Basic impairments in regulating the speed-accuracy tradeoff predict symptoms of attention-deficit/hyperactivity disorder

Biol Psychiatry. 2010 Dec 15;68(12):1114-9. doi: 10.1016/j.biopsych.2010.07.031.


Background: Attention-deficit/hyperactivity disorder (ADHD) is characterized by poor optimization of behavior in the face of changing demands. Theoretical accounts of ADHD have often focused on higher-order cognitive processes and typically assume that basic processes are unaffected. It is an open question whether this is indeed the case.

Method: We explored basic cognitive processing in 25 subjects with ADHD and 30 typically developing children and adolescents with a perceptual decision-making paradigm. We investigated whether individuals with ADHD were able to balance the speed and accuracy of decisions.

Results: We found impairments in the optimization of the speed-accuracy tradeoff. Furthermore, these impairments were directly related to the hyperactive and impulsive symptoms that characterize the ADHD-phenotype.

Conclusions: These data suggest that impairments in basic cognitive processing are central to the disorder. This calls into question conceptualizations of ADHD as a "higher-order" deficit, as such simple decision processes are at the core of almost every paradigm used in ADHD research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Child
  • Decision Making / physiology*
  • Female
  • Humans
  • Male
  • Models, Psychological
  • Psychomotor Performance / physiology*
  • Reaction Time / physiology*