Attention-deficit/hyperactivity disorder is a condition that is surrounded by discussion and controversy, in which the scientific community itself differs in both symptoms and treatment, and in some quarters even questions the existence of the condition.

Psychologist Russell A. Barkley created an alternative explanation model called behavioural inhibition disorder , which challenges the role of attention in ADHD and will be discussed throughout this article.

What is behavioral inhibition disorder?

Behavioral inhibition disorder is an explanatory model created by the American psychologist Russell A. Barkley. His intention was that it should be an alternative to the label of attention-deficit hyperactivity disorder (ADHD).

This alternative explanatory model of ADHD revolves around the executive function known as response inhibition . According to Barkley the main advantage of behavioural inhibition disorder is that it fits much better with the symptoms associated with the subcategories of ADHD: hyperactive and combined.

To better understand this model, the term executive function is described below.

Executive functions

Executive functions correspond to terms used in neuropsychology. This expression refers to all the cognitive skills to which a person resorts when his or her efforts are directed towards the achievement of an achievement or a goal.

These executive functions are essential for managing the cognitive, emotional and behavioural processes that enable the person to respond to any situation. In the same way, they are vital for carrying out most of the tasks and functions that a person must perform throughout the day; especially those actions that involve the generation of plans, decision making, problem solving, self-control and emotional regulation.

The processes to which the term “executive function” refers can be subdivided into two groups: basic functions and functions derived from them. These functions are:

  • Basic functions: response inhibition, cognitive flexibility and working memory.
  • Derived functions: planning and organization.

The role of behavioral inhibition

Of all the executive functions that human beings use, Barkley focuses on behavioral inhibition , giving it a crucial role in creating its own explanatory model of ADHD.

Behavior inhibition means the suspension of a response or a series of behaviors that the person has internalized or learned previously and that are usually automatic. The aim of this inhibition or containment is to solve any type of problem or task.

The functioning of response inhibition consists in, when faced with the appearance of a stimulus, suspending a certain behaviour or action and replacing it with another succession of acts or responses . Another option is to delay this sequence of actions in time until the person perceives that it is the right moment to carry them out.

Barkley’s explanatory model

In his work “ADHD and the nature of self-control”, published in 1997, Barkley structures all the information about ADHD collected during more than 25 years of study and constitutes the explanatory basis of Behavioural Inhibition Disorder .

Barkley assumes that the symptoms associated with ADHD can be divided into three groups or genders. These categories are: hyperactivity, impulsivity and attention deficit. However, Barkley only takes into account hyperactivity and impulsivity. Barkley argues that considering attention as a major symptom of this disorder can be misleading when it comes to treating it.

Likewise, within the executive functions mentioned above, Barkley highlights the work of response inhibition . Furthermore, he investigates how this can have a series of harmful effects on the other functions, which are subordinated to it in order to be able to perform correctly,

The following shows the relationship that behavioral inhibition has with the rest of the executive functions and the symptoms it causes as a result of this interference:

1. Alterations in non-verbal working memory

Behavioural inhibition causes problems in the representation and transformation of information, as well as deficiencies in the capacity to anticipate future actions and difficulties in time management.

2. Problems in verbal working memory

In this case both the verbal working memory and the internalization of speech are seriously affected. The main associated symptoms include obstruction of the capacity for reflection, problems in abiding by rules and in integrating regularised patterns of behaviour, decreased problem-solving ability , deficiencies in reading comprehension and deficits in moral reasoning.

3. Deficits in emotional and motivational self-regulation

Problems in the ability to express feelings and emotions, which become exaggeratedly disproportionate; deficiencies in perceiving the other’s point of view and alterations in the regulation of motivation are typical symptoms that cause behavioural inhibition in people with ADHD.

4. Reconstitution deficiencies

Finally, the person may also encounter obstacles when carrying out procedures of analysis and synthesis of behaviour; as well as deficits in the ability to imitate, copy or reproduce behaviours and a lesser variety of performance strategies when solving problems or reaching an objective.

The function of attention

As mentioned above, Barkley eliminates the effect of attention as a major factor or agent of the Behavior Inhibition Disorder model.

Yet recognizes the existence of two types of attention . That attention that is controlled externally through immediate reinforcements and the attention that originates and controls the person himself from within, which needs the inhibition of behaviours that are in progress and is more effective for the achievement of long-term objectives.

In this way, Barkley accepts that care is also included in his model but that it is subordinated to other factors and that all people diagnosed with ADHD have difficulties in care originating from within.