Effort-Related Decision-Making in ADHD.

Suzanne H Mitchell ,Deborah J Sevigny-Resetco

doi:10.20900/jpbs.20200027

Suzanne H Mitchell , Deborah J Sevigny-Resetco

Open Access

https://doi.org/10.20900/jpbs.20200027

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Abstract

ADHD is defined by behavioral symptoms that are not well characterized in relation to ADHD’s neurobiological mechanisms. This approach has limited our ability to define ADHD nosology and predict outcomes because it does not systematically examine facets of the disorder such as the inability to maintain cognitively effortful activities, as promoted in the NIMH RDoC approach. Existing data indicate ADHD is associated with differences in reward valuation and processing, but we do not know whether ADHD is also associated with higher levels of aversion to exerting cognitive effort and/or altered reward x effort interactions. Our ongoing study addresses this knowledge gap by examining individuals’ preferences between rewards associated with minimal effort and reward alternatives with a higher payoff but higher effort costs (“effort discounting”); thereby permitting us to characterize differences in biases and tradeoffs during effort-related decision-making in ADHD. The study takes advantage of a well-defined sample of ADHD-diagnosed and healthy control individuals to address three aims. First, we determine whether ADHD is associated with steeper discounting of larger, more effortful rewards. Second, we examine the subjective perception of effort in youth diagnosed with ADHD and healthy controls using tasks requiring varying levels of cognitive effort. Third, we explore relationships amongst indices of effort discounting, theoretically-related traits (e.g., grit, distress tolerance), biomarkers of effort-related decision-making (eye movements and pupil size), and various cognitive measures. Successful completion of the aims will permit us to better characterize ADHD-healthy control differences and lay a foundation for more computational approaches to ADHD diagnostic criteria.

Highlights

The inability or reluctance to engage in cognitive effort is a cross-cutting feature of numerous psychopathologies and related to the Research Domain Criteria (RDoC) construct: Reward Valuation; subconstruct: Effort [1]
Attention Deficit Hyperactivity Disorder (ADHD), has been strongly associated with this RDoC construct, and it is a cardinal concern raised by parents, teachers, and ADHD-diagnosed individuals themselves
It is our contention that, interesting information can be gained from studying physical effort, its correlation with decisionmaking for cognitive effort is limited [9] and studies focused on cognitive effort are more likely to yield data that will enhance our conceptualization of the behavioral symptoms of ADHD

Summary

Introduction

The inability or reluctance to engage in cognitive (mental) effort is a cross-cutting feature of numerous psychopathologies and related to the Research Domain Criteria (RDoC) construct: Reward Valuation; subconstruct: Effort [1] One such psychopathology, Attention Deficit Hyperactivity Disorder (ADHD), has been strongly associated with this RDoC construct, and it is a cardinal concern raised by parents, teachers, and ADHD-diagnosed individuals themselves. In the last few years, interest in the neurobiological mechanisms underlying effort-related decision-making has been growing, but most of these studies have examined physical effort, rather than cognitive effort, e.g., squeezing handgrips [2,3,4,5], typing letter strings [6], finger tapping [7] and have focused on healthy control samples or rodent models. It is our contention that, interesting information can be gained from studying physical effort, its correlation with decisionmaking for cognitive effort is limited [9] and studies focused on cognitive effort are more likely to yield data that will enhance our conceptualization of the behavioral symptoms of ADHD

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