Risky decision making in adults with ADHD
Abstract
Background and objectives Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD.Methods In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT.Results In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction.Limitations Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression.Conclusions Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research.
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Of three studies assessing the GDT in adults with ADHD, only one found that adults with ADHD performed in a more risky fashion than NCs.
“Of the three studies assessing the GDT in adults with ADHD [67], [68], only one study found that adults with ADHD performed in a more risky fashion than the NCs [67] (study 1).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
In the positive GDT study, adults with ADHD stayed less often with a safe option after positive feedback, and stayed more often with a risky option after negative feedback in comparison to NCs.
“In that the adults with ADHD stayed less often with a safe option after positive feedback, and stayed more often with a risky option after negative feedback in comparison to the NCs.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
In the first Matthies et al. study, adults with ADHD compared to NCs stayed less often with a safe option after positive feedback and stayed more often with a risky option after negative feedback.
“In their first study, Matthies et al. [67)] (study 1 found that adults with ADHD compared to NCs stayed less often with a safe option after positive feedback and stayed more often with a risky option after negative feedback.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
In the second GDT study with boredom induction, there was no difference between adults with ADHD and NCs in net score (Cohen's d = 0.70) or feedback use.
“In contrast to the first study [67] (study 1), this study did not find any difference between adults with ADHD and the NCs in net score (Cohen’s d = 0.70) or feedback use.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
While one study observed (33%) increased risky behavior in adults with ADHD on the GDT, the other two studies failed to find any overall group differences between adults with ADHD and NCs.
“While one study observed (1/3 = 33%) increased risky behavior in adults with ADHD [67] (study 1), the other two studies failed to find any overall group differences between adults with ADHD and NCs.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
A direct comparison between the two GDT studies reveals that NCs in the boredom condition more often selected risky options than NCs in the condition without boredom, while the ADHD groups performed in a similar fashion in both conditions.
“A direct comparison between these two studies reveals that the NCs in the boredom condition more often selected the risky options than the NCs in the condition without boredom, while the ADHD groups performed in a similar fashion in both conditions.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
In the second Matthies et al. study, in which boredom was induced before performing the gambling task, there were no differences in feedback use between adults with ADHD and NCs.
“However, in their second study, in which boredom was induced before performing the gambling task, there were no differences in feedback use between adults with ADHD and NCs [67] (study 2).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
In the positive GDT study, adults with ADHD gained a lower net score than NCs (Cohen's d = 0.93) by tending to choose the option with two dice more often and the option with four dice less often than NCs.
“Specifically, the adults with ADHD gained a lower net score than the NCs (Cohen’s d = 0.93) by tending to choose the option with two dice more often and the option with four dice less often than the NCs.”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
Some studies demonstrated aberrant feedback use in children/adolescents with ADHD, such as a reduced use of negative feedback.
“Some studies demonstrated aberrant feedback use in children/adolescents with ADHD, such as a reduced use of negative feedback [51] and a reduced adjustment of strategy after a punishment [55], [67] (reference 67 refers to study 2).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
Some studies demonstrated a reduced adjustment of strategy after a punishment in children/adolescents with ADHD.
“Some studies demonstrated aberrant feedback use in children/adolescents with ADHD, such as a reduced use of negative feedback [51] and a reduced adjustment of strategy after a punishment [55], [67] (reference 67 refers to study 2).”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
Other studies failed to find any deviations in feedback use in individuals with ADHD.
“Other studies failed to find any deviations in feedback use in individuals with ADHD [40], [48], [67].”
From Risky behavior in gambling tasks in individuals with ADHD–a systematic literature review (2013) · cites this paper as [67]
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- Authors
- Matthies, S., Philipsen, A., & Svaldi, J.
- Affiliations
- University Medical Center Freiburg (DE)
- University of Freiburg (DE)
- Corresponding author
- Matthies, S.
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2012-09
- Volume
- 43
- Issue
- 3
- Pages
- 938-946
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W1974370022
- Semantic Scholar
- e86f71a93a58bcda90ee1279c8674c3d61b479a2
- Cited by
- 85
- References
- 76
- Citations by year
- 2025: 3 · 2024: 3 · 2023: 5 · 2022: 6 · 2021: 6 · 2020: 7 · 2019: 9 · 2018: 9 · 2017: 4 · 2016: 8 · 2015: 9 · 2014: 6 · 2013: 8 · 2012: 1
- FWCI
- 5.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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, risky decision making, emotion regulation, Game of Dice Task, adult ADHD, emotional state
- MeSH terms
- Adult, Attention Deficit Disorder with Hyperactivity, Boredom, Decision Making, Female, Humans, Male, Neuropsychological Tests, Psychomotor Performance, Risk-Taking, Case-Control Studies, Feedback, Psychological, Self Report
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