Emotional Instability Relates to Ventral Striatum Activity During Reward Anticipation in Females.

Frida Bayard,Martin Ingvar,Christoph Abé,Eva Henje,Predrag Petrovic,Nathalie Wrobel

doi:10.3389/fnbeh.2020.00076

Abstract

Both non-emotional symptoms, such as inattention, and symptoms of emotional instability (EI) are partially co-varying and normally distributed in the general population. Attention Deficit Hyperactivity Disorder (ADHD), which is associated with both inattention and emotional instability, has been related to lower reward anticipation activation in the ventral striatum. However, it is not known whether non-emotional dysregulation, such as inattention, or EI—or both—are associated with this effect. We hypothesized that altered reward processing relates specifically to EI. To test this, 29 healthy participants were recruited to this functional MRI study (n = 15 females). Reward processing was studied using a modified version of the Monetary Incentive Delay (MID) task. Brown Attention-Deficit Disorder Scales questionnaire was used to assess EI and inattention symptoms on a trait level. We observed less ventral striatal activation during reward anticipation related to the EI trait in females, also when controlling for the inattention trait, but not in the whole sample or males only. Our study suggests the existence of sex differences in the relationship between reward processing and EI/inattention traits.

Highlights

Non-emotional symptoms such as inattention, impulsivity, and hyperactivity typically define Attention Deficit Hyperactivity Disorder (ADHD) according to standardized diagnostic criteria (DSM-5, 2013)
Since sex differences have been reported both about ADHD symptom profiles and reward processing (Rucklidge, 2010; Bobzean et al, 2014; Davies, 2014; Mowlem et al, 2018; Becker and Chartoff, 2019), we explored sex differences in reward processing concerning emotional instability (EI) and inattention traits
Since reward processing differs between sexes (Bobzean et al, 2014; Becker and Chartoff, 2019) and the symptomatology profile differs between female and male ADHD patients (Rucklidge, 2010; Trent and Davies, 2012; Davies, 2014) we explored the effects of sex-by-Emotion Instability and sex-byInattention interaction on brain activity

Summary

Introduction

Non-emotional symptoms such as inattention, impulsivity, and hyperactivity typically define Attention Deficit Hyperactivity Disorder (ADHD) according to standardized diagnostic criteria (DSM-5, 2013). In clinical practice, emotion dysregulation, including emotional instability (EI), has been reported in a subpopulation of ADHD patients (Skirrow and Asherson, 2013; Shaw et al, 2014; Moukhtarian et al, 2018). The theory suggests that ADHD and EI related symptoms—or traits—are normally distributed across the general population and depend on the underlying regulatory capacities for non-emotional and emotional processes. When these traits result in the functional loss they are regarded as clinically relevant symptoms constituting a psychiatric diagnosis. This further highlights the importance of complementing the existing research with a dimensional approach where these confounds are not present

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