Tuesday, 14 October 2014

Bad Calls II : Risk Taking and ADHD in Adults

In our last bad-calls we considered decision making, and part of this is of course attitude to risk taking and how sufferers tackle risk differently from average western people.

Risk is of course an every day part of being human, from our early perceptual development until the second we die. It can be broken down into a process>

> A stimuli presents itself or an idea arises
> The individual may have a peri-conscious aversive reation or an arousal reaction
> Risk is partly assessed in terms of a consideration of what could happen. outcome cognition.
> An action is taken / or inaction a passive response, / or the risk is avoided actively
> The action or event is experienced and percieved in real time and in cognitive capture time room
> a psyco-emtional summary is made probably before the brain actually consciously interprets what happened
> A risk appraisal process takes place at the time, but this can also be an ongoing process, a life long memory
> A new attitude is shaped based on the cognition of the risk taken and any reward or penalty

ADHD affects most likely all stages of this process, and that is what leads probably to so much risk taking being associated to the disease amongst unruly teenagers. In fact it could perhaps be demonstrated that a large minority of teenage ADHD sufferers are the opposite, inb being particularly risk aversive because the disease affects their cognitive ability, and they verge on using a flight response as the emotional reckoning.

I started with the bullet point ' a stimuli presents itself or an idea arises' to point out that ADHD influences not only how sufferers react to situations, but also how they may self stimulate from being planely in the deficacy stage or they may be over stimulated by a possibility which presents itself.

This is then pretty inseparable from the next part of the chain, where there is a peri-conscious assetion  leading to an emotional status, maybe linked to the flight or fight response, but also refering to previous learning experiences, and in the ADHD sufferer, the level of stimulation.

It is proposed by many authors that sufferers often self stimulate or seek out stimulating experiences or of course substances in order to in a way tackle the low phase of the attention deficy. The next stage then of considering potential outcomes, or in visualising the possible course of events, or in preparing a motory response, the ADHD sufferer has an abnormal relationship to risk taking, loaded at the earlier stages. 

Now at this key, conscious decision making level the ADHD sufferer often mis calculates the level of risk. As we propose from our group experience, some are actually risk aversive and over emphasise negative outcomes. This is probably a difference in the group of those presenting with adult diagnosis, not previously caught in the teen years when so many are, because risk aversion is not associated to the disease and nor does it often lead to doctors visits, quite the reverse.

ADHD sufferers are then handicapped in making the conscious cognitive processes by either being in the AD phase or in the Hyper stimulus stage. For adults 'normal /mature' behaviour would be to gather more information on an unkown risk, by refering to memory peri-consciously or via motor memory, or by seeking out new queues and information from the environment or people with them. ADHD are more likely to make a decision based on the feeling they have to make a decision, they rush into action before maybe stepping back, or they back off completely avoiding then the risk.

Our groups over the years have shown probably the gamete of risk taking, with as mentioned the earlier population of the group being younger, teenage diagnosed struggeling in young adult hood, and now the move partly by design, over to older sufferers diagnosed over the age of 21 all the way up to over 50 years old for first correct diagnosis.

Types of Risk

Physical motor-activity risks

this covers sports, high risk endeavours like bungee jumping, and of course most damagingly , motor vehicles.

Social Risks

This covers some of the rash, crass or socially aversive  behaviours and may be in part damaging because the risk is completly over emphasised and a fear element can be present at outset.

Stimulatory Risks

This probably covers sex, drugs, & rock and roll. Usually a reduced level of inhibition is typical. 

Further Thoughts On This

It is clear that the entry phases and the cognitive phase then are adversely affected by ADHD, as is then the action phase where a dispropotionate response or aversion is typical in the disease it seems. In fact the same person afflicted by this may show both these poles of behaviour depending perhaps on their previous experience, and their brains status in the deficy-super-stimulatory pathway of the disease.

This leads right on to the learning outcome, whcih is a new attitude to that particular situation, or in fact a new attitude to risk  in general. If the sufferer experiences a postive feedback socially or from a euphoria of adrenalin, seratonin and adrenalin, then the risky taking behaviour is positively reinforced. The same could be true of a stong aversive reaction, but then the stimuli is removed so perhaps another time the outcome will be self gratifying and a risk be taken.

As mentioned in previous posts, risk taking is prominent in ADHD sufferers, or rather the under emphasis of potential negative outcomes and the over emphasis of potential for reward and personal gratification are biased towards basically making bad decisions and then enjoying the outcomes and learning somethign positive from those in a loop if you like.

The most extreme ADHD thrill seeking teenagers and young adults, have in common with Hypomaniacs a tendency to be self destructive physically, where as the older group shows that the affliction can present a chain of bad decision making throughout life. ADHD people cannot summate information correctly, they cannot weigh up different outcomes and often they rush into action before making a more cognitive appraisal.

This can be more sublte than Sex and Drugs and Rock & Roll, or jack ass behaviour., It can show itself in poor choice or partners, reduced social acceptance in groups or at work,  financial imprudence, and most of all in adults, changing jobs frequently.Risk assessment ability is maybe not the explanation for all , but it is an important  factor in much of what goes a wry for sufferers through their lives.

As with other types of behavioural modification, perhaps physicians and psychologists have to use techniques from anger-management and assertiveness-in-the-work-place. The sufferers probably most of all need to firstly recognise the behaviour pattern and secondly, back up and learn to make a conscious assessment of the situation and buy themselves time before they either act or ar passive in response.