Impaired Decision-Making as a Young Adult Outcome of Girls Diagnosed with Attention-Deficit/Hyperactivity Disorder in Childhood

Abstract

We examined decision-making in young adulthood in a follow-up study of females diagnosed with attention-deficit/hyperactivity disorder (ADHD) between 6 and 12 years. Participants with childhood ADHD (n=114) and matched comparison females (n=77), followed prospectively for 10 years, performed the Iowa Gambling Task (IGT) at ages 17–25 years. This task assesses preference for high-reward/high-risk chances that result in lower overall gains (disadvantageous decks of cards) compared to low-reward/low-risk chances that result in higher overall gains (advantageous decks of cards). Relative to comparison participants, young adult females with a history of ADHD did not increase their preference for advantageous decks across time blocks, suggesting difficulties in learning to change behavior over the course of the IGT. Overall, childhood diagnoses of ADHD were associated with disadvantageous decision-making in young adulthood. These results extend findings on decision-making in males with ADHD by demonstrating comparable levels of impairment in an all-female sample.

Interactions among attention-deficit hyperactivity disorder (ADHD) and problem gambling in a probabilistic reward-learning task

“…Our data is in line with those which showed improvement in bet selections over time among medicated and possibly unmedicated (although not statistically) ADHD patients [31][32][33][34]. In contrast, some other studies found affective decision-making deficits in ADHD patients using IGT scores [35][36][37]. Neither the first nor the latter group of studies screened their ADHD patients for gambling.…”

“…Some other outcome measures used in this regard include total money won [38], total of cards selected on individual decks [29], comparison between the number of cards selected from the decks A and C (lowfrequency loses) and decks B and D (high-frequency loses) [29], and analysis of selections in the later trials versus the earlier ones [30,37]. This issue motivated us to compare the normalized number of good bets in the first-300 versus the last-100 trials.…”

Amphetamine Modestly Improves Conners’ Continuous Performance Test Performance in Healthy Adults

“…Accordingly, deficits in behavioral measures of impulsivity, and risk taking are also observed in individuals with ADHD. For example, ADHD has been associated with poor performance on the Iowa Gambling Task (IGT) in children/adolescents (Garon, Moore, & Waschbusch, 2006; Hobson, Scott, & Rubia, 2011; Masunami, Okazaki, & Maekawa, 2009; Miller, Sheridan, Cardoos, & Hinshaw, 2013; Toplak, Jain, & Tannock, 2005) and adults (Abouzari, Oberg, Gruber, & Tata, 2015; Malloy-Diniz, Fuentes, Leite, Correa, & Bechara, 2007). However, there are data to suggest that deficits in adults with ADHD may be more indicative of co-morbid problematic gambling (Abouzari et al, 2015; Abouzari, Oberg, & Tata, 2016).…”

Development of Hot and Cold Executive Function in Boys and Girls With ADHD

“…As a consequence, females are reported to be more risk averse and need more trials to reach the same level of performance as males (van den Bos et al, 2013). Few studies have investigated the impact of gender on decision-making in ADHD populations, but Miller, Sheridan, Cardoos, and Hinshaw (2013) found impaired decision-making performance in young adult females with ADHD compared with TD females. Despite the lack of between-sex comparisons in the study by Miller et al (2013), results indicate that young adult females with ADHD exhibit impaired decision-making compared with male counterparts (Hobson et al, 2011; Toplak et al, 2005).…”