Jay Tarnow, MD
Is the search for stimulation more rewarding than the reward? Slate Magazine’s Emily Yoffe has written an article suggesting that “seeking” stimulation, or anticipation of a payoff, is more rewarding than the reward itself. In 1954, James Olds attached electrodes to the lateral hypothalamus of rats and allowed rats to activate the electrode by pushing a small lever. He noticed that the rats would push on the lever repeatedly until they collapsed from exhaustion. Similar experiments done on humans (Heath, 1972; Portenoy et al., 1986) found that subjects elected to self-stimulation over other responsibilities, such as family commitments and hygiene.
While this area of the brain was then referred to as the “pleasure center”, later research has found that stimulation of the lateral hypothalamus actually produces the anticipation of pleasure, rather than pleasure itself. Kent Berridge makes the point that the brain is wired more for stimulation than satisfaction. Yoffe argues that this makes sense from an evolutionary standpoint. Those who are motivated to forage and find have a better shot at survival than do those who are easily satisfied.
Yoffe’s article goes on to share that the driving force behind this anticipation is the neurotransmitter dopamine. “Rats whose dopamine levels have been destroyed retain the ability to walk, chew, and swallow, but will starve to death even if food is right under their noses because they have lost the will to go get it.” Conversely, rats whose brains are flooded with dopamine are highly motivated to find the food, but do not find the food any more rewarding than rats with normal dopamine levels.
Given what we know about the connection between ADHD and decreased dopamine levels, this article presents three points that are highly relevant in regards to ADHD.
- Motivational difficulty with ADHD children and adolescents may in fact be due to the role that dopamine plays in anticipation of reward. If a child is not stimulated by the anticipation of a good grade, he is less likely to work for that grade.
- Anticipation of pleasure is no less stimulating for the ADHD child than the non-ADHD child, but it is harder to come by due to diminished dopamine levels. Therefore the ADHD child will be that much more drawn to activities that activate this arousal. This can result in the restlessness, impulsivity and impatience commonly seen in ADHD children. “This isn’t working, maybe that will…”
- Arguing is an example of an activity that does provide this high level of stimulation. Therefore, I encourage parents of ADHD children (or Bipolar, Oppositional, Tourette’s) to avoid arguing with the child. This doesn’t mean giving in; it means setting firm, clear boundaries that leave no room for argument.