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. 


Arizona State University

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


 ODD: reward processing is measured through various ANS responses


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

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. 


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