Risk taking and adult attention deficit/hyperactivity disorder: A gap between real life behavior and experimental decision making

- Adults with ADHD are prone to risk-taking behavior.
- Laboratory gambling tasks are used to model risk-taking behavior.
- Students with ADHD reported on increased past and present substance use.
- The same students did not show increased risk taking on a the Cambridge Gambling Test.
- Use of laboratory tasks as models of ADHD-related risk-taking behavior is challenged.

Adults with attention deficit/hyperactivity disorder (ADHD) are prone to suboptimal decision making and risk taking. The aim of this study was to test performance on a theoretically-based probabilistic decision making task in well-characterized adults with and without ADHD, and examine the relation between experimental risk taking and history of real-life risk-taking behavior, defined as cigarette, alcohol, and street drug use. University students with and without ADHD completed a modified version of the Cambridge Gambling Test, in which they had to choose between alternatives varied by level of risk, and reported their history of substance use. Both groups showed similar patterns of risk taking on the experimental decision making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD. These finding question the validity of experimental probabilistic decision making task as a valid model for ADHD-related risk-taking behavior.