Delay Aversion in Attention Deficit/Hyperactivity Disorder: An empirical investigation of the broader phenotype
Abstract
Background Delay-related motivational processes are impaired in children with Attention Deficit/Hyperactivity Disorder (ADHD). Here we explore the impact of ADHD on the performance of three putative indices of Delay Aversion (DAv): (i) the choice for immediate over delayed reward; (ii) slower reaction times following delay; and (iii) increased delay-related frustration-to see whether these tap into a common DAv construct that differentiates ADHD cases from controls and shows evidence of familiality.Method Seventy seven male and female individuals (age range 6-17) with a research diagnosis combined type ADHD, 65 of their siblings unaffected by ADHD and 50 non-ADHD controls completed three delay tasks.Results As predicted the size of the correlation between tasks was small but a common latent component was apparent. Children with ADHD differed from controls on all tasks (d=.4-.7) and on an overall DAv index (d=.9): The battery as a whole demonstrated moderate sensitivity and specificity. In general, deficits were equally marked in childhood and adolescence and were independent of comorbid ODD. IQ moderated the effect on the MIDA. Scores on the DAv factor co-segregated within ADHD families.Discussion There is value in exploring the broader DAv phenotype in ADHD. The results illustrate the power of multivariate approaches to endophenotypes. By highlighting the significant, but limited, role of DAv in ADHD these results are consistent with recent accounts that emphasize neuropsychological heterogeneity.
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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).”
From Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion (2010) · cites this paper as Bitsakou et al., 2009
ADHD cases can be satisfactorily differentiated from controls in terms of their choices of smaller sooner over larger later rewards.
“ADHD cases can be satisfactorily differentiated from controls in terms of their choices of SS over LL rewards (Kuntsi et al., 2001;Antrop et al., 2006;Bitsakou et al., 2009;Marco et al., 2009;Sonuga-Barke et al., 1992;Schweitzer and Sulzer-Azaroff, 1995;Solanto et al., 2001;Hoerger and Mace, 2006;Dalen et al., 2004;Marco et al., 2009).”
From Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion (2010) · cites this paper as Bitsakou et al., 2009
Bitsakou et al. found a significant difference in delay aversion between the ADHD and normal control groups, with an effect size of 0.9.
“The contrasts revealed a significant difference between the ADHD and normal control group (es ¼ 0.9)”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Bitsakou et al (2009)
The difference in delay aversion compared with the familial control group was not significant, but the sibling control average fell midway between the ADHD and normal control groups.
“even though the difference compared to the familial control group was not significant, the average for the sibling control fell midway between the average for the ADHD and the normal control groups.”
From Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder: A Decade of Progress (2011) · cites this paper as Bitsakou et al (2009)
The current study provides preliminary neurobiological support for behavioural literature indicating hypersensitivity to delay as a core characteristic of ADHD.
“First, they provide a preliminary neuro-biological perspective to the large and growing behavioural literature supporting a hypersensitivity to delay across different tasks and settings as a core characteristic of ADHD (Bitsakou et al., 2009).”
From Brain activation to cues predicting inescapable delay in adolescent Attention Deficit/Hyperactivity Disorder: An fMRI pilot study (2012) · cites this paper as Bitsakou et al., 2009
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References 76 · Cited by 134
- Authors
- Bitsakou, P., Psychogiou, L., Thompson, M., & Sonuga-Barke, E. J. S.
- Affiliations
- University of Southampton (GB)
- University of Oxford (GB)
- King's College London (GB)
- Corresponding author
- Sonuga-Barke, Edmund J.S.
- Venue
- Neuropsychologia
- Publisher
- Elsevier BV
- Published
- 2009-01
- Volume
- 47
- Issue
- 2
- Pages
- 446-456
- ISSN
- 0028-3932 (ISSN-L)
- OpenAlex
- W1993903183
- Cited by
- 134
- References
- 76
- Citations by year
- 2025: 3 · 2024: 6 · 2023: 4 · 2022: 2 · 2021: 4 · 2020: 4 · 2019: 8 · 2018: 8 · 2017: 8 · 2016: 14 · 2015: 13 · 2014: 12 · 2013: 12 · 2012: 12
- FWCI
- 5.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychologia (publishedVersion)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Figshare (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, endophenotypes, delay discounting, reaction time, frustration, familiality, children and adolescents
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Impulsive Behavior, Intelligence Tests, Male, Neuropsychological Tests, Phenotype, Psychomotor Performance, Surveys and Questionnaires, Reaction Time, Reward, Time Factors, Case-Control Studies
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