Temporal reward discounting in attention-deficit/hyperactivity disorder: the contribution of symptom domains, reward magnitude, and session length
Abstract
Background Theoretical models have hypothesized that one core problem in attention-deficit/hyperactivity disorder (ADHD) is abnormal reward processing. Temporal reward discounting (decreases in subjective reward value due to prereward delay) is of interest because of its relation with a key symptom of ADHD-impulsivity. This study investigated 1) whether steep temporal reward discounting (TD) is associated with ADHD-combined type (ADHD-C)/symptoms of hyperactivity-impulsivity specifically; 2) the role of reward magnitude in TD in ADHD-C/participants with symptoms of hyperactivity-impulsivity; and 3) whether steep TD in ADHD-C/participants with symptoms of hyperactivity-impulsivity is affected by session length.Methods Three TD tasks were administered to children and adolescents (aged 6-17) with ADHD-C (n = 25), ADHD-inattentive type (ADHD-I; n = 20), and matched typically developing participants (n = 37). Reward magnitude and session length were varied.Results Steep TD was observed in participants with ADHD-C but not in those with ADHD-I, independent of reward magnitude and session length. Dimensional analyses revealed that steep TD was associated with hyperactivity-impulsivity (transcending the arbitrary cutoff for ADHD subtypes), especially when reward magnitude at the trial level was small.Conclusions These findings suggest that steep TD in ADHD is best thought of as a correlate of the symptom dimension of hyperactivity/impulsivity. Additionally, steep TD in ADHD is the result of a trade-off between delay and reward magnitude, with all factors contributing to choice preferences. These findings may help refine the delay aversion theory of ADHD, and provide evidence for the notion that unique reward processing is one mechanism associated with symptoms of hyperactivity-impulsivity.
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Children, adolescents, and adults with ADHD discount delayed reinforcers at higher rates than healthy controls.
“Studies have shown that children (Scheres et al., 2010; Wilson et al., 2011), adolescents (Barkley et al., 2001; Scheres et al., 2010) and adults (Hurst et al., 2011; Scheres et al., 2008) with ADHD discount delayed reinforcers at higher rates than healthy controls.”
From Excessive discounting of delayed reinforcers as a trans-disease process contributing to addiction and other disease-related vulnerabilities: Emerging evidence (2012) · cites this paper as Scheres et al., 2010
Experimental data suggest an association between risky and impulsive behavior, characteristic of ADHD, and dopamine release or dopamine-dependent BOLD response to rewards in the striatum.
“Additionally, experimental data suggest an association between risky and impulsive behavior, which is characteristic of ADHD,14–16 and dopamine release or dopamine-dependent BOLD response to rewards in the striatum.11,17–20”
From Striatal sensitivity during reward processing in attention-deficit/hyperactivity disorder (2012) · cites this paper as [16]
The relatively small sample size (n=11) and inclusion of both genders and mixed ADHD subtypes in the prior study make direct comparisons difficult.
“Yet the relatively small sample size in that study (n=11)3 and the inclusion of both genders and mixed ADHD subtypes (factors that have been associated with reward-related activation and impulsivity16,45) make direct comparisons difficult.”
From Striatal sensitivity during reward processing in attention-deficit/hyperactivity disorder (2012) · cites this paper as [16]
Delay discounting paradigms have been used in few studies with ADHD patients, yielding somewhat inconsistent findings.
“Delay discounting paradigms overcome many of these problems, but have been used in few studies with ADHD patients, yielding somewhat inconsistent findings.”
From DAT1 and COMT effects on delay discounting and trait impulsivity in male adolescents with attention deficit/hyperactivity disorder and healthy controls (2010) · cites this paper as Scheres et al, 2010
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“Most studies did not make a distinction between ADHD subtypes and it is important to note that, when treated as different groups, some studies have reported that ADHD subtypes exhibit significantly different results for delay discounting (77) and Scheres et al.”
ResultDelay discounting of reward in ADHD: application in young children
Wilson, V. B., Mitchell, S. H., Musser, E. D., Schmitt, C. F., & Nigg, J. T. (2011) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2010.02347.x · Cited by 158 · see citing works
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“Steep discouting has thereby been rather associated with symptoms of impulsivity and hyperactivity than with inattention (Scheres et al., 2008, 2010, 2013).”
BackgroundTOWARDS A GENERAL MODEL OF TEMPORAL DISCOUNTING
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Behavioral trainings and manipulations to reduce delay discounting: A systematic review
Scholten, H., Scheres, A., de Water, E., Graf, U., Granic, I., & Luijten, M. (2019) · Psychonomic Bulletin & Review · doi:10.3758/s13423-019-01629-2 · Cited by 135 · see citing works
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Striatal sensitivity during reward processing in attention-deficit/hyperactivity disorder
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Abnormal striatal BOLD responses to reward anticipation and reward delivery in ADHD
Furukawa, E., Bado, P., Tripp, G., Mattos, P., Wickens, J. R., Bramati, I. E., Alsop, B., Ferreira, F. M., Lima, D., Tovar-Moll, F., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089129 · Cited by 90 · see citing works
de Water, E., Cillessen, A. H. N., & Scheres, A. (2014) · Child Development · doi:10.1111/cdev.12245 · Cited by 80 · see citing works
Self-citationMechanisms of impulsive choice: II. Time-based interventions to improve self-control
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Scheres, A., Tontsch, C., Thoeny, A. L., & Sumiya, M. (2014) · Frontiers in Psychology · doi:10.3389/fpsyg.2014.00711 · Cited by 62 · see citing works
Self-citationEffects of α-2A adrenergic receptor agonist on time and risk preference in primates
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Reward: empirical contribution. Temporal discounting and conduct disorder in adolescents
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Scheres, A., Sumiya, M., & Thoeny, A. L. (2010) · International Journal of Methods in Psychiatric Research · doi:10.1002/mpr.309 · Cited by 44 · see citing works
Self-citationOrtiz, N., Parsons, A., Whelan, R., Brennan, K., Agan, M., O'Connell, R., Bramham, J., & Garavan, H. (2015) · Acta Neurobiologiae Experimentalis · doi:10.55782/ane-2015-2038 · Cited by 40 · see citing works
Decision making: effects of methylphenidate on temporal discounting in nonhuman primates
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ADHD Subtype Differences in Reinforcement Sensitivity and Visuospatial Working Memory
Dovis, S., Van der Oord, S., Wiers, R. W., & Prins, P. J. M. (2015) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.895940 · Cited by 22 · see citing works
Hammer, R., Tennekoon, M., Cooke, G. E., Gayda, J., Stein, M. A., & Booth, J. R. (2015) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2015.06.002 · Cited by 21 · see citing works
- Authors
- Scheres, A., Tontsch, C., Thoeny, A. L., & Kaczkurkin, A.
- Affiliations
- University of Arizona (US)
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2010-04
- Volume
- 67
- Issue
- 7
- Pages
- 641-648
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2104902913
- Cited by
- 167
- References
- 92
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6 · 2023: 7 · 2022: 7 · 2021: 8 · 2020: 11 · 2019: 3 · 2018: 9 · 2017: 7 · 2016: 16 · 2015: 16 · 2014: 20 · 2013: 9 · 2012: 18
- FWCI
- 7.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- National Institute of Mental Health (MH074512-01A1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Decision Sciences › General Decision Sciences › Decision-Making and Behavioral Economics
- Keywords
- attention deficit hyperactivity disorder, hyperactivity/impulsivity, reward magnitude, session duration, ADHD subtypes, impulsivity, children and adolescents, delay discounting
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Surveys and Questionnaires, Reward, Severity of Illness Index, Time Factors
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