ADHD: State Regulation and Motivation by Van der Meere et al. (2010) - Article


Throughout past research, weak motivation has been shown to be a factor involved in ADHD. Two models exist to try and explain this deficit. The response inhibition model hypothesizes that the majority of problems related to ADHD can be explained by impaired response inhibition. The state regulation model, in contrast, associates ADHD with a motivation deficit which then results in negative outcomes for social functioning and cognition. In the more recent years, studies have investigated the effects of incentives, noise, and the rates of the presentation of stimuli.

Presence of incentives

Studies on the effect of incentives on response inhibition have produced mixed results. Some studies have shown that incentives increase response inhibition, others found the opposite. The authors suggest the following as possible reasons for these mixed results:

  1. Variation in the presentation of the rewards

  2. Effort allocation will only take place when arousal deviates from its basic state.

  3. Incentives act as signals; an increase in signals means an increase in motor activation

Noise

In accordance with the state regulation model, noise could activate the arousal system. One study showed that white noise was beneficial for the cognitive performance of children with ADHD, but was detrimental to control groups. The explanation for this result is the under-arousal found in ADHD.

Changing the presentation rate of stimuli

The state regulation model dictates that motor activation is effected by the presentation rate of a stimulus. Research has shown that children presented with a fast stimulus presentation rate perform better than when presented with a slow presentation rate. Very few studies have disputed this.

Top-down or bottom-up

From the studies conducted on reaction time and stimuli presentation rate, we see an interaction between motor activation and its control by effort. The researchers question whether this is due to a bottom up deficit in motor activation which in turn is hard to control by the top down effort mechanism, or actually the motor activation mechanism is functional and it is the effort mechanism which is not sufficiently in control. A suggestion is presented to examine the possibilities: to investigate the combined and individual effects of stimuli presentation rates and incentives on reaction time performance.

Looking at psychophysiological studies, dopamine, metabolic energy, and stimuli presentation rates

The following are findings from research conducted:

  1. Psychophysiological indices, under slow presentation rates of stimuli, support the hypothesis that ADHD is associated with an effort deficit

  2. Response impairments have been associated with either too high or too low levels of dopamine.

  3. Results of fMRI research show that ADHD participants use widespread frontostriatal activity, including the thalamus and the cingulate, when involved in accurate response inhibition

  4. Cortical excitability in adults is optimized by self chosen stimulation

  5. Effort allocation and boredom are negatively correlated

In conclusion

There is a growing accumulation of evidence supporting that cognitive performance of children with ADHD is associated with weak state regulation. The state regulation model is far from perfect. The plausibility of either a top-down or bottom-up deficit must be examined further.

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