ADHD, Risk-Taking Behavior and Self-Control in Light Of Decision Theory

The clinical literature is ample with evidence showing ADHD-related increased engagement in risk-taking behavior and a reduced self-control. This paper reviews three studies, inspired by decision theory, aimed to examine the role of decision variables in such ADHD-related problems.

In the first study, a large sample of adults rated the likelihood of engagement in a range of risk-taking behaviors, and the magnitude of perceived benefit and risk they ascribed to these behaviors. Mediation analyses confirmed that excessive views of the benefits mediated the association between ADHD symptoms and risk-taking behavior.

In a second study, we used gambling tasks to disentangle increased risk seeking from suboptimal decision-making. We showed that when expected value of choice alternatives were equal, individuals with and without ADHD showed similar choice patterns.

Finally, by priming levels of construal, we showed that ADHD symptoms moderated the link between construal level and delay discounting, a commonly regarded measure of self-control. In contrast to people with few ADHD symptoms, people with many ADHD symptoms showed similar delay discounting under both conditions of low and high construal level.

Taken together, these findings suggest that ADHD is not associated with risk seeking, but rather with exaggerated views regarding the positive outcomes of the behavior, as well as with insensitivity to unconscious contextual information. These differences affect risk-taking behavior and self-control exertion.

These studies prove that use of decision theory paradigm leads to meaningful conclusions in studying ADHD, and may inform clinical research aiming to improve decision making of people with ADHD.