The PEP of the heart is an index of the sympathetic nervous system used to measure reward sensitivity. Research shows that people with ODD and comorbid ADHD present low PEP reactivity to monetary rewards. Additionally, there was a correlation between gender specific aggression and PEP low reactivity to monetary rewards in boys and male adolescents. 


Reward processing and ODD measured through the PEP


Low resting HR is used as an ANS indicator of reduced reactivity to rewarding stimuli. This is because a low resting HR is typically linked to an unpleasant state. People with ODD must seek out higher levels of stimulation to achieve a pleasant state. 


Reward Processing Sensitivity Has Been Linked to HR


- Pre-ejection period (PEP)
- Heart rate (HR)


Arizona State University

- Autonomic Nervous System: heart functioning
- Brain Areas elated to Reward Processing: amygdala and orbitofrontal cortex
- Neurotransmitters: dopaminergic systems


Ways Reward Processing Sensitivty is Measured in People With ODD


Matthys, Vanderschuren, L. J. M. J., & Schutter, D. J. L. G. (2013). The neurobiology of oppositional defiant disorder and conduct disorder: Altered functioning in three mental domains. Development and Psychopathology, 25(1), 193–207. https://doi.org/10.1017/S0954579412000272

The neurobiology of oppositional defiant disorder and conduct disorder: Altered functioning in three mental domains

The amygdala plays a role in the experience of positive emotions and the determination of the appeal of stimuli. Since people with ODD have a dysfunctioning amygdala, they require increased levels of stimulation to experience positive emotions and interest/appeal. 


ODD: the amygdala and reward processing

 ODD: reward processing is measured through various ANS responses



Research states that lower activity in the brain’s dopaminergic systems result in decreased reward processing and result in a lack in motivation to obtain the feeling of reward. 


People with ODD have dysfunctional dopaminergic systems 


Research indicates that deficiencies in reward sensitivity in DBD’s are partially influenced by deficits in the orbitofrontal cortex because it disrupts stimulus-response learning and processing.  This results in response perserveration.


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