ADHD in Children
Visual Abstract
Delay and reward choice in ADHD: an experimental test of the role of delay aversion
Rewards and Delays in ADHD
Rafaela Marco , Ana Miranda, Wolff Schlotz, Amanda Melia, Aisling Mulligan, Ueli Müller, Penny Andreou, Louise Butler, Hanna Christiansen, Isabel Gabriels, Sheera Medad, Bjorn Albrecht, Henrik Uebel, Phillip Asherson, Tobias Banaschewski, Michael Gill, Jonna Kuntsi, Fernando Mulas, Robert Oades, Herbert Roeyers, Hans-Christoph Steinhausen, Aribert Rothenberger, Stephen V Faraone, Edmund J S Sonuga-Barke
Summarized by:
August 31, 2023
study source
Neuropsychology
May 2009
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What they studied
Does ADHD affect how we handle rewards and delays?
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What they found
Those with ADHD are more likely to choose smaller rewards if the smaller reward comes sooner and speeds up the trial.
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What this means
ADHD may make it more difficult to delay gratification. Those with ADHD may be more willing to pay more to wait less compared to those without ADHD.
Delay and reward choice in ADHD: an experimental test of the role of delay aversion
Objectives
Recent studies have shown that ADHD can affect much more than attention and hyperactivity.
It affects the way we think and behave in various ways.
This study wanted to see how ADHD affects how we handle rewards and delayed gratification.
Study Quote
Children with attention deficit/hyperactivity disorder (ADHD) choose smaller sooner (SS) over larger later (LL) rewards more than controls. Here we assess the contributions of impulsive drive for immediate rewards (IDIR) and delay aversion (DAv) to this pattern. We also explore the chara...
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Methods
Researchers studied 360 children with ADHD and compared them to 112 children without ADHD.
They asked the children to choose rewards with different sizes and delays.
Study Quote
We had 360 ADHD probands; 349 siblings and 112 controls (aged between 6 to 17 years) chose between SS (1 point after 2 s) and LL reward (2 points after 30 s) outcomes on the Maudsley Index of Delay Aversion (Kuntsi, Oosterlaan, & Stevenson, 2001)
Results
The results showed that those with ADHD were generally more likely to choose smaller rewards that came sooner, particularly if the smaller reward also sped up the trial.
This is similar to paying more for faster shipping when we’re shopping online:
Those with ADHD were much more likely to choose a smaller reward if the smaller reward came sooner and sped up the trial.
The siblings of those with ADHD also tended to choose smaller rewards in exchange for faster delivery, even if they didn’t have ADHD themselves:
Those with ADHD were much more likely to choose a smaller reward if the smaller reward came sooner and sped up the trial.
This suggests that this trait may run through families either due to genetics, upbringing, or both.
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SS responders with ADHD had siblings who were more likely to be SS responders themselves. This finding is consistent with the idea that SS choice in ADHD has a familial basis and provides some initial support for the idea that family based risk factors may be mediated by those processes of IDIR/DAv that are marked by this pattern of behavior.
Study Quote
Under one condition SS choice led to less overall trial delay under another it did not. ADHD participants chose SS more than controls under both conditions. This effect was larger when SS choice reduced trial delay. ADHD SS responders were younger, had lower IQ, more conduct disorder an...
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Conclusions
These results suggest that ADHD may make it more difficult to delay gratification. Those with ADHD may be more likely to pay more for faster delivery to receive a reward sooner.
The presence of additional delays further increases the likelihood that someone with ADHD will choose a smaller reward, in exchange for less delay.
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The results supported a two component model with ADHD preference for SS under the postRD condition (in which the choice of SS leads only to a reduction in preRD) being accentuated under the no-postRD (in which choice of the SS reward leads to the reduction of both preRD and TD). Both IDIR and DAv appear to contribute to SS choice in ADHD
A similar subsequent study found that intelligence may play a role in the relationship between ADHD and delayed gratification:
This effect is similar to other studies that have found difficulties with impulsivity among those with ADHD.
Study Quote
The results support a dual component model in which both IDIR and DAv contribute to SS choice in ADHD. SS choice may be a marker of an ADHD motivational subtype.