Cool Decision-Making in Adolescents with Behavior Disorder and/or Mild-to-Borderline Intellectual Disability.

Anika Bexkens,Brenda R J Jansen,Maurits W Van Der Molen,Hilde M Huizenga

doi:10.1007/s10802-015-9996-8

Abstract

Adolescents with Behavior Disorders (BD), Mild-to-Borderline Intellectual Disability (MBID), and with both BD and MBID (BD + MBID) are known to take more risks than normal controls. To examine the processes underlying this increased risk-taking, the present study investigated cool decision-making strategies in 479 adolescents (12–18 years, 55.9 % male) from these four groups. Cool decision-making was assessed with the paper-and-pencil Gambling Machine Task. This task, in combination with advanced latent group analysis, allows for an assessment of decision strategies. Results indicated that adolescents with BD and controls were almost equivalent in their decision-making strategies, whereas adolescents with MBID and adolescents with BD + MBID were characterized by suboptimal decision-making strategies, with only minor differences between these two clinical groups. These findings may have important clinical implications, as they suggest that risk taking in adolescents with MBID and in adolescents with BD + MBID can be (partly) attributed to the strategies that these adolescents use to make their decisions. Interventions may therefore focus on an improvement of these strategies.

Highlights

Adolescents with Behavior Disorders (BD), Mildto-Borderline Intellectual Disability (MBID), and with both BD and MBID (BD+MBID) are known to take more risks than normal controls
As the literature on executive function deficits in BD is not unequivocal, we explore whether a potential deficit in cool decision-making in adolescents with BD +MBID is more pronounced than in adolescents with MBID-only
We tested against a critical alpha value of 0.05. These contrasts showed that the performance of adolescents with BD was not different from the performance of to normal controls (p=0.16, d=0.37), whereas the performance of adolescents with MBID and adolescents with BD+MBID was less accurate than normal controls

Summary

Introduction

Adolescents with Behavior Disorders (BD), Mildto-Borderline Intellectual Disability (MBID), and with both BD and MBID (BD+MBID) are known to take more risks than normal controls. Research on adolescent risk-taking (e.g., Sonuga-Barke and Fairchild 2012) has focused on a group of adolescents that show high levels of risk-taking in daily life, namely adolescents with Behavior Disorders (BD). J Abnorm Child Psychol (2016) 44:357–367 have a stake, resulting in a heightened state of emotional arousal when gains or losses are experienced immediately after the decision (e.g., Fairchild et al 2009; Figner et al 2009) This suboptimal performance has been attributed to insufficient control over emotions, presumably linked to an altered functioning of the orbitofrontal cortex (Matthys et al 2012). The first aim of this study is to explore whether adolescents with BD are characterized by impaired cool decision-making and, if so, whether this can be explained by their use of suboptimal decision-making strategies

Objectives

Results

Conclusion