15. Time and reaction time in ADHD

Author: Ulrich Brennecke
Review: Dipl.-Psych. Waldemar Zdero

Reaction time variability in the Continuous Performance Test (CPT), the analog of the 5-CSRTT for humans, is the most frequently observed deficit in neurodevelopmental disorders.¹

An altered perception of time is often reported in ADHD.
In addition, ADHD is characterized by an increased reaction time variance in reaction tests. The increased reaction time variance clearly distinguishes ADHD from other mental disorders such as anxiety, PTSD, ODD, CD and typical developmental disorders.
A slower reaction time and a larger standard deviation of the reaction time may be due to a lower decoding accuracy of the brain. Reaction time variance is particularly high in persons with ADHD who make many commission errors (confusion errors, false-positive errors). In addition, increased cortisol secretion correlates with an increased variance in response time.
ADHD shows a later and less pronounced slowing of reaction time after errors compared to non-affected individuals. An increased reaction time and reaction time variance also appear to correlate with a high availability of dopamine receptors, which is associated with a reduced dopamine level.

There is evidence of shorter reaction time in ADHD, and even more so in SCT. In one study, reaction time to a stop signal, the percentage of failed response inhibitions, and the standard deviation of reaction time to the “go” trial (SDRT) successfully differentiated people with ADHD from those without. Ex-Gaussian decomposition of the reaction time distribution showed that both a larger tau and a larger sigma affected the results for the SDRT.² Meanwhile, the traditional measures of inhibitory control were equally if not better predictors of ADHD status than the ex-Gaussian parameters.³

• 15.1. Reaction time variance increased in ADHD
• 15.2. Reduced reaction time in ADHD?
• 15.3. Rhythm problems
• 15.4. Changed perception of time

15.1. Reaction time variance increased in ADHD¶

ADHD is characterized by an increased variance in reaction time in reaction tests.^4567891011
The increased reaction time variability is thought to correlate particularly with problems of sustained attention,^{1213 14} but this is controversial.⁷¹⁵ Slower reaction time and greater standard deviation of reaction time also appear to be the consequences of lower parieto-occipital multivariate decoding accuracy, which occurred around 240-340 ms after the onset of visual search.¹⁶
Apparently, the response time variance is particularly high in the group of people with ADHD who make a particularly large number of commission errors (confusion errors, false-positive errors).¹⁷ Increased cortisol responses to a stressor correlated with an increased variance in response time.¹⁸ Elevated cortisol stress responses are very common in the ADHD-I subtype and atypical for the ADHD-HI subtype.
Furthermore, a later and reduced slowdown in reaction times after errors was reported than in those not affected.⁸¹⁹
Increased individual response variance is a sign of increased neural noise. MPH improves this.²⁰ Neural noise is represented by arrhythmic signals in the cortex, which can be measured as “1/f noise” in the EEG. Dopamine deficiency worsens the signal-to-noise ratio. ADHD is characterized by reduced dopamine levels in the PFC and striatum. Stimulants such as MPH increase the dopamine level there. An increase in dopamine levels to the optimal level improves the signal-to-noise ratio.
Increased reaction time and increased reaction time variability seem to correlate with a high availability of dopamine receptors (“empty receptors”), which is associated with reduced tonic dopamine levels.²¹

The symptom of increased reaction time variance also distinguishes ADHD significantly from other mental disorders such as

• Fear
• Distress disorders (physical stress disorders, PTSD)
• Oppositional defiant behavior (ODD)
• Disorder of social behavior (Conduct Disorder, CD)
• Typical developmental disorders

We are currently testing a reaction test to explore whether reaction time variability can be used to diagnose ADHD. This is where the ADxS.org - ADHD reaction test starts.

15.2. Reduced reaction time in ADHD?¶

Several studies and reports indicate a shorter reaction time in ADHD.^{222324 14811}
According to Barkley, the reaction time is consistently reduced with SCT / CDS (sluggish cognitive tempo)
According to another study, the reaction times of people with ADHD do not differ from those without ADHD, but the level of care does.
Contrary to all expectations, people with ADHD who carried the DRD4-7R gene polymorphism, which is one of the main candidates for increased sensitivity and ADHD, did not show poorer reaction times than non-affected people. However, carriers of other DRD4 polymorphisms did. Others reported deviating audiovisual multisensory processing.²³
One study found a correlation of prolonged reaction times with ADHD-I.²⁵
One study found reduced reaction times in ADHD in a virtual environment with household tasks and increased reaction times in CPT²⁶

15.3. Rhythm problems¶

A study reports that people with ADHD have significantly more problems tapping out a given rhythm with their fingers.²⁷ The test targets the function of the cerebellum, which is one of the brain regions involved in ADHD.
The difficulties correlated with the degree of hyperactivity/impulsivity. Higher impulsivity correlated with a faster tapping frequency,²⁸

15.4. Changed perception of time¶

See under Time perception problems with ADHD (chronasthenia) In the article Perceptual symptoms in ADHD.