A Meta-Analysis of Decision-Making and Attention in Adults With ADHD
Abstract
Objective: Deficient reward processing has gained attention as an important aspect of ADHD, but little is known about reward-based decision-making (DM) in adults with ADHD. This article summarizes research on DM in adult ADHD and contextualizes DM deficits by comparing them to attention deficits. Method: Meta-analytic methods were used to calculate average effect sizes for different DM domains and continuous performance task (CPT) measures. Results: None of the 59 included studies (DM: 12 studies; CPT: 43; both: 4) had indications of publication bias. DM and CPT measures showed robust, small to medium effects. Large effect sizes were found for a drift diffusion model analysis of the CPT. Conclusion: The results support the existence of DM deficits in adults with ADHD, which are of similar magnitude as attention deficits. These findings warrant further examination of DM in adults with ADHD to improve the understanding of underlying neurocognitive mechanisms.
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Individuals with ADHD experience neuropsychological difficulties associated with deficient inhibition, memory, executive functioning, decision making, and emotional dysregulation.
“Individuals with ADHD also experience neuropsychological difficulties associated with deficient inhibition [22], memory [22], executive functioning [23,24], decision making [25], and emotional dysregulation [26].”
From Adult ADHD and comorbid disorders: clinical implications of a dimensional approach (2017) · cites this paper as [25]
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- Authors
- Mowinckel, A. M., Pedersen, M. L., Eilertsen, E., & Biele, G.
- Affiliations
- University of Oslo (NO)
- Oslo University Hospital (NO)
- Norwegian Institute of Public Health (NO)
- Venue
- Journal of Attention Disorders
- Publisher
- SAGE Publications
- Published
- 2014-12-04
- Volume
- 19
- Issue
- 5
- Pages
- 355-367
- ISSN
- 1087-0547 (ISSN-L)
- 1557-1246
- OpenAlex
- W2154185987
- Cited by
- 158
- References
- 22
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 14 · 2023: 20 · 2022: 16 · 2021: 14 · 2020: 12 · 2019: 13 · 2018: 11 · 2017: 12 · 2016: 12 · 2015: 4 · 2013: 1
- FWCI
- 1.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Attention Disorders (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 › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- adult ADHD, reward-based decision-making, attention deficits, reward processing, continuous performance test, drift-diffusion model, cognitive control, neurocognitive mechanisms
- MeSH terms
- Adolescent, Adult, Attention, Attention Deficit Disorder with Hyperactivity, Decision Making, Female, Humans, Middle Aged, Reward, Task Performance and Analysis, Young Adult
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