Department of Psychiatry & Psychotherapy, University Medical Centre Freiburg, Hauptstr. 5, D-79104 Freiburg, Germany.
J Behav Ther Exp Psychiatry. 2012 Sep;43(3):938-46. doi: 10.1016/j.jbtep.2012.02.002. Epub 2012 Feb 25.
Risky decision making and disadvantageous choices constitute core characteristics of patients with attention-deficit/hyperactivity disorder (ADHD). Consequences include negative psychosocial and health-related outcomes. However, risky decision making and its interrelations with emotional states in ADHD are poorly understood. Therefore, the authors investigated risky decision making without and after boredom induction in adults with and without ADHD.
In study 1, ADHD patients (n = 15) and age/education matched controls (CG; n = 16) were compared on the Game of Dice Task (GDT), an established task measuring decision making in unambiguous situations. In study 2, ADHD patients (n = 14) and CG (n = 13) underwent boredom induction prior to the GDT.
In study 1, ADHD patients selected the disadvantageous alternatives significantly more often than CG. In study 2, no significant group differences were found due to an increase in risky decision making in CG following the boredom induction.
Even if severity of depression did not affect our results, it may be necessary to compare GDT responses in ADHD patients with and without current depression.
Risk as a motor of disadvantageous decision making needs to be taken into account in therapeutic contexts as a maintenance factor of dysfunctional behaviour. The findings of study 2 are in line with postulated alterations of emotional state adjustment in ADHD. The link between decisions making and emotional regulation in ADHD needs further attention in research.
冒险决策和不利选择是注意力缺陷多动障碍（ADHD）患者的核心特征。其后果包括负面的社会心理和健康相关结果。然而，ADHD 患者的冒险决策及其与情绪状态的相互关系仍知之甚少。因此，作者研究了 ADHD 患者和对照组在无无聊诱导和无聊诱导后进行冒险决策的情况。
在研究 1 中，将 ADHD 患者（n = 15）和年龄/教育匹配的对照组（CG；n = 16）在骰子游戏任务（GDT）上进行比较，GDT 是一种用于测量明确情况下决策制定的既定任务。在研究 2 中，在 GDT 之前，对 ADHD 患者（n = 14）和 CG（n = 13）进行无聊诱导。
在研究 1 中，ADHD 患者选择不利替代方案的频率明显高于 CG。在研究 2 中，由于 CG 在无聊诱导后冒险决策增加，没有发现显著的组间差异。
即使抑郁严重程度没有影响我们的结果，但比较 ADHD 患者中有无当前抑郁的 GDT 反应可能是必要的。
风险作为不利决策的驱动力需要在治疗环境中被视为功能失调行为的维持因素。研究 2 的结果与 ADHD 中情绪状态调节改变的假设一致。ADHD 中决策制定和情绪调节之间的联系需要在研究中进一步关注。
