First Advisor

Sarah Karalunas

Date of Award


Document Type


Degree Name

Bachelor of Science (B.S.) in Psychology and University Honors




Attention-deficit hyperactivity disorder -- Longitudinal studies, Oppositional defiant disorder in children




Attention-Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder with heterogeneous symptom trajectories. Performance monitoring, which involves the ability to recognize errors and make behavioral adjustments, is one aspect of self-regulation that may contribute to symptom change. Early and late stages of error processing can be quantified via EEG-recorded event-related potentials. The final stage of performance monitoring, which involves making behavioral adjustments, is measured as post-error slowing. It is currently unclear whether impaired performance monitoring is associated with ADHD, specifically, or with comorbid symptoms of Oppositional Defiant Disorder (ODD). Here, better performance monitoring is hypothesized to be associated with ADHD, independent of comorbid ODD symptoms, and to predict ADHD symptom improvement.

Method: 122 children from an ongoing longitudinal study (Control= 60, ADHD= 62) completed behavioral ratings and semi-structured clinical interviews to assess ADHD and comorbid ODD symptoms. At annual follow-up visits 5-8 years later, clinical assessment was repeated, and children completed a computerized emotional go/no-go with EEG recorded.

Results: Controls had marginally larger ERN (p=.056, η2= .03) and larger Pe amplitudes than ADHD participants (F[1,118]=4.38, p=.04). Comorbid ODD did not explain these differences. Adolescents with ADHD also made less adaptive behavioral adjustments in emotional than in non-emotional conditions, F(2,198)=3.758, p=.025. Higher ERN amplitudes during positive conditions predicted greater ADHD symptom improvement, R2=.057, p=.016.

Conclusions: Performance monitoring is associated with ADHD, independently of ODD. Emotional context does not affect error processing, but may interfere with adaptive behavioral adjustments for individuals with ADHD. Emotion dysregulation may also influence ADHD symptom trajectories.


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