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The Mental Effort-Reward Imbalances Model and Its Implications for Behaviour Management

Published online by Cambridge University Press:  18 March 2016

Alison Poulton*
Affiliation:
Sydney Medical School Nepean, University of Sydney, New South Wales, Australia
Samina Whale
Affiliation:
Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
Joanne Robinson
Affiliation:
Coral Tree Family Service, Macquarie Hospital, Northern Sydney Local Health District, New South Wales, Australia
*
address for correspondence: Alison Poulton, Department of Paediatrics, Nepean Hospital, PO Box 63, Penrith, NSW 2751Australia. Email: alison.poulton@sydney.edu.au
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Abstract

Attention deficit hyperactivity disorder (ADHD) is frequently associated with oppositional defiant disorder (ODD). The Mental Effort Reward Imbalances Model (MERIM) explains this observational association as follows: in ADHD a disproportionate level of mental effort is required for sustaining concentration for achievement; in ODD the subjective experience of reward for achievement is less than normal. In combination, these mechanisms predispose to reductions in motivation and achievement, and to low mood, oppositional behaviour, and reward seeking. Self-regulation has been used as a management strategy in ADHD, with interventions directed towards encouraging individuals to evaluate and reinforce positive behaviour. Using the logic of the MERIM, self-management strategies would be directed towards encouraging the individual to attribute value to a task or activity with the goal of obtaining the emotional outcome of feeling good about themselves through their achievement. We describe the use of two such strategies: positive rumination and positive reappraisal. These could potentially lead to improvements in functioning, enhancing the quality of life of affected individuals and resulting in fewer incidents of destructive, reward-seeking behaviour in relation to those around them.

Type
Articles
Copyright
Copyright © The Author(s) 2016 

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