Risk Taking by Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD): a Behavioral and Psychophysiological Investigation of Peer Influence

Tycho J Dekkers,Hilde M Huizenga,Helena Oldenhof,Arne Popma,Anika Bexkens,Brenda R J Jansen,Edmund J.S Sonuga-Barke

doi:10.1007/s10802-020-00666-z

Abstract

Adolescents with ADHD demonstrate increased risk-taking behavior (RTB) like substance abuse and dangerous traffic conduct. RTB in adolescence is more likely under peer influence. The current investigation (1) tests the hypothesis that adolescents with ADHD are particularly susceptible to such influence and (2) tests whether groups differed in autonomic reactivity to peer influence. Adolescent boys between 12 and 19 years with (n = 81) and without (n = 99) ADHD performed the Balloon Analogue Risk Task twice. In the peer condition, a highly credible virtual peer manipulation that encouraged risk taking was added, in the solo condition this was absent. Autonomic reactivity was indexed by heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA). All adolescents engaged in more risk taking in the peer condition relative to solo condition. Autonomic differences between groups were only found on PEP: a stronger sympathetic response to peer influence was observed in typically developing adolescents relative to adolescents with ADHD. Increased physiological stress (as indexed by PEP) in the peer relative to the solo condition predicted peer-induced risk taking in all adolescents. We conclude that susceptibility to peer influence is not exaggerated in ADHD but rather reflects a general tendency of adolescents. As adolescents experiencing peer influence as stressful are most susceptible to peer influence, we suggest that increasing resistance to peer influence may be an important treatment aim for these adolescents specifically.

Highlights

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, defined by persistent patterns of inattention and/or hyperactivity/impulsivity, causing impairment in several life domains (American Psychiatric Association, 2013)
Adolescents with ADHD did not differ in risk taking from controls, and both groups demonstrated similar susceptibility to peer influence (Fig. 1)
We reasoned that increased susceptibility is likely, because of an ADHD-related enlarged imbalance between socio-emotional and control brain systems and because adolescents with ADHD encounter a wide range of social problems

Summary

Introduction

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder, defined by persistent patterns of inattention and/or hyperactivity/impulsivity, causing impairment in several life domains (American Psychiatric Association, 2013). Several lines of evidence lead us to hypothesize that adolescents with ADHD are more susceptible to peer influence, which has the potential to increase RTB This hypothesis has – to our knowledge – never been tested. As adolescents with ADHD experience more peer rejection relative to TD adolescents (Bagwell et al, 2001; de Boo & Prins, 2007), we reasoned that peer influence may elicit increased stress (i.e., ANS reactivity) in the ADHD group. As fear of exclusion can promote risk taking (Pickett et al, 2004), we reasoned that increased ANS reactivity is linked to more risk taking in the peer condition, thereby testing the link between physiological and behavioral effects of peer influence

Participants

Procedure

Results

Summary of Findings

Strengths and Limitations