The Impact of Irritability and Callous Unemotional Traits on Reward Positivity in Youth with ADHD and Conduct Problems

The Association Between Adolescent Adhd and Callous-unemotional Traits is Moderated by Electrophysiological Reinforcement Sensitivity

“…Integrating affective, cognitive, and motivational dimensions to decipher such heterogeneity has gained traction as both affective characteristics [67, 68], including CU traits [7,28], and reinforcement sensitivity [3,19,69] appear to account for clinically relevant differences in ADHD phenotypic and prognostic variation. We agree with others [31] that a critical next step in understanding the intersection of the ADHD clinical phenotype and affective symptoms is linking those on a mechanistic level with transdiagnostic processes. We thus evaluated the intersection of ADHD and CU traits in relation to electrophysiological response to anticipation of reward.…”

“…Across studies where the complex relation of ADHD, CU traits, and reinforcement sensitivity was examined in adolescents [30,31], CU traits was conceptualized as the moderator of the association between ADHD and measures of reinforcement sensitivity and this is certainly a conceptually appropriate approach. In these studies, samples involving children, adolescents, and adults, CU traits did not moderate the association between ADHD and measures of probabilistic reversal learning [30] and receipt of reward [31]. Here, electrophysiological response to anticipation of reward was conceptualized as the moderator of the association between ADHD and CU traits and the current ndings indicate this is also a framework that is justi able, as in adolescents, electrophysiological reinforcement sensitivity moderated the association between ADHD and CU traits.…”

“…In 328 adolescents and adults with ADHD, ADHD and ODD/CD, siblings of probands with ADHD, and without ADHD, ODD, or CD, the association was examined between CU traits on BOLD response to anticipation of reward and ndings indicated accounting for ADHD, ODD, and CD, CU traits were negatively associated with medial prefrontal cortex (mPFC) response [27]. In 48 children and adolescents with ADHD, CU traits were examined as a moderator of the association between ADHD, ODD, and CD symptoms with ERPs to receipt of reward and ndings indicated CU traits did not modulate these associations [31].…”

“…As such, available ndings are developmentally nonspeci c, and designs may hinder ability to detect effects apparent only in certain developmental periods or effects that differ across developmental periods. Further, despite their applicability to clinical samples and settings [32] and reliability and validity for measuring response to reward [33][34][35], only one study applied electrophysiological methods [31].…”

“…Adolescence as a developmental phase differs from childhood and adulthood with regard to reinforcement sensitivity; during adolescence, reward sensitivity peaks and compared to adults, adolescents exhibit greater reward but lower punishment sensitivity [29]. Yet, there is only a handful of studies on ADHD, CU traits, and reinforcement sensitivity involving adolescents [22,23,27,30,31] and only in three of these is ADHD a characteristic of interest. In 518 children, adolescents, and adults with and without ADHD, ODD, and CD, CU traits were examined as a moderator of the association between ADHD and ODD with behavioral indices of probabilistic reversal learning and ndings indicated CU traits did not modulate these associations [30].…”