Frontiers in Behavioral Neuroscience (Jul 2022)

Aversive Pavlovian inhibition in adult attention-deficit/hyperactivity disorder and its restoration by mindfulness-based cognitive therapy

  • Dirk E. M. Geurts,
  • Dirk E. M. Geurts,
  • Hanneke E. M. den Ouden,
  • Lotte Janssen,
  • Jennifer C. Swart,
  • Monja I. Froböse,
  • Roshan Cools,
  • Roshan Cools,
  • Anne E. M. Speckens

DOI
https://doi.org/10.3389/fnbeh.2022.938082
Journal volume & issue
Vol. 16

Abstract

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BackgroundControl over the tendency to make or withhold responses guided by contextual Pavlovian information plays a key role in understanding impulsivity and hyperactivity. Here we set out to assess (1) the understudied relation between contextual Pavlovian inhibitory control and hyperactivity/impulsivity in adults with ADHD and (2) whether this inhibition can be enhanced by mindfulness based cognitive therapy (MBCT).MethodsWithin the framework of a randomized controlled trial 50 Adult ADHD patients were assessed before and after 8 weeks of treatment as usual (TAU) with (n = 24) or without (n = 26) MBCT. We employed a well-established behavioral Pavlovian-to-instrumental transfer task that quantifies Pavlovian inhibitory control over instrumental behavior.ResultsTask results revealed (1) less aversive Pavlovian inhibition in ADHD patients with clinically relevant hyperactivity/impulsivity than in those without; and (2) enhanced Pavlovian inhibition across all ADHD patients after TAU+MBCT compared with TAU.ConclusionThese findings offer new insights in the neurocognitive mechanisms of hyperactivity/impulsivity in ADHD and its treatment: We reveal a role for Pavlovian inhibitory mechanisms in understanding hyperactive/impulsive behaviors in ADHD and point toward MBCT as an intervention that might influence these mechanisms.

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