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Continuous performance test in pediatric obsessive-compulsive disorder and tic disorders: the role of sustained attention

Published online by Cambridge University Press:  09 October 2014

Ilse M. Lucke ,
Charlotte Lin ,
Fatmata Conteh ,
Amanda Federline ,
Huyngmo Sung ,
Matthew Specht  and
Marco A. Grados
Ilse M. Lucke
Affiliation:
Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
Charlotte Lin
Affiliation:
Johns Hopkins University, Baltimore, Maryland, USA
Fatmata Conteh
Affiliation:
Johns Hopkins University, Baltimore, Maryland, USA
Amanda Federline
Affiliation:
Loyola University, Baltimore, Maryland, USA
Huyngmo Sung
Affiliation:
Department of Psychiatry, CHA University School of Medicine, Seoul, South Korea
Matthew Specht
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Marco A. Grados*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
*
*Address for correspondence: Marco A. Grados, MD, MPH, Johns Hopkins University School of Medicine, Psychiatry and Behavioral Sciences, 1800 Orleans St., 12th floor, Baltimore, MD 21287, USA. (Email: mjgrados@jhmi.edu)
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Abstract

Objective

Pediatric obsessive-compulsive disorder (OCD) and tic disorders (TD) are often associated with attention-deficit hyperactivity disorder (ADHD). In order to clarify the role of attention and inhibitory control in pediatric OCD and TD, a continuous performance test (CPT) was administered to a cohort of children and adolescents with OCD alone, TD alone, and OCD+TD.

Methods

A clinical cohort of 48 children and adolescents with OCD alone (n=20), TD alone (n=15), or OCD+TD (n=13) was interviewed clinically and administered the Conners Continuous Performance Test II (CPT-II). The Conners CPT-II is a 14-minute normed computerized test consisting of 6 blocks. It taps into attention, inhibitory control, and sustained attention cognitive domains. Key parameters include errors of omission (distractability), commission (inhibitory control), and variable responding over time (sustained attention). Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) criteria were applied in a best-estimate process to diagnose OCD, TD, ADHD, and anxiety disorders.

Results

Children with OCD+TD had more errors of omission (p=0.03), and more hit RT block change (p=0.003) and hit SE block change (p=0.02) than subjects with OCD alone and TD alone. These deficits in sustained attention were associated with younger age and hoarding tendencies. A clinical diagnosis of ADHD in the OCD+TD group also determined worse sustained attention.

Conclusions

A deficit in sustained attention, a core marker of ADHD, is also a marker of OCD+TD, compared to OCD alone and TD alone. Biological correlates of sustained attention may serve to uncover the pathophysiology of OCD and TD through genetic and imaging studies.

Keywords

Attention-deficit hyperactivity disordercontinuous performance testobsessive-compulsive disordersustained attentionTourette syndrome
Type
Original Research
Information
CNS Spectrums , Volume 20 , Issue 5 , October 2015 , pp. 479 - 489
Copyright
© Cambridge University Press 2014 

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