
about a stable mean.
each condition, participants slapped the drum with their dominant
hand in time with a synchronizing signal for 16 beats and then
continued without the signal for another 3 minutes. To prevent
counting, participants drummed while reading aloud from a non-
technical book review printed in large clear type. 1
Results
Figure 2 displays key statistics at the three target tempi: (A)
coefficient of variation, (B) power spectrum in log-log coordinates,
(C) serial correlation, and (D) sample entropy. 2 We use the coefficient
of variation as a measure of overall accuracy, recognizing that its
utility is compromised by drifting performance. The power spectrum
(see Thornton and Gilden (2005) for computational method), serial
correlation, and entropy are used to characterize drift. It is evident
from this figure that the statistics are resolving large group differences
in drumming performance at the target tempi. The tempo functions
are, however, fairly complex, and the data are best understood by
considering the conditions in the order of fastest to slowest tempi,
progressing from manifest rhythm to its complete breakdown.
At the fastest tempo, 60 bpm (1-s target), the ADHD and normal
control groups have similar performance characteristics. They have
similar accuracies, nonlinear predictability (entropy), and low fre-
quency power. As the power at low frequencies picks up the large-
scale hill-valley structure, equality between the two groups implies
that they have comparable stability in the long run. Where the two
groups differ in spectral power is at the high frequencies. Here the
normal control group actually shows greater fluctuation magnitude,
and this is reflected by the marginally larger coefficient of variation in
the normal control group. That the high frequency fluctuations are
relatively smaller in the ADHD group makes their performances
slightly more predictable in the short run as evidenced by the en-
hanced serial correlation. The finding that ADHD performance is not
in any way compromised at 60 bpm is an important benchmark for
our method. If the secondary counting suppression task differentially
disrupted drumming performance in the ADHD group it might be
expected to enter as a main effect across tempo conditions.
Group differences at 40 bpm are quite large and appear in the three
measures of sequential correlation that are sensitive to the loss of
rhythmic feel and the onset of random walking. Comparing ADHD
Empirical Assessment of Rhythmic Feel
The following pilot study assessed whether adults with ADHD
lose rhythm at faster tempo than do normal controls. The study
focused on the range of tempo where people typically lose their
sense of rhythm and was designed to provoke both stable and
wandering behavior in the two groups.
Method
Participants
Eleven adults with a diagnosis of ADHD and 11 adults without
ADHD participated in the study, which was approved by the
institutional review board. All participants were students at
the University of Texas and were between 18 and 30 years of age.
The participants with ADHD were referred by the Office for
Students with Disabilities. To register with the Office for Students
with Disabilities, students must have a DSM–IV or ICD diagnosis
of ADHD from an external clinician, and they must have received
a psychological evaluation in the past 3 years to demonstrate that
their assessment is current. All of the participants with ADHD had
received a clinical diagnosis, and about half received this diagnosis
in childhood. Those who were diagnosed as adults all reported
childhood-onset symptoms, as required by DSM–IV criteria. The
participants with ADHD had not taken any medication in the 24
hours before the study. After complete description of the study to
the subjects, written informed consent was obtained.
1 Interval discrimination studies have demonstrated that counting mark-
edly improves performance when durations exceed about 1.2 seconds
(Grondin, Mielleur-Wells, & Lachance, 1999). Counting must be pre-
vented in assessments of rhythm at target tempi slower than 60 bpm, if we
wish to ensure that performers do not substitute their own counting beat for
the intended target. Covert counting is a problem not often encountered in
studies of timing behavior as durations exceeding a second are rarely
examined. Madison’s (2001) work is almost unique in this regard, and he
dealt with this problem by simply instructing the participants to not count.
Such an instruction places conflicting task demands upon the participant as
there is always the implicit requirement in any drumming study that
performance be as accurate as possible. An alternative strategy is to
suppress counting through a secondary task that requires articulation, one
that is highly practiced and relatively automatic. Reading elementary text
fits this requirement and is the tactic used in this pilot study.
2 The sample entropy is a function of two parameters, m - the dimension
of the embedding space, and r - the neighborhood size. Here m 2, and
r .2 , where is the interval standard deviation. These values are typical
of practical application (Norris et al., 2006).
Materials
A Roland Handsonic percussion controller was used for the col-
lection of data. This device has time resolution comparable to the
keyboard but is superior to the keyboard in affording good tactile and
auditory feedback. The percussion controller was set to simulate
conga drums.
Procedure
Participants each completed three target-tempi conditions of 30,
40, and 60 bpm, corresponding to interbeat intervals of 2, 1.5,
and 1 second, respectively. These tempi were chosen to span the
critical interval where rhythm breaks down in normal function. In
268
BRIEF REPORT
Figure 2. Statistical measures of drumming performances produced by adults with ADHD (filled circles) and by normal
controls (open circles). Performance measures are given for the target interbeat intervals 1, 1.5, and 2 seconds, corresponding
to tempi of 60, 40, and 30 bpm. (A) Coefficient of variation standard deviation/mean. (B) Log power as a function of log
frequency. (C) Autocorrelation at lag 1. (D) Sample entropy. Error bars depict standard error of the mean.
with normal control participants, their spectra were steeper, t (20)
2.5, p .01, their entropies were lower, t (20) 1.88, p .04,
and their serial correlations were larger, t (20) 2.77, p .01. All
three of these statistics suggest that 40 bpm defines a new regime
of behavior for the ADHD group, a regime where the sense of
rhythm has become so diminished that they substitute replicates of
their previous estimates for the target interval. The coefficient
of variation in the ADHD group is also quite large at 40 bpm
compared to 60 bpm, t (10) 2.55, p .02, providing further
evidence that the nature of the performances at the two tempi are
quite different. It is equally evident that the normal control group
performance is rhythmically stable at 40 bpm, justifying the ex-
tension of the metronome to this tempo. On every statistical
measure of correlation as well as in the coefficient of variation, the
differences between 40 bpm and 60 bpm in the normal control
group were small and not significant.
Finally we consider performance beyond the metronome limit,
at 30 bpm. In this condition neither group produces competent
drumming. The coefficient of variation in both groups is some 50%
larger than it was at 60 bpm, a sure sign that rhythmic feeling has
been compromised (normal control t (10) 4.8, ADHD
t (10) 3.2). Consistent with previous findings (Madison, 2001),
the normal control group meanders at 30 bpm: the serial correla-
tions are almost triple that in the two faster conditions ( r .2 vs.
r .08, t (31) 2.0, p .025). As at 60 bpm, the normal control
group is slightly less accurate than the ADHD group, as measured
by the coefficient of variation. This difference is due, as it was
at 60 bpm, to the fact that the normal control group actually
fluctuates a little more wildly from beat to beat. Again, the relative
suppression of power at the high frequencies in the ADHD group
gives them a larger serial correlation. However, the groups are not
distinguished by the sample entropy. Both groups are sufficiently
erratic in the short run that even in the presence of strong drift,
micropatterns in the time series are poor predictors.
The observation that ADHD performance is both slightly more
stable and more accurate than that of the normal controls at the two
bounding tempi, 60 and 30 bpm, suggests that the secondary task
of reading is not differentially diminishing ADHD performance. If
the presence of a secondary task is critical in producing group
differences at 40 bpm it must be that the ADHD group is more
vulnerable at this tempo. If the ADHD group is more vulnerable to
the effects of a secondary task only at 40 bpm it must be that their
sense of rhythm is compromised differentially at 40 bpm. As this
is essentially the conjecture we seek to test, the secondary task is
justified as a reasonable measure to prevent counting.
Discussion
This pilot study of ADHD rhythmic behavior resolves three distinct
performance regimes that exemplify two different aspects of working
92861832.002.png
BRIEF REPORT
269
memory. At fast tempo (60 bpm) both ADHD and normal control
groups execute accurate and stable performances. The interpretation
of this finding is that the system of implicit working memory that
produces rhythmic feel has a temporal span that exceeds 1 second in
both groups. At rhythmic the metronome limit (40 bpm), this implicit
memory system appears to be unavailable to people with ADHD, and
their performance reflects a different and more explicit usage of
memory, memory of their most recent estimates. As normal controls
display rhythmic feel at 40 bpm, this difference implies a difference
in the span of rhythmic feel. The effective span of rhythmic feel is
apparently contracted in ADHD adults to less than 1.5 seconds. At 30
bpm, both the implicit sense of rhythm and the explicit sense of prior
estimates are largely attenuated in both groups. This is presumably
why metronomes typically do not offer a setting at 30 bpm. If there is any
distinction between the groups at this tempo, it is that the ADHD group
has a better sense of what they are doing, as they seem to have a better
sense of their most recent estimates. Outside of this observation there is
little to distinguish normal control from ADHD performance at 30 bpm.
In this article we have considered one aspect of temporal integra-
tion, rhythmic feeling, providing preliminary evidence that this feel-
ing exists over a relatively restricted tempo range in ADHD. Rhyth-
mic feeling is a good place to begin an analysis of the more general
issue of temporal integration because it is methodologically simple, it
is supported by clear signatures in data, and it involves a system of
measurement that does not require sustained vigilance. These prelim-
inary results, however, do not remotely exhaust the range of cognition
that is involved in the perceptual organization of temporally based
events. Virtually any percept or activity that involves synthesis across
time is potentially of interest. In particular, ethological investigation of
human actions that imply universal time scales (Schleidt, Eible-
Eibesfeldt, & P¨ppel, 1987) may be a particularly productive way of
investigating ADHD temporality and in understanding what exactly is
implied by hyperactivity and inattentiveness.
Gilden, D. L., Thornton, T., & Mallon, M. (1995). 1/ƒ noise in human
cognition. Science, 267, 1837–1839.
Grondin, S., Meilleur-Wells, G., & Lachance, R. (1999). When to start
explicit counting in a time-intervals discrimination task: A critical point
in the timing process of humans. Journal of Experimental Psychology:
Human Perception and Performance, 25, 993–1004.
Ivry, R. B., & Spencer, R. M. C. (2004). The neural representation of time.
Current Opinion in Neurobiology, 14, 225–232.
Kerns, K. A., McInerney, R. J., & Wilde, N. J. (2001). Time reproduction,
working memory, and behavioral inhibition in children with ADHD.
Child Neuropsychology, 7, 21–31.
Lemoine, L., Torre, K., & Delignieres, D. (2006). Testing for the presence
of 1/f noise in continuation tapping data. Canadian Journal of Experi-
mental Psychology, 60, 247–257.
Madison, G. (2001). Variability in isochronous tapping: Higher order
dependencies as a function of intertap interval. Journal of Experimental
Psychology: Human Perception and Performance, 27, 411–422.
Mangels, J. A., Ivry, R. B., & Shimizu, N. (1998). Dissociable contribu-
tions of the prefrontal and neocerebellar cortex to time perception.
Cognitive Brain Research, 7, 15–39.
Norris, P. R., Stein, P. K., Cao, H., & Morris, J. J., Jr. (2006). Heart rate
multiscale entropy reflects reduced complexity and mortality in 285
patients with trauma. Journal of Critical Care, 21, 343.
Richman, J. S., & Moorman, J. R. (2000). Physiological time-series analysis
using approximate entropy and sample entropy. American Journal of Phys-
iology - Heart and Circulatory Physiology, 278, 2039–2049.
Rubia, K., Taylor, A., & Taylor, E. (1999). Synchronization, anticipation, and
consistency in motor timing of children with dimensionally defined atten-
tion deficit hyperactivity behaviour. Perceptual and Motor Skills, 89, 1237–
1258.
Sagvolden, T., Johansen, E. B., Aase, H., & Russell, V. A. (2005). A
dynamic developmental theory of attention-deficit/hyperactivity disorder
(ADHD) predominantly hyperactive/impulsive and combined subtypes.
Behavioral Brain Science, 28, 397–419.
Schleidt, M, Eibl-Eibesfeldt, I., & P¨ppel, E. (1987). A universal constant
in temporal-segmentation of human short-term behavior. Naturwissen-
schaften, 74, 289–290.
Smith, A., Taylor, E., Lidzba, K., & Rubia, K. (2003). A right hemispheric
frontocerebellar network for time discrimination of several hundreds of
milliseconds. Neuroimage, 20, 344–350.
Smith, A., Taylor, E., Rogers, J. W., Newman, S., & Rubia, K. (2002).
Evidence for a pure time perception deficit in children with ADHD.
Journal of Child Psychology and Psychiatry, 43, 529–542.
Sonuga-Barke, E. J. S., Saxton, T., & Hall, M. (1998). The role of interval
underestimation in hyperactive children’s failure to suppress responses
over time. Behavioural Brain Research, 94, 45–50.
Thornton, T. L., & Gilden, D. L. (2005). Provenance of correlations in
psychological data. Psychonomic Bulletin and Review, 12, 409–441.
Toplak, M. E., & Tannock, R. (2005). Time perception: Modality and
duration effects in attention-deficit/hyperactivity disorder (ADHD).
Journal of Abnormal Child Psychology, 33, 639–654.
Valera, E. M., Faraone, S. V., Murray, K. E., & Seidman, L. J. (2007).
Meta-analysis of structural imaging findings in attention-deficit/hyper-
activity disorder. Biological Psychiatry, 61, 1361–1369.
Volkow, N. D., Wang, G.-J., Newcorn, J., Telang, F., Solanto, M. V., Fowler,
F. S., et al. (2007). Depressed dopamine activity in caudate and preliminary
evidence of limbic involvement in adults with attention-deficit/hyperactivity
disorder. Archives of General Psychiatry, 64, 932–940.
Wearden, J. H. (1991). Do humans possess an internal clock with scalar-
timing? Learning and Motivation, 22, 59–83.
References
Allan, L. G. (1979). The perception of time. Perception & Psychophys-
ics, 26, 340–354.
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and
executive functions: Constructing a unifying theory of ADHD. Pyscho-
logical Bulletin, 121, 65–94.
Barkley, R. A., Murphy, K. R., & Bush, T. (2001). Time perception and
reproduction in young adults with attention deficit hyperactivity disor-
der. Neuropsychology, 15, 351–360.
Castellanos, F. X., Lee, P. P., Sharp, W., Jeffries, N. O., Greenstein, D. K.,
Clasen, L. S., et al. (2002). Developmental trajectories of brain volume
abnormalities in children and adolescents with attention-deficit/hyper-
activity disorder. Journal of the American Medical Association, 288,
1740–1748.
Castellanos, F. X., Sonuga-Barke, E. J. S., Milham, M. P., & Tannock, R.
(2006). Characterizing cognition in ADHD: Beyond executive dysfunc-
tion. Trends in Cognitive Sciences, 10, 117–123.
Castellanos, F. X., & Tannock, R. (2002). Neuroscience of attention-
deficit/hyperactivity disorder: The search for endophenotypes. Nature
Reviews Neuroscience, 3, 617–628.
Conners, C. K. (1995.) Conners’ Continuous Performance Test . Toronto,
Multi-Health Systems.
Edwards, M. C., Gardner, E. S., Chelonis, J. J., Schulz, E. G., Flake, R. A.,
& Diaz, P. F. (2007). Estimates of the validity and utility of the Conners’
Continuous Performance Test in the assessment of inattentive and/or
hyperactive-impulsive behaviors in children. Journal of Abnormal Child
Psychology, 35, 393–404.
Received July 18, 2008
Revision received October 15, 2008
Accepted October 27, 2008
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