Skip to main content

Advertisement

SpringerLink
Log in

Instrumental Learning in ADHD in a Context of Reward: Intact Learning Curves and Performance Improvement with Methylphenidate

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

Abstract

We tested the hypothesis that instrumental learning is impaired in children with attention deficit/hyperactivity disorder (ADHD) and tested whether this deficiency can be ameliorated by the use of three different doses of methylphenidate (MPH): a low, a medium, and a high dose. Fifty children (23 with ADHD, 27 typically developing) performed an instrumental learning task in which they had to map four stimuli to two responses using feedback that differed in information value and that was coupled to monetary gain (€0.2). Feedback was either contingent, thus fully informative on performance, or probabilistic, and informative in only 88 % of the trials. Dependent variables were response accuracy and latency. Contrary to predictions, children with ADHD and typically developing controls did not differ in their ability to acquire the stimulus–response mappings, in either condition. This indicates that with a simple instrumental learning task, children with ADHD are able to learn from rewarded feedback, as controls do, suggesting that children with ADHD are capable of learning both at home and in class when the environment is adequate. Possibly, learning problems are more evident in children with comorbid ODD, as exploratory analyses indicated that accuracy scores were significantly reduced when children with ADHD exhibited high levels of parent-rated ODD symptoms. Medication analysis showed that children with ADHD completed the task more accurately and faster when taking MPH compared to placebo, particularly when the dose was high.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  • Achenbach, T. M., & Edelbrock, C. S. (1981). Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monographs of the Society for Research in Child Development, 46, 1–82.

    Article  PubMed  Google Scholar 

  • American Academy of Pediatrics. (2011). Subcommittee on attention-deficit/hyperactivity disorder; steering committee on quality improvement and management. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 128, 1007–1022.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). DSM IV-TR: diagnostic and statistical manual of mental disorders-text revision (4th ed.). Washington: American Psychiatric Association.

    Google Scholar 

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry, 40, 57–87.

    Article  PubMed  Google Scholar 

  • Barry, T. D., Lyman, R. D., & Klinger, L. G. (2002). Academic underachievement and attention-deficit/hyperactivity disorder: the negative impact of symptom severity on school performance. Journal of School Psychology, 40, 259–283.

    Article  Google Scholar 

  • Biederman, J., Faraone, S., Milberger, S., Guite, J., Mick, E., Chen, L., et al. (1996). A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Archives of General Psychiatry, 53, 437–446.

    Article  PubMed  Google Scholar 

  • Bloemsma, J. M., Boer, F., Arnold, R., Banaschewski, T., Faraone, S. V., Buitelaar, J. K., et al. (2013). What are the effects of comorbid anxiety on neurocognitive dysfunctions in children with ADHD? European Child & Adolescent Psychiatry, 4, 225–234.

    Article  Google Scholar 

  • Bull, R., & Scerif, G. (2001). Executive functioning as a predictor of children’s mathematics ability: inhibition, switching, and working memory. Developmental Neuropsychology, 19, 273–293.

    Article  PubMed  Google Scholar 

  • Bush, G. (2011). Cingulate, frontal, and parietal cortical dysfunction in attention-deficit/hyperactivity disorder. Biological Psychiatry, 69, 1160–1167.

    Article  PubMed Central  PubMed  Google Scholar 

  • Cohen, J. (1988). Statistical power analyses for the behavioral sciences (2nd ed.). NJ: Mahwah.

    Google Scholar 

  • Cools, R. (2008). Role of dopamine in the motivational and cognitive control of behavior. The Neuroscientist, 14, 381–395.

    Article  PubMed  Google Scholar 

  • Dennis, M., Francis, D. J., Cirino, P. T., Schachar, R., Barnes, M. A., & Fletcher, J. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15, 331–343.

    Article  PubMed Central  PubMed  Google Scholar 

  • Dodds, C. M., Mueller, U., Clark, L., van Loon, A., Cools, R., & Robbins, T. W. (2008). Methylphenidate has differential effects on blood oxygenation level-dependent signal related to cognitive subprocesses of reversal learning. Journal of Neuroscience, 28, 5976–5982.

    Article  PubMed  Google Scholar 

  • Dovis, S., Van der Oord, S., Wiers, R. W., & Prins, P. J. M. (2013). What part of working memory is not working in ADHD? Short-term memory, the central executive and effects of reinforcement. Journal of Abnormal Child Psychology, 41, 901–917.

    Article  PubMed  Google Scholar 

  • Drechsler, R., Rizzo, P., & Steinhausen, H. C. (2008). Decision-making on an explicit risk-taking task in preadolescents with attention-deficit/hyperactivity disorder. Journal of Neural Transmission, 115, 201–209.

    Article  PubMed  Google Scholar 

  • Elliott, R., Sahakian, B. J., Matthews, K., Bannerjea, A., Rimmer, J., & Robbins, T. W. (1997). Effects of methylphenidate on spatial working memory and planning in healthy young adults. Psychopharmacology, 131, 196–206.

    Article  PubMed  Google Scholar 

  • Ernst, M., Kimes, A. S., London, E. D., Matochik, J. A., Eldreth, D., Tata, S., et al. (2003). Neural substrates of decision making in adults with attention deficit hyperactivity disorder. American Journal of Psychiatry, 160, 1061–1070.

    Article  PubMed  Google Scholar 

  • Frank, M. J., Santamaria, A., O’Reilly, R. C., & Willcutt, E. (2007a). Testing computational models of dopamine and noradrenaline dysfunction in attention deficit/hyperactivity disorder. Neuropsychopharmacology, 32, 1583–1599.

    Article  PubMed  Google Scholar 

  • Frank, M. J., Scheres, A., & Sherman, S. J. (2007b). Understanding decision-making deficits in neurological conditions: insights from models of natural action selection. Philosophical Transactions of the Royal Society B-Biological Sciences, 362, 1641–1654.

    Article  PubMed Central  Google Scholar 

  • Gitten, J. C., Winer, J. L., Festa, E. K., & Heindel, W. C. (2006). Conditional associative learning of spatial and object information in children with attention deficit/hyperactivity disorder. Child Neuropsychology, 12, 39–56.

    Article  PubMed  Google Scholar 

  • Greene, R. W., Biederman, J., Zerwas, S., Monuteaux, M. C., Goring, J. C., & Faraone, S. V. (2002). Psychiatric comorbidity, family dysfunction, and social impairment in referred youth with oppositional defiant disorder. American Journal of Psychiatry, 159, 1214–1224.

    Article  PubMed  Google Scholar 

  • Groen, Y., Wijers, A. A., Mulder, L. J. M., Waggeveld, B., Minderaa, R. B., & Althaus, M. (2008). Error and feedback processing in children with ADHD and children with autistic spectrum disorder: an EEG event-related potential study. Clinical Neurophysiology, 119, 2476–2493.

    Article  PubMed  Google Scholar 

  • Groen, Y., Mulder, L. J. M., Wijers, A. A., Minderaa, R. B., & Althaus, M. (2009). Methylphenidate improves diminished error and feedback sensitivity in ADHD: an evoked heart rate analysis. Biological Psychology, 82, 45–53.

    Article  PubMed  Google Scholar 

  • Groth-Marnat, G. (1997). Handbook of psychological assessment (3rd ed.). New York: Wiley.

    Google Scholar 

  • Jacobson, N. S., & Truax, P. (1991). Clinical-significance - a statistical approach to defining meaningful change in psychotherapy-research. Journal of Consulting and Clinical Psychology, 59, 12–19.

    Article  PubMed  Google Scholar 

  • Jensen, P. S., Arnold, L. E., Richters, J. E., Severe, J. B., Vereen, D., Vitiello, B., et al. (1999). Moderators and mediators of treatment response for children with attention-deficit/hyperactivity disorder - the multimodal treatment study of children with attention-deficit/hyperactivity disorder. Archives of General Psychiatry, 56, 1088–1096.

    Article  Google Scholar 

  • Klein, T. A., Neumann, J., Reuter, M., Hennig, J., von Cramon, D. Y., & Ullsperger, M. (2007). Genetically determined differences in learning from errors. Science, 318, 1642–1645.

    Article  PubMed  Google Scholar 

  • Leth-Steensen, C., Elbaz, Z. K., & Douglas, V. I. (2000). Mean response times, variability, and skew in the responding of ADHD children: a response time distributional approach. Acta Psychologica, 104, 167–190.

    Article  PubMed  Google Scholar 

  • Loe, I. M., & Feldman, H. M. (2007). Academic and educational outcomes of children with ADHD. Journal of Pediatric Psychology, 32, 643–654.

    Article  PubMed  Google Scholar 

  • Luman, M., Oosterlaan, J., & Sergeant, J. A. (2005). The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal. Clinical Psychology Review, 25, 183–213.

    Article  PubMed  Google Scholar 

  • Luman, M., Oosterlaan, J., Hyde, C., van Meel, C. S., & Sergeant, J. A. (2007). Heart rate and reinforcement sensitivity in ADHD. Journal of Child Psychology and Psychiatry, 48, 890–898.

    Article  PubMed  Google Scholar 

  • Luman, M., Oosterlaan, J., Knol, D. L., & Sergeant, J. A. (2008). Decision-making in ADHD: sensitive to frequency but blind to the magnitude of penalty? Journal of Child Psychology and Psychiatry, 49, 712–722.

    Article  PubMed  Google Scholar 

  • Luman, M., van Meel, C. S., Oosterlaan, J., Sergeant, J. A., & Geurts, H. M. (2009). Is it reward frequency or magnitude that drives reinforcement learning in ADHD. Psychiatry Research, 168, 222–229.

    Article  PubMed  Google Scholar 

  • Matthys, W., van Goozen, S. H. M., Snoek, H., & van Engeland, H. (2004). Response perseveration and sensitivity to reward and punishment in boys with oppositional defiant disorder. European Child and Adolescent Psychiatry, 13, 362–364.

    Article  PubMed  Google Scholar 

  • Matthys, W., Vanderschuren, L. J., & Schutter, D. J. (2013). The neurobiology of oppositional defiant disorder and conduct disorder: altered functioning in three mental domains. Development and Psychopathology, 25, 193–207.

    Article  PubMed  Google Scholar 

  • Mehta, M. A., Owen, A. M., Sahakian, B. J., Mavaddat, N., Pickard, J. D., & Robbins, T. W. (2000). Methylphenidate enhances working memory by modulating discrete frontal and parietal lobe regions in the human brain. Journal of Neuroscience, 20(RC65), 1–6.

    Google Scholar 

  • Nigg, J. T., & Casey, B. J. (2005). An integrative theory of attention-deficit/hyperactivity disorder based on the cognitive and affective neurosciences. Development and Psychopathology, 17, 785–806.

    PubMed  Google Scholar 

  • Pelham, W. E., Evans, S. W., Gnagy, E. M., & Greenslade, K. E. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders - prevalence, factor-analyses, and conditional probabilities in a special-education sample. School Psychology Review, 21, 285–299.

    Google Scholar 

  • Pietrzak, R. H., Mollica, C. M., Maruff, P., & Snyder, P. J. (2006). Cognitive effects of immediate-release methylphenidate in children with attention-deficit/hyperactivity disorder. Neuroscience and Biobehavioral Reviews, 30, 1225–1245.

    Article  PubMed  Google Scholar 

  • Pliszka, S. R. (2000). Patterns of psychiatric comorbidity with attention deficit/hyperactivity disorder. Child and Adolescent Psychiatric Clinics of North America, 9, 525–540.

    PubMed  Google Scholar 

  • Prasad, V., Brogan, E., Mulvaney, C., Grainge, M., Stanton, W., & Sayal, K. (2013). How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis. European Child and Adolescent Psychiatry, 22, 203–216.

    Article  PubMed  Google Scholar 

  • Sagvolden, T., Johansen, E. B., Aase, H., & Russell, V. A. (2005). A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes. Behavioral and Brain Sciences, 28, 397.

    Article  PubMed  Google Scholar 

  • Scheres, A., Milham, M. P., Knutson, B., & Castellanos, F. X. (2007). Ventral striatal hyporesponsiveness during reward anticipation in attention-deficit/hyperactivity disorder. Biologial Psychiatry, 61, 720–724.

    Article  Google Scholar 

  • Schultz, W., & Dickinson, A. (2000). Neural coding of prediction errors. Annual Review of Neuroscience, 23, 473–500.

    Article  PubMed  Google Scholar 

  • Schultz, W., Dayan, P., & Montague, P. R. (1997). A neural substrate of prediction and reward. Science, 275, 1593–1599.

    Article  PubMed  Google Scholar 

  • Schultz, W., Tremblay, L., & Hollerman, J. R. (2003). Changes in behavior-related neuronal activity in the striatum during learning. Trends in Neurosciences, 26, 321–328.

    Article  PubMed  Google Scholar 

  • Seeman, P., & Madras, B. K. (1998). Anti-hyperactivity medication: methylphenidate and amphetamine. Molecular Psychiatry, 3, 386–396.

    Article  PubMed  Google Scholar 

  • Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH diagnostic interview schedule for children version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.

    Article  PubMed  Google Scholar 

  • Shiels, K., & Hawk, L. W. (2010). Self-regulation in ADHD: the role of error processing. Clinical Psychology Review, 30, 951–961.

    Article  PubMed Central  PubMed  Google Scholar 

  • Solanto, M. V. (1998). Neuropsychopharmacological mechanisms of stimulant drug action in attention-deficit hyperactivity disorder: a review and integration. Behavioural Brain Research, 94, 127–152.

    Article  PubMed  Google Scholar 

  • Spinath, B., Spinath, F. M., Harlaar, N., & Plomin, R. (2006). Predicting school achievement from general cognitive ability, self-perceived ability, and intrinsic value. Intelligence, 34, 363–374.

    Article  Google Scholar 

  • Sutton, R. S., & Barto, A. G. (1998). Reinforcement learning. Cambridge: MIT Press.

    Google Scholar 

  • Taylor, S. F., Stern, E. R., & Gehring, W. J. (2007). Neural systems for error monitoring: recent findings and theoretical perspectives. The Neuroscientist, 13, 160–172.

    Article  PubMed  Google Scholar 

  • Tremblay, L., & Schultz, W. (2000). Modifications of reward expectation-related neuronal activity during learning in primate orbitofrontal cortex. Journal of Neurophysiology, 83, 1877–1885.

    PubMed  Google Scholar 

  • Tripp, G., & Alsop, B. (1999). Sensitivity to reward frequency in boys with attention deficit hyperactivity disorder. Journal of Clinical Child Psychology, 28, 366–375.

    Article  PubMed  Google Scholar 

  • Tripp, G., & Wickens, J. (2008). Research review: dopamine transfer deficit: a neurobiological theory of altered reinforcement mechanisms in ADHD. Journal of Child Psychology and Psychiatry, 49, 691–704.

    Article  PubMed  Google Scholar 

  • van Goozen, S. H. M., Cohen-Kettenis, P. T., Snoek, H., Matthys, W., Swaab-Barneveld, H., & van Engeland, H. (2004). Executive functioning in children: a comparison of hospitalised ODD and ODD/ADHD children and normal controls. Journal of Child Psychology and Psychiatry, 45, 284–292.

    Article  PubMed  Google Scholar 

  • van Meel, C. S., Oosterlaan, J., Heslenfeld, D. J., & Sergeant, J. A. (2005). Telling good from bad news: ADHD differentially affects processing of positive and negative feedback during guessing. Neuropsychologia, 43, 1946–1954.

    Article  PubMed  Google Scholar 

  • van Meel, C. S., Heslenfeld, D. J., Oosterlaan, J., Luman, M., & Sergeant, J. A. (2011). ERPs associated with monitoring and evaluation of monetary reward and punishment in children with ADHD. Journal of Child Psychology and Psychiatry, 52, 942–953.

    Article  PubMed  Google Scholar 

  • Volkow, N. D., Wang, G. J., Fowler, J. S., Gatley, S. J., Logan, J., Ding, Y. S., et al. (1998). Dopamine transporter occupancies in the human brain induced by therapeutic doses of oral methylphenidate. American Journal of Psychiatry, 155, 1325–1331.

    Article  PubMed  Google Scholar 

  • Volkow, N. D., Wang, G. J., Fowler, J. S., Logan, J., Gerasimov, M., Maynard, L., et al. (2001). Therapeutic doses of oral methylphenidate significantly increase extracellular dopamine in the human brain. Journal of Neuroscience, 21(2), U1–U5.

    Google Scholar 

  • Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biological Psychiatry, 57, 1336–1346.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We would like to thank all children and parents that participated in our study. Further we would like to thank Diane Veugelers, MA, Janneke van Oostenbruggen-Scheffer, MA, and Alky Papanikolau, MD, working at the outpatient clinic for children with ADHD (Bascule Duivendrecht) for their help in the recruitment of patients.

Conflict of Interest Statement

JO has been on the advisory board of UCB and Shire pharmaceuticals and has received an unrestricted investigator initiated research grant from Shire pharmaceuticals.

Author information

Authors and Affiliations

  1. Department of Clinical Neuropsychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT, Amsterdam, The Netherlands

    Marjolein Luman, Vanessa Goos & Jaap Oosterlaan

Authors
  1. Marjolein Luman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vanessa Goos
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaap Oosterlaan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marjolein Luman.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Luman, M., Goos, V. & Oosterlaan, J. Instrumental Learning in ADHD in a Context of Reward: Intact Learning Curves and Performance Improvement with Methylphenidate. J Abnorm Child Psychol 43, 681–691 (2015). https://doi.org/10.1007/s10802-014-9934-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-014-9934-1

Keywords

Search

Navigation