Decision making in adults with ADHD.

OBJECTIVES This study examined decision-making competence in ADHD by using multiple decision tasks with varying demands on analytic versus affective processes. METHODS Adults with ADHD and healthy controls completed two tasks of analytic decision making, as measured by the Adult Decision-Making Competence (A-DMC) battery, and two affective decision tasks (the Balloon Analog Risk Task and the lowa Gambling Task). RESULTS Although a majority of the ADHD participants were tested under medication, they showed impairments in both types of task. However, logistic regression analysis showed that the applying-decision-rules task of the A-DMC battery was the only significant predictor of ADHD status. CONCLUSIONS These findings suggested that ADHD is associated with impaired decision making in tasks involving a significant degree of cognitive control. Although both deliberative and affective neurocognitive systems probably contributed to ADHD-related problems in decision making, the findings underlined the involvement of prefrontally mediated executive functions.