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6. Thinking blockades / decision making problems in ADHD

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6. Thinking blockades / decision making problems in ADHD

6.1. Thinking blocks as an ADHD symptom

Thinking blocks are a phasic impairment of cognitive performance, usually caused by a large acute stress load.

A typical example of thinking blocks are exam blackouts
Thinking blocks occur with about equal frequency in ADHD-HI as in ADHD-I.

6.2. Decision-making problems as an ADHD symptom

Decision-making problems means problems with making decisions, not problems with the quality or correctness of decisions made.

Decision-making problems seem to occur significantly more frequently in ADHD-I than in ADHD. This suggests that the different manifestations have different neurophysiological correlates.

While ADHD-HI correlates more strongly with too spontaneous, too impulsive decision-making, in ADHD-I the ability to make a decision is often massively impaired. Even simple decisions can trigger the feeling of being overwhelmed.

One study found that the decision quality problems of adolescents with ADHD resulted less from an affinity for risk than from suboptimal decision making that did not take into account all factors relevant to decision making because it was less complex to evaluate.1

6.3. Neurophysiological correlates of thinking blocks and decision making problems

High levels of norepinephrine block the PFC via alpha-1 adrenoceptors and shift behavioral control to posterior brain regions.2345 Since the PFC is very important for weighing multiple decision options, blockade of the PFC naturally leads to increased decision-making problems.
Decision-making problems are to be distinguished from difficulties of time perception.6

For more details, see Neurophysiological correlates of thinking blocks and decision problems

6.4. Thought blocks as symptoms of stress

Thought blocks are also known to be symptoms of severe stress.78

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