Impulsivity Moderates End-of-Cycle but not Midcycle Effects on Executive Function and ADHD Symptoms

Michelle M. Martel; Patrick K. Goh; Ashley G. Eng; Urveesha Nirjar; Krystina N. Monticello; Carleigh A. Litteral; Tory A. Eisenlohr-Moul

doi:10.1007/s10862-025-10245-5

Impulsivity Moderates End-of-Cycle but not Midcycle Effects on Executive Function and ADHD Symptoms

Michelle M. Martel
, Patrick K. Goh
, Ashley G. Eng
, Urveesha Nirjar
, Krystina N. Monticello
, Carleigh A. Litteral
, Tory A. Eisenlohr-Moul

Research output: Contribution to journal › Article › peer-review

Abstract

While previous research has proposed the existence of hormonally sensitive subtypes in other psychopathologies, such as depression, it remains unknown whether impulsivity is a hormone-sensitive phenotype for disorders like attention-deficit/hyperactivity disorder (ADHD). The current paper offers a novel contribution by investigating this concept within a sample of women characterized by high impulsivity, specifically ADHD, as they are monitored daily across the menstrual cycle, with data collected on ADHD symptoms, trait impulsivity, and task and self-ratings of executive function. The study sample was 103 young adults, aged 18 to 25, who had regular menstrual cycles and were monitored for one month, during which phase-specific data were collected. Diagnostic and trait data was collected at an initial diagnostic visit at the beginning the cycle (mid-follicular phase), self-reported ADHD symptoms were assessed daily, while self-reported executive functioning and response inhibition and working memory tasks were evaluated over four cycle phases, namely at the mid-follicular, post-ovulatory, mid-luteal, and perimenstrual phases. Study findings suggested ADHD symptoms and cognition are worse in more impulsive women and that cycle effects appear more salient for those lower in trait impulsivity. Namely, results of the current study indicated that the midfollicular phase was risky for self reported EF deficits compared to the midluteal phase which seemed protective not just for self reported EF deficits but also inattentive symptoms. In contrast, the postovulatory period seemed particularly risky for hyperactivity symptoms. Effects were more salient at low levels of impulsivity and mainly carried by negative urgency. At lower levels of positive urgency, the midluteal phase seemed protective for working memory performance. Impulsivity, similar to negative affect or PMDD, may be a hormone-sensitive phenotype in women with ADHD.

Original language	English
Article number	67
Journal	Journal of Psychopathology and Behavioral Assessment
Volume	47
Issue number	3
DOIs	https://doi.org/10.1007/s10862-025-10245-5
State	Published - Sep 2025

Bibliographical note

Publisher Copyright:
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.

Funding

The authors thank all participants for making this work possible. Materials and analysis code for this study are available by emailing the corresponding author. The datasets generated and analyzed for the current study are publicly available through the NIH NDA. The authors complied with APA ethical standards in the treatment of their participants and ethics approval was obtained from the Institutional Review Board at the University of Kentucky. This research was supported by grants from the National Institutes of Health (R01-MH119119 (MMM, TAEM), T32-AA027488 (AGE), R01MH126940 (TAEM), and RF1MH120843 (TAEM). All authors contributed to the manuscript with most writing and analysis done by MMM and PKG and revisions and other contributing work done by the remaining authors. The authors have no relevant financial or non-financial interests to disclose.

Funders	Funder number
University of Kentucky
National Institutes of Health (NIH)	R01-MH119119, T32-AA027488, R01MH126940
TAEM	RF1MH120843

Keywords

ADHD
Executive function
Impulsivity
Menstrual cycle

ASJC Scopus subject areas

Clinical Psychology

Access to Document

10.1007/s10862-025-10245-5

Cite this

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title = "Impulsivity Moderates End-of-Cycle but not Midcycle Effects on Executive Function and ADHD Symptoms",

abstract = "While previous research has proposed the existence of hormonally sensitive subtypes in other psychopathologies, such as depression, it remains unknown whether impulsivity is a hormone-sensitive phenotype for disorders like attention-deficit/hyperactivity disorder (ADHD). The current paper offers a novel contribution by investigating this concept within a sample of women characterized by high impulsivity, specifically ADHD, as they are monitored daily across the menstrual cycle, with data collected on ADHD symptoms, trait impulsivity, and task and self-ratings of executive function. The study sample was 103 young adults, aged 18 to 25, who had regular menstrual cycles and were monitored for one month, during which phase-specific data were collected. Diagnostic and trait data was collected at an initial diagnostic visit at the beginning the cycle (mid-follicular phase), self-reported ADHD symptoms were assessed daily, while self-reported executive functioning and response inhibition and working memory tasks were evaluated over four cycle phases, namely at the mid-follicular, post-ovulatory, mid-luteal, and perimenstrual phases. Study findings suggested ADHD symptoms and cognition are worse in more impulsive women and that cycle effects appear more salient for those lower in trait impulsivity. Namely, results of the current study indicated that the midfollicular phase was risky for self reported EF deficits compared to the midluteal phase which seemed protective not just for self reported EF deficits but also inattentive symptoms. In contrast, the postovulatory period seemed particularly risky for hyperactivity symptoms. Effects were more salient at low levels of impulsivity and mainly carried by negative urgency. At lower levels of positive urgency, the midluteal phase seemed protective for working memory performance. Impulsivity, similar to negative affect or PMDD, may be a hormone-sensitive phenotype in women with ADHD.",

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note = "Publisher Copyright: {\textcopyright} The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025.",

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AU - Monticello, Krystina N.

AU - Litteral, Carleigh A.

AU - Eisenlohr-Moul, Tory A.

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Impulsivity Moderates End-of-Cycle but not Midcycle Effects on Executive Function and ADHD Symptoms

Abstract

Bibliographical note

Funding

Keywords

ASJC Scopus subject areas

Access to Document

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Cite this