Reinforcement sensitivity theory, adult AD/HD symptoms, and comorbidity: an examination of pathways based on behavioral approach and inhibition

UNCG Author/Contributor (non-UNCG co-authors, if there are any, appear on document)
John Thomas Mitchell (Creator)
The University of North Carolina at Greensboro (UNCG )
Web Site:
Rosemery Nelson-Gray

Abstract: Recent reviews indicate that Hyperactive-Impulsive symptoms associated with Attention-Deficit/Hyperactivity Disorder (AD/HD), which are considered the core symptoms of AD/HD, are caused by relatively distinct etiological pathways. Overactive behavioral approach motivation tendencies are among these proposed causal pathways and are addressed within Reinforcement Sensitivity Theory (RST). RST proposes that overactive behavioral approach tendencies are associated with over responsiveness to immediately reinforcing stimuli and result from an overactive appetitive motivational subsystem of the brain--the Behavioral Approach System (BAS). The BAS is dopaminergically-based and is associated with impulsivity-sensation seeking. However, other externalizing disorder symptoms, such as Psychopathy, are also associated with overactive BAS functioning and frequently co-occur with AD/HD symptoms. Given this co-occurrence, any relationship between Hyperactive-Impulsive AD/HD symptoms and the BAS may be spurious. The current study tested the hypothesis that BAS functioning is differentially associated with Hyperactive-Impulsive AD/HD and Psychopathy symptoms (Primary and Secondary forms) among a sample of college undergraduates (n = 232). In addition, a second motivational subsystem of the brain, the Behavioral Inhibition System (BIS), which is associated with sensitivity to punishment and trait anxiety, was also assessed. Correlational analyses indicated that performance on an experimental behavior task of BAS functioning was unrelated or was modestly related to self-report measures of psychopathology and BAS functioning. However, correlations between self-report measures of BIS and BAS functioning with measures of psychopathology were significantly associated. Therefore, structural equation modeling of self-report measures of BIS and BAS functioning was conducted. This analysis assessed the relationship between each psychopathology variable with a BIS and BAS latent variable while also taking the other psychopathology symptoms into account. This analysis indicated that Hyperactive-Impulsive AD/HD symptoms are associated with high BAS functioning, and Primary Psychopathy symptoms are associated with high BAS and low BIS functioning. Secondary Psychopathy symptoms were positively correlated with BAS functioning, but this relationship failed to reach significance in the structural equation analysis. Instead, Secondary Psychopathy symptoms were associated high BIS functioning. Implications of these findings, particularly theoretical and treatment recommendations for AD/HD and its persistence into adulthood, and future research directions are discussed.

Additional Information

Language: English
Date: 2009
Attention Deficit Hyperactivity Disorder, ADHD, Behavioral Approach System, Behavioral Inhibition System, Reinforcement Sensitivity Theory
Attention-deficit hyperactivity disorder $x Physiological aspects.
Reinforcement (Psychology)
Human behavior $x Physiological aspects.

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