How does adult temperament relate to ADHD symptom domains?
Testing the dual-pathway model
Publication date
2025-11-29
Document type
Forschungsartikel
Author
Organisational unit
Scopus ID
Publisher
Sage
Series or journal
Journal of Attention Disorders
ISSN
Periodical volume
30
Periodical issue
3
First page
386
Last page
406
Peer-reviewed
✅
Part of the university bibliography
✅
Language
English
Keyword
ADHD
adult
dual-pathway model
effortful control
temperament
Abstract
Object: Temperament provides a valuable framework for understanding ADHD across the lifespan, as extreme temperamental traits are considered etiological risk factors. The dual-pathway model links specific temperamental traits to ADHD symptom domains: elevated reactive traits, surgency and negative affect, to hyperactivity/impulsivity, and a low regulatory trait, effortful control, to inattention.
Method: One hundred fifty-eight adults (79 with clinical diagnoses of ADHD and 79 controls) filled in the Adult Temperament Questionnaire. Consistent with a compensatory extension of the dual-pathway model, it was hypothesized that effortful control would moderate the effects of reactive traits (surgency/negative affect) on hyperactive/impulsive symptoms and influence both ADHD symptom domains. For exploratory purposes, orienting sensitivity, an adult temperament factor related to perceptual sensitivity, was included in the analyses.
Results: Binary logistic regression identified lower effortful control as the strongest predictor of an ADHD diagnosis. Negative affect had a significant but small effect, while surgency and orienting sensitivity were non-significant. Two hierarchical regressions were performed for self-rated symptoms of hyperactivity/impulsivity and inattention. Consistent with a compensatory model, effortful control was significantly related to symptom expression in both ADHD symptom domains. Contrary to expectations, surgency did not explain variance in hyperactivity/impulsivity, and the effect of negative affect was strongly reduced, after effortful control was added to the model. Effortful control did not moderate the effects of surgency and negative affect.
Conclusion: These findings challenge the dual-pathway model and highlight self-regulation deficits over reactive traits in sustaining ADHD in adulthood. They underscore the value of temperament-based approaches for refining diagnosis and developing targeted interventions for adult ADHD.
Method: One hundred fifty-eight adults (79 with clinical diagnoses of ADHD and 79 controls) filled in the Adult Temperament Questionnaire. Consistent with a compensatory extension of the dual-pathway model, it was hypothesized that effortful control would moderate the effects of reactive traits (surgency/negative affect) on hyperactive/impulsive symptoms and influence both ADHD symptom domains. For exploratory purposes, orienting sensitivity, an adult temperament factor related to perceptual sensitivity, was included in the analyses.
Results: Binary logistic regression identified lower effortful control as the strongest predictor of an ADHD diagnosis. Negative affect had a significant but small effect, while surgency and orienting sensitivity were non-significant. Two hierarchical regressions were performed for self-rated symptoms of hyperactivity/impulsivity and inattention. Consistent with a compensatory model, effortful control was significantly related to symptom expression in both ADHD symptom domains. Contrary to expectations, surgency did not explain variance in hyperactivity/impulsivity, and the effect of negative affect was strongly reduced, after effortful control was added to the model. Effortful control did not moderate the effects of surgency and negative affect.
Conclusion: These findings challenge the dual-pathway model and highlight self-regulation deficits over reactive traits in sustaining ADHD in adulthood. They underscore the value of temperament-based approaches for refining diagnosis and developing targeted interventions for adult ADHD.
Description
This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/).
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