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ADHD

The Marshmallow Test, “Willpower” and ADHD, Part 1

The capacity to resist temptation is not so easily taught. Part 1 of 2

Oscar Wilde famously said: “I can resist anything but temptation.” In his recent book, The Marshmallow Test: Mastering Self-Control, psychologist Walter Mischel argues that children can be taught to resist temptation—that the ability to delay immediate gratification for the sake of getting something better in the future—is a skill that can be learned. As a psychologist who specializes in working with children and adults who often struggle with motivation and excessive impulsivity, I am writing to suggest that the capacity to resist temptations is not so easily taught nor easily sustained by any of us.

Mischel’s famous studies of preschoolers in the 1960s showed that some kids were quite able to resist the temptation to gobble up immediately one marshmallow placed in front of them. They delayed that pleasure so they could get a double portion of the treat simply by waiting a short time until the adult returned to the room. Others were unable to make themselves wait; they ate the single marshmallow without delay, despite knowing that they could have had twice as much if they had been able to hold off for a few minutes longer.

Self-control ability in preschool years predicted self-control in adulthood.

Follow-up studies done when those preschoolers grew older showed that, for most, the differences in ability to exercise self-control were remarkably consistent over the years. Evaluation of the preschoolers when they were 27-32 years old found that those who had been able to cope best with the delay, who were able to wait for the bigger reward, also earned higher scores on the SAT test, used risky drugs less, had reached higher educational levels, and had significantly lower body mass index scores. They were also reportedly better able than their less patient peers to deal with interpersonal problems and to maintain close relationships.

For most of those young children, that simple marshmallow test administered in preschool effectively predicted their ability to exercise effective self-control over much of their lifespan in many activities that can really matter. So what made it possible for some preschoolers to wait longer for the bigger reward when others could not wait?

Brain foundations for self-control

According to Mischel, what is needed for adequate self-control in any situation is adequate development of the brain’s management system—its executive functions (EF). He writes that children who have well-developed EF during preschool can not only resist the temptation to grab the one marshmallow, but also can inhibit other impulsive responses, keep instructions in mind, and focus their attention to do schoolwork. He notes that “those children whose EF functioning is not developing well in preschool years are at increased risk for ADHD and a variety of other learning and emotional problems throughout their school years" (p.108).

Self-control, executive functions and ADHD

Mischel’s description of children with inadequate development of EF compared to their age peers fits quite well with current descriptions of children with ADHD. On the basis of research over recent years, ADHD, once considered simply a problem in little boys with chronic behavior problems who were unwilling to listen to adults, has been redefined as a developmental impairment of the brain’s self-management system, its executive functions.

ADHD is now recognized by most specialists as a cluster of cognitive difficulties that affects both males and females, often, though not always, persisting into or throughout adulthood. Children and adults with ADHD typically demonstrate chronic problems with being able to focus attention, organize their work, sustain effort, utilize working memory, and inhibit excessively impulsive actions. These difficulties are usually inherited and are associated with differences and delays in brain development and functioning.

When Mischel’s preschoolers underwent brain scans at midlife, those who had shown more difficulty in waiting demonstrated differences in brain functioning similar to those found in children and adults with ADHD. It seems likely that those preschoolers who had much difficulty in waiting for the double marshmallow treat and continued to have relative weaknesses in self-control into adulthood had inherited brain-based difficulties with EF similar to most of those with ADHD. Perhaps the preschoolers who were able to wait longer were more fortunate in their genetic inheritance.

The essential ingredient for resisting temptation: motivation

Yet Mischel is well aware that even those individuals who have extraordinarily strong intellectual and executive functioning skills often demonstrate very poor self-control. He knows that having such skills for one situation does not necessarily mean that those skills will be deployed in different circumstances. In this recent book he explains that “Delay ability can help preschoolers resist one marshmallow now to get two later, but they have to want to do that" (p.189, emphasis added).

This statement that a child’s ability to resist immediate temptation in order to obtain a later reward depends upon the child’s “wanting to do it” may give the impression that the difference between those preschoolers who waited for the double reward and those who didn’t was that they simply wanted that bigger reward more than did the others. But Mischel’s interpretation is more sophisticated. He wants to emphasize that exercise of “willpower” is a skill that depends upon the complexities of motivation.

Mischel’s understanding of “willpower” is that it is essentially a skill, not some persisting internal power that causes the person always to make the best possible choice: “…like all skills, self-control skill is exercised only when we are motivated to use it. The skill is stable, but if the motivation changes, so does the behavior " (p.189). He explains that an individual’s ability to resist temptation depends upon how that person at that specific time perceives that specific situation and the probable consequences of yielding to the temptation or not. He emphasizes that “…our motivation and goals and the intensity of the temptation are especially important" (p.189). Here Mischel is noting a problem now considered the core of understanding ADHD.

Motivation is situationally specific.

The most puzzling feature of ADHD is that it is situationally specific. Virtually all children and adults with ADHD have at least a few specific activities in which they are able to focus their attention very well for long periods of time, are able to keep several different things in mind simultaneously, are able to sustain their efforts for challenging tasks, and can prevent themselves from acting too impulsively—all this even though they have great difficulty in demonstrating those same skills for many other tasks that they recognize as important.

Both clinical reports and empirical experiments show that those with ADHD are able to demonstrate excellent self-control for a few specific tasks in particular contexts, even though they show great difficulty in exercising these same skills in any other situation. For some, these strengths emerge when engaged in a favored sport or playing video games. For others, strong EF may emerge only when they are making art, or playing music, or doing mechanical tasks.

For those with ADHD, exercise of EF is often significantly impaired for most tasks and activities, unless the task is one which has especially strong interest for them. For most other activities and tasks, it is extremely difficult for them to mobilize their executive functions. This “you-can-focus-and-work-for-this-but-not-for that-and-that-and-that” characteristic of ADHD was captured by a patient who once told me:

Having ADHD is like having erectile dysfunction of the mind. If the task you are trying to do is actually interesting to you, if it really turns you on, you’re ‘up for it.’ But if the task you’re faced with is not intrinsically interesting to you, you can’t ‘get it up.’ And in that situation, it doesn’t matter how much you may say to yourself, “I need to; I ought to; I should” you can’t make it happen because ADHD is simply not a willpower kind of thing (Brown, 2013, 2014).

The capacity to resist the temptation to grab one appealing reward right now rather than waiting or working longer to get a bigger reward—that capacity to take the longer view, that capacity to inhibit an impulsive action while weighing the potential benefits of an anticipated future reward—is dependent upon whether the task “turns the person on” in that time and place. It depends upon motivation.

Part 1 of 2

Image: iStock

Copyright Thomas E. Brown

Thomas E. Brown is Associate Director of the Yale Clinic for Attention & Related Disorders in the Dept. of Psychiatry at Yale University School of Medicine. His most recent books are A New Understanding of ADHD in Children and Adults: Executive Function Impairments (Routledge, 2013) and Smart but Stuck: Emotions in Teens and Adults with ADHD (Jossey-Bass/Wiley, 2014) See: DrThomasEBrown.com

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