What motivates individuals with ADHD? A qualitative analysis from the adolescent’s point of view

Abstract

Individuals with ADHD appear to respond differently to incentives than their peers. This could be due to a general altered sensitivity to reinforcers. However, apart from differences in the degree of motivation, individuals with ADHD might also be motivated by qualitatively different factors. This study aimed to harvest a range of motivational factors and identify ADHD-related qualitative differences in motivation, from the adolescent’s point of view. Semi-structured interviews allowing participants to describe what motivates them in daily life were conducted with young adolescents (9–16 years) with and without ADHD. Thematic analysis was undertaken using NVivo software. Major themes relating to motivation were identified from the interview data. These were: (1) achieving a sense of togetherness; (2) feeling competent; (3) fulfilling a need for variation; (4) gaining pleasure from applying effort to achieve a goal; (5) valuing social reinforcement; (6) desiring to be absorbed/forget problems; (7) feeling free and independent, (8) attaining material reinforcement; and (9) an enjoyment of bodily stimulation. The theme structure was very similar for both groups. However, individuals with ADHD differed in some specifics: their focus on the passing of time, the absence of preference for predictable and familiar tasks, and their less elaborate description of the togetherness theme. A broad range of motivational themes was identified, stretching beyond the current focus of ADHD research and motivational theories. Similarities and differences in motivational values of individuals with and without ADHD should be taken into account in reward sensitivity research, and in psychological treatment.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    Able SL, Haynes V, Hong J (2014) Diagnosis, treatment, and burden of illness among adults with attention-deficit/hyperactivity disorder in Europe. Pragmat Obs Res 5:21–33

    PubMed  PubMed Central  Google Scholar 

  2. 2.

    American Psychiatric Association. (2013) Diagnostic and statistical manual of mental disorders, 5th edn. VA: American Psychiatric Publishing, Arlington

  3. 3.

    Faraone SV, Asherson P, Banaschewksi T, Biederman J, Buitelaar J, Ramos-Quiroga JA et al (2013) Attention-deficit/hyperactivity disorder. Nat Rev Dis Primers 1:15020

    Google Scholar 

  4. 4.

    Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365

    Article  PubMed  Google Scholar 

  5. 5.

    Skounti M, Philalithis A, Galanakis E (2007) Variations in prevalence of attention deficit hyperactivity disorder worldwide. Eur J Pediatr 166(2):117–123

    Article  PubMed  Google Scholar 

  6. 6.

    Danckaerts M, Sonuga-Barke EJ, Banaschewski T, Buitelaar J, Döpfner M, Hollis C et al (2010) The quality of life of children with attention deficit/hyperactivity disorder: a systematic review. Eur Child Adolesc Psychiatry 19(2):83–105

    Article  PubMed  Google Scholar 

  7. 7.

    Wu S-Y, Gau SS-F (2013) Correlates for academic performance and school functioning among youths with and without persistent attention-deficit/hyperactivity disorder. Res Dev Disabil 34(1):505–515

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Chorozoglou M, Smith E, Koerting J, Thompson MJ, Sayal K, Sonuga-Barke EJ (2015) Preschool hyperactivity is associated with long-term economic burden: evidence from a longitudinal health economic analysis of costs incurred across childhood, adolescence and young adulthood. J Child Psychol Psychiatry 56(9):966–975

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    Frazier TW, Demaree HA, Youngstrom EA (2004) Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology. 18(3):543

    Article  PubMed  Google Scholar 

  10. 10.

    Barkley RA (1997) Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 121(1):65

    CAS  Article  PubMed  Google Scholar 

  11. 11.

    Plichta MM, Scheres A (2014) Ventral–striatal responsiveness during reward anticipation in ADHD and its relation to trait impulsivity in the healthy population: a meta-analytic review of the fMRI literature. Neurosci Biobehav Rev 38:125–134

    Article  PubMed  Google Scholar 

  12. 12.

    Sonuga-Barke EJ, Fairchild G (2012) Neuroeconomics of attention-deficit/hyperactivity disorder: differential influences of medial, dorsal, and ventral prefrontal brain networks on suboptimal decision making? Biol Psychiatry 72(2):126–133

    Article  PubMed  Google Scholar 

  13. 13.

    Deci EL, Ryan RM (2000) The “what” and“ why” of goal pursuits: human needs and the self-determination of behavior. Psychol Inq 11(4):227–268

    Article  Google Scholar 

  14. 14.

    Luman M, Oosterlaan J, Sergeant JA (2005) The impact of reinforcement contingencies on AD/HD: a review and theoretical appraisal. Clin Psychol Rev 25(2):183–213

    Article  PubMed  Google Scholar 

  15. 15.

    Modesto-Lowe V, Chaplin M, Soovajian V, Meyer A (2013) Are motivation deficits underestimated in patients with ADHD? A review of the literature. Postgrad Med 125(4):47–52

    Article  PubMed  Google Scholar 

  16. 16.

    Ma I, van Duijvenvoorde A, Scheres A (2016) Interaction between reinforcement and inhibitory control in ADHD: a review and research guidelines. Clin Psychol Rev [Internet]. Beschikbaar op: http://www.sciencedirect.com/science/article/pii/S0272735816000027. geciteerd 3 februari 2016

  17. 17.

    Tripp G, Wickens JR (2009) Neurobiology of ADHD. Neuropharmacology 57(7):579–589

    CAS  Article  PubMed  Google Scholar 

  18. 18.

    Sagvolden T, Johansen EB, Aase H, Russell VA (2005) A dynamic developmental theory of attention-deficit/hyperactivity disorder (ADHD) predominantly hyperactive/impulsive and combined subtypes. Behav Brain Sci 28(3):397–418

    Article  PubMed  Google Scholar 

  19. 19.

    Tripp G, Wickens JR (2008) Research review: dopamine transfer deficit: a neurobiological theory of altered reinforcement mechanisms in ADHD. J Child Psychol Psychiatry 49(7):691–704

    Article  PubMed  Google Scholar 

  20. 20.

    Dovis S, Van der Oord S, Wiers RW, Prins PJ (2012) Can motivation normalize working memory and task persistence in children with attention-deficit/hyperactivity disorder? The effects of money and computer-gaming. J Abnorm Child Psychol 40(5):669–681

    Article  PubMed  Google Scholar 

  21. 21.

    Konrad K, Gauggel S, Manz A, Schöll M (2000) Lack of inhibition: a motivational deficit in children with attention deficit/hyperactivity disorder and children with traumatic brain injury*. Child Neuropsychol 6(4):286–296

    CAS  Article  PubMed  Google Scholar 

  22. 22.

    Marx I, Höpcke C, Berger C, Wandschneider R, Herpertz SC (2013) The impact of financial reward contingencies on cognitive function profiles in adult ADHD. Beschikbaar op: http://dx.plos.org/10.1371/journal.pone.0067002. geciteerd 28 januari 2016

  23. 23.

    Demurie E, Roeyers H, Baeyens D, Sonuga-Barke E (2011) Common alterations in sensitivity to type but not amount of reward in ADHD and autism spectrum disorders. J Child Psychol Psychiatry 52(11):1164–1173

    Article  PubMed  Google Scholar 

  24. 24.

    Carlson CL, Booth JE, Shin M, Canu WH (2002) Parent-, teacher-, and self-rated motivational styles in ADHD subtypes. J Learn Disabil 35(2):104–113

    Article  PubMed  Google Scholar 

  25. 25.

    Sonuga-Barke EJ (2011) Editorial: ADHD as a reinforcement disorder—moving from general effects to identifying (six) specific models to test. J Child Psychol Psychiatry 52(9):917–918

    Article  PubMed  Google Scholar 

  26. 26.

    Daley D, Van der Oord S, Ferrin M, Danckaerts M, Doepfner M, Cortese S et al (2014) Behavioral interventions in attention-deficit/hyperactivity disorder: a meta-analysis of randomized controlled trials across multiple outcome domains. J Am Acad Child Adolesc Psychiatry. 53(8):835–847

    Article  PubMed  Google Scholar 

  27. 27.

    Boyer BE, Geurts HM, Prins PJ, Van der Oord S (2014) Two novel CBTs for adolescents with ADHD: the value of planning skills. Eur Child Adolesc Psychiatry 24(9):1075–1090

    Article  PubMed  Google Scholar 

  28. 28.

    Evans SW, Timmins B, Sibley M, White LC, Serpell ZN, Schultz B (2006) Developing coordinated, multimodal, school-based treatment for young adolescents with ADHD. Educ Treat Child 29: 359–78

    Google Scholar 

  29. 29.

    Kaufman J, Birmaher B, Brent D, Rao UMA, Flynn C, Moreci P et al (1997) Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry 36(7):980–988

    CAS  Article  PubMed  Google Scholar 

  30. 30.

    Bennett G. Miller, WR, Rollnick S (1991) Motivational interviewing: preparing people to change addictive behavior. New York: Guilford Press, 1991. Pp. xvii+ 348.\pounds 24.95 hardback,\pounds 11.50 paper. ISBN 0–89862–566–1 [Internet]. Wiley Online Library; 1992. Beschikbaar op: http://onlinelibrary.wiley.com/doi/10.1002/casp.2450020410/abstract. geciteerd 28 januari 2016

  31. 31.

    Castleberry A (2014) NVivo 10 [software program]. Version 10. QSR International; 2012. Am J Pharma Educ 78(1):25. http://doi.org/10.5688/ajpe78125

  32. 32.

    Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3(2):77–101

    Article  Google Scholar 

  33. 33.

    Tufford L, Newman P (2012) Bracketing in qualitative research. Qual Soc Work 11(1):80–96

    Article  Google Scholar 

  34. 34.

    Ma I, van Duijvenvoorde A, Scheres A (2016) Interaction between reinforcement and inhibitory control in ADHD: a review and research guidelines. Clin Psychol Rev [Internet]. Beschikbaar op: http://www.sciencedirect.com/science/article/pii/S0272735816000027. geciteerd 14 maart 2016

  35. 35.

    Sonuga-Barke E, Bitsakou P, Thompson M (2010) Beyond the dual pathway model: evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry 49(4):345–355

    PubMed  Google Scholar 

  36. 36.

    Kerns KA, McInerney RJ, Wilde NJ (2001) Time reproduction, working memory, and behavioral inhibition in children with ADHD. Child Neuropsychol 7(1):21–31

    CAS  Article  PubMed  Google Scholar 

  37. 37.

    McInerney RJ, Kerns KA (2003) Time reproduction in children with ADHD: motivation matters. Child Neuropsychol 9(2):91–108

    Article  PubMed  Google Scholar 

  38. 38.

    Dovis S, Van der Oord S, Wiers RW, Prins PJ (2015) Improving executive functioning in children with ADHD: training multiple executive functions within the context of a computer game. A randomized double-blind placebo controlled trial. PLoS One 10(4):e0121651

    Article  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Shaw R, Grayson A, Lewis V (2005) Inhibition, ADHD, and computer games: the inhibitory performance of children with ADHD on computerized tasks and games. J Atten Disord 8(4):160–168

    Article  PubMed  Google Scholar 

  40. 40.

    Mikami AY (2010) The importance of friendship for youth with attention-deficit/hyperactivity disorder. Clin Child Fam Psychol Rev 13(2):181–198

    Article  PubMed  PubMed Central  Google Scholar 

  41. 41.

    Blachman DR, Hinshaw SP (2002) Patterns of friendship among girls with and without attention-deficit/hyperactivity disorder. J Abnorm Child Psychol 30(6):625–640

    Article  PubMed  Google Scholar 

  42. 42.

    de Boo GM, Prins PJ (2007) Social incompetence in children with ADHD: possible moderators and mediators in social-skills training. Clin Psychol Rev 27(1):78–97

    Article  PubMed  Google Scholar 

  43. 43.

    Heiman T (2005) An examination of peer relationships of children with and without attention deficit hyperactivity disorder. Sch Psychol Int 26(3):330–339

    Article  Google Scholar 

  44. 44.

    Deci EL, Koestner R, Ryan RM (1999) A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychol Bull 125(6):627

    CAS  Article  PubMed  Google Scholar 

  45. 45.

    Cerasoli CP, Nicklin JM, Ford MT (2014) Intrinsic motivation and extrinsic incentives jointly predict performance: a 40-year meta-analysis. Psychol Bull 140(4):980

    Article  PubMed  Google Scholar 

  46. 46.

    Boyer BE, Geurts HM, Prins PJ, Van der Oord S (2015) Two novel CBTs for adolescents with ADHD: the value of planning skills. Eur Child Adolesc Psychiatry 24(9):1075–1090

    Article  PubMed  Google Scholar 

  47. 47.

    Sibley MH, Graziano PA, Kuriyan AB, Coxe S, Pelham WE, Rodriguez L et al (2016) Parent–teen behavior therapy+ motivational interviewing for adolescents with ADHD. Beschikbaar op: http://psycnet.apa.org/psycinfo/2016-18388-001/. geciteerd 4 januari 2017

  48. 48.

    Slusarek M, Velling S, Bunk D, Eggers C (2001) Motivational effects on inhibitory control in children with ADHD. J Am Acad Child Adolesc Psychiatry 40(3):355–363

    CAS  Article  PubMed  Google Scholar 

  49. 49.

    Sonuga-Barke EJ, Dalen L, Remington B (2003) Do executive deficits and delay aversion make independent contributions to preschool attention-deficit/hyperactivity disorder symptoms? J Am Acad Child Adolesc Psychiatry 42(11):1335–1342

    Article  PubMed  Google Scholar 

  50. 50.

    Deci EL, Ryan RM (2008) Self-determination theory: a macrotheory of human motivation, development, and health. Can Psychol Can 49(3):182

    Article  Google Scholar 

  51. 51.

    Vansteenkiste M, Niemiec CP, Soenens B (2010) The development of the five mini-theories of self-determination theory: an historical overview, emerging trends, and future directions. Adv Motiv Achiev 16:105–166

    Article  Google Scholar 

  52. 52.

    Ryan RM, Deci EL (2000) Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 55(1):68

    CAS  Article  PubMed  Google Scholar 

  53. 53.

    Vallerand RJ, Pelletier LG, Blais MR, Briere NM, Senecal C, Vallieres EF (1992) The Academic Motivation Scale: a measure of intrinsic, extrinsic, and amotivation in education. Educ Psychol Meas 52(4):1003–1017

    Article  Google Scholar 

  54. 54.

    Cloninger CR, Svrakic DM (1997) Integrative psychobiological approach to psychiatric assessment and treatment. Psychiatry. 60(2):120–141

    CAS  Article  PubMed  Google Scholar 

  55. 55.

    TEMPERAMENT APMO, CLONINGER’IN PMHVK (2003) Psychobiological model of temperament and character: TCI. In: Yeni Symposium [Internet], pp 86–97. Beschikbaar op: http://www.yenisempozyum.net/Pdf/EN-YeniSempozyum-91e271f5.pdf. geciteerd 20 mei 2016

  56. 56.

    Melegari MG, Nanni V, Lucidi F, Russo PM, Donfrancesco R, Cloninger CR (2015) Temperamental and character profiles of preschool children with ODD, ADHD, and anxiety disorders. Compr Psychiatry 58:94–101

    Article  PubMed  Google Scholar 

  57. 57.

    Donfrancesco R, Di Trani M, Porfirio MC, Giana G, Miano S, Andriola E (2015) Might the temperament be a bias in clinical study on attention-deficit hyperactivity disorder (ADHD)?: novelty seeking dimension as a core feature of ADHD. Psychiatry Res 227(2–3):333–338

    Article  PubMed  Google Scholar 

  58. 58.

    Demurie E, Roeyers H, Baeyens D, Sonuga-Barke E (2012) The effects of monetary and social rewards on task performance in children and adolescents: liking is not enough. Int J Methods Psychiatr Res 21(4):301–310

    Article  PubMed  Google Scholar 

  59. 59.

    Dai X, Brendl CM, Ariely D (2010) Wanting, liking, and preference construction. Emotion 10(3):324

    Article  PubMed  Google Scholar 

  60. 60.

    Efron D, Bryson H, Lycett K, Sciberras E (2016) Children referred for evaluation for ADHD: comorbidity profiles and characteristics associated with a positive diagnosis. Child Care Health Dev [Internet]. Beschikbaar op: http://onlinelibrary.wiley.com/doi/10.1111/cch.12364/full. geciteerd 15 juni 2016

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Edmund Sonuga-Barke.

Ethics declarations

Conflict of interest

Jurgen Lemiere received research Grants from FWO (G.0738.14) and the research council KU Leuven (OT/12/096). Saskia Van der Oord has been a paid speaker (Shire, MEDICE) and consultant (Janssen Cilag). Co-developer/author of a cognitive training game “Brain game Brian” and two cognitive-behavioural treatments “Plan my Life” and “Solution Focused Treatment”. Grants received from ZonMW, FWO (G.0738.14), Kinderpostzegels, Research council KU Leuven (OT/12/096), Achmea, Nuts-Ohra. Marina Danckaerts has been a paid member of advisory boards organized by Shire and Neurotech Solutions, a paid speaker at conferences (not product-related) by Shire, Novartis, Medice and paid for consultancy for Neurotech Solutions; she received research grants from Shire and Janssen-Cilag, from FWO (G.0738.14), and the research council KU Leuven (OT/12/096). Dr. Edmund Sonuga-Barke has received speaker fees from Shire Pharma, Janssen-Cilag, and Medice. He has received consultancy fees from Shire Pharma, and Neurotech Solutions; research funding and conference support from Shire Pharma, and speaker fees from Janssen-Cilag, and Medice. He has also received book royalties from Open University Press and Jessica Kingsley. All other authors reported no financial interests or potential conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Morsink, S., Sonuga-Barke, E., Mies, G. et al. What motivates individuals with ADHD? A qualitative analysis from the adolescent’s point of view. Eur Child Adolesc Psychiatry 26, 923–932 (2017). https://doi.org/10.1007/s00787-017-0961-7

Download citation

Keywords

  • ADHD
  • Motivation
  • Qualitative research
  • Interview