Task complexity enhances response inhibition deficits in childhood and adolescent ADHD: A meta regression analysis

Background: The ability to inhibit motor responses, as assessed by the stop-signal reaction time (SSRT), is impaired in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). However, the between-study variation in effect sizes is large. The aim of this study was to investigate whether this variability can be explained by between-study variation in Go task complexity. Method: Forty-one studies comparing children or adolescents diagnosed with ADHD to normal control subjects were incorporated in a random-effects meta-regression analysis. The independent variables were a global index of Go task complexity (i.e., mean reaction time in control subjects [RTc]) and a more specific index (i.e., spatial compatibility of the stimulus-response mapping). The dependent variable was the SSRT difference between ADHD and control subjects. Results: The SSRT difference increased significantly with increasing RTc. Moreover, the SSRT difference was significantly increased in studies that employed a noncompatible, that is, arbitrary, mapping compared with studies that incorporated a spatially compatible stimulus-response mapping. Conclusions: These results indicate that inhibitory dysfunction in children and adolescents with ADHD varies with task complexity: inhibitory dysfunction in ADHD is most pronounced for spatially noncompatible responses. Explanations in terms of inhibition and working memory deficits and a tentative neurobiological explanation are briefly discussed