Restraint and cancellation: multiple inhibition deficits in attention deficit hyperactivity disorder.

We used variations of the stop signal task to study two components of motor response inhibition-the ability to withhold a strong response tendency (restraint) and the ability to cancel an ongoing action (cancellation)-in children with a diagnosis of attention deficit hyperactivity disorder (ADHD) and in non-ADHD controls of similar age (ages 7-14 years). The goal was to determine if restraint and cancellation were related and if both were deficient in ADHD. The stop signal task involved a choice reaction time task (go task) which required a rapid response. The demand for inhibitory control was invoked through the presentation of a stop signal on a subset of go trials which required that the ongoing response be suspended. The stop signal was presented either concurrently with the go signal (restraint version) or after a variable delay (cancellation version). In Study 1, we compared ADHD and control children on the cancellation version of the stop task; in Study 2, we compared ADHD and controls on the restraint version. In Study 3, a subset of ADHD and control participants completed both tasks so that we could examine convergence of these dimensions of inhibition. Compared to control participants, ADHD participants showed a deficit both in the ability to cancel and to restrain a speeded motor response. Performance on the restraint version was significantly correlated with performance on the cancellation version in controls, but not in ADHD participants. We conclude that ADHD is associated with deficits in both restraint and cancellation subcomponents of inhibition.