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1、Spatial working memory and strategy formation in adults diagnosed with attention deficit hyperactivity disorderSusan Young a,*, Robin Morris a, Brian Toone b, Carolyn Tyson cAbstractThe study investigated problem spatial working memory in ADHD adults. Twenty-seven patients diagnosed with ADHD in adu
2、lthood and 27 matched normal controls were tested using the Executive Golf Task, a test that also measures spatial strategy formation. Overall the ADHD patients were significantly impaired, the deficit increasing with task difficulty. They were also more impaired on a measure of task strategy format
3、ion, and when taking this into account in terms of memory performance the patient deficit remained, suggesting that their spatial working memory deficits are not wholly explained by problems with strategy formation.1. IntroductionWorking memory is defined as a cognitive system that provides temporar
4、y storage and manipulation of the information necessary for activities such as reasoning, language comprehension and learning (Baddeley, 1992). This process requires the ability to hold information on-line during a brief time until a decision and subsequent response is made (Goldman-Rakic, 1990). It
5、 has been postulated that there is a dissociation between basic memorial requirements of tasks and their executive components which control response selection, e.g. the adoption of an overall strategy or plan, or the utilization of specific attentional inhibitory mechanisms. Thus performance is dete
6、rmined by two factors, one related to short-term spatial memory and the other to strategic factors (Robbins, 1996). Several studies have shown that spatial working memory deficits in patients with frontal lobe excisions may be related to the inefficient use of a particular search strategy (Miotto, B
7、ullock, Polkey, Owen, Morris, Sahakian, Polkey, & Robbins, 1996). This suggests that part of the deficit may arise from executive failure and use of a strategy can reduce the load on memory caused by interference from previous choices.Spatial working memory deficits have been found in studies compar
8、ing ADHD and normal children (Karatekin Gorenstein, Mammato, Shue & Douglas, 1992). However, most studies have not considered whether deficits in spatial working memory may be accounted for by problems with strategy formation. The importance of strategy has been considered in other neurological or p
9、sychiatric disorders. For example, strategy formation impairment has been shown to be linked to spatial working memory impairment patients with frontal excisions (Miotto et al., 1996) but not for patients with Aspergers Syndrome (Morris et al., 1999).The current study explores spatial working memory
10、 deficits and strategy impairment of ADHD adults using the computerised Executive Golf task (cf. Feigenbaum, Polkey, & Morris, 1996), a development of the spatial working memory task designed by Morris et al. (1988). Working memory is of relevance in the investigation of adult ADHD because it is tho
11、ught to be particularly impaired in relation to other types of psychiatric disorders that have associated neuropsychological deficits (Gallagher & Blader, 2001). This has been explored in a previous study by Dowson et al. (2004) using a different task but a similar methodology. In the Dowson et al.
12、(2004) study the CANTAB method of measuring spatial working memory involves an array of spatial locations on a screen in which the participant has to avoid going back to previously successful locations.They found impairments on return errors and associated poor strategy when conducting the tasks. Th
13、e Executive Golf task is more akin to a real life activity in that, as well measuring spatial working memory it simulates a game of golf, the participant searching for places in which a golferis predicted to putt a ball, avoiding returning to these places during subsequent searches. The golf holes a
14、re presented using three dimensional computer graphics with the golfer presented in the distance. The task has a game-like format, with the golfer putting the balls into the golf holes when a correct golf hole has been selected by the golfer. Performance can be improved using the strategy of followi
15、ng a predetermined search sequence, beginning with a particular place and returning to the same place for every new search sequence. The aim of the study was to investigate whether patients with ADHD had a spatial working memory deficit in adulthood and to establish whether the deficit persisted if
16、a measure of strategy formation was covaried in the analysis. It was hypothesised that ADHD patients would make a greater number of errors in relation to returning to previously successful locations (i.e. between subject errors), and that this deficit would increase with task difficulty.2. Methodology2.1. ParticipantsThe study included 27 (21 male, 6 female) adult ADHD patients at the Maudsley Hospital, London UK. All patients met the DSM-IV criteria for ADHD followin
