Decision Making Strategies in Adolescents with ADHD

Attention Deficiency/Hyperactivity Disorder (ADHD) is associated with several forms of risky decision making. For example, ADHD is related to elevated substance abuse, antisocial behavior and sexual risk-taking. To treat or prevent this risky decision making, underlying mechanisms as well as contextual factors need to be elucidated. In this presentation, we outline which variables are, in our opinion, of special interest. First, on experimental gambling tasks, participants with ADHD show more risky decision making. However, in most tasks, risk and expected value were confounded, meaning that risky options were also disadvantageous. Therefore, it is not possible to disentangle whether ADHD is associated with risky or suboptimal (i.e. not opting for the highest expected value) decision making. In several studies, we disentangle risk seeking and suboptimal decision making. Second, using a lexicographic decision making framework, the complexity of strategies in decision making is compared between adolescents with and without ADHD. Potentially, more frequent usage of simple strategies could ultimately lead to poor decision making/increased risk taking in adolescents with ADHD. Third, as adolescent risk taking often emerges in social contexts, two sorts of social influences were investigated: peer pressure and parental monitoring. We investigated whether ADHD is characterized by increased susceptibility to peer pressure, potentially predicting increased risk taking. Finally, recent evidence shows that low parental monitoring mediates the relationship between ADHD and real life risk taking. A replication study on this topic is currently being conducted.

In the symposium, preliminary results of several ongoing studies will be presented on those candidate mechanisms explaining risk taking in adolescents with ADHD.