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

• Published in: Frontiers in behavioral neuroscience Vol. 16; p. 938082
• Main Authors: Geurts, Dirk E. M., den Ouden, Hanneke E. M., Janssen, Lotte, Swart, Jennifer C., Froböse, Monja I., Cools, Roshan, Speckens, Anne E. M.
• Format: Journal Article
• Language: English
• Published: Lausanne Frontiers Research Foundation 25.07.2022; Frontiers Media S.A
• Subjects: ADHD; Adults; Animal cognition; Attention deficit hyperactivity disorder; Behavior; Cognition; Cognitive ability; Cognitive therapy; Hyperactivity; Hypotheses; Impulsive behavior; Impulsivity; inhibition; Mindfulness; mindfulness based cognitive therapy; Neuroscience; Patients; Pavlovian to instrumental transfer; Tau protein
• ISSN: 1662-5153; 1662-5153
• DOI: 10.3389/fnbeh.2022.938082

Background: Control 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). Methods: Within 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. Results: Task 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. Conclusions: These 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 towards MBCT as an intervention that might influence these mechanisms.