We used the Balloon Analog Risk Task (BART) to examine risk taking and sensitivity to punishment, two relevant aspects of behavioral inhibition, in 203 school-age children with attention-deficit/hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), ADHD+ODD, and controls. Participants earned points on the BART by pumping 30 separate balloons that exploded at variable intervals. No points were earned on a trial when a balloon exploded. The number of pumps across all balloons estimated risk taking and the reduction in pumps following balloon explosions was interpreted as an indicator of sensitivity to negative punishment. We found that all groups significantly differed from one another on risk taking. The ADHD+ODD group pumped the most, followed by the ODD, ADHD, and the control group, respectively. For sensitivity to negative punishment, all groups performed differently, with the ODD group showing the least sensitivity to an exploded balloon, followed by the ADHD, control, and ADHD+ODD groups, respectively. Children with ADHD+ODD demonstrated significantly different patterns of risk taking and sensitivity to negative punishment than children with either ADHD-only or ODD-only. ADHD youth with comorbid ODD had the greatest levels of risk taking, but they were also the most sensitive to negative punishment. The relationship between ADHD and ODD, as well as the nature of comorbidity in constructs related to risk taking and related behaviors, are discussed.
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We wish to thank Dr. Lara Ray for her comments and revisions on earlier versions of this manuscript. We also thank the families for participation in the study and the research staff for their help with data collection and management. This work was partially supported by the Consortium for Neuropsychiatric Phenomics (CNP) (NIH Roadmap for Medical Research grant UL1-DE019580, RL1DA024853) and NIH grant 1R03AA020186-01 to Steve S. Lee. This work was also supported by a National Science Foundation (NSF) Graduate Research Fellowship to the first author.
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Humphreys, K.L., Lee, S.S. Risk Taking and Sensitivity to Punishment in Children with ADHD, ODD, ADHD+ODD, and Controls. J Psychopathol Behav Assess 33, 299–307 (2011). https://doi.org/10.1007/s10862-011-9237-6
- Oppositional defiant disorder
- Risk taking