How Do Emotions and Motivation Affect Thinking in Children with ADHD?

What you need to know

• “Hot” executive functioning refers to thinking and decision-making in emotional or motivating situations.
• Youth with ADHD show deficits in hot executive functioning compared to typically developing youth.
• These deficits are most apparent in tasks involving impulsive choices, emotional control, and risky decision-making.
• More research is needed to clarify how emotion and motivation impact cognitive abilities in ADHD.

What is hot executive functioning?

Executive functioning refers to the mental processes that allow us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. Traditionally, executive functioning has been studied in emotionally neutral settings. However, researchers have become increasingly interested in how these cognitive abilities operate in more emotional or motivating real-world contexts. This is referred to as “hot” executive functioning.

Hot executive functioning is thought to be important for understanding disorders like attention-deficit/hyperactivity disorder (ADHD). Youth with ADHD often struggle with executive functioning tasks in laboratory settings. But studying hot executive functioning may provide more insight into the real-world challenges these children face, where emotions and motivations come into play.

How is hot executive functioning measured?

This review looked at two main types of tasks used to assess hot executive functioning in youth with ADHD:

1. Decision-making tasks: These evaluate how youth make choices involving rewards and risks. They include:

• Choice impulsivity tasks: Participants choose between small immediate rewards or larger delayed rewards.
• Gambling tasks: Participants make choices with varying odds of rewards or penalties.

2. Adapted tasks: These take traditional “cool” executive functioning tasks and add an emotional or motivational element. For example:

• Emotional working memory tasks
• Rewarded attention tasks

What does the research show?

Overall, studies find that youth with ADHD tend to perform worse on hot executive functioning tasks compared to typically developing youth. Some key findings include:

• Youth with ADHD are more likely to choose smaller immediate rewards over larger delayed ones, showing greater impulsivity.
• They tend to make riskier choices on gambling tasks, especially when evaluating complex risk scenarios.
• Adding emotional elements to inhibition tasks (like controlling responses to emotional faces) reveals greater difficulties for youth with ADHD.
• Youth with ADHD and co-occurring behavior problems may struggle even more with risky decision-making.

Interestingly, simply adding rewards to cognitive tasks does not seem to consistently improve or worsen performance for youth with ADHD compared to peers. The relationship between motivation and cognitive performance in ADHD is complex.

Challenges in hot executive functioning research

While hot executive functioning is a promising area of study, the review highlighted several challenges:

• Inconsistent measurement: Many different tasks are used to assess hot executive functioning, making it difficult to compare results across studies.

• Conceptual ambiguity: It’s not always clear how “hot” tasks differ from traditional executive functioning measures or other related constructs.

• Varied effects of emotion/motivation: Adding emotional or motivational elements to tasks can sometimes improve performance and sometimes impair it. More work is needed to understand these complex effects.

• Limited research on development: Few studies have looked at how hot executive functioning abilities change from childhood to adolescence in ADHD.

Why does this matter?

Understanding hot executive functioning in ADHD could help explain why some youth struggle in real-world situations even when they perform well on standard cognitive tests. It may also provide insight into why some children with ADHD develop additional behavior problems while others do not.

Ultimately, clarifying how emotions and motivations impact thinking and decision-making in ADHD could lead to better interventions. Treatments could potentially be tailored to address specific hot executive functioning deficits.

Conclusions

• Youth with ADHD show deficits in hot executive functioning, particularly for impulsive decision-making and emotional control.
• More research is needed to develop consistent ways of measuring hot executive functioning.
• Understanding how emotions and motivations impact cognition in ADHD could improve diagnosis and treatment.

While hot executive functioning is a promising area of study, much work remains to be done. Researchers need to clarify how best to measure these abilities and how they relate to real-world outcomes for youth with ADHD. With further study, hot executive functioning may provide valuable insights into the diverse challenges faced by children and adolescents with ADHD.