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1、Memory Capacity, Selective Control, and Value-Directed Remembering in Children With and Without Attention-Deficit/Hyperactivity Disorder (ADHD)Alan D. Castel, Steve S. Lee, and Kathryn L. Humphreys University of California, Los Angeles Amy N. MoorePennsylvania State UniversityObjective: The ability
2、to select what is important to remember, to attend to this information, and to recall high-value items leads to the efficient use of memory. The present study examined how children with and without attention-deficit/hyperactivity disorder (ADHD) performed on an incentive-based selectivity task in wh
3、ich to-be-remembered items were worth different point values. Method: Participants were 6-9 year old children with ADHD (n = 57) and without ADHD (n = 59). Using a selectivity task, participants studied words paired with point values and were asked to maximize their score, which was the overall valu
4、e of the items they recalled. This task allows for measures of memory capacity and the ability to selectively remember high-value items. Results: Although there were no significant between-groups differences in the number of words recalled (memory capacity), children with ADHD were less selective th
5、an children in the control group in terms of the value of the items they recalled (control of memory). All children recalled more high-value items than low-value items and showed some learning with task experience, but children with ADHD Combined type did not efficiently maximize memory performance
6、(as measured by a selectivity index) relative to children with ADHD Inattentive type and healthy controls, who did not differ significantly from one another. Conclusions: Children with ADHD Combined type exhibit impairments in the strategic and efficient encoding and recall of high-value items. The
7、findings have implications for theories of memory dysfunction in childhood ADHD and the key role of metacognition, cognitive control, and value-directed remembering when considering the strategic use of memory. Keywords: ADHD, memory, cognitivecontrol, metamemory, encoding strategiesAttention-defici
8、t/hyperactivity disorder (ADHD) is characterized by an early onset of developmentally aberrant and impairing levels of inattention and/or hyperactivity -impulsivity (American Psychiatric Association APA, 2000). In addition to its concurrent and prospective association with disrupted social/family re
9、lationships, substandard academic achievement, and elevated comorbidity (Barkley, Fischer, Edelbrock, & Smallish, 1990; Barkley, Fischer, Smallish, & Fletcher, 2002; Lee, Lahey, Owens, & Hinshaw, 2008; Owens, Hinshaw, Lee, & Lahey, 2009), ADHD is also associated with neuropsychological deficits acro
10、ss domains such as cognitive flexibility, problem solving, and working memory (Willcutt, Doyle, Nigg, Faraone, & Pennington, 2005). Working memory (WM) involves the active maintenance and manipulation of information, and is governed by executive control processes (Baddeley, 1992, 2007). A recent met
11、a-analysis showed that children with ADHD have specific, robust deficits in WM, which are more pronounced in spatial WM tasks than in verbal WM tasks (Martinussen, Hayden, Hogg-Johnson, & Tannock, 2005). Furthermore, there is evidence that neuropsychological deficits, including problems with WM, par
12、tially mediate the persistence of ADHD over time, as well as the degree of functional impairment associated with ADHD (Halperin, Trampush, Miller, Mark, & Newcorn, 2008). & NewcornFor example, ADHD is associated with ineffective use of memory strategies and/or a failure to sustain effortful processi
13、ng over time (ONeill & Douglas, 1996). This may also be related to impairments in goal maintenance (Kane & Engle, 2003). A great deal of research shows that inhibitory control changes dramatically across the life span (Bedard, Nichols, Barbosa, Schachar, Logan, & Tannock, 2002; Zelazo, Craik, & Boot
14、h, 2004), and that children with ADHD have specific deficits in inhibitory control (Barkley,1997). However, most research on WM, inhibition, and executive control has used tasks that do not provide strong incentives to selectively focus on and remember important or high value information, at the cos
15、t of lower-value information. Typically WM tasks do not discriminate items by their relative importance and WM performance is operationalized by how many items are retained. The present study expands on the literature on WM by examining how children with and without ADHD strategically focus on and r
16、etain high-value information in WM and how this ability changes with task experience.The “selectivity task,” a relatively novel method for examining how people can selectively encode and maintain high-value information, differs from traditional measures of WM in that it investigates how one selectiv
17、ely encodes information using strategic control, and has now been used in several studies with various populations (see Castel, Benjamin, Craik, & Watkins, 2002; Castel, Farb, & Craik, 2007; Hanten, Li, Chapman, Swank, Gamino, Roberson, & Levin, 2007; Watkins & Bloom, 1999). In the present study, we
18、 used a modified form of this paradigm, in which words with different values (e.g., points) were to be remembered by the participant. This procedure allows one to examine the extent to which people use value-based information to guide the efficient use of memory (e.g., by intentionally recalling hig
19、her valued items). The point value assigned to each item during encoding indicates how important each item is to remember. This task differs from traditional measures of episodic memory or common tests of WM span as it examines the strategic control of encoding high-value information. Whereas this v
20、alue-directed remembering approach may share some resources with WM function, the selectivity task specifically allows for an examination of the strategic deployment of memory capacity, and the awareness of limited memory capacity (which can be conceptualized as a form of metamemory).In the selectiv
21、ity paradigm, participants are presented with lists of words, with each word in the list having a distinct value ranging from 1 to 12 points. Participants are instructed to remember as many words as possible, with the goal of maximizing their score, which is the sum of the point values of each recal
22、led word. After recall,participants are told their score, and then are given a new list, with instructions to maximize their score. Using a selectivity index (SI) developed by Watkins and Bloom (1999; see also Hanten et al., 2007), we examined how selectivity changed with task experience. This SI is
23、 based on the participants score (the sum of the points that were paired with therecalled items, or the “value” of the recalled items), relative to chance and ideal performance. The equation accounts for the participants score relative to an ideal score that represents recall of only the most highly
24、 valued words at that level of recall. For example, if a given participant remembered four words, and the points associated with the words were 12, 10, 9, and 8, that participants SI would be considered quite high. The ideal score for four words is 12 +11 +10 +9 = 42, whereas the score of the partic
25、ipant in question is 39. A chance score is based on calculating the average value of the points (using a 12-word list, with numbers ranging from 1 to 12, the average would be 6.5) and multiplying that value by the number of words recalled (in this case, 4). Thus, the SI in this case is (39 26)/(4226
26、) = .81. It is important to note that the index can range from 1 to _1. Perfect selectivity would result in an SI of 1.0, whereas selection of words with the lowest values (e.g., recalling the 1-, 2-, and 3-point words) would result in an SI of _1.0. A set of words recalled with no regard to their p
27、oint values (i.e., showing no selectivity) would result in a selectivity index close to 0. Thus, the SI provides a selectivity, or efficiency, index based on ones actual score, relative to an ideal score, taking into account the number of words recalled.Previous work using the selectivity task has s
28、hown that although healthy older adults recalled fewer words than younger adults, older adults enhanced their selectivity score (to levels similar to younger adults) by recalling high-value items (Castel et al., 2002). In addition, Castel and colleagues (2009) have shown that, despite recalling fewe
29、r items relative to younger adults, healthy older adults begin to develop a strategy (after several lists) of focusing on the higher value items to maximize their score. This ability to be selective was found to be somewhat impaired in older adults with early signs of Alzheimers disease (Castel, Bal
30、ota, & McCabe, 2009).In addition, Hanten and colleagues found deficits among children with brain injury and autism (Hanten et al., 2002, 2004). Of significance to the current study, Hanten and colleagues (2007)observed that the number of words recalled and selectivity were independent in a diverse s
31、ample of children, suggesting that perhaps different neural systems may contribute to memory capacity and the selective control of attention to high-value items. Thus, the SI provides a useful measure of memory efficiency that goes beyond simply measuring the overall quantity of recalled items (cf.
32、Koriat & Goldsmith, 1996). These findings suggest an important distinction between memory quantity and efficiency across the life span.The selectivity task can also provide a measure of how people learn which items to attend to across lists (i.e., with task experience).In this task, participants are
33、 presented with several lists or trials, and after each list are given feedback about their score, which is the sum of the point values of the words that they recalled. To achieve an optimal score (via efficient use of memory), participants need to focus on or attend to the high-value items and reca
34、l lthem on the immediate memory test. The number of items presented in each list (i.e., 12) is greater than the typical memory span of an individual, so many participants learn that they cannot remember all of the items, and, consequently, attempt to maximize their score by focusing on remembering o
35、nly the most valuable items in each list. Participants typically learn to attend to high valueitems, as reflected by the finding that the SI increases across successive lists and with task experience (Castel, 2008). The ability to selectively recall high-value items has been examined in children as
36、young as 6 years old and has been shown to be impaired in children with traumatic brain injury (Hanten et al.,2004, 2007).Given the need to selectively allocate attention to high-value words and to inhibit the allocation of attention to low-value words in the selectivity task, we were especially int
37、erested in how children with ADHD would perform on this task. To more rigorously ascertain the nature of WM deficits in ADHD, we administered the selectivity task to examine how value influences strategic encoding processes and attentional control. Specifically, we hypothesized that children with AD
38、HD would show similar levels of overall recall relative to age-matched control children in the selectivity task, but that children with ADHD would have a specific deficit in directing attention to, and recalling, high-value items (and might possibly recall more low-value items) resulting in a lower
39、SI. This would suggest that ADHD is associated with a specific deficit in value-directed remembering. In addition, the selectivity task measure show value-directed remembering emerges and/or changes2 CASTEL, LEE, HUMPHREYS, AND MOORE with task experience via the use of multiple study-test lists, wit
40、h different words and point values. We were also interested in whether children with ADHD can learn to focus on high-value items with task experience.We were particularly interested in examining whether deficits in selectivity varied depending on ADHD subtypes (APA, 2000).ADHD Combined type (ADHD-C)
41、 is the most common subtype of ADHD and it is characterized by clinically significant in attention disorganization and hyperactivity-impulsivity whereas ADHD Inattentive type (ADHD-I) is specific to inattention-disorganization only. The validity of ADHD subtypes is subject to debate (Geurtset al., 2
42、002; Milich et al., 2001), and cognitive deficits have the potential to clarify the etiology of ADHD (Nigg et al., 2002).Specifically, executive function (EF) constructs, including planning, WM, and inhibition, have been proposed as potentially useful domains to discriminate children with different
43、subtypes of ADHD. For example, there is some evidence that children with ADHD-C may exhibit greater deficits in planning relative to children with ADHD-I (Klorman et al., 1999), and relative to healthy controls (Nigg et al., 2002). However, other studies found no differences in EF between ADHD subty
44、pes (Geurts et al., 2002;Houghton et al., 1999). Given that the encoding of high-value information in the selectivity task requires the allocation of attention to high-value items while concurrently inhibiting attention to low-value items, we predict that children with ADHD would display some impair
45、ments in terms of the SI. Although we do not predict large group differences in the total number of words recalled during the task, we hypothesize that control children will be more selective in the value of words recalled relative to the ADHD-C group. This type of finding would help clarify importa
46、nt differences between these two subtypes of ADHD and further specify the nature of cognitive and memory deficits associated with ADHD.MethodParticipantsParticipants were 116 ethnically diverse 6-9 year old children（M=8.11. SD=1.1) with ADHD（n=57）and without ADHD (n=59) (see Table 1 for more details
47、 regarding the sample). Approximately 40% of the sample was White. Participants were recruited through presentations to families attending self-help groups, educators, and advertisements mailed to local elementary schools, pediatric offices, and clinical service providers. Partici pants were exclude
48、d from the study if they had a Full Scale IQ (FSIQ) 70, or if they had ever been diagnosed with a pervasive developmental disorder, seizure disorder, or any neurological disorder that prevented full participation in the study. Participants were required to live with at least one biological parent no
49、 less than half time and both parent and child were required to be fluent in English. Control children were recruited, screened, and assessed using the same methods as the probands.Probands were further divided into subtypes based on the diagnostic criteria specified in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision (DSM-IV-TR; APA,2000) for ADHD-I (n=25), ADHD Hyperactive/Impulsive Type (ADHD-H/I, n=6), and ADHD-C (n=26). Based on evidence that ADHD-H/I is a developmental precursor to ADH