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Abstract
ADHD is associated with altered reinforcement sensitivity, despite a number of inconsistent
findings. This review focuses on the overlap and differences between seven neurobiologically
valid models and lists 15 predictions assessing reinforcement sensitivity in ADHD.
When comparing the models it becomes clear that there are great differences in the
level of explanation. For example, some models try to explain a single core deficit
in terms lower-level reinforcement systems, such as the dopamine transfer to reward
back in time. Other models explain multiple deficits, by describing higher-level systems,
such as impaired bottom-up prefrontal activation. When reviewing the available experimental
evidence in support of the predictions, most experimental studies have been focusing
on behavioral changes in the face of reward and response cost over no-reward, and
on delay discounting. There is currently a lack in studies that focus on explaining
underlying cognitive or neural mechanisms of altered reinforcement sensitivity in
ADHD. Additionally, there is a lack in studies that try to understand what subgroup
of children with ADHD shows alterations in reinforcement sensitivity. The scarcity
in studies testing the neurobiological predictions is explained partly by a lack in
knowledge how to test some of these predictions in humans. Nevertheless, we believe
that these predictions can serve as a useful guide to the systematic evaluation of
altered reinforcement sensitivity in ADHD.
Copyright 2009 Elsevier Ltd. All rights reserved.