Features of attention deficit/hyperactivity disorder and antisocial behaviour in a general population-based sample of adults.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is known to be a risk factor for antisocial and delinquent behaviour, but there is still a lack of information on how features of ADHD relate to offending behaviour among adults not already defined by their offending. AIMS: Our aim was to add to knowledge about relationships between ADHD and antisocial behaviour among adults in the general population by answering the following questions: (A) Does the level of self-reported ADHD features relate to criminal and non-criminal antisocial behaviour? (B) To what extent are self-ratings of ADHD features independent of socio-demographic features previously identified as predictors of antisocial behaviour? METHODS: A sample of adults was originally recruited to study public response to the COVID-19 outbreak through an online panel to be representative of the Israeli population. Among other scales, the 2025 participants completed an ADHD self-report scale, an antisocial behaviour self-report scale and a socio-demographic questionnaire probing for age, gender, urbanity, place of birth, socioeconomic status (education and income), family status (being in a relationship and having children) and religiosity. RESULTS: Higher mean totals for the inattention and hyperactivity ADHD scale scores were associated with higher mean antisocial behaviour scores. These relationships were only slightly affected by socio-demographic variables, including sex, age, education and income. CONCLUSION: Our findings suggest that not only may features of ADHD, even below a diagnostic threshold, constitute a risk factor for antisocial behaviour, but also that the self-rated levels of these problems covary. These findings are important for informing the early detection of risk of antisocial behaviour in the general population and its prevention.

Background and concurrent factors predicting non-adherence to public health preventive measures during the chronic phase of the COVID-19 pandemic.

BACKGROUND: To determine factors that predict non-adherence to preventive measures for COVID-19 during the chronic phase of the pandemic. METHODS: A cross-sectional, general population survey was conducted in Israel. Sociodemographic, health-related, behavioral and COVID-19-related characteristics were collected. RESULTS: Among 2055 participants, non-adherence was associated with male gender, young age, bachelorhood, being employed, lower decrease in income, low physical activity, psychological distress, ADHD symptoms, past risk-taking and anti-social behavior, low pro-sociality, perceived social norms favoring non-adherence, low perceived risk of COVID-19, low perceived efficacy of the preventive measures, and high perceived costs of adherence to the preventive measures. CONCLUSION: There appears to be a need for setting out and communicating preventive measures to specifically targeted at-risk populations.

Symptoms of ADHD Predict Lower Adaptation to the COVID-19 Outbreak: Financial Decline, Low Adherence to Preventive Measures, Psychological Distress, and Illness-Related Negative Perceptions.

OBJECTIVE: The COVID-19 outbreak created numerous multidimensional stressors, to which people show different levels of vulnerability. The current paper examines whether symptoms of ADHD are associated with poorer adaptation. METHOD: After the first quarantine in Israel, 2,055 adults participated in an online survey. Participants completed scales probing adaptation indicators: financial status, adherence to preventive measures, mental health, and COVID-19 related perceptions. Background measures, including the level of symptoms of ADHD, were collected. RESULTS: Adaptation indicators negatively correlated with the level of symptoms of ADHD. Financial decline explained a small portion of the link between ADHD and decreased mental health. Background risk-taking, anti-social, and pro-social behavior partially explained the link between ADHD and non-adherence to preventive measures. COVID-19 related perceptions also partially explained that link. CONCLUSION: This study suggests that people with ADHD are more vulnerable to the challenges created by the COVID-19 pandemic and therefore deserve special attention and care.

Intertwined associations among attachment styles, emotional dysregulation, and ADHD: examining unique associations with general risk-taking behavior.

Attachment insecurity, emotional dysregulation, and attention-deficit/hyperactivity disorder (ADHD) have all been implicated across the literature with various forms of negative life outcomes and increased risk-taking behavior (RTB). Furthermore, abundant research has demonstrated that the three seem to go together. Given these intercorrelations, it is unclear if any of them possess exclusive links with RTB independent of the others across multiple life domains. The present study examined the relations among attachment styles, emotional dysregulation, ADHD symptoms, and hypothetical RTBs across multiple real-life domains. Including a total of 155 mostly undergraduate students, we found in the main analysis that only ADHD symptoms were associated with RTB over and above all other variables. Specifically, the links between both attachment insecurity and emotional dysregulation with RTB disappeared when ADHD symptoms were included in the final model, but not vice versa. An exploratory analysis suggested that attachment insecurity was linked to romantic/sexual RTB over and above the others. These results further substantiate the link between ADHD symptoms and a general propensity for RTB and demonstrate that the link between the two seems to be inherent to the disorder and independent of its co-occurrence with attachment insecurity and emotional dysregulation.

ADHD Is Associated With a Widespread Pattern of Risky Behavior Across Activity Domains.

Objective: ADHD has been linked to higher engagement in risky behaviors in circumscribed domains such as dangerous driving, substance abuse, and gambling. This study tests whether ADHD is associated with a pervasive tendency to engage in risky behavior across a spectrum of activities and domains, and whether this tendency is driven by comorbid disorders. Method: A sample of 97 adults with ADHD and 103 typically developing controls completed a self-report questionnaire measuring the likelihood and frequency of engaging in a broad range of risky behaviors. ADHD, comorbid psychiatric disorders, and demographic variables were extensively assessed using standardized instruments. Results: Participants with ADHD reported a pervasive tendency to engage in risky behaviors across multiple activities. This tendency was associated with ADHD over and above the contribution of comorbid psychiatric disorders. Conclusion: These results suggest that ADHD is uniquely linked to a pervasive pattern of engagement in risky behaviors.

Decision-Making Deficits in ADHD Are Not Related to Risk Seeking But to Suboptimal Decision-Making: Meta-Analytical and Novel Experimental Evidence.

Objective: ADHD is related to decision-making deficits in real-life (e.g., substance abuse) and on experimental tasks (increased preference for risky options). In most tasks, risk and expected value are confounded (risky options have lowest expected value), making it impossible to disentangle risky from suboptimal (i.e., not choosing highest expected value) decision-making. We differentiated between risky and suboptimal decision-making in ADHD in two studies. Method and Results: First, on a multilevel meta-regression analysis (k = 48, n_ADHD = 1,144, n_Control = 1,108), ADHD and controls differed if the risky option was suboptimal (ADHD choosing more risky/suboptimal), whereas groups performed similar if the risky option was not suboptimal. Second, an empirical study showed that adults with ADHD (n = 40) made more suboptimal, but not more risky choices than controls (n = 40). Conclusion: These results contribute to a growing body of evidence that decision-making deficits in ADHD are driven by suboptimal decision-making and not by risk seeking.

What Drives Risky Behavior in ADHD: Insensitivity to its Risk or Fascination with its Potential Benefits?

OBJECTIVE: ADHD is linked to increased engagement in risky behavior (ERB). Recent work suggests that this link is mediated by the perceived benefits of the behaviors, but not by the perceived risks or the attitudes toward the risks. Here we examine this hypothesis, using the psychological risk-return and psychometric multidimensional measurement models. METHOD: Adults with or without ADHD completed questionnaires measuring the likelihood of different risky behaviors and the perceived risks and benefits ascribed to these behaviors. Participants' ratings of 25 characteristics of various risky behaviors allowed us to derive two factors corresponding to perceived risk and perceived benefit of ERBs. Overall attitudes toward the perceived risks and benefits were extracted. RESULTS: Perceived benefit mediated the link between ADHD and ERB, in both models. Attitudes toward the perceived risks mediated that link in the psychometric model only. CONCLUSION: Perceived benefit plays an important role in the link between ADHD and ERB.

Risk-Taking Behavior in Attention Deficit/Hyperactivity Disorder (ADHD): a Review of Potential Underlying Mechanisms and of Interventions.

PURPOSE OF REVIEW: Attention deficit/hyperactivity disorder (ADHD) is associated with several forms of risk-taking behavior (RTB). This paper aims to examine the scope of ADHD-related RTB, to highlight potential underlying mechanisms of this association, and to review initial evidence for interventions aimed to treat ADHD-related RTB. RECENT FINDINGS: Multiple lines of evidence indicate that ADHD is associated with real-life RTB across several domains (e.g., reckless driving, substance use, and unprotected sex), which is corroborated by evidence on laboratory risk-taking tasks. Several individual differences, some of them informed by decision theory, e.g., comorbid disorders, parental monitoring, and perceived enlarged benefits of RTB, may explain the link between ADHD and RTB. A number of studies showed that interventions designed for ADHD may reduce RTB. ADHD is linked to RTB across several domains. Decision theory may serve as a conceptual framework for understanding the underlying mechanisms, and thus may inform future research.

ADHD-associated risk taking is linked to exaggerated views of the benefits of positive outcomes.

Attention deficit and hyperactivity disorder (ADHD) is often assumed to be associated with increased engagement in risk-taking behaviors. The current study sought to understand the mental processes underlying this association using a theory-driven behavioral economics perspective. Psychological risk-return models suggest that risk and benefit are inherently subjective, and risk taking is best understood as the interplay between cognitions and motivations regarding the benefits and risks of alternatives. A sample of 244 adults was assessed for ADHD symptoms. The likelihood of engagement in a range of risky behaviors (e.g., driving without wearing a seat belt), the magnitude of perceived benefit and risk ascribed to these behaviors, and benefit and risk attitudes of each participant were extracted from the Domain Specific Risk Taking (DOSPERT) scales. ADHD symptoms were correlated with more risky behaviors and perception of greater benefits from engaging in these behaviors, but were not correlated with risk perception. Mediation analysis revealed that the association between ADHD symptoms and engagement in risk taking was mediated by perceived benefits. These findings highlight the idea that people with high level ADHD symptoms tend to engage in risky behaviors because they find such behavior particularly appealing, rather than because they seek risk per se.

Feedback May Harm: Role of Feedback in Probabilistic Decision Making of Adolescents with ADHD.

Inept probabilistic decision making is commonly associated with ADHD. In experimental designs aimed to model probabilistic decision making in ADHD, feedback following each choice was, in the majority of studies, part of the paradigm. This study examined whether feedback processing plays a role in the maladaptive choice behavior of subjects with ADHD by comparing feedback and no-feedback conditions. Sixty adolescents (49 males), ages 13-18, with and without ADHD, performed a descriptive probabilistic choice task in which outcomes and probabilities were explicitly provided. Subjects performed the task either with or without feedback. Under the no-feedback condition, adolescents with ADHD and controls performed similarly, whereas under the feedback condition, subjects with ADHD chose the unfavorable outcomes more frequently and risked smaller sums than controls. These finding demonstrate the crucial role of feedback in the decision making of adolescents with ADHD.