Is ADHD a Disinhibitory Disorder?

• Published in: Psychological bulletin Vol. 127; no. 5; pp. 571 - 598
• Main Author: Nigg, Joel T
• Format: Journal Article
• Language: English
• Published: Washington, DC American Psychological Association 01-09-2001
• Subjects: Anxiety; Anxiety Disorders - diagnosis; Anxiety Disorders - psychology; Attention Deficit Disorder with Hyperactivity; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - parasitology; Attention deficit disorders. Hyperactivity; Attention deficit hyperactivity disorder; Behavioural disorders; Biological and medical sciences; Child; Child Behavior Disorders - diagnosis; Child Behavior Disorders - psychology; Child clinical studies; Children; Clinical psychology; Cognitive Processes; Comorbidity; Disinhibition; Executive control; Experiments; Fear; Health; Human; Humans; Illness; Inhibition (Personality); Inhibition (Psychology); Internal-External Control; Medical research; Medical sciences; Motivation; Motor ability; Motor Processes; Psychiatric Status Rating Scales; Psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Human; Disinhibition; Executive function; Attentional disorder; Cognitive disorder; Hyperactivity; Review; Inhibition; Child; Cognitive control
• ISSN: 0033-2909; 1939-1455
• DOI: 10.1037/0033-2909.127.5.571

Attention deficit hyperactivity disorder (ADHD) is widely theorized to stem from dysfunctional inhibitory processes. However, the definition of inhibition is imprecisely distinguished across theories. To clarify the evidence for this conception, the author relies on a heuristic distinction between inhibition that is under executive control and inhibition that is under motivational control (anxiety or fear). It is argued that ADHD is unlikely to be due to a motivational inhibitory control deficit, although suggestions are made for additional studies that could overturn that conclusion. Evidence for a deficit in an executive motor inhibition process for the ADHD combined type is more compelling but is not equally strong for all forms of executive inhibitory control. Remaining issues include specificity to ADHD, whether inhibitory problems are primary or secondary in causing ADHD, role of comorbid anxiety and conduct disorder, and functional deficits in the inattentive ADHD subtype.