In this chapter we describe a clinical model for ADHD: the Mental Effort Reward Imbalances Model (MERIM). We use this model to explain some of the behaviour commonly observed in children with ADHD and to guide approaches to treatment. The MERIM views the behaviour associated with ADHD as an outcome of two unfavourable imbalances: 1.Imbalance of the level of mental effort required for achievement. 2.Imbalance in the level of reward experienced. These imbalances each contribute to lower levels of achievement and fewer rewarding experiences in ADHD. This results in a poorer mood with less tolerance for frustration, together with seeking rewards that do not involve high levels of effort. The concept of ADHD as dual imbalances in mental effort and reward gives a useful framework for understanding the behaviour and the strategies that individuals use to compensate and improve their mood.
Part of the book: ADHD