Risk Perception in Adults With Attention Deficit and Hyperactivity Disorder (ADHD)
Condition: ADHD
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Observational

Summary: 
      People with ADHD often engage in risky behaviors, such as dangerous driving, substance abuse
      and gambling. Current behavioral economy theories differentiate between risk perception and
      risk attitude. This study aims to measure both risk taking and risk perception in adults with
      and without ADHD. It is hypothesized that people with ADHD show decreased risk perception,
      accounting for their risky behavior. In contrast, it is hypothesized that people with ADHD do
      not show increased risk attitude, namely, they are not risk seeking.
    

Detailed description: 
      INTRODUCTION:

      People with ADHD are found to be engaged in risky behavior and tend to take risks such as
      dangers driving, substance abuse, gambling and more. These tendencies are in line with
      findings of poor decision making in individuals with ADHD. Even though none of the existing
      theories of ADHD manage to explain the full spectrum of decision making among ADHD, yet this
      population interpreted as risk seekers regardless causative correlation that link the
      disorder to risk taking behavior. Studies regarding decision making under uncertainty have
      uncovered common patterns of behavior that are inconsistent with the grasp that individuals
      with ADHD are risk seekers. First, studies that used gambling tasks showed that subjects with
      ADHD bet on smaller wages than non ADHD subjects. Second, when subjects with ADHD confronted
      with risky options that showed similarity in its expected value or that the expected value
      was beneficial compared to the safe one, they did not choose the risky options. Surprisingly,
      when the risky options did not carry any gain or benefit they tend to choose the risky
      options upon the beneficial or safer ones. Third, subjects with ADHD who preformed explicit
      pure risk seeking tasks under two conditions, with and without feedback, differ from control
      group only in the with feedback condition and were conservative in choosing risky
      alternatives. All of the above questions upon the risk perception of people with ADHD in more
      skeptical light and is being researched in this study in a direct and more comprehensive way.

      METHODS:

      Participants:

      Two hundred adults with and with out ADHD will be recruited through addressing to
      undergraduate students at the Hebrew University and Talpiot Collage in Israel, who will be
      enrolled in special education course for teachers, and through addressing work colleagues.

      All participants will complete the following questionnaire:

      ADHD Adult Self Report Scale (ASRS-v1.1) in order to measure the severity of ADHD symptoms.

      Domain-specific Risk-Taking (DOSPERT): The subjects will be asked to complete a
      paper-and-pencil questionnaire in groups of 5-10 individuals or in private.of the DOSPERT
      questionnaire consisted of a total set of 30 items assessing 3 scales (risk taking, risk
      perception and expected benefits) in five domains of risk: financial, health/safety,
      recreational, ethics, and social, 6 items in each domain. The set of 30 items was presented
      three times in counterbalanced order.

      The Hebrew version of the DOSPERT scale was developed for this study using the method of
      back-translation. Internal consistency for the 3 measures was good. Cronbach's alpha was
      0.85, 0.83 and 0.86, for Risk Taking, Risk Perception and Expected Benefit perception,
      respectively.

      Hypothesis:

      We predict that: (a) higher level of ADHD symptoms will be associated with higher risk taking
      ; (b) lower risk perception and higher benefit perception will be associated with higher risk
      taking ; (c) higher level of ADHD symptoms will be associated with lower risk perception and
      higher benefit perception ; (d) risk and benefit perceptions will mediate the relation
      between level of ADHD symptoms and risk taking.

      Analysis:

      Three measures will be analyzed: Risk Taking (defined as the willingness to engage in a risky
      activity as a function of its perceived riskiness), Risk Perception (defined as the reported
      level of risk taking), and Expected Benefits (define as the benefit responders expect to
      obtain from engaging in each risky behavior). Correlations with the ASRS scores will be
      examined. A mediation analysis will be conducted in order to examine the role of risk and
      benefit perception as potential mediator of ADHD-related risk taking.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Adults with ADHD