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Investigating the Impact of Cognitive Load and Motivation on Response Control in Relation to Delay Discounting in Children with ADHD

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Abstract

Attention-deficit/hyperactivity disorder (ADHD) is characterized by deficits in impulse control across a range of behaviors, from simple actions to those involving complex decision-making (e.g., preference for smaller-sooner versus larger later rewards). This study investigated whether changes in motor response control with increased cognitive load and motivational contingencies are associated with decision-making in the form of delay discounting among 8–12 year old children with and without ADHD. Children with ADHD (n = 26; 8 girls) and typically developing controls (n = 40; 11 girls) completed a standard go/no-go (GNG) task, a GNG task with motivational contingencies, a GNG task with increased cognitive load, and two measures of delay discounting: a real-time task in which the delays and immediately consumable rewards are experienced in real-time, and a classic task involving choices about money at longer delays. Children with ADHD, particularly girls, exhibited greater delay discounting than controls during the real-time discounting task, whereas diagnostic groups did not significantly differ on the classic discounting task. The effect of cognitive load on response control was uniquely associated with greater discounting on the real-time task for children with ADHD, but not for control children. The effect of motivational contingencies on response control was not significantly associated with delay discounting for either diagnostic group. The findings from this study help to inform our understanding of the factors that influence deficient self-control in ADHD, suggesting that impairments in cognitive control may contribute to greater delay discounting in ADHD.

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Notes

  1. After selecting for all other inclusionary criteria, only one participant met for the hyperactive/impulsive subtype of ADHD. This participant was excluded in an effort to create a more uniform sample and avoid potential diagnostic confounds.

  2. Data for the current study was collected as a part of a larger laboratory study, which recently transitioned from using the DICA-IV to the Kiddie Schedule for Affective Disorders and Schizophrenia for School Aged Children Present Lifetime version (KSADS-PL; Kaufman et al. 2013). Among the subset of participants selected for inclusion in the present study, one had been assessed for diagnostic status using the KSADS-PL. All other participants (n = 65) were assessed using the DICA-IV.

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Acknowledgements

This work was supported in part by grants from the National Institute of Mental Health (RO1 MH078160; RO1 MH085328; K23 MH101322) and the Johns Hopkins University School of Medicine Institute for Clinical and Translational Research National Institutes of Health/National Center for Research Resources Clinical and Translational Science Award program UL1 TR 000424-06. The authors do not have any conflicts of interest to disclose.

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  1. Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 716 North Broadway, Baltimore, MD, 21205, USA

    Mary K. Martinelli, Stewart H. Mostofsky & Keri S. Rosch

  2. Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Stewart H. Mostofsky

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Stewart H. Mostofsky & Keri S. Rosch

  4. Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA

    Keri S. Rosch

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Correspondence to Keri S. Rosch.

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Martinelli, M.K., Mostofsky, S.H. & Rosch, K.S. Investigating the Impact of Cognitive Load and Motivation on Response Control in Relation to Delay Discounting in Children with ADHD. J Abnorm Child Psychol 45, 1339–1353 (2017). https://doi.org/10.1007/s10802-016-0237-6

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