Factors Influencing Parental Decision Making About Stimulant Treatment for Attention-Deficit/Hyperactivity Disorder

2013 ◽  
Vol 23 (3) ◽  
pp. 163-178 ◽  
Author(s):  
Rana Ahmed ◽  
Kirsten J. McCaffery ◽  
Parisa Aslani
Keyword(s):  
Decision Making ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Stimulant Treatment ◽  
Parental Decision ◽  
Hyperactivity Disorder ◽  
Parental Decision Making ◽  
Factors Influencing

scholarly journals Shifting uncertainty intolerance: methylphenidate and attention-deficit hyperactivity disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alekhya Mandali ◽  
Arjun Sethi ◽  
Mara Cercignani ◽  
Neil A. Harrison ◽  
Valerie Voon
Keyword(s):  
Decision Making ◽  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Computational Models ◽  
Risky Choice ◽  
Risk Tolerance ◽  
Healthy Population ◽  
Hyperactivity Disorder ◽  
Risky Choices ◽  
Cardinal Symptom

AbstractRisk evaluation is a critical component of decision making. Risk tolerance is relevant in both daily decisions and pathological disorders such as attention-deficit hyperactivity disorder (ADHD), where impulsivity is a cardinal symptom. Methylphenidate, a commonly prescribed drug in ADHD, improves attention but has mixed reports on risk-based decision making. Using a double-blinded placebo protocol, we studied the risk attitudes of ADHD patients and age-matched healthy volunteers while performing the 2-step sequential learning task and examined the effect of methylphenidate on their choices. We then applied a novel computational analysis using the hierarchical drift–diffusion model to extract parameters such as threshold (‘a’—amount of evidence accumulated before making a decision), drift rate (‘v’—information processing speed) and response bias (‘z’ apriori bias towards a specific choice) focusing specifically on risky choice preference. Critically, we show that ADHD patients on placebo have an apriori bias towards risky choices compared to controls. Furthermore, methylphenidate enhanced preference towards risky choices (higher apriori bias) in both groups but had a significantly greater effect in the patient population independent of clinical scores. Thus, methylphenidate appears to shift tolerance towards risky uncertain choices possibly mediated by prefrontal dopaminergic and noradrenergic modulation. We emphasise the utility of computational models in detecting underlying processes. Our findings have implications for subtle yet differential effects of methylphenidate on ADHD compared to healthy population.

Forty years of methylphenidate treatment in Attention-Deficit/Hyperactivity Disorder

2002 ◽  
Vol 6 (1_suppl) ◽  
pp. 17-30 ◽  
Author(s):  
C. K. Conners
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Attention Deficit ◽  
Drug Effects ◽  
Long Term Effects ◽  
Stimulant Treatment ◽  
Hyperactivity Disorder ◽  
Subject Selection ◽  
Methodological Rigor ◽  
Adolescents And Adults ◽  
Core Symptoms

This paper reviews approximately 40 years of stimulant drug treatment of children with behavior and learning problems. These patients generally fall under the rubric of Attention-Deficit/Hyperactivity Disorder (ADHD), with core symptoms of hyperactivity, impulsivity, and inattention being the most studied and most robust of the targets for stimulant treatment. In addition, the drug effects on other targets, such as cognitive and academic function, are included. The largest selection of studies involves methylphenidate. Both qualitative studies and meta-analytic studies from major reviews are examined. Variations in the methodology of the reviews are described and some of the discrepancies in interpretation examined. Despite wide variations in subject selection, types of trials, degree of methodological rigor, and the decade in which the studies took place, the evidence is remarkably consistent. The overall results suggest significant clinical impact upon the core features of ADHD. More studies of long-term effects and special populations such as older adolescents and adults will be necessary, though existing evidence strongly supports similar findings as for the younger patients with a diagnosis of ADHD.

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