Intertemporal impatience has been proposed to be centrally and transdiagnostically implicated across mental health difficulties, including maladaptive behaviors, psychopathologies, and other psychological outcomes. We empirically tested this proposal using a novel research approach that integrates per-category , trans-category , scale-level , and item-level analyses. First, we studied per-category continuous associations between intertemporal impatience and a broad range of mental health-related behaviors and psychological constructs. Next, we examined which of several latent, trans-category dimensions were associated with impatience, thereby studying which mental health difficulties may be connected through shared impatience. Finally, we investigated which specific symptoms or behaviors were driving these associations. This study was conducted in a community sample of 899 participants who completed an intertemporal choice task and various self-report mental health measures. Per-category analyses involved bivariate correlations and multiple regressions; trans-category analyses involved exploratory factor analyses to identify transdiagnostic dimensions, and structural-after-measurement models to test for associations between the dimensions and intertemporal impatience. Intertemporal impatience was associated with increased nicotine use, reactive aggression, non-planning impulsivity, motor impulsivity, and dispositional greed. Moreover, impatience was positively associated with a transdiagnostic impulsivity dimension (including attention-deficit/hyperactivity disorder, low self-control, and motor and non-planning impulsivity). Symptom-level analyses suggested that this association was mainly driven by information impulsivity (also known as lack of premeditation) and financial impulsivity. Our results provide support for the role of intertemporal impatience across several externalizing but not internalizing mental health difficulties and offer a detailed and nuanced interpretation of the transdiagnostic role of intertemporal impatience across mental health.

The current cross-sectional and observational online study investigated previously reported associations between chronotype, sleep duration, inattention traits, and self-esteem within one indirect-effect model in a general, mostly student, population. Chronotype was operationalized as a continuous μMCTQ-derived score, with higher values indicating later sleep timing and greater evening orientation. We found that chronotype and self-esteem were negatively related, with lower self-esteem observed in participants with later sleep timing. This association was statistically accounted for in part by reported inattention traits, irrespective of reported sleep duration. Participants with higher chronotype scores on average reported more inattention traits, and lower self-esteem. Age effects, found for chronotype score, sleep duration, and inattention traits, were controlled for. Because all variables were measured concurrently, these findings should not be interpreted as evidence that eveningness causes inattention or low self-esteem. Instead, they show that previously reported bivariate relationships are likely connected in the same correlational pattern. Longitudinal, experimental, or network approaches are needed to test temporal ordering, alternative explanations, and possible intervention targets.

Previous research has found the anticipation of immediate (compared with delayed) rewards to enhance instrumental approach behaviour and interfere with instrumental inhibition. This so-called intertemporal Pavlovian bias has been proposed as a mechanism contributing to impatient actions. In the present preregistered study, we aimed to replicate this intertemporal Pavlovian bias effect, and examined whether individual differences in the strength of this bias were associated with mental health symptoms characterized by increased or decreased intertemporal impatience. A sample of 389 participants completed an intertemporal go/no-go learning task, as well as questionnaires that assessed symptoms of alcohol use disorder, nicotine dependence, depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), disordered eating, impulsivity, and body mass index. We replicated the intertemporal Pavlovian bias effect on the probability of go responding (a response bias), and reinforcement learning models again pointed to a Pavlovian cue-response bias as computational mechanism driving this effect. Contrary to our expectations, the response bias was not associated with mental health symptoms. We also observed an intertemporal Pavlovian bias effect on the vigour of correct go responses, with faster responses in anticipation of immediate rewards (a response time or RT bias). A stronger RT bias was associated with ADHD hyperactivity/impulsivity and nonplanning impulsivity symptoms, while a reversed RT bias (with faster incorrect go responses in anticipation of delayed rewards) was associated with eating disorder symptoms and total and motor impulsivity. Together, our results support the robustness of the intertemporal Pavlovian response bias and point towards the possible relevance of the RT bias for several mental health problems.

We often forego a larger future reward in order to obtain a smaller reward immediately, known as impatient intertemporal choice. The current study investigated the role of Pavlovian-to-instrumental transfer (PIT) as a mechanism contributing to impatient intertemporal choice, following a theoretical framework proposing that cues associated with immediate gratification trigger a Pavlovian approach response, interfering with goal-directed (instrumental) inhibitory behavior. We developed a paradigm in which participants first learned to make instrumental go/no-go responses in order to win rewards and avoid punishments. Next, they learned the associations between Pavlovian cues and rewards varying in amount and delay. Finally, we tested whether these (task-irrelevant) cues exerted transfer effects by influencing instrumental actions while participants again completed the go/no-go task. Across two experiments, Pavlovian cues associated with larger (versus smaller) and immediate (versus delayed) rewards were evaluated more positively, reflecting the successful acquisition of Pavlovian cue–outcome associations. These findings replicated the previously reported classical transfer effect of reward amount on instrumental behavior, as large (versus smaller) cues increased instrumental approach. In contrast, we found no evidence for the hypothesized transfer effects for reward delay, contrary to the proposed role of PIT in impatient intertemporal choice. These results suggest that although both reward amount and delay were important in the evaluation of cues, only the amount associated with cues influenced instrumental choice. We provide concrete suggestions for future studies, addressing instrumental outcome identity, competition between cue–amount and cue–delay associations, and individual differences in response to Pavlovian cues.

Emotional expressivity plays an essential role in the functioning and well-being of romantic relationships. In the current research, we examined the potential role of trait self-control in emotional expressivity, and predicted that trait self-control would be negatively associated with emotional expressivity. Four pre-registered studies tested this basic hypothesis using two perspectives: the partner's perspective (Study 1, N = 202; Study 2, N = 190), and the actor's perspective (Study 3, N = 177; Study 4, N = 60 couples). Across studies, regardless of perspective, the results generally showed that trait self-control was negatively associated with the experienced intensity of emotions (i.e., emotion strength), but not with the expression of positive emotions (i.e., positive expressivity). In three out of four studies, there was support for the negative association between trait self-control and the expression of negative emotions (i.e., negative expressivity). We discuss the implications of these findings for understanding the nature of the link between trait self-control and emotional expressivity, in romantic relationships and more broadly.

•STAND intervention did not outperform usual care (UC) on any mechanistic outcomes.•UC showed superior effects on teen executive functioning outcomes versus STAND.•STAND was superior to UC on some outcomes when delivered by licensed therapist.

People often exhibit intertemporal impatience by choosing immediate small over delayed larger rewards, which has been implicated across maladaptive behaviours and mental health symptoms. In this preregistered study, we tested the role of an intertemporal Pavlovian bias as possible psychological mechanism driving the temptation posed by immediate rewards. Concretely, we hypothesized that the anticipation of immediate rewards (compared with preference-matched delayed rewards) enhances goal-directed approach behaviour but interferes with goal-directed inhibition. Such a mechanism could contribute to the difficulty to inhibit ourselves in the face of immediate rewards (e.g., a drug), at the cost of long-term (e.g., health) goals. A sample of 184 participants completed a newly developed reinforcement learning go/no-go task with four trial types: Go to win immediate reward; Go to win delayed reward; No-go to win immediate reward; and No-go to win delayed reward trials. Go responding was increased in trials in which an immediate reward was available compared with trials in which a preference-matched delayed reward was available. Computational models showed that on average, this behavioural pattern was best captured by a cue-response bias reflecting a stronger elicitation of go responses upon presentation of an immediate (versus delayed) reward cue. The results of this study support the role of an intertemporal Pavlovian bias as a psychological mechanism contributing to impatient intertemporal choice.

Purpose of Review This brief review explores to what extent ADHD and SUD are both associated with reward-related impulsivity, operationalized as steep delay discounting (DD). However, an integrated view on DD as a potentially shared intermediate phenotype for these frequently co-occurring conditions is lacking. Recent Findings Though mostly studied in separate conditions, some studies have investigated DD specifically in patients with co-occurring conditions of SUD and ADHD. In addition to reviewing literature that has documented the associations between ADHD and relatively steep DD and between SUD and relatively steep DD, we also reviewed more recent literature in which steep DD has been examined as a transdiagnostic mechanism. Summary Overall, literature on DD in SUD suggests a dose-response relation between SUD severity and DD. The literature suggests that relatively steep DD is a mechanism associated to (ab)use of a range of substances. As for the link between DD and ADHD, several meta-analyses reported steeper DD in individuals with ADHD than controls (medium effect sizes). Because these bodies of literature are based on studies in which the influence of comorbidity was not assessed, it is hard to conclude that relatively steep DD is directly related to the ADHD symptoms per se, or to the SUD per se. Therefore, a close inspection of more recent literature in which comorbidity was taken into account, and DD was treated as a transdiagnostic mechanism, was included here. Based on this reviewed recent work, we propose a model about the nature of the co-occurrence of ADHD, SUD, and DD. Implications of the nature of co-occurring ADHD, SUD, and relatively steep DD for prevention and intervention strategies are discussed.

Temporal discounting (TD) tasks measure the preference for immediate rewards and have been widely used to study impulsivity in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Relatively impulsive individuals tend to show high variability in their choices, which makes it difficult to determine commonly used TD outcome measures (e.g., area under the curve; AUC). In this study, we leveraged two published datasets to compare four methods (i.e., two predetermined rules methods, a proportion method, and logistic regression) to determine TD outcome measures in children and adolescents (ages 8-17 years) with (n = 107) and without ADHD (n = 128). In both datasets, TD outcome measures were highly correlated and group differences in TD were similar when using the two predetermined rules methods and the proportion method. When using logistic regression, a large proportion of AUCs (95% in dataset 1; 33% in dataset 2) could not be computed due to inconsistent choice patterns. These findings indicate that predetermined rules methods (for studies with small sample sizes or experienced raters) and a proportion method (for studies with larger sample sizes or less experienced raters) are recommended over logistic regression when determining TD outcome variables in children and adolescents with and without ADHD.

One of the most concerning aspects of attention-deficit/hyperactivity disorder (ADHD) is its association with numerous risk-taking behaviors. Following a discussion of the definition and measures of risk-taking behavior in real life and laboratory, this chapter reviews meta-analyses, registry studies, and large prospective studies that documented links between ADHD and risk-taking behavior in several domains: substance use, sex, driving, gambling, finance, lifestyle, and delinquency. Next, the chapter reviews socio-demographic, clinical, social, personality, cognitive, and biological mechanisms involved in the link between ADHD and risk-taking behavior. Finally, established interventions targeting risk-taking behavior in people with ADHD are reviewed, and potential theory-based interventions are suggested.

Impulsive and risky decision-making peaks in adolescence, and is consistently associated with the neurodevelopmental disorder Attention-Deficit/Hyperactivity Disorder (ADHD), regardless of age. In this brief review, we demonstrate the similarity of theoretical models explaining impulsive and risky decision-making that originate in two relatively distinct literatures (i.e., on adolescence and on ADHD). We summarize research thus far and conclude that the presence of ADHD during adolescence further exacerbates the tendency that is already present in adolescents to make impulsive and risky decisions. We also conclude that much is still unknown about the developmental trajectories of individuals with ADHD with regard to impulsive and risky decision making, and we therefore provide several hypotheses that warrant further longitudinal research.

OBJECTIVE:Motivation is what moves us to act, what engages us in goal-directed behavior. The Self Determination Theory (SDT) is a motivational framework conceptualizing motivation-or internal motives-as a continuum of motivation qualities fueled by satisfaction of the three basic psychological needs Autonomy, Relatedness, and Competence. ADHD has been associated with motivational alterations that contribute to academic difficulties. However, ADHD theories and research are mainly focused on the effects of reinforcement on behavior, with little attention for the broader definition of motivation, that is, internal motives. Therefore, the main objective here was to introduce the SDT as theoretical framework within which we can develop relevant research questions about motivation in the field of ADHD.METHOD:To this end, we (i) present the SDT as a comprehensive motivational framework, and (ii) describe current motivation-related ADHD theories and research.RESULTS:Based on this, we suggest how SDT can be used as a guiding framework in generating relevant research questions that can help broaden our understanding of the role motivation plays in individuals with ADHD.CONCLUSION:We conclude that ADHD research on motivation would benefit from (i) including internal motives as potential key mediators in the relation between environmental factors and behavior/symptoms; (ii) studying potential negative effects of external reinforcers intrinsic motivation, affect, and well-being. Finally, we conclude that this framework carries value for further development of clinical interventions for those with ADHD.

The purpose of this study was to examine the relationship between temporal reward discounting and attention deficit hyperactivity disorder (ADHD) symptoms in college students. Additionally, we examined whether temporal reward discounting was associated with executive functioning in daily life and with learning and study strategies in this group. Thirty-nine college students (19 with ADHD and 20 controls) participated after meeting criteria for ADHD or non-ADHD based on standardized assessment. Strong preferences for small immediate rewards were specifically associated with the ADHD symptom domain hyperactivity–impulsivity. Additionally, these preferences were associated with daily life executive function problems and with weak learning and study strategies. This suggests that steep temporal discounting may be a key mechanism playing a role in the daily life challenges that college students with ADHD symptoms face. If these findings are replicated in larger samples, then intervention strategies may profitably be developed to counteract this strong preference for small immediate rewards in college students with ADHD symptoms.

Background: Misconceptions about ADHD stigmatize affected people, reduce credibility of providers, and pre-vent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base. Methods: We reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder. Results: We generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents. Conclusions: Many findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

Objective This purpose of this study was to assess the feasibility, acceptability, and effectiveness of a new group cognitive-behavioral treatment (CBT) to enhance executive function (EF) in college students with ADHD. Methods Eighteen students meeting rigorous DSM-5 criteria for ADHD were enrolled in two nine-member groups. The treatment targeted time-awareness, distractibility, procrastination, and failure to plan, and included strategies to facilitate academic EF skills. Results Eighty-four percent of students attended nine or more of the 12 weekly sessions. Repeated measures analyses of change from pre- to posttreatment yielded improvement in clinician- and self-ratings of DSM-5 ADHD inattentive symptoms, with robust effect sizes. Also improved were scores on standardized scales of time-management, concentration, and total EF. Discussion Results provide support for the feasibility, acceptability, and effectiveness of a CBT program in reducing inattentive symptoms and enhancing EF in college students with ADHD, and warrant investigation on a larger scale.

Previous research has demonstrated that trait self-control is related to a range of positive romantic relationship processes, suggesting that trait self-control should be positively and robustly linked to relationship satisfaction in both partners in a romantic relationship. However, the existing empirical evidence is limited and mixed, especially regarding partner effects (i.e., the effect of one’s self-control on the partner’s relationship satisfaction). With three datasets of heterosexual couples (S1: N = 195 newlyweds, longitudinal; S2: N = 249 couples who transition into first parenthood, longitudinal; S3: N = 929 couples, cross-sectional), the present pre-registered studies examined: (1) the dyadic associations between trait self-control and relationship satisfaction both cross-sectionally and longitudinally, and (2) whether these effects hold when controlling for both partners’ relationship commitment. The results indicated a cross-sectional positive actor effect, some support for a positive cross-sectional partner effect, and only little support for a longitudinal actor (but not partner) effect. After controlling for relationship commitment, all effects of trait self-control on satisfaction diminished except for a longitudinal actor effect among women in Study 2. Potential explanations for the current results, and implications for theory and practice, are discussed.

OBJECTIVES:To provide more insight into treatment and research responsivity in offenders with attention-deficit hyperactivity disorder (ADHD).METHOD:Via self-reports and patients' scores on cognitive computer tasks, it was examined whether poorer cognitive-motivational, interpersonal, and behavioral functioning were related to treatment no-shows, longer treatment time duration intervals, and no-show at the research appointment in 52 forensic outpatients with ADHD (Mage  = 35.3, SD = 9.38). Treatment adherence was tracked for 10 appointments after research participation.RESULTS:Regression analyses showed that higher self-reported impulsivity was associated with research no-show, and more alcohol use with longer treatment time intervals. Yet, self-reported delay aversion was associated with fewer treatment no-shows, and, uncontrolled for alcohol use, impulsivity was associated with shorter treatment time intervals in a subsample of patients.CONCLUSIONS:These preliminary results indicate that externalizing behaviors increase the risk for nonadherence in forensic ADHD patients, but that cognitive-motivational problems also motivate patients to be more engaged.

Background: Attention-deficit/hyperactivity disorder (ADHD) is presumed to involve mental effort application difficulties. To test this assumption, we manipulated task difficulty and measured behavioral, as well as subjective and psychophysiological indices of effort. Methods: Fifteen adolescent ADHD boys and 16 controls performed two tasks. First, subjective estimates and behavioral and pupillary measures of effort were recorded across five levels of N-back task difficulties. Second, effort discounting was assessed. In the latter, participants made repeated choices between performing a difficult N-back task for a high reward versus an easier N-back task for a smaller reward. Results: Increasing task difficulty led to similar deteriorations in performance for both groups - although ADHD participants performed more poorly at all difficulty levels than controls. While ADHD and control participants rated the tasks equally difficult and discounted effort similarly, those with ADHD displayed slightly different pupil dilation patterns with increasing task difficulty. Conclusion: The behavioral results did not provide evidence for mental effort problems in adolescent boys with ADHD. The subtle physiological effects, however, suggest that adolescents with ADHD may allocate effort in a different way than controls.

Individuals with attention deficit hyperactivity disorder (ADHD) often show poor planning and poor organization of tasks and activities which has been related to reduced memory for delayed intentions (prospective memory) and procrastination-in addition to other cognitive or motivational factors. This study set out to bring the fields of prospective memory and procrastination research together and to explore possible relations between the two constructs in ADHD. Twenty-nine adults with ADHD and 24 healthy controls performed several laboratory-based and real-life prospective memory tasks and filled in questionnaires measuring their symptom severity and procrastination behaviour. Overall, individuals' with ADHD showed clear deficits in everyday prospective memory performance. Individuals with ADHD recalled and executed less of their own real-life intentions. Moreover, there were clear links between everyday prospective memory performance and reported procrastination behaviour, and everyday prospective memory performance mediated the link between ADHD symptoms and procrastination behaviour.

In everyday decision-making, individuals make trade-offs between short-term and long-term benefits or costs. Depending on many factors, individuals may choose to wait for larger delayed reward, yet in other situations they may prefer the smaller, immediate reward. In addition to within-subject variation in the short-term versus long-term reward trade-off, there are also interindividual differences in delay discounting (DD), which have been shown to be quite stable. The extent to which individuals discount the value of delayed rewards turns out to be associated with important health and disorder-related outcomes: the more discounting, the more unhealthy or problematic choices. This has led to the hypothesis that DD can be conceptualized as trans-disease process. The current systematic review presents an overview of behavioral trainings and manipulations that have been developed to reduce DD in human participants aged 12 years or older. Manipulation studies mostly contain one session and measure DD directly after the manipulation. Training studies add a multiple session training component that is not per se related to DD, in between two DD task measurements. Ninety-eight studies (151 experiments) were identified that tested behavioral trainings and manipulations to decrease DD. Overall, results indicated that DD can be decreased, showing that DD is profoundly context dependent and changeable. Most promising avenues to pursue in future research seem to be acceptance-based/mindfulness-based trainings, and even more so manipulations involving a future orientation. Limitations and recommendations are discussed to identify the mechanistic processes that allow for changes in discount rate and behavior accordingly.