Shared and Unique Patterns of Dysregulated Dual Systems Between Adolescent Problematic Video Gaming and ADHD

The association between problematic video gaming (PVG) and ADHD has long attracted attention. Dual-systems models posit that reward sensitivity (RS, the tendency to pursue rewards), inhibitory control (IC, the capacity to suppress prepotent responses), and the imbalance between them (where one system predominates over the other) constitute a useful framework for explaining their association. However, empirical tests of whether and how specific dual-system mechanisms explain the association or phenotypic differentiation of PVG and ADHD remain limited. We hypothesize that (H1) both RS and IC predict PVG and ADHD symptoms; (H2) the degree of imbalance between RS and IC is associated with both PVG and ADHD. Additionally, we explore whether the specific associations between imbalance and symptoms differ between PVG and ADHD. Two waves of data from 10,973 participants (52.43% male, aged 12-14 years) from the Adolescent Brain Cognitive Development (ABCD) study were analyzed. Cross-lagged panel models (CLPM) and Response Surface Analysis (RSA) were used to assess shared and unique relationships of RS, IC, and their imbalance with PVG and ADHD. CLPM analyses found that RS predicted subsequent IC, IC predicted subsequent ADHD, and ADHD predicted subsequent PVG, suggesting H1 was only partially supported. RSA revealed that a greater degree of imbalance was associated with more severe PVG and ADHD symptoms (supporting H2), and that imbalance configurations exhibited both shared and disorder-specific patterns between PVG and ADHD. Specifically, reward sensitivity showed a linear association with PVG but a curvilinear association with ADHD, and IC correlated with ADHD only. We observed similarities between PVG and ADHD in the degree of dual-systems imbalance, alongside differences in imbalance configuration. These findings provide theoretical insight into dual-systems features linking PVG and ADHD and may inform future research on early identification and prevention in high-risk populations.