Neuropsychology Review

, Volume 20, Issue 1, pp 86–102 | Cite as

Context-dependent Dynamic Processes in Attention Deficit/Hyperactivity Disorder: Differentiating Common and Unique Effects of State Regulation Deficits and Delay Aversion

  • Edmund J. S. Sonuga-Barke
  • Jan R. Wiersema
  • Jacob J. van der Meere
  • Herbert Roeyers


The ability to specify differential predictions is a mark of a scientific models’ value. State regulation deficits (SRD) and delay aversion (DAv) have both been hypothesized as context-dependent dynamic dysfunctions in ADHD. However, to date there has been no systematic comparison of their common and unique elements. Here we review these hypotheses—and describe the core and secondary manifestations of the two constructs and review evidence in support of them. Second, we focus on what are seen as the hallmark indicators of the two deficits—preference of small immediate over large delayed rewards for DAv and the slow event rate effect for SRD. We describe the overlap between these two manifestations and then explore how experimental manipulations and the analysis of neuropsychological and physiological mediators of effects can allow us to differentiate these two patterns of neuropsychological dysfunction on the basis of specific predictions. Finally, we highlight the implications of neuropsychological heterogeneity for the practical implementation of tests of DAv and SRD.


Attention deficit/hyperactivity disorder Delay aversion State regulation Cognitive energetic Event rate Delay of gratification Delayed reward 



Edmund J S Sonuga-Barke:

Recent speaker board: Shire Pharma, UCB Pharma

Current & recent consultancy: UCB Pharma, Shire

Current & recent research support: Janssen Cilag, Shire, Qbtech

Advisory Board: Shire, Flynn Pharma, UCB Pharma, Astra Zeneca

Conference support: Shire

Jan R Wiersema: no disclosures or conflicts of interest to report

Jacob J van der Meere: no disclosures or conflicts of interest to report

Herbert Roeyers: no disclosures or conflicts of interest to report


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Edmund J. S. Sonuga-Barke
    • 1
    • 2
  • Jan R. Wiersema
    • 2
  • Jacob J. van der Meere
    • 2
    • 3
  • Herbert Roeyers
    • 2
  1. 1.Institute for Disorders of Impulse and Attention, School of PsychologyUniversity of SouthamptonSouthamptonUK
  2. 2.Department of Clinical Experimental & Health PsychologyGhent UniversityGhentBelgium
  3. 3.Department of NeuropsychologyUniversity of GroningenGroningenThe Netherlands

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