Risky decision making in adults with ADHD

Matthies, Swantje; Philipsen, Alexandra; Svaldi, Jennifer

doi:10.1016/j.jbtep.2012.02.002

Cited by 72 publications

(75 citation statements)

References 57 publications

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“…Three studies investigated the performance of adults with ADHD using an explicit gambling task, the GDT [67], [68] (reference 67 describes 2 separate studies). An overview of these studies and their results is given in Table 5.…”

Section: Resultsmentioning

confidence: 99%

Risky Behavior in Gambling Tasks in Individuals with ADHD – A Systematic Literature Review

et al. 2013

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ObjectiveThe aim of this review was to gain insight into the relationship between Attention deficit hyperactivity disorder (ADHD) and risky performance in gambling tasks and to identify any potential alternate explanatory factors.MethodsPsycINFO, PubMed, and Web of Knowledge were searched for relevant literature comparing individuals with ADHD to normal controls (NCs) in relation to their risky performance on a gambling task. In total, fourteen studies in children/adolescents and eleven studies in adults were included in the review.ResultsHalf of the studies looking at children/adolescents with ADHD found evidence that they run more risks on gambling tasks when compared to NCs. Only a minority of the studies on adults with ADHD reported aberrant risky behavior. The effect sizes ranged from small to large for both age groups and the outcome pattern did not differ between studies that applied an implicit or explicit gambling task. Two studies demonstrated that comorbid oppositional defiant disorder (ODD) and conduct disorder (CD) increased risky behavior in ADHD. Limited and/or inconsistent evidence was found that comorbid internalizing disorders (IDs), ADHD subtype, methylphenidate use, and different forms of reward influenced the outcomes.ConclusionThe evidence for increased risky performance of individuals with ADHD on gambling tasks is mixed, but is stronger for children/adolescents with ADHD than for adults with ADHD, which may point to developmental changes in reward and/or penalty sensitivity or a publication bias for positive findings in children/adolescents. The literature suggests that comorbid ODD/CD is a risk factor in ADHD for increased risky behavior. Comorbid IDs, ADHD subtype, methylphenidate use, and the form of reward received may affect risky performance in gambling tasks; however, these factors need further examination. Finally, the implications of the findings for ADHD models and the ecological validity of gambling tasks are discussed.

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Section: Resultsmentioning

confidence: 99%

Risky Behavior in Gambling Tasks in Individuals with ADHD – A Systematic Literature Review

et al. 2013

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“…Because cognitive control networks rely heavily on prefrontal cortex function, impairment in these regions can promote impulsivity, a core symptom of ADHD [11]. These deficits can be particularly debilitating for adults diagnosed with ADHD, as they are associated with poor occupational outcomes and difficulty in maintaining relationships [12–14]. Impulsivity in adult ADHD patients can be evaluated using computerized measures such as the Conners Continuous Performance Test (CPT) [15] and Stop Signal Task [16].…”

Section: Introductionmentioning

confidence: 99%

Transcranial direct current brain stimulation decreases impulsivity in ADHD

et al. 2018

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Background Impulsivity is a core deficit in attention deficit hyperactivity disorder (ADHD). Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits and could enhance DLPFC activity, leading to improved impulse control in ADHD. Objective/Hypothesis We predicted 2.0 mA anodal stimulation (tDCS) versus sham stimulation applied over the left DLPFC would improve Conners Continuous Performance Task (CPT) scores. Our secondary hypothesis predicted that stop signal task (SST) reaction time would decrease with tDCS (versus sham). Methods Thirty-seven participants completed two periods of three tDCS (or sham) sessions two weeks apart in a within-subject, double-blind, counterbalanced order. Participants performed a fractal N-back training task concurrent with tDCS (or sham) stimulation. Participants completed the CPT and SST at the beginning of treatment (baseline), at the end of the treatment, and at a 3-day post-stimulation follow-up. Results There was a significant stimulation condition by session interaction for CPT false positive scores (χ2 =15.44, p<0.001) driven by a decrease in false positive errors from baseline to end of treatment in the tDCS group (β=−0.36, 95% Confidence Interval (CI) −0.54 to −0.18, p<0.001). This effect did not persist at follow-up (β=−0.13, p>0.05). There was no significant stimulation condition by session interaction effect on CPT true positive errors or response time (ps>0.05). No significant change in SSRT performance was observed (p>0.05). Conclusion These findings suggest that stimulation of the left DLPFC with tDCS can improve impulsivity symptoms in ADHD, supporting the therapeutic potential for tDCS in adult ADHD patients.

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“…Most of the risky decision-making literature in externalizing disorders has focused on either adults (Miranda et al, 2009; Matthies et al, 2012; Duarte et al, 2012; Galvan et al, 2013) or youth behavioral outcomes (Drechsler et al, 2008; Fairchild et al, 2009; Drechsler et al, 2010; Schutter et al, 2011). These studies highlight an increased probability of disadvantageous decisions, correlations of risky-decision-making with impaired working memory and a propensity for lower probability/high reward choices in both youth and adults with externalizing psychopathology.…”

Section: Introductionmentioning

confidence: 99%

Neural activation during risky decision-making in youth at high risk for substance use disorders

Hulvershorn

Hummer

Fukunaga

et al. 2015

Psychiatry Research: Neuroimaging

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Risky decision-making, particularly in the context of reward-seeking behavior, is strongly associated with the presence of substance use disorders (SUDs). However, there has been little research on the neural substrates underlying reward-related decision-making in drug-naïve youth who are at elevated risk for SUDs. Participants comprised 23 high-risk (HR) youth with a well-established SUD risk phenotype and 27 low-risk healthy comparison (HC) youth, aged 10–14. Participants completed the balloon analog risk task (BART), a task designed to examine risky decision-making, during functional magnetic resonance imaging. The HR group had faster reaction times, but otherwise showed no behavioral differences from the HC group. HR youth experienced greater activation when processing outcome, as the chances of balloon explosion increased, relative to HC youth, in ventromedial prefrontal cortex (vmPFC). As explosion probability increased, group-by-condition interactions in the ventral striatum/anterior cingulate and the anterior insula showed increasing activation in HR youth, specifically on trials when explosions occurred. Thus, atypical activation increased with increasing risk of negative outcome (i.e., balloon explosion) in a cortico-striatal network in the HR group. These findings identify candidate neurobiological markers of addiction risk in youth at high familial and phenotypic risk for SUDs.

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Risky decision making in adults with ADHD

Cited by 72 publications

References 57 publications

Risky Behavior in Gambling Tasks in Individuals with ADHD – A Systematic Literature Review

Risky Behavior in Gambling Tasks in Individuals with ADHD – A Systematic Literature Review

Transcranial direct current brain stimulation decreases impulsivity in ADHD

Neural activation during risky decision-making in youth at high risk for substance use disorders

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