Neural and psychophysiological markers of delay aversion in attention-deficit hyperactivity disorder
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Delay aversion (DAv) is thought to be a crucial factor in the manifestation of impulsive behaviors in patients with attention-deficit/hyperactivity disorder (ADHD). The imposition of delay is predicted to elicit negative emotional reactions in ADHD. The present study offers a multimodal approach to the investigation of DAv. Twelve adult patients with ADHD and 12 matched healthy controls were tested on a new task with several levels of anticipated delays during functional magnet resonance imaging (fMRI). Behavioral measures of delay discounting, DAv, and delay frustration were collected. Skin conductance and finger pulse rate were assessed. Results indicated a group difference in response to changes in delay in the right amygdala: For control participants activity decreased with longer delays, whereas activity tended to increase for ADHD patients. The degree of amygdala increase was correlated with the degree of behavioral DAv within the ADHD group. Patients also exhibited increased emotional arousal on physiological measures. These results support the notion of an exacerbated negative emotional state during the anticipation and processing of delay in ADHD.
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Anticipation of forced waiting times, which are particularly aversive to individuals with ADHD, also elicited enhanced amygdala activation.
“Interestingly, the anticipation of forced waiting times, which are particularly aversive to individuals with ADHD (Sonuga-Barke et al., 2010) also elicited enhanced amygdala activation (Wilbertz et al., 2013).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Wilbertz et al., 2013
The Neuroimaging Results report a significant group difference in how right-amygdala activity changed with the length of anticipated delays. But they found no overall difference in amygdala responses during anticipation, and the increase with longer delays within the ADHD group was only a statistical trend. Thus, the unqualified statement that anticipation elicited enhanced activation overstates the finding. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWilbertz et al. (2013) found increased SCL (i.e., hyperarousal) during the delay interval in adults with ADHD.
“One study (Wilbertz et al., 2013) investigating ANS activity during delay aversion, an often-reported feature of ADHD (Van Dessel et al., 2018), found increased SCL (i.e., hyperarousal) during the delay interval in adults ADHD children showed no change in SCL between reward and extinction (in controls, increase of SCL between reward and extinction and decrease from extinction to reward).”
From Is autonomic nervous system function atypical in Attention Deficit Hyperactivity Disorder (ADHD)? A systematic review of the evidence (2020) · cites this paper as Wilbertz et al., 2013
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Self-citationCarter Leno, V., Forth, G., Chandler, S., White, P., Yorke, I., Charman, T., Pickles, A. R., & Simonoff, E. (2021) · Figshare · doi:10.6084/m9.figshare.15001315
Network analyses identify critical factors for facilitating future-oriented decision-making
Wu, H., Xue, Z., Xiao, X., Ma, J., Xiao, Z., Chen, K., Jiang, Y., & Guo, Y. (2026) · Cognitive Psychology · doi:10.1016/j.cogpsych.2026.101815
McNaboe, R. Q., Díaz, L. R. M., Faremi, B. E., & Posada-Quintero, H. F. (2026) · Signals · doi:10.3390/signals7040073
Sleep regulation as a function of boredom proneness
Nettinga, J., Khan, Y., Teka, A., Drody, A. C., & Danckert, J. (2026) · Personality and Individual Differences · doi:10.1016/j.paid.2026.114110
- Authors
- Wilbertz, G., Trueg, A., Sonuga-Barke, E. J. S., Blechert, J., Philipsen, A., & Tebartz van Elst, L.
- Affiliations
- University of Freiburg (DE)
- University of Southampton (GB)
- Venue
- Journal of Abnormal Psychology
- Published
- 2013-05
- Volume
- 122
- Issue
- 2
- Pages
- 566-572
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2065245541
- Cited by
- 69
- References
- 36
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 4 · 2023: 1 · 2022: 3 · 2021: 7 · 2020: 8 · 2019: 7 · 2018: 8 · 2017: 5 · 2016: 4 · 2015: 9 · 2014: 4
- FWCI
- 4.01
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- other-oa
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- German Research Foundation (DFG BL 1009/2-1))
- German Federal Ministry of Education and Research (BMBF 01GV0606)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- delay aversion, attention deficit hyperactivity disorder, delay discounting, amygdala, emotional arousal, skin conductance, impulsivity, negative emotions
- MeSH terms
- Adult, Amygdala, Attention Deficit Disorder with Hyperactivity, Brain Mapping, Cerebral Cortex, Female, Frustration, Galvanic Skin Response, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Photic Stimulation, Task Performance and Analysis, Case-Control Studies
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