Dorien Bangma

DECISION-MAKING IN ADHD | 153 Conclusion This systematic literature review on decision making in adults with ADHD cautiously provides evidence of differences between decision making in healthy individuals and adults with ADHD. Specifically, the majority of the included studies (i.e., 55%) reported that adults with ADHD showed aberrant performances on one or more of the decision-making tasks at hand as compared to the control group(s). However, the current findings are rather inconsistent, which has been further explained by the variety of decision-making domains that have been examined, the comorbid disorders, and the medication use in the ADHD groups. The overall pattern of the findings of this literature review appears to be consistent with the dual-pathway model of ADHD, as adults with ADHD show aberrant performances in both intuitive as well as deliberative decision-making tasks. The decision-making deficits of adults with ADHD may therefore originate from a dysregulation of the motivational-emotional pathway in the brain as well as from a dysregulation of the cognitive routes. The suitability of the dual-pathway model of ADHD as an explanatory model for the deficits in the decision making of individuals with ADHD is, however, questioned by the finding that 45% of the included studies reported no significant between-group differences. Future research must aim to further expand the evidence base on decision making in adults with ADHD. Special attention is recommended to be given to the ecological validity of the adopted task paradigms in order to ensure generalizability of the findings to everyday decision-making. The information yielded by such research, can add to the help that is offered to reduce risky behavior and decision-making difficulties in the daily life of adults with ADHD.