title: Risky decision making in Attention-Deficit/Hyperactivity Disorder: A meta-regression analysis.
abstract: ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore performed a meta-regression analysis in which 37 studies (n ADHD=1175; n Control=1222) were included, containing 52 effect sizes. The overall analysis yielded a small to medium effect size (standardized mean difference=.36, p<.001, 95% CI [.22, .51]), indicating that groups with ADHD showed more risky decision making than control groups. There was a trend for a moderating influence of co-morbid Disruptive Behavior Disorders (DBD): studies including more participants with co-morbid DBD had larger effect sizes. No moderating influence of co-morbid internalizing disorders, age or task explicitness was found. These results indicate that ADHD is related to increased risky decision making in laboratory settings, which tended to be more pronounced if ADHD is accompanied by DBD. We therefore argue that risky decision making should have a more prominent role in research on the neuropsychological and -biological mechanisms of ADHD, which can be useful in ADHD assessment and intervention.
authors.affiliation: University of Amsterdam, Department of Psychology, The Netherlands; De Bascule, Academic Center for Child- and Adolescent Psychiatry, Department of Forensic Psychiatry and Complex Behavioral Disorders, The Netherlands. Electronic address: t.j.dekkers@uva.nl.
authors.forename: Tycho J
authors.initials: TJ
authors.lastname: Dekkers
authors.affiliation: De Bascule, Academic Center for Child- and Adolescent Psychiatry, Department of Forensic Psychiatry and Complex Behavioral Disorders, The Netherlands; Free University Medical Center (VUmc) Amsterdam, Department of Child- and Adolescent Psychiatry, The Netherlands; University of Leiden, Department of Criminology, The Netherlands.
authors.forename: Arne
authors.initials: A
authors.lastname: Popma
authors.affiliation: University of Amsterdam, Department of Psychology, The Netherlands.
authors.forename: Joost A
authors.initials: JA
authors.lastname: Agelink van Rentergem
authors.affiliation: University of Leiden, Department of Developmental and Educational Psychology, The Netherlands; GGZ Delfland, Center for Psychiatry, Department of Psychiatry in Individuals with Intellectual Disability, The Netherlands.
authors.forename: Anika
authors.initials: A
authors.lastname: Bexkens
authors.affiliation: University of Amsterdam, Department of Psychology, The Netherlands; University of Amsterdam, Amsterdam Brain and Cognition Center, The Netherlands; University of Amsterdam, Research Priority Area Yield, The Netherlands.
authors.forename: Hilde M
authors.initials: HM
authors.lastname: Huizenga
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000503:physiopathology* / Q000523:psychology*; D019955:Conduct Disorder / Q000503:physiopathology / Q000523:psychology; D003657:Decision Making / Q000502:physiology*; D006801:Humans; D012309:Risk-Taking
keywords: Attention-Deficit/Hyperactivity Disorder (ADHD); Decision making; Disruptive Behavior Disorders (DBD); Gambling task; Meta-analysis; Risk taking