Researchers reported results where they tested performance on a theoretically-based probabilistic decision-making video simulation in adults with and without attention-deficit/hyperactivity disorder (ADHD). The study examined the relationship between experimental risk taking and history of real-life, risk-taking substance use behavior. Both groups showed similar patterns of risk taking, but adults with ADHD had more history and use of substance use and abuse.
The link between attention-deficit/hyperactivity disorder (ADHD) and risk-taking behavior, including substance abuse, is a major public health issue. Studies estimate 30% of adults presenting with substance use disorder (SUD) have ADHD, and approximately 20% to 40% of adults with ADHD have histories of SUD.
In a recent study published in Psychiatry Research, researchers tested performance on a theoretically-based probabilistic decision-making video simulation in adults with and without ADHD. The study examined the relationship between experimental risk taking and history of real-life risk-taking behavior, deﬁned as cigarette, alcohol, and street drug use.
University students with and without ADHD (n = 62, with 31 in each group), completed a modiﬁed version of the Cambridge Gambling Test (CGT), in which they had to choose between alternatives varied by level of risk. They also reported their history of substance use. Those who were on prescription medication for ADHD were asked not to take the medicine for 24 hours before the tests.
Both groups showed similar patterns of risk taking on the experimental decision-making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD.
The researchers wrote that their ﬁnding questions the validity of the simulation as a valid model for ADHD-related risk-taking behavior.
The CGT or other risk-taking simulators have become more widely used in recent years as a way to provide a model of actual risk-taking behavior while controlling for key variables. The CGT uses pricing tasks, where participants are asked how much money (points) they wish to invest for the chance to gamble. Subjects are given explicit probabilistic information (eg, 20% chance that a token was hidden inside a blue box, 80% chance it was hidden inside a red box). The subjects are then asked to guess in which box the token is placed, and to determine the magnitude of bet they are willing to risk, given the probabilities.
The CGT separately taps several processes that are involved in decision making:
In this study, no signiﬁcant diﬀerences between groups were observed regarding sum of bet, risk adjustment, and deliberation time. Adults with ADHD did not choose the riskier options more often than controls. These ﬁndings suggest that other characteristics of the task, such as the need to wait before choosing an option, account for previous ﬁndings showing greater risk taking by participants with ADHD on similar tasks.
Pollaka T, Shalita R, Aranb A. Risk taking and adult attention deficit/hyperactivity disorder: A gap between real life behavior and experimental decision making. Psychiatry Res. 2018; (259):56—62. dx.doi.org/10.1016/j.psychres.2017.10.012