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Cited by 94Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesChild and Adolescent Psychosocial and Emotional Development

Risk taking and sensitivity to punishment in children with ADHD, ODD, ADHD+ODD, and controls

Open access
Humphreys, Kathryn L., Lee, Steve S.·2011·Journal of Psychopathology and Behavioral Assessment
DOI 10.1007/s10862-011-9237-6PMC PMC7597674
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Abstract

We used the Balloon Analog Risk Task (BART) to examine risk taking and sensitivity to punishment, two relevant aspects of behavioral inhibition, in 203 school-age children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), ADHD+ODD, and controls. Participants earned points on the BART by pumping 30 separate balloons that exploded at variable intervals. No points were earned on a trial when a balloon exploded. The number of pumps across all balloons estimated risk taking and the reduction in pumps following balloon explosions was interpreted as an indicator of sensitivity to negative punishment. We found that all groups significantly differed from one another on risk taking. The ADHD+ODD group pumped the most, followed by the ODD, ADHD, and the control group, respectively. For sensitivity to negative punishment, all groups performed differently, with the ODD group showing the least sensitivity to an exploded balloon, followed by the ADHD, control, and ADHD+ODD groups, respectively. Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only. ADHD youth with comorbid ODD had the greatest levels of risk taking, but they were also the most sensitive to negative punishment. The relationship between ADHD and ODD, as well as the nature of comorbidity in constructs related to risk taking and related behaviors, are discussed.

AI snapshot

Written from the paper’s full text.

TL;DR

Using the Balloon Analog Risk Task (BART) in 203 children, the study found that ADHD+ODD showed the greatest risk taking, while ODD-only showed the least sensitivity to negative punishment. Comorbid ADHD+ODD was also the most sensitive to punishment, indicating distinct patterns from ADHD-only or ODD-only.

Key findings

  • Risk taking differed significantly across all four groups (Wald χ²=372.81, p<.001): ADHD+ODD pumped the most, followed by ODD-only, ADHD-only, and controls, who pumped the least.
  • Sensitivity to negative punishment also differed significantly across all groups (Wald χ²=200.24, p<.001): ODD-only was least sensitive to an exploded balloon, followed by ADHD-only, controls, and ADHD+ODD, which was most sensitive.
  • Mean TotalPumps was 923.44 (SD=489.16; range 167–2288); mean PostExp was 66.67 (SD=144.21; range −345 to 519, with 346 added for analysis).
  • ADHD and ODD status were moderately correlated (r=.38), and risk taking and punishment sensitivity were modestly related (r=.18).

Methods

  • Participants were 203 children aged 5–10 (M=7.39, SD=1.12; 71% male; 49% Caucasian), grouped as controls (n=87), ADHD-only (n=55), ODD-only (n=13), and ADHD+ODD (n=48); ADHD/ODD diagnoses used the parent-administered DISC-IV.
  • The BART presented 30 balloons; children pumped for points, balloons exploded at variable intervals, and no points were earned on exploded trials. Two versions were used (mouse press vs. typed number of pumps), both with an average explosion point of 65 pumps.
  • TotalPumps indexed risk taking; PostExp indexed sensitivity to negative punishment by summing differences between pumps on the trial before and after each explosion. Poisson regression in PASW 18.0 controlled for age and BART version, plus number of explosions for PostExp, followed by Fisher’s LSD post hoc tests.

Limitations

  • Stated: the cross-sectional design could not address BART sensitivity over time; alternative BART outcome measures exist; sample size prevented examination of sex or racial-ethnic differences; some children took usual medication on testing day and medication effects could not be meaningfully examined; ODD may be a proxy for callous-unemotional traits, temperament, or other constitutional features.
  • Stated: the study could not determine whether ODD per se related to BART performance or whether it reflected other underlying features.
  • Evident from the text: the ODD-only group was small (n=13), limiting power for that cell, and controls could meet criteria for any disorder other than ADHD, which may affect generalizability of control comparisons.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1007/s10862-011-9237-6

Cites

88 of 88 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 52 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Controlling for age and BART version, group status was significantly related to risk taking (Wald χ2=372.81, p<.001).

    “Controlling for age and BART version, the omnibus test for the group variable was significantly related to risk taking (i.e., TotalPumps) (Wald χ2=372.81, p<.001).”
    Quote in the paperSubstantial claim
  • Findingown data

    Pure ADHD (without ODD) positively predicted increased risk taking relative to controls.

    “Among 203 5–10 year-old children (controls, ODD-only, ADHD-only, ADHD+ODD), “pure” ADHD (i.e., without ODD) positively predicted increased risk taking relative to controls.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.
  • Findingown data

    Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only.

    “Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only.”
    • Also stated in: § Discussion · boosted
      “The increased risk taking found in children with ADHD+ODD provides additional evidence that this group is distinct from ADHD-only or ODD-only (Hinshaw et al. 1993; Lahey et al. 1999).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Hinshaw et al. 1993 source

      Not checked in the free run.

    • cites Lahey et al. 1999 source

      Not checked in the free run.

    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.
  • Findingreasoning

    Children with both ADHD and ODD had the greatest level of risk taking.

    “Children with both ADHD and ODD had the greatest level of risk taking, further supporting that this group of children is a clinically significant subgroup of the population by virtue of its elevated risk for negative outcomes (Gadow and Nolan 2002; Kuhne et al. 1997).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.
  • Findingown data

    Risk taking and sensitivity to negative punishment were modestly significantly associated (r=.18).

    “A modest significant association was found for risk taking and sensitivity to negative punishment (r=.18), suggesting that these constructs are related but meaningfully different and justify separate examination.”
    Quote in the paperSubstantial claim
  • May combine two claims. 15
  • Classified as probably not a substantial claim. 33

  • May combine two claims.

    Findingown data

    All groups significantly differed from one another on sensitivity to negative punishment, with ODD showing the least sensitivity, followed by ADHD-only, controls, and ADHD+ODD.

    “For sensitivity to negative punishment, all groups performed differently, with the ODD group showing the least sensitivity to an exploded balloon, followed by the ADHD, control, and ADHD+ODD groups, respectively.”
    • Also stated in: § Sensitivity to Punishment · plain
      “Post hoc tests found that that all groups significantly differed from one another. As higher values suggest greater reactivity to explosions (i.e., fewer pumps following a balloon explosion), the ODD group was the least sensitive to punishment, followed by the ADHD-only and the control group (Fig. 2). Interestingly, the ADHD+ODD group was the most sensitive to punishment.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Age was significantly associated with TotalPumps.

    “Age was significantly associated with TotalPumps, but child sex was not significantly associated with either outcome variable.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    ADHD and ODD status were moderately correlated (r=.38).

    “As expected, ADHD and ODD status were moderately correlated (r=.38).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    ODD predicted the greatest level of risk taking, as children with ODD and ADHD+ODD pumped more than ADHD-only and control groups.

    “ODD predicted the greatest level of risk taking (Schwebel et al. 2002), as children with ODD and ADHD+ODD pumped more than the ADHD-only and control groups.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Schwebel et al. 2002 source

      Not checked in the free run.

    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.

  • May combine two claims.

    Findingown data

    All groups significantly differed from one another on risk taking, with ADHD+ODD pumping the most, followed by ODD-only, ADHD-only, and controls.

    “We found that all groups significantly differed from one another on risk taking. The ADHD+ODD group pumped the most, followed by the ODD, ADHD, and the control group, respectively.”
    • Also stated in: § Risk Taking · plain
      “Post hoc analyses revealed that all groups significantly differed from one another with ADHD+ODD children pumping the most. This was followed by the ODD-only group, and then the ADHD-only group. The comparison children pumped the least across the task (Fig. 1).”
    • Also stated in: § Discussion · plain
      “ODD predicted the greatest level of risk taking (Schwebel et al. 2002), as children with ODD and ADHD+ODD pumped more than the ADHD-only and control groups.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Child sex was not significantly associated with either outcome variable.

    “Age was significantly associated with TotalPumps, but child sex was not significantly associated with either outcome variable.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S1 (asserted).

    Premisecitation

    Differences between hyperactive and non-hyperactive children on delay aversion were fully explained by co-occurring DBD.

    “However, Kuntsi et al. (2001) reported that differences between hyperactive and non-hyperactive children on delay aversion were fully explained by co-occurring DBD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kuntsi et al. 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Risk taking is a BI-related construct.

    “Risk taking is a BI-related construct, and consists broadly of the tendency to engage in negative behavior that compromises health, well-being, and the life-course (Jessor 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jessor 1998 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    It is unclear whether the association between risk taking and ADHD is explained by its frequent comorbidity with disruptive behavior disorders.

    “However, it is unclear whether the association between risk taking and ADHD is explained by its frequent comorbidity with disruptive behavior disorders (DBDs) (i.e., oppositional defiant disorder [ODD] and conduct disorder [CD]).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Risk taking and sensitivity to negative punishment are related but meaningfully different constructs.

    “A modest significant association was found for risk taking and sensitivity to negative punishment (r=.18), suggesting that these constructs are related but meaningfully different and justify separate examination.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    ADHD was positively associated with BI deficits, controlling for ODD and CD.

    “There is also evidence that ADHD was positively associated with BI deficits, controlling for ODD and CD (Nigg et al. 1998) and that ADHD predicted BI even after accounting for concurrent ODD among 6–13 year-old children (de Zeeuw et al. 2008).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nigg et al. 1998 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Children with ADHD are significantly more likely to have ever used nicotine and drugs and to develop nicotine, alcohol, and drug abuse or dependence in adolescence and early adulthood.

    “A recent meta-analysis reported that children with ADHD were significantly more likely to have ever used nicotine and drugs and to develop nicotine, alcohol, and drug abuse or dependence in adolescence and early adulthood (Lee et al. 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lee et al. 2011

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  • May combine two claims.

    Premisecitation

    The number of pumps across all balloons on the BART estimates risk taking, and the reduction in pumps following balloon explosions indicates sensitivity to negative punishment.

    “The number of pumps across all balloons estimated risk taking and the reduction in pumps following balloon explosions was interpreted as an indicator of sensitivity to negative punishment.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Lejuez et al. 2002 source

      Not checked in the free run.

    • cites Lejuez et al. 2007

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  • May combine two claims.

    Premisecitation

    ADHD prospectively predicted risky driving, sexual behavior, gambling, and unintentional injury.

    “ADHD also prospectively predicted risky driving, sexual behavior, gambling, and unintentional injury (Breyer et al. 2009; Flory et al. 2006; Garzon et al. 2008; Thompson et al. 2007).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Breyer et al. 2009 source

      Not checked in the free run.

    • cites Flory et al. 2006 source

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    • cites Garzon et al. 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Behavioral inhibition deficits have been proposed as a central feature of ADHD.

    “Although behavioral inhibition (BI) deficits have been proposed as a central feature of ADHD (Aron and Poldrack 2005; Barkley 1997), its multifactorial nature, including impulsivity, executive control, working memory, and vigilance, has complicated efforts to identify its precise architecture (Congdon and Canli 2005).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Aron and Poldrack 2005 source

      Not checked in the free run.

    • cites Barkley 1997 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Risk taking is associated with later substance use.

    “For example, risk taking is associated with later substance use (Burt et al. 2000), a common outcome among individuals diagnosed with childhood ADHD (Charach et al. 2011; Lee et al. 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Burt et al. 2000 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    BART balloon pumping is positively associated with risky sexual behavior, smoking, and a composite of substance use, sexual behavior, delinquency, and health domains.

    “Previous studies found that balloon pumping on the BART was positively associated with risky sexual behavior (Lejuez et al. 2005), smoking (Lejuez et al. 2003), and a composite of substance use, sexual behavior, delinquency, and health domains (Lejuez et al. 2007).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Lejuez et al. 2005 source

      Not checked in the free run.

    • cites Lejuez et al. 2003 source

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    • cites Lejuez et al. 2007

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Children with ADHD and DBD are centrally characterized by poor affect regulation.

    “Nigg et al. (2004) proposed that children with ADHD and DBD are centrally characterized by poor affect regulation.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Nigg et al. 2004 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Fisher's LSD post hoc test provided a conservative test to protect against Type I error.

    “We then conducted pairwise comparisons using Fisher’s least significant difference (LSD) post hoc test to probe group differences, thereby providing a conservative test to protect against Type I error.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Children with ADHD had greater risk taking in conditions of punishment.

    “Previous studies that examined risk taking and sensitivity to negative punishment found that children with ADHD had greater risk taking in conditions of punishment (DeVito et al. 2008), and fewer behavioral responses to punishment (Masunami et al. 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites DeVito et al. 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Post-explosion behavior may also reflect a failure to learn the task appropriately.

    “Post-explosion behavior may also reflect a failure to learn the task appropriately.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Performance on the BART indexes risk taking and sensitivity to punishment.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Comorbid DBD may mediate the relation between ADHD and substance use outcomes.

    “For example, comorbid DBD may mediate the relation between ADHD and substance use outcomes (Flory and Lynam 2003; Lee et al. 2011).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Flory and Lynam 2003 source

      Not checked in the free run.

    • cites Lee et al. 2011

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  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The ability to accurately determine the importance of an event may require the ability to efficiently recover from a punishment or negative consequence.

    “The ability to accurately determine the importance of an event (i.e., balloon explosion) may require the ability to efficiently recover from a punishment or negative consequence, and children with ADHD and ODD may be more prone to excessive emotional reactivity to minor negative events.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Performance on the BART indexes risk taking and sensitivity to punishment.

  • Classified as probably not a substantial claim.

    Premisecitation

    ADHD is clinically heterogeneous, particularly with respect to comorbidity.

    “It is well known that ADHD is clinically heterogeneous (Faraone 2000; Wåhlstedt et al. 2009), particularly with respect to comorbidity.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Faraone 2000 source

      Not checked in the free run.

    • cites Wåhlstedt et al. 2009 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All interviewers were blind to the child's diagnostic status.

    “All interviewers were blind to the child’s diagnostic status.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Some children had taken their usual medication on the day of testing.

    “In addition, some children had taken their usual medication on the day of testing, and it is unclear if medication influenced BART performance.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The number of explosions was covaried in the models of post-explosion behavior.

    “Given that individuals differed in the number of explosions across the task and each explosion allowed estimating post explosion behavior, the number of explosions was covaried in the models of post explosion behavior.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    BART simultaneously presents rewards and negative punishment, which is necessary to optimally evoke impulsive responding.

    “BART also simultaneously presents rewards (points) and negative punishment (points revoked for an exploded balloon), which is necessary to optimally evoke impulsive responding (Gomez 2003).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Gomez 2003 source

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    The sequential nature of the BART implies a learning effect, which enables participants to determine the nonstationary probabilistic nature of the task.

    “Pleskac (2008) observed that the sequential nature of the BART implies a learning effect, which enables participants to determine the nonstationary probablistic nature of the task.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Pleskac 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Diagnostic designations from the DISC have shown predictive validity in other studies of ADHD.

    “Diagnostic designations from the DISC have shown predictive validity in other studies of ADHD (Owens et al. 2009; Lee et al. 2008).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Owens et al. 2009 source

      Not checked in the free run.

    • cites Lee et al. 2008 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The cross-sectional design did not address relevant questions such as the sensitivity of the BART to ADHD and ODD across time.

    “Our cross-sectional design did not address relevant questions such as the sensitivity of the BART to ADHD and ODD across time.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    Age and BART version were controlled for in the analyses.

    “Next, because the BART is sensitive to age effects (MacPherson et al. 2010), we controlled for the child’s age, as well as the BART version.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites MacPherson et al. 2010 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    It is unclear if medication influenced BART performance.

    “In addition, some children had taken their usual medication on the day of testing, and it is unclear if medication influenced BART performance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Children with ADHD+ODD may be more inclined to perform inconsistently across the task by taking greater risks but also greatly moderating their behavior when their actions led to an undesirable outcome.

    “In fact, these children may be too reactive or unable to adaptively respond to punishment, and therefore may be more inclined to perform inconsistently across the task by taking greater risks but also greatly moderating their behavior when their actions led to an undesirable outcome (i.e., loss of points).”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Performance on the BART indexes risk taking and sensitivity to punishment.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The sample size prevented examination of potential sex or racial-ethnic differences.

    “It should also be noted that alternative BART outcome measures have been used by other researchers (e.g., Lejuez et al. 2003; Pleskac 2008) and our sample size prevented examination of potential sex or racial-ethnic differences.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The findings substantiate the importance of considering DBD in studies of ADHD, BI, risk taking, and punishment sensitivity.

    “Our findings substantiate the importance of considering DBD in studies of ADHD, BI, risk taking, and punishment sensitivity.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: Performance on the BART indexes risk taking and sensitivity to punishment.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Alternative BART outcome measures have been used by other researchers.

    “It should also be noted that alternative BART outcome measures have been used by other researchers (e.g., Lejuez et al. 2003; Pleskac 2008) and our sample size prevented examination of potential sex or racial-ethnic differences.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Lejuez et al. 2003 source

      Not checked in the free run.

    • cites Pleskac 2008 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The study did not determine whether ODD per se related to BART performance or whether ODD was a proxy for callous-unemotional traits or temperament or other constitutional features that may underlie ODD.

    “Another consideration was that we did not determine whether ODD per se related to BART performance or whether ODD was a proxy for callous-unemotional traits or temperament (e.g., harm avoidance) or other constitutional features that may underlie ODD.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The literature on the association between ADHD and sensitivity to punishment is inconsistent, with reports of both diminished reactivity and comparable sensitivity to controls.

    “The literature consists of inconsistent evidence on the association of ADHD and sensitivity to punishment, including reports of diminished reactivity (Masunami et al. 2009) and comparable sensitivity to controls (Geurts et al. 2006).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Masunami et al. 2009 source

      Not checked in the free run.

    • cites Geurts et al. 2006 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Control children who met criteria for any disorder other than ADHD were included to avoid recruiting an improbably high-functioning control group.

    “To avoid recruiting an improbably ‘high-functioning’ control group, which could exaggerate group differences, control children who met criteria for any disorder other than ADHD were included.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Including control children with disorders other than ADHD does not bias the group comparisons.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Test-retest reliability for ADHD diagnosed by the DISC was between .51 and .64 and for ODD was .54.

    “Test-retest reliability for ADHD diagnosed by the DISC was between .51 and .64 and for ODD was .54 in the DSM-IV Field Trials (Lahey et al. 1994a, b).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Lahey et al. 1994a, b

      Not checked in the free run.

41 of 41

  • The paper relies on this without support.

    Including control children with disorders other than ADHD does not bias the group comparisons.

    “To avoid recruiting an improbably ‘high-functioning’ control group, which could exaggerate group differences, control children who met criteria for any disorder other than ADHD were included.”

  • The paper relies on this without support.

    Medication use is not randomly distributed in the population.

    “Given that medication use is not randomly distributed in the population, we could not meaningfully examine the effects of medication on these findings.”

  • The paper relies on this without support.

    Performance on the BART indexes risk taking and sensitivity to punishment.

    “Our findings suggest that children with ADHD-only were slightly less sensitive to punishment compared to control children, but more sensitive than children with ODD-only.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In an experimental decision-making under risk task, children with oppositional defiant disorder, unlike their healthy peers, did not switch from a risky to a safe behavioral strategy after encountering failure.

    “В экспериментальной задаче на принятие решения в условиях риска дети с оппозиционновызывающим расстройством, в отличие от их здоровых сверстников, не переключались с рискованной на безопасную стратегию поведения, столкнувшись с неуспехом (Humphreys, Lee, 2011).”

    From Когнитивные механизмы дисфункционального принятия решений при психических расстройствах (2025) · cites this paper as Humphreys, Lee, 2011

    The Results (Sensitivity to Punishment; page unavailable) report that children with ODD were less responsive than controls to a balloon explosion in a risk-taking task. The Methods measure responsiveness by changes in the number of pumps after an explosion, not by whether a child switched from a risky to a safe strategy. The paper therefore does not establish that children with ODD did not switch strategies at all. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • On the BART, children with ADHD and comorbid ODD were most sensitive to punishment, pumping the balloon less in trials after a balloon pop, followed by NCs, and then children with ADHD without ODD, who were least sensitive.

    “Contrary to expectations, the children with ADHD and comorbid ODD were most sensitive to punishment, in that they pumped the balloon less in trials after having just been penalized with a balloon pop, followed by the NCs, and then the children with ADHD without ODD, who were the least sensitive to punishment.”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [55]

  • Children with ADHD scored lower on post explosion reactivity on the BART than NCs, whereas children with ADHD with comorbid ODD scored higher on this measure than NCs.

    “Another study reported that children with ADHD scored lower on post explosion reactivity on the BART than NCs, whereas children with ADHD with comorbid ODD scored higher on this measure than the NCs [55].”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [55]

  • On the BART, children with ADHD and comorbid ODD pumped up balloons more than children with ADHD without comorbid ODD.

    “The study showed that the ADHD group with comorbid ODD ran more risks by pumping up the balloons more than the ADHD group without comorbid ODD”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [55]

  • On the BART, children with ADHD without comorbid ODD pumped up balloons more than NCs.

    “who did, however, still pump the balloons more than the NCs.”

    From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [55]

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Authors
Humphreys, K. L., & Lee, S. S.
Affiliations
University of California, Los Angeles (US)
Corresponding author
Lee, Steve S.
ORCID
Humphreys, Kathryn L.
Venue
Journal of Psychopathology and Behavioral Assessment
Publisher
Springer Science and Business Media LLC
Published
2011-06-11
Volume
33
Issue
3
Pages
299-307
ISSN
  • 0164-0305 (ISSN-L)
  • 0882-2689
  • 1573-3505
DOI
10.1007/s10862-011-9237-6
PMC
PMC7597674
OpenAlex
W2073945980
Cited by
94
References
88
Citations by year
2026: 5 · 2025: 6 · 2024: 2 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 7 · 2019: 12 · 2018: 8 · 2017: 7 · 2016: 7 · 2015: 11 · 2014: 5 · 2013: 3 · 2012: 2
FWCI
2.19
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Journal of Psychopathology and Behavioral Assessment (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Science Foundation
  • National Institutes of Health
  • National Institute on Alcohol Abuse and Alcoholism (R03AA020186)
  • National Institute on Drug Abuse (RL1DA024853)
  • National Institute of Dental and Craniofacial Research (UL1DE019580)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
risk-taking, punishment sensitivity, negative punishment, behavioral inhibition, attention deficit hyperactivity disorder, oppositional defiant disorder, Balloon Analogue Risk Task, children

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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