Abstract
Objectives: Neurocognitive functions might indicate specific pathways in developing attention deficit hyperactivity disorder (ADHD). We focus on reward-related dysfunctions and analyze whether reward-related inhibitory control (RRIC), approach motivation, and autonomic reactivity to reward-related stimuli are linked to developing ADHD, while accounting for comorbid symptoms of oppositional defiant disorder (ODD), and callous-unemotional (CU) traits.Methods: A sample of 198 preschool children (115 boys; age: m = 58, s = 6 months) was re-assessed at age 8 years (m = 101.4, s = 3.6 months). ADHD diagnosis was made by clinical interviews. We measured ODD symptoms and CU traits using a multi-informant approach, RRIC (Snack-Delay task, Gift-Bag task) and approach tendency using neuropsychological tasks, and autonomic reactivity via indices of electrodermal activity (EDA).Results: Low RRIC and low autonomic reactivity were uniquely associated with ADHD, while longitudinal and cross-sectional links between approach motivation and ADHD were completely explained by comorbid ODD and CU symptoms.Conclusion: High approach motivation indicated developing ADHD with ODD and CU problems, while low RRIC and low reward-related autonomic reactivity were linked to developing pure ADHD. The results are in line with models on neurocognitive subtypes in externalizing disorders.
Highlights
Attention deficit hyperactivity disorder (ADHD) and oppositional defiant and conduct disorder (ODD/CD) frequently occur together—about 50% of ADHD cases develop ODD/CD [1]
Based on the research reviewed above, we examined the following hypotheses: (a) Low reward-related IC (RRIC) is associated with developing ADHD
Consistent with our hypothesis, the T1 Snack-Delay task and the T2 Gift-Bag task were significantly associated with the T2 ADHD diagnosis (Table 3A, model 1)
Summary
Attention deficit hyperactivity disorder (ADHD) and oppositional defiant and conduct disorder (ODD/CD) frequently occur together—about 50% of ADHD cases develop ODD/CD [1]. Longitudinal research has revealed a common developmental progression from preschool symptoms of ADHD to comorbid symptoms of ODD/CD in childhood and adolescence [2, 3]. CU traits, which comprise reduced guilt and remorse, callousness, low empathy, and deficient prosocial emotions, overlap with the dimensions of ADHD and ODD/CD symptoms [2, 4]. ADHD, ODD/CD and CU traits have been found to be associated with diverse neurocognitive dysfunctions [1]. As these dysfunctions might represent markers of etiological subtypes or predictors of specific developmental pathways, the question of whether a dysfunction is uniquely related to ADHD or pertains to a specific combination with comorbid symptoms is an important issue of research [5]. Longitudinal research on this issue is scarce, especially between preschool and school age
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