Decision-making patterns and sensitivity to reward and punishment in children with attention-deficit hyperactivity disorder

Abstract

Earlier studies have demonstrated that attention-deficit hyperactivity disorder (ADHD) is associated with aberrant sensitivity to rewards and punishments. Although some studies have focused on real-life decision making in children with ADHD using the Iowa gambling task, the number of good deck choices, a frequently used index of decision-making ability in the gambling task, is insufficient for investigating the complex decision-making strategies in subjects. In the present study, we investigated decision-making strategies in ADHD children, analyzing T-patterns with rewards, with punishments, and without rewards and punishments during the gambling task, and examined the relationship between decision-making strategies and skin conductance responses (SCRs) to rewards and punishments. We hypothesized that ADHD children and normal children would employ different decision-making strategies depending on their sensitivity to rewards and punishments in the gambling task. Our results revealed that ADHD children had fewer T-patterns with punishments and exhibited a significant tendency to have many T-patterns with rewards, thus supporting our hypothesis. Moreover, in contrast to normal children, ADHD children failed to demonstrate differences between reward and punishment SCRs, supporting the idea that they had an aberrant sensitivity to rewards and punishments. Therefore, we concluded that ADHD children would be impaired in decision-making strategies depending on their aberrant sensitivity to rewards and punishments. However, we were unable to specify whether large reward SCRs or small punishment SCRs is generated in ADHD children.

Avaliação neuropsicológica do processo de tomada de decisões em crianças e adolescentes: uma revisão integrativa da literatura

“…According to Masunami et al 49 , children with ADHD and healthy children may have different strategies and patterns of choice, which are hardly detectable by the number of cards selected from the advantageous decks. Since Luman et al 57 proposed that children with ADHD have increased sensitivity to immediate reinforcement; the differences in strategies related to decision-making processes may be the result of changes in sensitivity to reinforcement and punishment 49 .…”

“…At the end of the selection process of papers, 36 studies were included in the sample. 56 , Japan 49 and Romania 53 .…”

“…Among the studies reviewed, only eleven used the Iowa Gambling Task to assess decision-making 11,20,21,26,29,[47][48][49]51,52,54 . Seven of them used variations very similar to the original task in which there were small changes in the amount of the loan, gains and punishments after the choices 17,28,31,32,36,40,44 .…”

“…Among the 36 studies, 15 investigated the performance of children with a neuropsychiatric diagnosis (or maladaptive behavior pattern typical of psychopathology in childhood and adolescen ce) 11,17,25,27,32,35,36,[45][46][47][48][49]56,57,61 . Table 2 presents the description of all the papers, considering the paradigm used, the study sample, the experimental design, the main results and the level of evidence generated by the study.…”

T-pattern analysis for the study of temporal structure of animal and human behavior: A comprehensive review

“…Initiating declarative behavior was qualitatively and quantitatively different, characterized by isolated instances of communication instead of a fluent shift of attention between object and person. Masunami et al (2009) studied, utilizing the Iowa gambling task, decision making strategies in children with attention-deficit hyperactivity disorder (ADSD). The authors analyzed T-patterns with rewards, with punishments, and without rewards and punishments during the task.…”