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Examination of developmental pathways from preschool temperament to early adolescent ADHD symptoms through initial responsiveness to reward

Published online by Cambridge University Press:  16 March 2021

Nóra Bunford*
Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, ‘Lendület’ Developmental and Translational Neuroscience Research Group, Magyar Tudósok körútja 2, Budapest, Hungary
Autumn Kujawa
Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
Margaret Dyson
Child Mind Institute, New York, NY, USA
Thomas Olino
Department of Psychology, Temple University, Philadelphia, PA, USA
Daniel N. Klein
Department of Psychology, Stony Brook University, Stony Brook, NY, USA
Author for Correspondence: Nóra Bunford, at Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, 1117 Budapest, Magyar Tudósok körútja 2, Hungary; E-mail: or


To identify sources of phenotypic heterogeneity in attention-deficit/hyperactivity disorder (ADHD) accounting for diversity in developmental/ pathogenic pathways, we examined, in a large sample of youth (N = 354), (a) associations between observed temperamental emotionality at age 3, an electrocortical index (i.e., reward positivity [RewP]) of initial responsiveness to reward at age 9, and ADHD symptoms at age 12, and (b) whether the association between emotionality and ADHD symptoms is mediated by initial responsiveness to reward. Bivariate analyses indicated greater positive emotionality (PE) was associated with enhanced RewP, lower age-9ADHD and lower age-12 inattention (IA). Negative emotionality (NE) was not associated with RewP or ADHD. Mediation analyses revealed the association between PE and hyperactivity/impulsivity (H/I) was mediated by RewP; enhanced RewP was associated with greater H/I. Greater PE was associated with enhanced RewP at a trend level. These effects held accounting for age-9 ADHD, age-12 IA and age-12 oppositional defiant and conduct disorder symptoms. As such, preschool emotionality is associated with adolescent ADHD-H/I symptoms through late childhood initial responsiveness to reward. These relations indicate that individual differences in emotionality and reward responsiveness may be informative for personalizing ADHD interventions.

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© The Author(s), 2021. Published by Cambridge University Press

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