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.

为了确定注意力缺陷/多动障碍 (ADHD) 表型异质性的来源，解释了发育/致病途径的多样性，我们在大量青年样本中进行了检查 ( N= 354），（a）在 3 岁时观察到的气质情绪、9 岁时对奖赏的初始反应的皮质指数（即奖赏积极性 [RewP]）和 12 岁时的 ADHD 症状之间的关联，以及（b）是否情绪和 ADHD 症状之间的关联是由对奖励的初始反应介导的。双变量分析表明，更大的积极情绪 (PE) 与增强的 RewP、较低的 9 岁多动症和较低的 12 岁注意力不集中 (IA) 相关。消极情绪 (NE) 与 RewP 或 ADHD 无关。中介分析显示 PE 与多动/冲动 (H/I) 之间的关联是由 RewP 介导的。增强的 RewP 与更高的 H/I 相关。在趋势水平上，更大的 PE 与增强的 RewP 相关。这些影响解释了 9 岁多动症，12 岁 IA 和 12 岁对立违抗和品行障碍症状。因此，学龄前情绪与青少年 ADHD-H/I 症状通过儿童后期对奖励的初始反应有关。这些关系表明，情绪和奖励反应的个体差异可能为个性化 ADHD 干预提供信息。