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Cited by 142Attention Deficit Hyperactivity DisorderNeural and Behavioral Psychology StudiesDevelopmental and Educational Neuropsychology

Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion

Open access
Sonuga-Barke, Edmund J. S., Wiersema, Jan R., van der Meere, Jacob J., Roeyers, Herbert·2010·Neuropsychology Review
DOI 10.1007/s11065-009-9115-0
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Abstract

The ability to specify differential predictions is a mark of a scientific models' value. State regulation deficits (SRD) and delay aversion (DAv) have both been hypothesized as context-dependent dynamic dysfunctions in ADHD. However, to date there has been no systematic comparison of their common and unique elements. Here we review these hypotheses-and describe the core and secondary manifestations of the two constructs and review evidence in support of them. Second, we focus on what are seen as the hallmark indicators of the two deficits-preference of small immediate over large delayed rewards for DAv and the slow event rate effect for SRD. We describe the overlap between these two manifestations and then explore how experimental manipulations and the analysis of neuropsychological and physiological mediators of effects can allow us to differentiate these two patterns of neuropsychological dysfunction on the basis of specific predictions. Finally, we highlight the implications of neuropsychological heterogeneity for the practical implementation of tests of DAv and SRD.

Verified 2026-10-06 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This review compares delay aversion (DAv) and state regulation deficit (SRD) as context-dependent accounts of ADHD and argues that they overlap but can be distinguished by specific experimental predictions. It concludes that neuropsychological heterogeneity means neither construct likely explains all ADHD, so future work should partition subgroups rather than test one theory against the other.

Key findings

  • DAv and SRD both predict context- and state-dependent performance, but differ in predicted patterns: SRD predicts a nonlinear inverted-U effect of event rate, with deficits at both fast and slow rates and better performance at intermediate rates; DAv predicts linear-like worsening as delays lengthen or event rates slow.
  • Stimulant medication predictions diverge: SRD allows that methylphenidate could impair performance if it pushes an already optimal state into overactivation, whereas DAv predicts neutral or beneficial effects across conditions.
  • Evidence supports both constructs, but effects are modest and inconsistent; case-control neuropsychological differences are no larger than moderate (Cohen’s d < .7), and only subgroups of ADHD cases show any one deficit.
  • Heterogeneity is illustrated by Solanto et al. (2001): DAv and inhibitory deficits were uncorrelated and produced four subgroups (DAv only, inhibitory only, both, neither); a similar dissociation was reported for SRD and executive deficits.

Methods

  • Conceptual and theoretical review, not an empirical study; no new sample or primary data are reported.
  • Synthesizes prior behavioral, psychophysiological, neuroimaging, and pharmacological evidence for DAv and SRD.
  • Proposes differential predictions and experimental manipulations—event rate, pre- and post-reward delay, stimulation type, and stimulant medication—plus multivariate approaches to identify patient subgroups.

Limitations

  • The paper states that no systematic in-depth comparison of DAv and SRD existed before; it also notes unresolved questions about how motor readiness and effort allocation interact in SRD and whether overactivation effects are absent or difficult to induce.
  • It states that optimal event rates and delays vary by task and individual, making tests difficult; evidence for overactivation is scarce, and direct tests of neurobiological independence are lacking.
  • Evident from the text: as a review, it offers no new empirical validation of the proposed differentiating tests, and it notes that co-occurrence of DAv and SRD and individual-level classification remain unclear.

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

Integrity signals

Registry

Crossref · 10.1007/s11065-009-9115-0

Cites

135 of 136 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

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  • Findingcitation

    Context plays an important role in determining the extent to which performance on executive tasks is deficient in ADHD.

    “In keeping with this, context has been shown to play an important role in determining the extent to which performance on executive tasks is deficient in ADHD (cf.Shiels et al., 2008; but see also Shanahan et al., 2008).”
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  • Findingcitation

    When two distinctly different impairments are studied in the same sample, different patients appear to be affected by each one.

    “Finally, when two distinctly different impairments are studied in the same sample different patients appear to be affected by each one.”
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  • Findingcitation

    ADHD children show a preference for smaller sooner over larger later rewards.

    “This is often characterized as a preference for smaller sooner (SS) over larger later rewards (LL) (see Willcutt et al., 2008 for a meta-analysis; but see also Scheres et al., 2006 andBidwell et al., 2007; for a counter case).”
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  • Findingcitation

    There is more consistent evidence for an effect of delay, prior to delivery of rewards, on ADHD children's responses and choices.

    “In contrast to this generally disappointing picture is the more consistent evidence for an effect of delay, prior to delivery of rewards, on ADHD children's responses and choices (Tripp and Alsop, 2001).”
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  • Findingcitation

    ADHD children are unusually vigilant to environmental delay-related cues.

    “are unusually vigilant to environmental delay-related cues (Sonuga-Barke et al., 2004)”
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    Findingcitation

    Many children with ADHD do not show dysfunctional executive processes, while many children without ADHD do show such dysfunction.

    “For instance, many children with ADHD appear not to have dysfunctional executive processes, while many children without ADHD, either with others disorders or with no disorder at all, do (Willcutt et al., 2005).”
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    Findingcitation

    Even when ADHD and executive dysfunction co-occur, the pattern is fragmented and variable, and pervasive severe executive deficit is rare.

    “Even where ADHD and executive dysfunction co-present the pattern is rather fragmented and variable so that pervasive and severe executive deficit appears quite rare (Nigg et al., 2005).”
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    Findingcitation

    Only a sub-sample of ADHD cases show any one deficit to a clinically significant degree, and rarely in a sufficiently pervasive and severe form to suggest a unitary cause for all children.

    “Furthermore, only a sub-sample of ADHD cases seem to show any one deficit to a clinically significant degree and then rarely in a sufficiently pervasive and severe form to suggest a unitary cause for all children (Nigg et al., 2005).”
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    Findingcitation

    A similar pattern of different patients being affected by different impairments was found for SRD and executive deficits, but not for DAv.

    “More recently, a similar pattern was found for SRD and executive deficits (but not DAv; Wåhlstedt et al., 2009).”
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    Findingcitation

    When a choice exists between different levels of delay and escape from delay is possible, children with ADHD choose smaller sooner over larger later rewards or invest less time and effort in a task even though this leads to poorer performance.

    “So for instance, where there is a choice between different levels of delay associated with different activities and outcomes, and escape from delay is possible, children with ADHD choose SS over LL rewards or invest less time and effort in a task even though it would lead to poorer performance and associated outcomes (Sonuga-Barke et al., 2004).”
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    Findingcitation

    A recent review failed to provide much convincing evidence for specific alterations in a wide range of putative motivational mechanisms theorized to be implicated in ADHD.

    “However, a recent review failed to provide much convincing evidence for specific alterations in a wide range of different putative motivational mechanisms theorized, at one time or another, to be implicated in ADHD (e.g., over-or under-sensitivity to reward delivery; Luman et al., 2005).”
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    Findingcitation

    The effect size of case-control differences in neuropsychological or neurological deficits in ADHD is never more than moderate (Cohen's d < .7), and ADHD accounts for only a small proportion of variation in these factors.

    “First, the effect size of case-control differences in neuropsychological or neurological deficits are never more than moderate (Cohen's d < .7;Willcutt et al., 2008) with ADHD accounting for only a small proportion of variation in these factors.”
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    Findingcitation

    DAv and inhibitory control deficits are uncorrelated but both are associated with ADHD; four subgroups can be identified: DAv only, inhibitory deficits only, both deficits, and neither deficit.

    “For instance, the classic paper by Solanto et al., (2001) illustrates this most clearly -DAv and inhibitory control deficits were uncorrelated but yet both were associated with ADHD: Four subgroups of children could be identified -DAv and no inhibitory deficits; inhibitory deficits and no DAv; both deficits and neither deficits (see also Thorell, 2007).”
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    Findingcitation

    Recent studies suggest underactivation in the ventral striatum in ADHD following the signaling of future rewards.

    “To date the role of structural and/or functional alterations within this circuit in ADHD remain under-researched although recent studies suggest underactivation in the ventral striatum in ADHD following the signaling of future rewards (Scheres et al., 2007) and over-activation of the amygdala as delay to rewards increase (Plichta et al., 2009).”
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    Findingcitation

    Different brain networks are differentially activated in relation to rewards and delay.

    “Furthermore, our understanding of the functional neuroanatomy of delay-related activity more generally is developing with, for instance, the suggestion that different brain networks are differentially activated in relation to rewards and delay (Ballard and Knutson, 2009).”
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    Findingcitation

    A subsequent analysis suggested that there might actually be two separate delay-related factors.

    “although a subsequent analysis suggested that there might actually be two separate delay-related factors; Bitsakou and Sonuga-Barke, submitted”
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    Findingcitation

    Stimulant medication reduces symptoms of ADHD and improves academic and more general functioning.

    “Stimulant medication (e.g., methylphenidate and amphetamine) reduces symptoms of ADHD and improves academic and more general functioning (Taylor and Sonuga-Barke, 2008).”
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    Findingcitation

    The ventral striatum is highly sensitive to relatively minor temporal alterations on reward discounting tasks.

    “Indeed Gregorios-Pippas et al., (2009) recently demonstrated that the ventral striatum is highly sensitive to relatively minor temporal alterations on reward discounting tasks.”
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    Findingcitation

    The effects of methylphenidate on performance on an academic task appear to be mediated by an increase in task salience and enhanced positive task valence.

    “Consistent with a motivational account of the therapeutic action of methylphenidate, Volkow et al. (2004) has shown that the effects of methylphenidate on performance on an academic task appear to be mediated by an increase in task salience and enhanced positive task valence.”
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    Findingcitation

    The effects of stimulant medication can be mirrored in improved performance on laboratory-based cognitive tasks.

    “These effects can be mirrored in improved performance on laboratory-based cognitive tasks (Coghill et al., 2007).”
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    Findingcitation

    Recent studies suggest over-activation of the amygdala as delay to rewards increases in ADHD.

    “To date the role of structural and/or functional alterations within this circuit in ADHD remain under-researched although recent studies suggest underactivation in the ventral striatum in ADHD following the signaling of future rewards (Scheres et al., 2007) and over-activation of the amygdala as delay to rewards increase (Plichta et al., 2009).”
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    Findingcitation

    Evidence from animal and human models suggests that stimulants reduce impulsiveness, increase preference for delayed over immediate rewards, and speed up the internal clock, thereby reducing the perception of the passage of external time.

    “Evidence from animal (Bizot et al., 2007) and human models (van Gaalen et al., 2006) suggest that stimulants reduce impulsiveness and increase preference for delayed over immediate rewards (Pietras et al., 2003) and speed up the 'internal clock' thereby reducing the perception of the passage of external time (Mattel et al., 2004).”
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    Findingcitation

    Although the effect of smaller sooner over larger later choice in ADHD appears generally robust, there is variability across studies with a number reporting negative results.

    “Although the effect appears generally robust there is a degree of variability across studies with a number reporting negative results (Bidwell et al., 2007;Scheres et al., 2006;Wåhlstedt, et al., 2009).”
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    Findingcitation

    ADHD children's preference for larger later rewards increased when they were given access to additional stimulation, a finding consistent with the relationship between DAv and stimulation seeking.

    “In one study, ADHD children's preference for LL increased when they were given access to additional stimulation -a finding consistent with the relationship between DAv and stimulation seeking (Antrop et al., 2006).”
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    Findingcitation

    The first study examining the extent to which methylphenidate reduces impulsive choice in ADHD using a discounting procedure has been published with positive results.

    “The first study examining the extent to which methylphenidate reduces impulsive choice in ADHD using a discounting procedure has been published with positive results (Shiels et al., in press).”
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    Findingcitation

    Two other recent studies give rather mixed results in relation to related concepts of risk taking/gambling and reflection/impulsivity.

    “Two other recent studies give rather mixed results in relation to related concepts (Risk Taking/Gambling -DeVito et al., 2008;reflection/impulsivity -DeVito et al. 2008).”
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    Findingcitation

    In the Marco et al. (2009) study, ADHD children chose smaller sooner over larger later rewards more than controls under both conditions, but this preference was greater when there was no post-reward delay and overall delay could be avoided.

    “In this study ADHD children chose SS over LL more than controls under both conditions -but this preference was greater when there was no post-reward delay and overall delay could be avoided.”
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    Findingcitation

    A recent study by Scheres et al. (2008) supported the notion that DAv may be associated with the hyperactive/impulsive dimension rather than the inattentive one.

    “As far as ADHD sub-types are concerned it has been suggested that DAv may be associated with the hyperactive/impulsive dimension rather than the inattentive one.Inconsistent with the DAv theory, a recent study by Scheres et al. (2008) supported this notion.”
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    Premisecitation

    Heterogeneity is an established characteristic of ADHD at the level of etiology and clinical presentation.

    “Heterogeneity is an established characteristic of ADHD at the level of etiology (with different genes and different environments being implicated in different individuals; Zhou et al., 2008) and at the level of clinical presentation (as captured by diagnostic subtypes; Brookes et al., 2008).”
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    Premisecitation

    Executive functions are dynamic processes, and performance on executive tasks fluctuates across states and settings.

    “Executive functions are themselves dynamic processes and performance on executive tasks will fluctuate from state-tostate and setting-to-setting (Nigg and Casey, 2005).”
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    Interpretationcitation

    DAv can also be manifest in non-choice settings through secondary adaptations, giving it a broad impact across choice and non-choice settings, with effects being context specific.

    “DAv can also be manifest in non-choice settings through what we refer to here as secondary adaptations -in this sense DAv has a broad impact across different choice and non-choice settings -with effects being context specific (Sonuga-Barke, 1994;Sonuga-Barke, 2005;Bitsakou et al., 2009).”
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    Interpretationcitation

    Executive deficits and DAv appear to be based within different brain circuits.

    “In keeping with the notion that executive deficits and DAv are dissociable elements within the pathophysiology of ADHD, they appear to be based within different brain circuits (Dalley et al., 2008).”
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    Interpretationreasoning

    There is some initial support for the statistical overlap between primary manifestations and secondary adaptations of DAv, although this may be more complicated than initially thought.

    “There is therefore some initial support for the statistical overlap between primary manifestations and secondary adaptations of DAv, although this may be more complicated than initially thought.”
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    Premisecitation

    Dopamine appears to play a special role in the control of delay-related responding.

    “Dopamine is a key neuro-modulator (Cools, 2008) and appears to play a special role in the control of delay-related responding (Roesch et al., 2007).”
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    Premisecitation

    At a cellular level, stimulant drugs increase levels of extra-cellular dopamine either by increasing its release or by reducing its reuptake through blocking the dopamine or norepinephrine transporter.

    “At a cellular level it seems fairly clear that stimulant drugs increase levels of extra-cellular dopamine either by increasing its release, (e.g., amphetamines; Joyce et al., 2007), or reducing its reuptake by blocking the dopamine or norepinephrine transporter (e.g., methylphenidate; Schiffer et al., 2006).”
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    Premisecitation

    In the cognitive-energetic framework, task efficiency is considered as a product of a combination of elementary cognitive stages and their energy distribution.

    “In this model task efficiency is considered as a product of a combination of elementary cognitive stages (level 1 -stimulus encoding, memory search, binary decision and motor preparation) and their energy distribution (level 2 and 3 -see figure 2).”
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    Interpretationreasoning

    If deficits in ADHD were located exclusively at level 1, independent of levels 2 and 3, this would be consistent with a model that presents ADHD as the result of a fixed core cognitive deficit.

    “Therefore if deficits in ADHD were to be located exclusively at this level, independent of levels 2 and 3, this would be consistent with a model that presents ADHD as the result of a fixed core cognitive deficit.”
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    Premisecitation

    Later accounts have drawn a distinction between phasic arousal processes and tonic activation processes, with the former specifically affecting input processes such as stimulus encoding and the latter affecting output processes such as motor preparation.

    “Although at first arousal was seen as a unified construct, being the non-directional component of motivation, later accounts (Mulder, 1986;Sanders, 1983Sanders, , 1998)), have drawn a useful distinction between phasic arousal processes and tonic activation processes, with the former specifically affecting input processes (i.e., stimulus encoding) and the later affecting output processes (i.e., mot”
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    Interpretationreasoning

    These effects are relatively modest in size, suggesting neuropsychological heterogeneity and that only a sub-set of ADHD children display DAv.

    “As is the case with executive deficits these effects are relatively modest in size suggesting neuropsychological heterogeneity and that only a sub-set of ADHD children display DAv.”
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    Interpretationcitation

    In part, the impulsive choices associated with substance abuse disorders and conduct disorders may be due to the overlap between these conditions and ADHD, or at least to a common neuro-biological vulnerability.

    “In part the impulsive choices associated with substance abuse disorders and conduct disorders may be due to the overlap between these conditions and ADHD, or at least to a common neuro-biological vulnerability (Szobot and Bukstein, 2008).”
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    Premisenone given

    SRD models emphasize that impairment in ADHD is highly variable as a function of context.

    “These models emphasize that impairment in ADHD is highly variable as a function of context.”
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    Interpretationreasoning

    There is evidence to support the notion that ADHD children can be DAv in both the narrow sense of choosing smaller sooner over larger later rewards to escape delay in choice situations and in the broader sense seen in the effects of time-on-task or trial length on performance in non-choice situations.

    “In summary there is evidence to support the notion that ADHD children can be DAv in both the narrow sense of choosing SS over LL rewards to escape delay in choice situations and in the broader sense as in seen in the effects of time-on-task/trial length on performance in non-choice situations.”
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    Premisecitation

    Level 1 components are core structural processes that mediate between a stimulus and response.

    “Level 1components are seen as core structural processes that mediate between a stimulus and response.”
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    Premisecitation

    Effort at level 3 is necessary to meet task demands and to compensate for a sub-optimal energetic state by modulating arousal and activation levels.

    “Effort (level 3) is necessary to meet task demands and to compensate for a sub-optimal energetic state by modulating arousal and activation levels.”
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    Premisecitation

    The development of SRD accounts of ADHD is situated within the cognitive-energetic framework of information processing efficiency developed by Sanders.

    “The development of SRD accounts of ADHD are situated within the cognitiveenergetic framework of information processing efficiency developed by Sanders (1983Sanders ( , 1998)).”
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    Premisecitation

    According to the cognitive energetic framework, the functioning of elementary stages at level 1 is regulated by the arousal and activation processes of the subject represented at level 2.

    “According to the cognitive energetic framework the functioning of these elementary stages at level 1 is regulated by the arousal and activation processes of the subject represented at level 2.”
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    Premisenone given

    In contrast to the DAv model, SRD models have as their primary focus the energetic state of the ADHD child and the explanation of state-specific and context-dependent aspects of cognitive performance deficits.

    “In contrast to the DAv model, however, their primary focus is on the energetic state of the ADHD child and they have as their primary goal the explanation of statespecific and context dependent aspects of cognitive performance deficits.”
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    Premisecitation

    Energetic processes are also affected by task characteristics; for instance, arousal level is influenced by stimulus repetition.

    “Energetic processes are also affected by task characteristics.For instance, arousal level is influenced by stimulus repetition.”
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    Premisecitation

    Worse performance in a slow condition by adults with ADHD was accompanied by less activity in ACC and diminished activity in thalamus.

    “Worse performance in a slow condition by adults with ADHD was accompanied, together with diminished activity in thalamus, by less activity in ACC”
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    Premisecitation

    Using Sternberg's additive factor method, Sanders showed that the processing stages at level 1, as well as the energetic levels 2 and 3, could be separately influenced by task manipulations.

    “Using Sternberg's additive factor method (1969), Sanders showed that the processing stages at level 1, as well as the energetic levels 2 and 3 could be separately influenced by what he called 'task manipulations'.”
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    Premisecitation

    The typically slow and variable response style in ADHD, when stimuli are presented at a low rate, is a consistent finding, whereas findings are mixed with respect to errors of commission.

    “The typically slow and variable response style in ADHD, when stimuli are presented at a low rate, is a consistent finding in these studies, whereas findings are mixed with respect to errors of commission”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Börger et al., 2000a

      Not checked in the free run.

    • cites Potgieter et al., 2000

      Not checked in the free run.

    • cites Scheres et al., 2001 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisenone given

    The SRD model of ADHD attributes deficits to failures to properly regulate energetical state (arousal/activation) when challenged in sub-optimal settings or states.

    “In a general sense the SRD model of ADHD deficits sees these as being due to failures to properly regulate energetical state (arousal/activation) when challenged to do so in sub-optimal settings or states.”
    Quote in the paperSubstantial claim

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

    Interpretationcitation

    From an SRD perspective, slow event rates produce under-activation and MPH increases the activation state, which in turn results in enhanced task performance.

    “From an SRD perspective this is interpreted as evidence that slow event rates produce under-activation and that MPH increases the activation state, which in turn results in enhanced task performance”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Sikstrom and Söderlund, 2007 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    The hallmark of the state regulation deficit is the impact of variations in required activation level induced by changes in task characteristics on task performance.

    “The hallmark of this deficit is the impact of variations in required activation level induced by changes in task characteristics on task performance.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Event rate is a key probe of activation processes.

    “Of these, event rate has been seen as a / the key probe of activation processes.”
    Quote in the paperNot a substantial claim

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

    Interpretationnone given

    Neuropsychological heterogeneity changes how neuropsychological dysfunction in ADHD is conceptualised, theorised, and measured.

    “Neuropsychological heterogeneity significantly alters the way we conceptualise, theorise and measure neuropsychological dysfunction in ADHD.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: ADHD is neuropsychologically heterogeneous.

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    The DAv model predicts linear-like effects whereby performance deficits are expected on delayed compared with a non-delayed condition; no difference under high event rate, some differences on intermediate trials, and largest effects on slow event rate conditions.

    “In contrast, the DAv model predicts linear-like effects whereby performance deficits are expected on delayed compared with a non-delayed condition; the prediction being no difference under high event rate conditions, some differences emerging on intermediate trials and the largest effects on slow event rate conditions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The Kooistra et al. (2006) fMRI study indicated that the anterior cingulate and the thalamus are involved in maintaining a state of optimal readiness to respond through effort allocation; during a slow event rate, these areas were less active in adults who had been diagnosed with ADHD as children.

    “The Kooistra et al, (2006) fMRI study mentioned above indicated that the anterior cingulate and the thalamus are involved in maintaining a state of optimal readiness to respond through effort allocation; during a slow event rate, these areas were less active in adults who had been diagnosed with ADHD as children.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kooistra et al, (2006)

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Children with ADHD have a rapid decline in task efficiency over time with a slow presentation rate, but not with a fast presentation rate.

    “Children with ADHD were found to have a rapid decline in task efficiency over time with a slow presentation rate, but not with a fast presentation rate”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites van der Meere, 2002

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Both SRD and DAv highlight the dynamic and context dependent nature of task performance.

    “In general terms they both highlight the dynamic and context dependent nature of task performance”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisereasoning

    SS is related to higher event rate and LL to lower.

    “SS is related to higher event rate and LL to lower.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S1 (asserted), S4 (based).

    Interpretationreasoning

    The effects of delay on preference for SS would be more strongly related to delay level (event rate) than reward magnitude per se.

    “One might also predict that these effects would be more strongly related to delay level (event rate) than reward magnitude per se.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisenone given

    ADHD children choose SS over LL more than controls.

    “The fact that ADHD children choose SS over LL more than controls has traditionally been regarded as the hallmark of DAv.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    The DAv account sees accessing stimulation during delay as a means of altering the perception and aversiveness of the passage of time during delay.

    “The DAv account see accessing stimulation during delay as a means of altering the perception and aversiveness of the passage of time during delay.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The processes and effects involved in state regulation deficit and delay aversion are dynamic and vary across time and settings.

    “First, is the dynamic nature of these processes and effects and the way that they vary from time-to-time and setting to setting.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    The DAv model predicts that non-temporal stimulation would be most influential in reducing preference for SS, while temporal stimulation should make time drag and increase preference for SS.

    “For the DAv model the stimulation would be most influential in reducing preference for SS if it is non-temporal in nature (i.e., de-emphasized time in passing) while temporal stimulation should make time drag and increase preference for SS.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    For DAv, performance is expected to be worse 'off' medication under slow event rates, but medication would have either a neutral or a positive effect on performance in the fast rate condition.

    “For DAv, as with the SRD model performance is expected to be worse 'off' medication under slow event rates.However, in contrast to the SRD model the DAv theory predicts that medication would have either a neutral or a positive effect on performance in the fast rate condition.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    The SRD and DAv theoretical constructs share many features in common and often make similar predictions.

    “the SRD and DAv theoretical constructs share many features in common and often make similar predictions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationnone given

    The underlying impairments in state regulation deficit and delay aversion are expressed very similarly in many settings, so telling them apart requires subtle distinctions.

    “differentiating these different elements relies on dissecting some rather subtle distinctions -with the two different underlying patterns of impairment expressing themselves in very similar ways in many settings.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    In SRD, both event rate and MPH are regarded as important regulators of activation state and are predicted to act additively to change cognitive energetic dynamics and alter performance.

    “Second, in SDR both event rate and MPH are regarded as important regulators of activation state and these factors are predicted to act additively to change the cognitive energetic dynamics of the task and therefore alter performance.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    The effect of choosing SS over LL is especially pronounced where choice of the SS allows the child to reduce trial/session length and seems to be normalised where patients are allowed access to additional stimulation during delay.

    “It is especially pronounced where choice of the SS allows the child to reduce trial/session length (Marco et al., 2009) and seems to be normalised where patients are allowed access to additional stimulation during delay (Antrop et al., 2006).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Marco et al., 2009 source

      Not checked in the free run.

    • cites Antrop et al., 2006

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The ISI effect on RT performance diminishes as a function of age, is independent of IQ level, and differentiates at the group level between ADHD and aggressive behaviour problems such as conduct disorder and oppositional defiant disorder.

    “The ISI effect on RT performance diminishes as a function of age (van der Meere and Stemerdink, 1999), is independent of IQ level (van der Meere and van der Meere, 2004), and differentiates at the group level between ADHD and aggressive behaviour problems such as conduct disorder and oppositional defiant disorder (van der Meere et al., 2005).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites van der Meere and Stemerdink, 1999 source

      Not checked in the free run.

    • cites van der Meere and van der Meere, 2004

      Not checked in the free run.

    • cites van der Meere et al., 2005

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    State regulation deficit and delay aversion are conceptually and theoretically distinct constructs.

    “While these two notions share some features we established their conceptual and theoretical distinctiveness”
    • Also stated in: § ISSUES OF IMPLEMENTATION AND APPLICATION · plain
      “we can differentiate SRD and DAv in terms of concepts and predictions”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    From the SRD perspective, these findings are consistent with the notion that ADHD are either easily under-activated or find it more difficult to counteract under-activation.

    “From the perspective of the SRD model these findings are consistent with the notion that ADHD are either easily under-activated or find it more difficult to counteract under-activation.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based). May combine two claims.

    Premisenone given

    In the DAv hypothesis, MPH is predicted to operate by increasing the salience of events and/or improving their valence by changing time perception and/or enhancing the signalling of future events and rewards.

    “In contrast, in the DAv hypothesis MPH is predicted to operate by increasing the salience of events and/or improving their valence by changing time perception and/or enhancing the signalling of future events and rewards.”
    Quote in the paperNot a substantial claim
70 of 70

  • The paper relies on this without support.

    There has been no systematic in-depth attempt to compare and contrast DAv and SRD in the literature.

    “Given this uncertainty it is perhaps surprising that there has been no systematic in-depth attempt to compare and contrast DAv and SRD so far in the literature.”

  • The paper relies on this without support.

    There has been no direct study of the independence of the neurobiological foundations of executive deficits and DAv within ADHD.

    “However, there has to date been no direct study of the independence of the neurobiological foundations of these distinctive elements within ADHD.”

  • The authors state this as an assumption.

    The relationship between cognitive energetic processes and performance follows an inverted U function.

    “the relationship between cognitive energetic processes and performance as affected by these factors is predicted to follow an inverted 'U' function.”

  • The authors state this as an assumption.

    The concept of optimality can be extended from required to desired event rate/delay.

    “if we assume that the concept of optimality can be extended from required to desired event rate/delay as described above.”

  • The paper relies on this without support.

    ADHD is neuropsychologically heterogeneous.

    “Neuropsychological heterogeneity significantly alters the way we conceptualise, theorise and measure neuropsychological dysfunction in ADHD.”
5 of 5

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?

  • There is considerable heterogeneity in cognitive impairments in ADHD, with some patients not showing impairments or only in some cognitive domains.

    “Last, there is considerable heterogeneity in cognitive impairments, with some patients not showing impairments or only in some cognitive domains, which may be underpinned by different pathophysiological pathways (Sonuga-Barke, 2003; Nigg et al., 2005; Sonuga-Barke et al., 2010).”

    From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Sonuga-Barke et al., 2010

  • Anticipation of forced waiting times, which are particularly aversive to individuals with ADHD, also elicited enhanced amygdala activation.

    “Interestingly, the anticipation of forced waiting times, which are particularly aversive to individuals with ADHD (Sonuga-Barke et al., 2010) also elicited enhanced amygdala activation (Wilbertz et al., 2013).”

    From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Sonuga-Barke et al., 2010

  • Most studies report that ADHD-related increases in reaction time variability are attenuated or disappear during faster event rates.

    “Most studies report that ADHD-related increases in RTV disappear are attenuated, and often disappear, during faster ERs [39,83,85,86].”

    From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [85]

  • Long event rates, relative to what is optimal for the task, appear to exacerbate ADHD-related between-group differences.

    “Alternatively, long ERs, relative to what is optimal for the task, appear to exacerbate ADHD-related between-group differences [14,85].”

    From Reaction Time Variability in ADHD: A Review (2012) · cites this paper as [85]

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Banaschewski, T., Sergeant, J. A., Sonuga-Barke, E. J. S., Coghill, D., Döpfner, M., Rohde, L., et al. (in press). Attention-deficit hyperactivity disorder (ADHD) and hyperkinetic disorder (HKD). London: Oxford.
  2. Damasio, A. R. (1994). Decartes error. Emotion, reason, and the human brain. New York: Avon Books.
  3. Shiels, K., Hawk, L.W., Jr., Reynolds, B., Mazzullo, R., Rhodes, J., Pelham, W.E., Jr., et al. (in press). The effects of methylphenidate on discounting of delayed rewards in ADHD. Experimental and Clinical Psychopharmacology.

Cited by

Sorted by citations

Related

Authors
Sonuga-Barke, E. J. S., Wiersema, J. R., van der Meere, J. J., & Roeyers, H.
Affiliations
Ghent University (BE)
Corresponding author
Sonuga-Barke, Edmund J. S.
ORCID
Venue
Neuropsychology Review
Publisher
Springer Science and Business Media LLC
Published
2009-09-15
Volume
20
Issue
1
Pages
86-102
ISSN
  • 1040-7308 (ISSN-L)
  • 1573-6660
DOI
10.1007/s11065-009-9115-0
OpenAlex
W2154741675
Semantic Scholar
7c9cd3b4ec28aa5e0532a9c053845ecfbf2401e5
Cited by
142
References
135
Citations by year
2026: 5 · 2025: 4 · 2024: 4 · 2023: 8 · 2022: 5 · 2021: 10 · 2020: 6 · 2019: 6 · 2018: 7 · 2017: 8 · 2016: 9 · 2015: 12 · 2014: 13 · 2013: 11 · 2012: 18
FWCI
6.68
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Neuropsychology Review (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, other-oa)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
  • ePrints Soton (University of Southampton) (submittedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
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 › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
attention deficit hyperactivity disorder, delay aversion, impulsivity, delay discounting
MeSH terms
Attention Deficit Disorder with Hyperactivity, Cognition Disorders, Environment, Humans, Models, Psychological, Executive Function

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 2026-10-06.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-06.

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