To eat or not to eat: Reward delay impulsivity in children with loss of control eating, attention deficit/hyperactivity disorder, a double diagnosis, and healthy children

Reward delay impulsivity is a feature of attention deficit/hyperactivity disorder (ADHD) and a likely feature of loss of control eating (LOC-E), which might explain the higher risk of children with ADHD or LOC-E to become obese. The goal of this study was to investigate reward delay impulsivity in children with LOC-E, ADHD, or a double diagnosis, in contrast to healthy children. Children (8 to 13 years) with LOC-E (n = 24), ADHD (n = 33), a double diagnosis (n = 9), and healthy children (n = 34) performed a computer game (door opening task [DOT]) and the delay of gratification task (DoGT) to assess food related facets of reward delay impulsivity. In addition, children reported whether they worried to lose control over eating during the DoGT. There were no group differences in the DOT. However, children with ADHD or a double diagnosis had a significantly higher risk to eat prematurely during the DoGT than children with LOC-E, who were not significantly different from healthy children. Children with a double diagnosis were most likely to worry about losing control over eating during the DoGT, followed by children with LOC-E, and both had a significantly higher probability to worry than healthy children. For children with a double diagnosis the probability to worry was significantly higher than for children with ADHD. If replicated, these findings point to a special relevance of reward delay impulsivity in children with ADHD or a double diagnosis, compared to children with LOC-E. ADHD should be regularly assessed in children with LOC-E.