Article

Luman M, Oosterlaan J, Sergeant JA. The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal. Clin Psychol Rev 25: 183-213

VU University Amsterdam, Amsterdamo, North Holland, Netherlands
Clinical Psychology Review (Impact Factor: 7.18). 03/2005; 25(2):183-213. DOI: 10.1016/j.cpr.2004.11.001
Source: PubMed

ABSTRACT

One of the core deficits in attention deficit/hyperactivity disorder (AD/HD) is thought to be an aberrant sensitivity to reinforcement, such as reward and response cost. Twenty-two studies (N=1181 children) employing AD/HD and reinforcement contingencies are reviewed from vantage points: task performance, motivation, and psychophysiology. Results indicate that reinforcement contingencies have a positive impact on task performance and levels of motivation for both children with AD/HD and normal controls. There is evidence that the effect related to task performance is somewhat more prominent in AD/HD. There is some evidence that a high intensity of reinforcement is highly effective in AD/HD. Children with AD/HD prefer immediate over delayed reward. From a psychophysiological point of view, children with AD/HD seem less sensitive to reinforcement compared to controls. While comorbid disorders are suggested to be confounders of the dependent variables, many studies do not examine the effect of oppositional defiant disorder (ODD) and conduct disorder (CD). We discuss the implications of the findings for five theoretical frameworks, including the model by, the cognitive-energetic model (CEM), the dual-pathway model and the BIS/BAS model. Results show a discrepancy between the theoretical models and the behavioural findings.

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    • "Regarding ADHD, the current leading perspective on this topic is that regulation problems (abnormal regulation) occur in most children with ADHD and that there is a subgroup characterized by negative and positive approach problems (abnormal reactivity) (Nigg et al. 2004). Specifically, the findings of studies conducted with youth with ADHD indicate that they exhibit deficits in approach such that they make errors in their predictions about the environment and the predictions they make prioritize immediate reward at the expense of potentially greater but delayed reward (see Luman et al. 2005 for review). However, data on the association between ADHD and personality traits (i.e., neuroticism, agreeableness and extraversion) indicate that differences in these traits, and therefore in the reactivity of the neural systems that underlie them, are not specific to ADHD but are associated with comorbid psychopathologies (see Nigg 2006 for review). "

    Full-text · Article · Aug 2015 · Clinical Child and Family Psychology Review
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    • "Regarding ADHD, the current leading perspective on this topic is that regulation problems (abnormal regulation) occur in most children with ADHD and that there is a subgroup characterized by negative and positive approach problems (abnormal reactivity) (Nigg et al. 2004). Specifically, the findings of studies conducted with youth with ADHD indicate that they exhibit deficits in approach such that they make errors in their predictions about the environment and the predictions they make prioritize immediate reward at the expense of potentially greater but delayed reward (see Luman et al. 2005 for review). However, data on the association between ADHD and personality traits (i.e., neuroticism, agreeableness and extraversion) indicate that differences in these traits, and therefore in the reactivity of the neural systems that underlie them, are not specific to ADHD but are associated with comorbid psychopathologies (see Nigg 2006 for review). "
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    ABSTRACT: Individuals with attention-deficit/hyperactivity disorder (ADHD) experience impairments in a number of functional domains. Although current evidence-based treatments for ADHD reduce symptoms and improve academic and behavioral functioning, they have minimal impact on social functioning or on risky behaviors (see Evans et al. in J Clin Child Adolesc Psychol, 43:527–551, 2014 for review). Preliminary evidence indicates that emotion dysregulation (ED) is associated with impairments across the developmental spectrum, such as social impairment and risky behaviors, and that its relative absence/presence is differentially associated with treatment response. It thus stands to reason that by incorporating a focus on ED in interventions targeting social impairment and risky behaviors, we may be able to increase the number of youth who respond to such interventions and decrease the prevalence or degree of these impairments and behaviors among youth and adults with ADHD. However, a number of questions remain unaddressed about the association between ADHD and ED, such as the portion of individuals with ADHD who experience ED, the extent to which ED is associated with the above impairments and behaviors, and whether or not ED is malleable. To begin addressing these questions, we summarize and critically evaluate the literature on the association between ADHD and ED and make recommendations for future basic, translational, and treatment outcome research.
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    • "The second question is important from a practical point of view as in daily life individuals are often required to wait for the outcome of a decision, or the commencement of an activity. Failures to wait are linked to a range of mental disorders such as mania, substance abuse disorders and personality disorders (Evenden, 1999; Luman et al., 2005; Moeller et al., 2001). From a scientific point of view the question is also important because waiting resembles resting in a number of ways. "

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