4 - (SYM 56) the Effects of ADHD, Co-occurring Psychopathology, and Neural Processing of Social and Monetary Reward on Personality Pathology in Female Adolescents

Background: Female youth with ADHD are at risk for developing personality disorders, but very little is known about the mechanisms underlying risk for personality pathology, and how psychiatric comorbidities, commonly identified among female youth with ADHD may be associated with risk for personality disorders. The goal of this study was to examine the effects of ADHD, psychiatric comorbidities (i.e., oppositional defiant disorder [ODD], conduct disorder [CD], anxiety, and depression), and neural processing of social and monetary reward on personality pathology. It was hypothesized that ADHD, psychiatric comorbidities, and neural processing of social and monetary reward would contribute to personality pathology.

Method: Female youth (10-13 years old) with (n=80) and without (n=30) a mental health history completed ratings of anxiety, depression, and personality pathology. Parent report of ADHD, ODD, and CD was also collected. Youth completed laboratory tasks assessing neurophysiological (i.e., event-related potentials [ERP]) processing of social and monetary reward. These tasks reliably elicit a reward positivity (RewP) enhanced for social acceptance relative to rejection and monetary gain relative to loss, respectively. 

Results: ADHD was associated with ODD (r=.69), CD (r=.59), anxiety (r=.19), depression (r=.38), and personality pathology (r=.22). None of the measures of psychopathology were associated with neural measures at the bivariate level. In a regression, considering ADHD, psychiatric comorbidities, age, and neural processing variables, ODD (B=2.42, p=.01), anxiety (B=.207, p< .001), depression (B=.68, p< .001), and RewP to social acceptance (B=.16, p=.03), and RewP to rejection (B=-.16, p=.04) were significantly associated with personality pathology. ADHD, CD, and neural measures of monetary reward and loss were not associated with personality pathology.

Discussion: ADHD was not uniquely associated with personality pathology when considering the effects of psychiatric comorbidities and neural measures of social and monetary reward. Instead, ODD, anxiety, and depression, and altered processing of social acceptance contributed unique variance in explaining personality pathology. Prospective longitudinal research examining dynamic transactions between psychopathology and social processing may advance efforts to clarify the pathway through which ADHD begets risk for personality pathology.