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

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

doi:10.3389/fnbeh.2022.938082

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

Front Behav Neurosci. 2022 Jul 25:16:938082. doi: 10.3389/fnbeh.2022.938082. eCollection 2022.

Authors

Dirk E M Geurts^{1

2}, Hanneke E M den Ouden¹, Lotte Janssen², Jennifer C Swart¹, Monja I Froböse³, Roshan Cools^{1

2}, Anne E M Speckens²

Affiliations

¹ Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.
² Department of Psychiatry, Radboud University Medical Centre, Nijmegen, Netherlands.
³ Institute of Experimental Psychology, Heinrich Heine University of Düsseldorf, Düsseldorf, Germany.

Abstract

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.

Conclusion: 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 toward MBCT as an intervention that might influence these mechanisms.

Keywords: ADHD; Pavlovian to instrumental transfer; impulsivity; inhibition; mindfulness based cognitive therapy.