The relationship between night eating symptoms, impulsivity, and inhibitory control in adolescents with attention deficit/ hyperactivity disorder

Objective: This study aimed to determine the prevalence and severity of night eating symptoms in adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD), to examine the associations between night eating symptoms, impulsivity, and inhibitory control, and to compare these characteristics with those of healthy peers. Material and Methods: A total of 166 adolescents aged 11–18 years were included in the study. Eighty-two participants were diagnosed with ADHD, while 84 healthy adolescents constituted the control group. All participants completed the Sociodemographic Data Form, Night Eating Questionnaire (NEQ), Eating Disorder Examination Questionnaire-13 (EDE-Q-13), Barratt Impulsiveness Scale-11 Short Form (BIS-11-SF), Conners Parent Rating Scale-48 (CPRS-48), and Revised Child Anxiety and Depression Scale (RCADS). Inhibitory control functions were assessed using the antisaccade task and the No-Go/fixation task administered with the Gazepoint GP3 eye-tracking system. Group comparisons, correlation analyses, and multiple linear regression analyses were performed. Results: Night eating symptoms were significantly higher in the ADHD group compared with the control group (p=0.007). Participants with NEQ scores of 25 or higher were more likely to belong to the ADHD group (p=0.027). Adolescents with ADHD demonstrated significantly higher levels of impulsivity, ADHD symptoms, eating disorder symptoms, and anxiety-depression symptoms than healthy controls (all p<0.05). In the antisaccade task, the ADHD group showed lower numbers of correct antisaccades and correct fixations, whereas direction errors, omission errors, and commission errors were significantly higher (all p<0.05). Correlation analyses revealed that night eating symptoms were positively associated with impulsivity and anxiety-depression symptoms. Multiple linear regression analysis demonstrated that only anxiety-depression symptoms independently predicted night eating symptoms (p=0.038). In a second regression model including impulsivity and emotional symptom subscales, only major depressive symptoms remained a significant independent predictor of night eating symptoms (p<0.001). Antisaccade performance parameters did not independently predict night eating symptoms. Conclusions: The findings of this study indicate that night eating symptoms are more prevalent among adolescents with ADHD compared to healthy peers. Although night eating symptoms were associated with impulsivity and emotional symptoms, no significant relationship was identified with objective indicators of inhibitory control obtained through eye-tracking measures. Multivariable analyses further demonstrated that depressive symptoms were the strongest independent predictors of night eating symptoms. These findings emphasize the importance of considering emotional factors and emotion regulation processes when evaluating night eating behaviors in adolescents with ADHD. Keywords: Attention-deficit/hyperactivity disorder, Night eating symptoms, Impulsivity, Inhibitory control, Antisaccade, Adolescent.