The neuroscience of ADHD: Understanding the brain’s impact on choices

Attention-Deficit/Hyperactivity Disorder, ADHD, is much more than about being more or less attentive.

This neurodivergence is linked to changes in the brain like time perception, reward processing, and executive functions.

The role of the brain in ADHD
People with ADHD show differences in brain areas like the prefrontal cortex compared to neurotypical people. The prefrontal cortex is responsible for higher cognitive functions like decision-making, planning, and problem-solving. It also plays a key role in controlling emotions, attention, and social behavior.

Differences are also seen in the striatum, which is involved in how we process rewards.

These differences impact decision-making. For instance, some neurodivergent people might make more impulsive choices without considering the consequences than neurotypical. Or they might seek immediate rewards even when the long-term outcome isn’t favorable.

Research shows that brain connectivity in neurodivergence can be weaker, particularly in the circuits that manage attention and control, making it harder for individuals to stay focused and inhibit impulsive actions.

Decision-Making
The decision-making process is a complex brain process. It typically includes several essential stages, such as identifying the problem, gathering relevant information, evaluating possible options, considering advantages and disadvantages, choosing the most appropriate action, implementing it, and assessing the outcome.

Effective decision-making often requires a mix of rational and intuitive thinking tailored to the complexity of the situation and the individual's mental approach.

A rational approach involves a detailed examination of available information, while an intuitive approach is based on instinct and previous experiences. Thus, achieving a balance between rational analysis and intuitive insight is key to making sound, informed decisions across various contexts.

A neurodivergent person will more often have difficulties with the rational stepwise approach and make choices based more on intuition than the neurotypical. Since intuition is often shaped by emotions and pattern recognition, it can introduce biases or errors in judgment.

Economic Decision-Making
Though neurodivergent people are as clever as neurotypical people, it may still impact the economy of the neurodivergent. Their atypical brains may impact how they make financial and economic decisions.

They may engage in risky financial behaviors, or the decisions made may not support the goal they have set for their life.

Or fail to recognize the value of waiting for a larger reward or may focus on short-term gains instead. These decision-making patterns are influenced by both their brain’s altered reward systems and their challenges in controlling impulsivity.

Understanding how these behaviors affect things like spending habits, investment choices, and career decisions is crucial for designing better strategies to help manage these tendencies in daily life.

Implications for treatment and society
The effects go beyond just individual decision-making; they also affect the broader society. Neurodivergence can lead to financial difficulties, educational challenges, and workplace struggles.

Fortunately, research into neuroeconomics—the study of how brain activity influences economic decisions—offers valuable insights into how we can better support. For instance, neurofeedback therapy is emerging as an effective tools in helping individuals improve their decision-making skills.

Understanding neurodivergence from a neurological perspective helps guide more targeted treatments and interventions, which can improve the quality of life and reduce the societal costs of having a bit different brain than most.

About the scientific paper:

First author: Aisha Sanober Chachar, Pakistan
Published: Frontiers in Neuroscience. October 2024
Link to paper: https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2024.1339825/full