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Sex differences in physiological correlates of affectively driven decision-making behavior in adult ADHD

BMC Psychiatry, vol. 24, pp. 602

Abstract

BACKGROUND: Sex differences in the symptomatology of adults with attention-deficit/hyperactivity disorder (ADHD) have often been overlooked when studying behavioral abnormalities. However, it is known that women exhibit considerably more stronger symptoms related to emotional competence than men. Since affective functions significantly influence the processing of risky decision-making and risk-engagement, we assume that risky behavior in ADHD is affected by sex differences. Therefore, we specifically investigated sex-specific effects on the interaction between emotionally induced changes in physiology and behavioral performance on a decision-making task. METHODS: Skin conductance responses of twenty-nine adults with ADHD (n = 16 male; n = 13 female) and thirty-three adults in the control group (n = 14 male; n = 19 female) were recorded during the performance in a modified version of the Balloon Analogue Risk Task (BART). Additional questionnaires were used to reveal insights in the self-assessment of emotional competence, risk perception, and feedback sensitivity. Emotional arousal and decision-making behavior were analyzed using linear mixed-effects models. RESULTS: Results showed different effects of sex on risk behaviors in controls and ADHD. In contrast to healthy controls, female adults with ADHD showed a significantly greater risk engagement in the BART compared to males with ADHD. This contrary sex relation was not observed in skin conductance responses and revealed a significantly different sex-dependent correlation of body response and behavioral task performance in ADHD. Comparisons with results from self-assessments furthermore indicate a reduced behavioral self-perception in women with ADHD, but not in men. CONCLUSION: In summary, we found an altered interaction between physiological activity and risky behavior in women with ADHD. Thus, the present study indicates a reduced sensitivity towards the own bodily responses in women with ADHD, which could consequently cause increased risky DM behavior in daily life. The current results suggest that more consideration needs to be given to sex-specific effects on physiological processes and behavior in adults with ADHD.

Authors 9

  1. Eva Halbe corresponding

    University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany. eva_halbe@web.de

  2. University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

  3. University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

  4. Jülich Aachen Research Alliance · RWTH Aachen University

    Affiliation as printed

    Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany

    JARA - Translational Brain Medicine, Aachen, Germany

  5. University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

  6. The University of Melbourne

    Affiliation as printed

    Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia

  7. The University of Melbourne

    Affiliation as printed

    Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia

  8. University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

  9. University of Bonn

    Affiliation as printed

    Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany

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References 70