The Effects of Attention-Deficit Hyperactivity Disorder and Depression Symptomatalogy on Reward and Punishment Sensitivity in Adults

Reward and punishment sensitivity play important roles in eliciting, inhibiting, and guiding behavior. Previous research has indicated aberrant levels of reward and punishment sensitivity in those with depression or ADHD. However, few studies have explored the synergistic effects of both depression and ADHD on reward/punishment sensitivity, particularly in adults. Study 1 examined performance on a delay discounting task across diagnostic groups (ADHD, depression, co-morbid ADHD/depression, N=119). Study 2 investigated associations between ADHD/depression symptoms and self-report/behavioral measures of reward and punishment sensitivity among N=152 young adults. MANOVAs in Study 1 indicated that diagnostic groups differed in their average rate of delay discounting compared to the control group; however, diagnostic groups did not differ from each other. In Study 2, hierarchical regression models revealed a modest interaction effect between ADHD and depression symptoms in females when predicting behavioral changes to reward/punishment. Sex also moderated the separate effects of ADHD/depression symptoms on reward/punishment sensitivity. Our results suggested that reward/punishment sensitivity processes are altered among individuals with diagnoses and symptoms of ADHD and depression, but that the impact of psychopathology on these processes may vary by sex. Future work should explore sex differences in reward/punishment processing in the context of psychopathology while also investigating associations between ADHD/depression and subconstructs of reward/punishment sensitivity.