Why do individuals with Attention Deficit/Hyperactivity Disorder (ADHD) struggle to disengage from social media, and what do their eye movements reveal?

Abstract

Background: 

A considerable body of research has been published on the impact of ADHD on brain function and cognition in relation to exposure to digital media. However, many popular digital platforms have been developed using engagement-based architecture (e.g. variable schedule reinforcement, endless scrolling, personalization algorithms, push notification systems and content curation via algorithms).

Method: 

This narrative review synthesizes extant theory and research on the issues of ADHD, the design of digital media platforms, social communication processes, and oculomotor behaviors. The search for relevant studies was conducted using key electronic databases (e.g., PsycINFO, MEDLINE, Web of Science, Scopus, and Google Scholar) with no date restrictions.

Results: 

This literature review suggests that engagement-oriented digital architectures may exacerbate vulnerabilities associated with ADHD, such as those involving inhibitory control, reward sensitivity, delay aversion, and difficulty regulating attention/behavior. The social media feedback mechanisms of likes, views, followers, and response times have the potential to trigger Rejection-Sensitive Dysphoria (RSD), enhancing reactivity to social rejection and activating the dorsal anterior cingulate cortex, the anterior insula, and broader fronto-limbic networks involved in emotion regulation and social rejection. A variety of oculomotor signs of ADHD have been identified with eye-tracking technology.

Conclusion: 

The combination of salient bottom-up cues with engagement-driven features such as variable reward schedules, infinite scrolling, content selection based upon algorithms, and notifications has been demonstrated to create an environment that heightens the likelihood of amplification of the top-down self-regulatory deficits associated with ADHD. Eye-tracking has the potential to become a valuable, objective tool for measuring overt oculomotor behaviors.