The effects of methylphenidate on decision making in attention-deficit/hyperactivity disorder
Open accessAbstract
BACKGROUND: Children with attention-deficit/hyperactivity disorder (ADHD) frequently display poor judgment and risk taking in their everyday behavior, but there are little empirical data on decision-making cognition in this disorder. The objectives of the study were to assess the effects of stimulant medication on decision making in ADHD and compare performance on the Cambridge Gamble Task between boys with and without ADHD. METHODS: Twenty-one boys (aged 7-13) diagnosed with ADHD underwent a double-blind, placebo-controlled trial of methylphenidate (.5 mg/kg) during which they performed the Cambridge Gamble Task (CGT). A healthy age-matched control group was tested on two occasions off drug. RESULTS: The ADHD group bet more conservatively on the methylphenidate session than on the placebo session. In comparison with healthy control subjects, the ADHD group made more poor decisions, placed their bets more impulsively, and adjusted their bets less according to the chances of winning. Poor decision making was correlated with parent-reported symptoms and disruptive behavior in the ADHD group. CONCLUSIONS: Methylphenidate reduced risk-prone betting behavior on the CGT. Compared with control subjects, children with ADHD display a number of decision-making deficits on the task, and the measure of rational decision making may serve as an ecologically valid neuropsychological marker of impairment.
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MPH reduced the number of points bet in the CGT, indicating that fewer risks were run by children/adolescents with ADHD treated with MPH.
“Finally, another study demonstrated that MPH reduced the number of points bet in the CGT, which indicates that fewer risks were run by children/adolescents with ADHD who were treated with MPH [57].”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [57]
In the MPH condition of the CGT, children with ADHD bet fewer points, lowering their risk, but did not differ from the placebo condition in number of rational choices or risk adjustment.
“In the MPH condition, the children with ADHD bet fewer points, thereby lowering their risk, but did not differ from the placebo condition in their number of rational choices or risk adjustment.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [57]
In the placebo condition of the CGT, children with ADHD did not differ from NCs on mean betting proportion (risk-taking; Cohen's d = 0.27).
“In the placebo condition, the children with ADHD did not differ from the NCs on the mean betting proportion (risk-taking; Cohen’s d = 0.27).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [57]
On the CGT, children with ADHD made less rational choices and scored lower on risk adjustment than NCs.
“However, children with ADHD made less rational choices and scored lower on risk adjustment than the NCs.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [57]
One study found that children with ADHD on MPH performed less risky on a gambling task compared to placebo.
“While one study found that children with ADHD on MPH performed in a less risky fashion on a gambling task compared to when on a placebo [57]”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [57]
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).”
From Risk taking and sensitivity to punishment in children with ADHD, ODD, ADHD+ODD, and controls (2011) · cites this paper as DeVito et al. 2008
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- Authors
- DeVito, E. E., Blackwell, A. D., Kent, L., Ersche, K. D., Clark, L., Salmond, C. H., Dezsery, A. M., & Sahakian, B. J.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- DeVito, Elise E.
- ORCID
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 64
- Issue
- 7
- Pages
- 636-639
- ISSN
- 0006-3223 (ISSN-L)
- PMC
- PMC2577132
- OpenAlex
- W2090107670
- Cited by
- 142
- References
- 19
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 4 · 2023: 5 · 2022: 4 · 2021: 9 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 9 · 2016: 13 · 2015: 11 · 2014: 5 · 2013: 13 · 2012: 8
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Biological Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust (086041, 076274/Z/04/Z)
- 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, methylphenidate, decision-making, risk-taking, impulsivity, stimulant medication, children, rational decision-making, neuropsychological markers, disruptive behavior
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Child, Decision Making, Gambling, Humans, Male, Methylphenidate, Neuropsychological Tests
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