Dorien Bangma

SUMMARY | 267 no clear performance profiles for the different NDDs could be identified based on current results. Finally, contextual factors and the financial performances in everyday life have been studied only to a limited extent. Therefore, caution is called for when using the FDM test battery on individual patients and drawing conclusions about their capability to make financial decisions. Nevertheless, the test battery has been shown to be sensitive to evaluate strengths and weaknesses of FDM capability in patients with NDDs. Part III: FDM capability in adults with ADHD Previous research reported money management problems in adults with ADHD based on indirect assessment of FDM capability. However, no study was performed using direct assessment (i.e., performance-based tests) to evaluate the FDM capability of adults with ADHD. Furthermore, problems with decision-making are frequently described in children with ADHD, but are less clearly objectified in adults with ADHD. The systematic review presented in chapter 6 , therefore, aims to provide a comprehensive and objective overview of the decision-making capabilities (including FDM capability) of adults with ADHD in order to evaluate the nature and extent of problems with decision making in this patient group. For this, only studies using performance-based tests of decision making were included. In total, 31 studies met the inclusion criteria and focused on either risky decision-making (k = 20), deliberative/analytic decision-making (k = 2), delay discounting (k = 9), reward-related decision-making (k = 3), social decision-making (k = 1), decision making related to driving (k = 1) or decision making related to financial decisions (k = 1). In a small majority of studies (i.e., 55%), adults with ADHD showed lower performances on decision-making tests compared to healthy controls, providing careful evidence that adults with ADHD have more problems with several domains of decision-making compared to healthy controls. Nevertheless, for all decision-making domains assessed in the studies, the results were mixed. Differences between studies might be the result of covariates that are of influence on the decision-making capability of adults with ADHD, such as comorbidities, use of stimulant medication or boredom during testing. Furthermore, most domains (i.e., all except risky decision-making) were widely underrepresented in the currently available research. The systematic review as presented in chapter 6 concludes with the evaluation of the potential underlying mechanism of decision- making problems in adults with ADHD, in particular the evaluation of the dual-pathway model of ADHD as basis of decision-making problems. Based on the included studies, it is conceivable that this model can be (partly) explanatory for the lower performances of adults with ADHD found in the field of decision-making. The studies presented in chapter 7 and 8 continue the evaluation of decision-making problems in adults with ADHD, but focus explicitly on FDM capability. For this, (parts of) the new FDM test battery was used. In chapter 7, a study is presented that included 45 clinically diagnosed adults with ADHD (age range 19 – 61 year; 57.8% male). All were assessed with several (neuro)psychological tests, including FDM tests and questionnaires from the FDM test battery and the Cognitive Functions