Investigators Look at How ADHD, ODD Dimensions Relate to Impulsivity

For the first time ever, investigators have begun to untangle the association between attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) and the symptoms of impulsivity.

A team based in Australia, led by Rapson Gomez, Federation University, evaluated the inter-relationships of dimensions within ADHD and ODD with components of impulsivity.

ADHD and ODD

ADHD and ODD are both high prevalent conditions that frequently co-occur with one another.

“The trait-impulsivity hypothesis model posits that a unidimensional general impulsivity factor underlies the behavioral expression of ADHD and ODD symptom dimensions,” the authors wrote. “However, there is now robust evidence that impulsivity is multidimensional have proposed a multidimensional impulsivity model with dimensions for sensation seeking, lack of premeditation, lack of perseverance, negative urgency, and positive urgency.”

Previously, there has not been a study conducted on the different dimensions of impulsivity related to the 2 diseases, using the trait impulsivity hypothesis as the framework.

Impulsivity

In the network analysis, the investigators captured the inter-relationships between inattention and hyperactivity/impulsivity in patients with ADHD and anger/irritability, vindictiveness, and argumentative/defiant behavior in patients with ODD using the UPPS-P model (negative urgency, lack of premeditation, lack of perseverance, sensation seeking, and positive urgency).

The study included 324 emerging adults from the general community, 246 of which were women. The mean age for the patient populated was 23.12 years. In addition, 3.7% (n = 12) reported that they have been diagnosed with either ADHD or ODD.

Each participant completed questionnaires on demographic information, including age, gender, education, employment and relationship status, and previous diagnosis of ADHD and ODD. They also completed the Current Symptom Scale and the Short-Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency to obtain ratings for the ADHD and ODD symptoms, comparable to diagnostic symptoms for the disorders in the DSM-IV/DSM-IV-TR and DSM-5.

Results

The results show ADHD and ODD dimensions were associated differently with different types of impulsivity, with unique patterns of network connectivity.

There were noticeable and positive relations for inattention connecting with negative urgency, positive urgency, lack of perseveration, and lack of premeditation, with associations involving a lack of preservation being the strongest with a medium effect size.

“This study is the first to tease out the unique associations of the ADHD and ODD dimensions with different types of impulsivity, and in that way provide new contributions to our understanding of the existing trait impulsivity theory,” the authors wrote.

The results likely will have some implications on treatment for the diseases.

“Our edge weight findings linking the ADHD and ODD dimensions with different types of impulsivity have important treatment implications for ADHD, ODD, and comorbid ADHD/ODD,” the authors wrote. “In this respect, the findings raise the possibility that directly focusing on emotionally and cognitively driven impulsivity can be an effective treatment for ADHD and/or ODD.”

The study, “Inter-relationships between ADHD, ODD and impulsivity dimensions in emerging adults revealed by network analysis: extending the ‘trait impulsivity hypothesis’,” was published online in Heliyon.