Harm Avoidance is Correlated with the Reward System in Adult Patients with Attention Deficit Hyperactivity Disorder: A Functional Magnetic Resonance Imaging Study

Clin Psychopharmacol Neurosci. 2023 Feb 28;21(1):99-107. doi: 10.9758/cpn.2023.21.1.99.

Abstract

Objective: Hypoactivity in the reward system among patients with attention deficit hyperactivity disorder (ADHD) is a well-known phenomenon. Whether the activity in the reward pathway is related to harm avoidance, such as in sensitivity to punishment, is unclear. Evidence regarding the potential difference between ADHD patients and controls in terms of this association is scarce.

Methods: Event-related functional magnetic resonance imaging was conducted on subjects performing the Iowa gambling test. Fourteen adults with ADHD and 14 controls were enrolled in the study.

Results: Harm avoidance was found to be positively correlated with the activities of the bilateral orbitofrontal cortex and right insula in individuals with ADHD. A group difference was also confirmed.

Conclusion: Understanding the roles of harm avoidance and brain activation during risk tasks is important.

Keywords: ADHD; Harm avoidance; Iowa gambling test; Reward system; fMRI.