The impact of ADHD symptom severity on reinforcement and punishment learning among adults

Cogn Neuropsychiatry. 2023 Mar;28(2):147-161. doi: 10.1080/13546805.2023.2178398. Epub 2023 Feb 14.

Abstract

Introduction: Aberrations in feedback learning are hypothesised to contribute to the behavioural disruptions and impairment of attention-deficit/hyperactivity disorder (ADHD). However, few studies have evaluated the relation of reward/punishment feedback and ADHD symptom severity on learning. The current study evaluates the differential effects of reward and punishment feedback on learning among adults with elevated ADHD. Methods: One hundred five participants self-reported their level of current ADHD symptoms and completed an innovative instrumental learning task. Results: Consistent with predictions, participants with low self-reported ADHD symptom severity benefitted equally from reward and punishment feedback during the learning task, whereas participants with high self-reported symptom severity performed better (indexed by accuracy on learning task) from reward than punishment feedback trials. Conclusions: Overall, adults with high self-reported symptom severity of ADHD learned more from reward-based feedback, which provides critical implications for motivational theories about ADHD, as well as for treatment protocols. Future work should examine the translatability of results within a treatment setting.

Keywords: Attention-deficit/hyperactivity disorder (ADHD); instrumental learning; punishment feedback; reward feedback.

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity* / diagnosis
  • Humans
  • Learning
  • Punishment*
  • Reinforcement, Psychology
  • Reward