Concurrent and Prospective Associations of Reward Response with Affective and Alcohol Problems: ADHD-Related Differential Vulnerability

Alexandra Rádosi; Kristóf Ágrez; Bea Pászthy; János M Réthelyi; István Ulbert; Nóra Bunford

doi:10.1007/s10964-023-01794-7

Concurrent and Prospective Associations of Reward Response with Affective and Alcohol Problems: ADHD-Related Differential Vulnerability

J Youth Adolesc. 2023 Sep;52(9):1856-1872. doi: 10.1007/s10964-023-01794-7. Epub 2023 Jun 3.

Authors

Alexandra Rádosi^{1

2}, Kristóf Ágrez¹, Bea Pászthy³, János M Réthelyi⁴, István Ulbert^{5

6}, Nóra Bunford⁷

Affiliations

¹ Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.
² Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary.
³ Department of Pediatrics, Semmelweis University, Budapest, Hungary.
⁴ Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
⁵ Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.
⁶ Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary.
⁷ Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary. bunford.nora@ttk.hu.

PMID: 37270465
DOI: 10.1007/s10964-023-01794-7

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder. Data on the role of transdiagnostic, intermediate phenotypes in ADHD-relevant characteristics and outcomes are needed to advance conceptual understanding and approaches to precision psychiatry. Specifically, the extent to which the association between neural response to reward and ADHD-associated affective, externalizing, internalizing, and substance use problems differ depending on ADHD status is unknown. Aims were to examine, in 129 adolescents, whether concurrent and prospective associations of fMRI-measured initial response to reward attainment (relative to loss) with affectivity and externalizing, internalizing, and alcohol use problems differs between youth at-risk for (i.e., subclinical) (n = 50) and not at-risk for ADHD. Adolescents were, on average, 15.29 years old (SD = 1.00; 38% female), 50 were at-risk for (M_age = 15.18 years, SD = 1.04; 22% female) and 79 not at-risk for (M_age = 15.37 years, SD = 0.98; 48.1% female) ADHD. Both concurrent and prospective relations differed given ADHD risk: across analyses, in at-risk youth, greater superior frontal gyrus response was associated with lower concurrent depressive problems but in not at-risk youth, these characteristics were not related. Controlling for baseline use, in at-risk youth, greater putamen response was associated with greater 18-month hazardous alcohol use, whereas in not at-risk youth, greater putamen response was associated with lower use. Where in brain and for which outcomes modulate (direction of) observed relations: superior frontal gyrus response is relevant for depressive problems whereas putamen response is relevant for alcohol problems and greater neural responsivity is linked to less depressive but to more alcohol problems in adolescents at-risk for ADHD and less alcohol problems in adolescents not at-risk. Differences in neural response to reward differentially confer vulnerability for adolescent depressive and alcohol problems depending on ADHD risk.

Keywords: ADHD; Affect; Alcohol; Reinforcement sensitivity.

MeSH terms

Alcohol-Related Disorders*
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / genetics
Attention Deficit Disorder with Hyperactivity* / psychology
Female
Humans
Male
Reward
Substance-Related Disorders*