Standardization of decision-making skills but persistent impulsivity after chronic stimulant exposure in ADHD patients

Abstract

Attention deficit hyperactivity disorder (ADHD) is commonly associated with deficits in executive function. Even though attention, hyperactivity, and impulsivity are the more distinctive symptoms, impairment in other cognitive processes, for instance memory, could be due to the interferences from these symptoms. However, it remains unclear whether information processing errors made by individuals with ADHD arise primarily from impulsive responding or reflect a more fundamental difference in how they process information, potentially due to compensatory mechanisms developed throughout childhood. This study analyzes pattern separation (distinguishing similar stimuli), recognition memory, decision-making, and impulsivity in both ADHD-diagnosed and non-diagnosed youth population. We further examined possible treatment effects by dividing the ADHD group into three cohorts based on stimulant medication duration. We evaluate their response latency and responses utilizing the signal detection theory method. While ADHD participants exhibited poorer recognition memory compared to controls, this pattern did not show a statistically significant difference in pattern separation. Additionally, both processes improved with longer treatment duration within the ADHD group, leading to decreased error commission. Decision-making analyses revealed sex-specific response strategies within the ADHD group, but both groups showed similar adjustment to task difficulty. However, the ADHD group responses were notably faster, associated with a higher error rate. Additionally, response times varied depending on the stimulus type, suggesting potential differences in how the ADHD group processed information compared to the control group. These findings collectively point towards a possible difference in information management in ADHD, that is also characterized by faster, but less accurate, processing.