Dorien Bangma

FDM IN ADULTS WITH ADHD | 159 Introduction Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder that is characterized by symptoms of inattention, hyperactivity and impulsivity (American Psychiatric Association, 2013). The symptoms of ADHD persist into adulthood in about 50% of children with ADHD (range 32.8 – 84.1%; Lara et al., 2009), resulting in a prevalence of adult ADHD of approximately 3.4% (range 1.2 – 7.3%; Fayyad et al., 2007). ADHD is a condition which has a negative impact on several aspects of everyday functioning, including educational and occupational performances (Barkley et al., 2008; Daley & Birchwood, 2010), social functioning (Michielsen et al., 2015; Nijmeijer et al., 2008) and driving (Barkley et al., 2002; Fuermaier et al., 2017). Financial decision-making (FDM) is also a domain of everyday functioning that is of utmost importance for independent living, in particular for adults who have to make numerous financial decisions with often far-reaching consequences (e.g., concerning insurances, mortgages or pension schemes). FDM describes various aspects of functioning related to decision-making in a financial context, such as dealing with money, paying bills or making financial decisions for the future. Poor FDM can have serious negative consequences, such as debts, poverty or financial dependency. So far, very few studies focused on FDM in patients with ADHD and the studies that have been performed only applied self-report measures and interviews. These studies reported that symptoms of ADHD (both hyperactivity- impulsivity and inattention) were found to be associated with financial problems (Altszuler et al., 2016; Barkley & Fischer, 2010; Das et al., 2012). Adults with ADHD specifically reported less often to have a credit card or a savings account and also to be more often financially dependent on their parents or welfare systems than healthy individual (Altszuler et al., 2016). Some studies found that adults with ADHD and healthy individuals do not differ with regard to income level and the amount of debts (Altszuler et al., 2016; Barkley et al., 2006). The participants in these studies were, however, relatively young (age at assessment was between 19 and 25) and predominantly male. In a follow-up of the Milwaukee study (Barkley et al., 2008), participants with ADHD aged 27 reported significantly more often problems with money management than age-matched controls, including difficulties with managing money, problems with buying on impulse, exceeding credit card limits, a lower monthly income, a lower saving- income ratio and problems with saving money. Similar money management problems were found in the UMASS study of Barkley et al. (2008) in adults with ADHD with an average age of 32.4 years. However, in the latter study the healthy comparison group was with an average age of 36.4 years significantly older than the adults with ADHD, which needs to be taken into account. Biederman and Faraone (2006) included adults with ADHD up to 64 years old and also found significantly lower income levels in their ADHD group compared to a healthy control group. In summary, the limited research available clearly indicates that adults with ADHD are more vulnerable to money management problems than healthy controls; problems that may become more evident when becoming older. Indications that adults with ADHD may experience difficulties with FDM also come from the field of general decision-making. Within this field standardized tests are used that do not focus on FDM, but are context independent instead. Two systems of information processing