Delay discounting of reward in ADHD: application in young children

Abstract

Background A key underlying process that may contribute to attention-deficit/hyperactivity disorder (ADHD) involves alterations in reward evaluation, including assessing the relative value of immediate over delayed rewards. This study examines whether children with ADHD discount the value of delayed rewards to a greater degree than typically developing children using a delay discounting task. Methods Children aged 7–9 years diagnosed with ADHD and controls completed a task in which they chose between a hypothetical $10 available after a delay (7, 30, 90 and 180 days) versus various amounts available immediately. Results ADHD participants discounted more steeply than controls. However, this effect did not survive covarying of IQ. Conclusions ADHD is associated with a steeper delay gradient when contemplating hypothetical later rewards, but not independently of IQ. The interplay of cognitive processing and IQ with reward evaluation in ADHD requires further exploration.

Attention Deficit/Hyperactivity Disorder and the Clinical Management of Obesity

“…Less valuable immediate rewards (eg, $200 today) can often be preferred to more valuable future rewards (ie, $240 in 3 months). A number of studies have found steeper delay discounting among children and adults with ADHD relative to controls [43,44]. These effects appear to be more robust among those with the hyperactive/impulsive or combined subtypes [44][45][46], which is consistent with the conceptualization of delay discounting as a facet of impulsivity.…”

“…A number of studies have found steeper delay discounting among children and adults with ADHD relative to controls [43,44]. These effects appear to be more robust among those with the hyperactive/impulsive or combined subtypes [44][45][46], which is consistent with the conceptualization of delay discounting as a facet of impulsivity. The tendency to discount delayed rewards steeply is associated with several conditions in which impulsivity and hyper-responsivity to appetitive cues are thought to play an etiological role, such as compulsive gambling, tobacco use, and drug addiction [47][48][49].…”

Domain-general and domain-specific aspects of temporal discounting in children with ADHD and autism spectrum disorders (ASD): A proof of concept study

“…Steeper TD has been associated with impulsivity and hyperactivity (Barkley, Edwards, Laneri, Fletcher, & Metevia, 2001;Critchfield & Kollins, 2001;Scheres, Lee, & Sumiya, 2008). Individuals with attention deficit/hyperactivity disorder (ADHD) show higher rates of TD of money, preferring immediate (monetary) rewards over larger delayed rewards to a greater extent than typically developing controls (Barkley et al, 2001;Demurie, Roeyers, Baeyens, & Sonuga-Barke, 2012;Marco et al, 2009;Paloyelis, Asherson, Mehta, Faraone, & Kuntsi, 2010;Scheres, Tontsch, Thoeny, & Kaczkurkin, 2010;Sonuga-Barke, Taylor, Sembi, & Smith, 1992;Wilson, Mitchell, Musser, Schmitt, & Nigg, 2011). This has been regarded as evidence for a constitutional tendency to prefer immediate over delayed rewards even when the delayed reward is larger, which has been referred to as higher trait time preference in ADHD (Sonuga-Barke & Fairchild, 2012).…”

“…The evidence for increased TD in ADHD comes from TD tasks with both real and hypothetical monetary rewards (Barkley et al, 2001;Scheres, Tontsch, et al, 2010;Wilson et al, 2011) and over the short and the very long term (Barkley et al, 2001;Scheres, Tontsch, et al, 2010; but see Scheres et al, 2006 for a counter case).…”

Impact of Clinician Expectations on Termination Status and Therapeutic Outcome

“…Delay discounting procedures have recently demonstrated utility in mental health research by providing greater understanding of addictive behaviors, (Bickel & Marsch, 2001;de Wit, 2009;Gottdiener, Murawski, & Kucharski, 2008;Heil, Johnson, Higgins, Bickel, 2006;Khwaja, Silverman, & Sloan, 2007;Ohmura, Takahashi, Kitamura, 2005) and a variety of clinical disorders (Barkley, Edwards, Laneri, Fletcher, & Metevia, 2001;Crean, de Wit, & Richards, 2000;Wilson, Mitchell, Musser, Schmitt, & Nigg, 2010). Swift and Callahan (2008) demonstrated the effectiveness of these delay discounting methods in psychotherapy research by using these procedures to examine clients' outcome expectations for psychotherapy.…”