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Haza B, Gosling CJ, Ciminaghi F, Conty L, Pinabiaux C. Research Review: Social cognition and everyday social skills in children and adolescents with attention-deficit/hyperactivity disorder: a meta-analysis of case-control studies. J Child Psychol Psychiatry 2024. [PMID: 38860431 DOI: 10.1111/jcpp.14006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Previous studies that have assessed social cognition in Attention-Deficit/Hyperactivity Disorder (ADHD) have produced inconsistent findings. To summarize these data and shed light upon moderators that may explain observed inconsistencies, we conducted a systematic review and meta-analysis exploring social cognition (Theory of Mind (ToM), Empathy, Facial and Non-Facial Emotion Recognition) and Everyday Social Skills in children and adolescents with ADHD. METHODS The current meta-analysis involved 142 studies including 652 effect sizes. These studies compared children and adolescents with ADHD (n = 8,300) and with typical development (n = 7,983). RESULTS Participants with ADHD exhibited moderate to very large deficits in ToM (SMD = 0.84, 95% CI = 0.68-0.99), Facial Emotion Recognition (SMD = 0.63, 95% CI = 0.46-0.81), and Everyday Social Skills (SMD = 1.23, 95% CI = 1.08-1.37). The magnitude of these impairments was similar when considering effect sizes adjusted for some covariates and the methodological quality of the studies. Few studies have investigated Empathy and Non-Facial Emotion Recognition, which precludes definitive conclusions. CONCLUSIONS Children and adolescents with ADHD experience robust impairments in ToM, Facial Emotion Recognition and Everyday Social Skills. Future studies should explore whether these deficits are a consequence of difficulties in other areas of cognition (e.g., executive functioning). We have made all our raw data open access to facilitate the use of the present work by the community (e.g., clinicians looking for tools, assessing social impairments, or researchers designing new studies).
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Affiliation(s)
- Belen Haza
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Corentin J Gosling
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
- Laboratory of Psychopathology and Health Process, Université Paris Cité, Boulogne Billancourt, France
- Faculty of Environmental and Life Sciences, School of Psychology, Centre for Innovation in Mental Health (CIMH), University of Southampton, Southampton, UK
| | - Flavia Ciminaghi
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Laurence Conty
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
| | - Charlotte Pinabiaux
- Laboratory of Cognitive Functioning and Dysfunctioning (DysCo), Université Paris Nanterre, Nanterre, France
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Chen Y, Ma Y, Fan X, Lyu J, Yang R. Facial expression recognition ability and its neuropsychological mechanisms in children with attention deficit and hyperactive disorder. Zhejiang Da Xue Xue Bao Yi Xue Ban 2024; 53:254-260. [PMID: 38650447 PMCID: PMC11057990 DOI: 10.3724/zdxbyxb-2023-0390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/17/2024] [Indexed: 04/25/2024]
Abstract
Attention deficit and hyperactive disorder (ADHD) is a chronic neurodevelopmental disorder characterized by inattention, hyperactivity-impulsivity, and working memory deficits. Social dysfunction is one of the major challenges faced by children with ADHD. It has been found that children with ADHD can't perform as well as typically developing children on facial expression recognition (FER) tasks. Generally, children with ADHD have some difficulties in FER, while some studies suggest that they have no significant differences in accuracy of specific emotion recognition compared with typically developing children. The neuropsychological mechanisms underlying these difficulties are as follows. First, neuroanatomically. Compared to typically developing children, children with ADHD show smaller gray matter volume and surface area in the amygdala and medial prefrontal cortex regions, as well as reduced density and volume of axons/cells in certain frontal white matter fiber tracts. Second, neurophysiologically. Children with ADHD exhibit increased slow-wave activity in their electroencephalogram, and event-related potential studies reveal abnormalities in emotional regulation and responses to angry faces when facing facial stimuli. Third, psychologically. Psychosocial stressors may influence FER abilities in children with ADHD, and sleep deprivation in ADHD children may significantly increase their recognition threshold for negative expressions such as sadness and anger. This article reviews research progress over the past three years on FER abilities of children with ADHD, analyzing the FER deficit in children with ADHD from three dimensions: neuroanatomy, neurophysiology and psychology, aiming to provide new perspectives for further research and clinical treatment of ADHD.
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Affiliation(s)
- Yi Chen
- Zhejiang University School of Medicine, Hangzhou 310058, China.
| | - Ye Ma
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Xiaoli Fan
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Jiamin Lyu
- Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Rongwang Yang
- Department of Psychology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou 310052, China.
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Bozkurt A, Yıldırım Demirdöğen E, Kolak Çelik M, Akıncı MA. An assessment of dynamic facial emotion recognition and theory of mind in children with ADHD: An eye-tracking study. PLoS One 2024; 19:e0298468. [PMID: 38329958 PMCID: PMC10852339 DOI: 10.1371/journal.pone.0298468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/24/2024] [Indexed: 02/10/2024] Open
Abstract
Deficits in social cognition in attention deficit hyperactivity disorder (ADHD) have been associated with difficulties in functioning. Since recognizing emotional facial expressions is essential for developing the perceptual components of the theory of mind (ToM), it is important to assess this relationship in children with ADHD. This study therefore compared the recognition of emotional stimuli and gaze patterns between children with ADHD and healthy children using eye-tracking with dynamic facial images. It also examined the relationship between facial emotion recognition accuracy, gaze patterns, ToM scores, and ADHD symptoms. Children with ADHD aged 8-13 (n = 47) and a control group (n = 38) completed a facial emotion recognition test, ToM tests, and the Conners' Parent Rating Scale. Participants' gaze patterns in response to dynamic facial emotion expressions were recorded using eye-tracking technology. Children with ADHD exhibited significantly lower accuracy in the recognition of the facial expressions of disgust and anger. The percentage fixation in the eye region was also significantly lower for happy, angry, sad, disgusted, and neutral emotions in the children with ADHD compared to the control group. No relationship was determined between the percentage of fixations on facial areas of interests and ADHD symptoms or ToM tests. This study provides evidence that children with ADHD experience deficits in visual attention to emotional cues. In addition, it suggests that facial emotion recognition deficits in children with ADHD represent a separate domain of social cognition that develops independently of ToM skills and core symptoms. Understanding and treating the social difficulties of individuals with ADHD may help improve their social functioning.
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Affiliation(s)
- Abdullah Bozkurt
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | | | - Müberra Kolak Çelik
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
| | - Mehmet Akif Akıncı
- Department of Child and Adolescent Psychiatry, Ataturk University, Erzurum, Türkiye
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Levy T, Dupuis A, Andrade BF, Crosbie J, Kelley E, Nicolson R, Schachar RJ. Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability. Eur Child Adolesc Psychiatry 2023; 32:2271-2280. [PMID: 36050559 DOI: 10.1007/s00787-022-02033-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14 years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.
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Affiliation(s)
- Tomer Levy
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Annie Dupuis
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Brendan F Andrade
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Elizabeth Kelley
- Department of Psychology and Center for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Rob Nicolson
- Department of Psychiatry, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada
| | - Russell James Schachar
- Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Yildirim Demİrdöğen E, Turan B, Gülşen M, Çubukçu HC, Dursun OB. Voluntary imitation of dynamic facial expressions in attention deficit hyperactivity disorder: a facial-behavior analysis. J Clin Exp Neuropsychol 2023; 45:915-927. [PMID: 38380655 DOI: 10.1080/13803395.2024.2320464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 01/28/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE The difficulties involved in social interaction among children with attention deficit hyperactivity disorder (ADHD) have been shown in many studies. Based on the knowledge that the imitation of facial expressions is a key factor in social interaction and functionality, the focus of prior studies has been on the evaluation of facial expressions in individuals with ADHD. However, little is known about voluntary facial mimicry in individuals with ADHD. In this context, we aimed to evaluate the voluntary-facial-imitation intensity of dynamic facial expressions in children with ADHD. METHOD Forty-one children with ADHD and 53 typically developing children were included in the study. Participants were presented with a video of six basic emotions and neutral facial expressions selected from the EU-Emotion Stimulus Set via a screen. After each emotion, the instruction "now imitate it" was given. While the children watched the video, their faces were recorded with a webcam. The intensity of the children's voluntary facial imitations was examined with a computer vision program (Openface) that performs facial analysis on recorded videos. RESULTS There was no significant difference between the groups in terms of facial emotion recognition accuracy. In group comparisons of voluntary facial mimicry, children with ADHD showed a significantly higher imitation intensity after emotional expressions of sadness, surprise and fear. There was no difference between the groups after the emotions of happiness, anger and disgust. CONCLUSION This non-obtrusive, noninvasive, and cost-effective method allowed us to measure the quantitative differences in facial mimicry between children with ADHD and typically developing children. Our results contribute new information to the literature by indicating which emotions can be used in the evaluation of social communication skills, as well as intervention targets for these skills, in children with ADHD.
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Affiliation(s)
- Esen Yildirim Demİrdöğen
- Department of Child and Adolescent Psychiatry, Atatürk University Medicine Faculty, Erzurum, Turkey
| | - Bahadır Turan
- Department of Child and Adolescent Psychiatry, Karadeniz Technical University Medicine Faculty, Trabzon, Turkey
| | - Murat Gülşen
- Department of Autism, Mental Special Needs and Rare Diseases, Turkish Ministry of Health, Ankara, Turkey
| | - Hikmet Can Çubukçu
- Department of Autism, Mental Special Needs and Rare Diseases, Turkish Ministry of Health, Ankara, Turkey
| | - Onur Burak Dursun
- Department of Autism, Mental Special Needs and Rare Diseases, Turkish Ministry of Health, Ankara, Turkey
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Alkalay S, Dan O. Effect of short-term methylphenidate on social impairment in children with attention deficit/hyperactivity disorder: systematic review. Child Adolesc Psychiatry Ment Health 2022; 16:93. [PMID: 36443766 PMCID: PMC9706974 DOI: 10.1186/s13034-022-00526-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 11/14/2022] [Indexed: 11/30/2022] Open
Abstract
Attention Deficit/Hyperactivity disorder (ADHD) is one of the most common disorders in school-age children. In addition to learning difficulties associated with the disorder's core symptoms of inattention and hyperactivity, children with ADHD display substantial social impairments. Methylphenidate (MPH) in formulations such as Ritalin or Concerta mitigates inattention and hyperactivity, but the effects of the therapy on social behavior in children with ADHD are not clear. This review aims to determine the effectiveness of short term (up to 6 months) MPH treatment on three domains of social skills in children aged 6-14 with ADHD: (i) Recognition of nonverbal emotional expressions, which are a marker of inherent (unlearned) social understanding, (ii) theory of mind (ToM) components that relate to learned cognition and social communication, and (iii) social competence in everyday environments. 15 relevant studies were identified based on inclusion/exclusion criteria. The results show mixed effects: the overall social performance as evaluated by parents, teachers or peers, and some components of ToM, were found to improve following a weeks-long course of MPH treatment. However, the effects of the medication are less clear when evaluating momentary/nonverbal social responses such as reactions to emotional facial expressions. While the findings of this review indicate that an MPH medication regime of order weeks to months could improve, to a degree, social impairment in children with ADHD, more studies are required to identify the medications' mechanism and confirm such a conclusion.
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Affiliation(s)
- Sarit Alkalay
- Department of Psychology, The Center for Psychobiological Research, Max Stern Jezreel Valley Academic College, P.O.B. 72, 10806, Sede Nahum, Israel.
| | - Orrie Dan
- Department of Psychology, The Center for Psychobiological Research, Max Stern Jezreel Valley Academic College, P.O.B. 72, 10806 Sede Nahum, Israel
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7
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Nejati V. Reading mind from the eyes in individuals with attention deficit-hyperactivity disorder (ADHD): A meta-analysis. Expert Rev Neurother 2022; 22:889-896. [PMID: 36420829 DOI: 10.1080/14737175.2022.2151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Individuals with ADHD struggle with social impairments. The present study aimed to find out the inconsistent results of theory of mind skill in individuals with ADHD. METHODS The current meta-analysis reviewed 17 empirical studies that compared theory of mind in individuals with and without ADHD based on reading mind from the eyes test (RMET). RESULTS Finding from 1620 participants with ADHD and 1249 healthy controls showed a significant impairment in theory of mind in individuals with ADHD (Hedges' g = 0.66). Moderator analyses indicated that the impaired theory of mind was not affected by age and gender. CONCLUSION These findings describe impaired theory of mind in individuals with ADHD and provide an insight to pay attention to theory of mind in respective clinical assessments and treatments.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411 Tehran, Iran
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8
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Levy T, Peskin M, Kohn Y, Sheinhorn S, Schoen G, Weizman A, Golubchik P. Callous-Unemotional Traits and Face-Emotion Recognition as Mediators in Conduct Problems of Children With ADHD. Clin Child Psychol Psychiatry 2022; 27:978-990. [PMID: 35608436 DOI: 10.1177/13591045221093876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) is associated with increased risk for conduct problems (CP), as well as with callous-unemotional traits (CUt) and lower accuracy in face emotional recognition (FER). It is unclear, however, whether CUt and low accuracy in FER contribute to the risk for CP in ADHD. The present study investigated the possibility of such contribution. METHODS This pilot study's participants included 31 children aged 7-17 years, diagnosed with ADHD, and treated in a psychiatric outpatient clinic. The parents rated their children on the ADHD Rating Scale, Inventory of Callous-Unemotional Traits, and the Child Behavior Checklist-Conduct Problems scale. Participants completed the Hebrew version of the children's Reading the Mind in the Eyes Test (cRMET)-a Theory of Mind measure. A bootstrapped multiple mediator model was used, adjusting for age and gender. RESULTS ADHD symptoms were associated with CP. This association was not mediated by CUt or cRMET. CUt was associated with CP independent of ADHD symptom severity. CONCLUSIONS ADHD symptoms and CUt both should be considered when assessing risk for CP and devising a treatment plan, in children with ADHD. Current results did not confirm the hypothesis that cRMET and CUt mediate between ADHD symptoms and CP. More studies employing larger samples, longitudinal design, and other emotion recognition measures are needed.
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Affiliation(s)
- Tomer Levy
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Behavior Regulation Services, Geha Mental Health Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Peskin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Preschool Department, Geha Mental Health Center, Petah Tikva, Israel
| | - Yoav Kohn
- Donald Cohen Child and Adolescent Psychiatry Department, Eitanim Psychiatric Hospital, Jerusalem Mental Health Center, Jerusalem, Israel.,Hadassah School of Medicine, Hebrew University, Jerusalem, Israel
| | - Sapir Sheinhorn
- Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tikva, Israel
| | - Gila Schoen
- Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tikva, Israel
| | - Abraham Weizman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Research Unit, Geha Mental Health Center, Petah Tikva, Israel.,Felsenstein Medical Research Center, Tel Aviv University, Petah Tikva, Israel
| | - Pavel Golubchik
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tikva, Israel
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Aral A, Onat M, Aydemir H. Functional outcomes of extended-release methylphenidate and atomoxetine in children: retrospective chart analysis. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2022. [DOI: 10.1186/s41983-022-00532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Recent guidelines emphasize the importance of functional outcomes in children with attention-deficit/hyperactivity disorder (ADHD). Here, we assess the functional outcomes of the oral delivery system of osmotic-release methylphenidate (OROS-MPH) and atomoxetine (ATX) from the retrospective review of the chart for the last 2 years in the clinic.
Results
Linear mixed-effects models were performed with outcome measures of difference in ADHD symptoms and functional impairment. After 9–12 weeks, OROS-MPH and ATX were statistically equivalent for total Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) scores (difference in slope is β = 0.004, p = 1.000). However, OROS-MPH was superior to ATX in terms of school domain (difference in slope is β = 0.139, p < 0.001); ATX was superior in the family domain (slope difference in slope is β = 0.103, p < 0.001). The other domains of functioning both were not responsive to pharmacotherapy and were similar between the two medications.
Conclusions
Optimal management should monitor functional progress in ADHD beyond the core symptoms. As expected, ADHD medications provide a distinct pattern of functional improvement. Pharmacotherapy alone offers promising and reliable outcomes to improve school and family functions in ADHD. Some functional improvements did not respond to the medication; therefore, many of the techniques derived from behavioral interventions should be considered.
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Mishra MV, Fry RM, Saad E, Arizpe JM, Ohashi YGB, DeGutis JM. Comparing the sensitivity of face matching assessments to detect face perception impairments. Neuropsychologia 2021; 163:108067. [PMID: 34673046 DOI: 10.1016/j.neuropsychologia.2021.108067] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 10/15/2021] [Accepted: 10/17/2021] [Indexed: 11/29/2022]
Abstract
Numerous neurological, developmental, and psychiatric conditions demonstrate impaired face recognition, which can be socially debilitating. These impairments can be caused by either deficient face perception or face memory mechanisms. Though there are well-validated, sensitive measures of face memory impairments, it currently remains unclear which assessments best measure face perception impairments. A sensitive, validated face perception measure could help with diagnosing causes of face recognition deficits and be useful in characterizing individual differences in unimpaired populations. Here, we compared the computerized Benton Face Recognition Test (BFRT-c) and Cambridge Face Perception Test (CFPT) in their ability to differentiate developmental prosopagnosics (DPs, N = 30) and age-matched controls (N = 30). Participants completed the BFRT-c, CFPT, and two additional face perception assessments: the University of Southern California Face Perception Test (USCFPT) and a novel same/different face matching test (SDFMT). Participants were also evaluated on objective and subjective face recognition tasks including the Cambridge Face Memory Test, famous faces test, and Prosopagnosia Index-20. We performed a logistic regression with the perception tests predicting DP vs. control group membership and used multiple linear regressions to predict continuous objective and subjective face recognition memory. Our results show that the BFRT-c performed as well as, if not better than, the CFPT, and that both tests clearly outperformed the USCFPT and SDFMT. Further, exploratory analyses revealed that face lighting-change conditions better predicted DP group membership and face recognition abilities than viewpoint-change conditions. Together, these results support the combined use of the BFRT-c and CFPT to best assess face perception impairments.
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Affiliation(s)
- Maruti V Mishra
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Boston Healthcare, Jamaica Plain Division, 150 S Huntington Ave., Boston, MA, USA
| | - Regan M Fry
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Boston Healthcare, Jamaica Plain Division, 150 S Huntington Ave., Boston, MA, USA
| | - Elyana Saad
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Joseph M Arizpe
- Science Applications International Corporation (SAIC), Fort Sam Houston, TX, USA
| | - Yuri-Grace B Ohashi
- Department of Psychology, Harvard University, Cambridge, MA, USA; Harvard Decision Science Laboratory, Harvard Kennedy School, Cambridge, MA, USA
| | - Joseph M DeGutis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Boston Attention and Learning Laboratory, VA Boston Healthcare, Jamaica Plain Division, 150 S Huntington Ave., Boston, MA, USA.
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Fantozzi P, Sesso G, Muratori P, Milone A, Masi G. Biological Bases of Empathy and Social Cognition in Patients with Attention-Deficit/Hyperactivity Disorder: A Focus on Treatment with Psychostimulants. Brain Sci 2021; 11:1399. [PMID: 34827398 PMCID: PMC8615705 DOI: 10.3390/brainsci11111399] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 10/18/2021] [Accepted: 10/22/2021] [Indexed: 12/16/2022] Open
Abstract
In recent years, there has been growing interest in investigating the effect of specific pharmacological treatments for ADHD not only on its core symptoms, but also on social skills in youths. This stands especially true for ADHD patients displaying impulsive aggressiveness and antisocial behaviors, being the comorbidity with Disruptive Behavior Disorders, one of the most frequently observed in clinical settings. This systematic review aimed to synthesize research findings on this topic following PRISMA guidelines and to identify gaps in current knowledge, future directions, and treatment implications. Search strategies included the following terms: ADHD; methylphenidate and other ADHD drugs; empathy, theory of mind and emotion recognition. Full-text articles were retrieved and data from individual studies were collected. Thirteen studies were finally included in our systematic review. Ten studies assessing changes in empathy and/or theory of mind in patients with ADHD treated after pharmacological interventions were identified. Similarly, seven partially overlapping studies assessing changes in emotion recognition were retrieved. Despite a great heterogeneity in the methodological characteristics of the included studies, most of them reported an improvement in emphatic and theory of mind abilities in youths with ADHD treated with psychostimulants and nonstimulant drugs, as well as positive but less consistent results about emotion recognition performances.
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Affiliation(s)
- Pamela Fantozzi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Department of Child and Adolescent Psychiatry and Psychopharmacology, 56128 Pisa, Italy; (P.F.); (G.S.); (P.M.); (A.M.)
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Fantozzi P, Muratori P, Caponi MC, Levantini V, Nardoni C, Pfanner C, Ricci F, Sesso G, Tacchi A, Milone A, Masi G. Treatment with Methylphenidate Improves Affective but Not Cognitive Empathy in Youths with Attention-Deficit/Hyperactivity Disorder. CHILDREN-BASEL 2021; 8:children8070596. [PMID: 34356575 PMCID: PMC8307630 DOI: 10.3390/children8070596] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/07/2021] [Accepted: 07/13/2021] [Indexed: 12/30/2022]
Abstract
Background: Beside the core symptoms, patients with attention-deficit/hyperactivity disorder (ADHD) frequently show relevant difficulty in developing relationships with peers. Although ADHD symptoms may account for social impairment, deficits in cognitive and/or affective empathy have also been involved. Our aim was to investigate the effect of methylphenidate (MPH) treatment on affective and cognitive empathy. Methods: Sixty-one drug-naïve youths with ADHD (age range 6 to 17 years, mean 10.3 ± 2.8 years, 51 males) naturalistically treated with MPH monotherapy were followed up for 6 months for ADHD symptoms and empathy, measured with the Basic Empathy Scale. Results: After being treated with MPH, the patients showed a significant improvement in affective and cognitive empathy scores. Linear regression models showed that changes in inattention symptoms predicted changes in affective but not in cognitive empathy, while changes in the hyperactivity/impulsivity symptoms did not predict changes in affective or cognitive empathy. Conclusions: Our study provides a further contribution for a better understanding of the possible effects of the MPH on youth’s characteristics.
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Affiliation(s)
- Pamela Fantozzi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
- Correspondence: ; Tel.: +39-050-886293
| | - Pietro Muratori
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Maria Celeste Caponi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Valentina Levantini
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Cristina Nardoni
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Chiara Pfanner
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Federica Ricci
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Gianluca Sesso
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
- Department of Clinical and Experimental Medicine, University of Pisa, 56126 Pisa, Italy
| | - Annalisa Tacchi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Annarita Milone
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
| | - Gabriele Masi
- IRCCS Stella Maris Foundation, Scientific Institute of Child Neurology and Psychiatry, Calambrone, 56128 Pisa, Italy; (P.M.); (M.C.C.); (V.L.); (C.N.); (C.P.); (F.R.); (G.S.); (A.T.); (A.M.); (G.M.)
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Dessoki HH, Amin OR, Soltan MR, Abbas MM, Dawoud ME. Social cognitive deficits in male children with attention deficit hyperactivity disorder in relation to salivary oxytocin level. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is evidence supporting a pathophysiological role of oxytocin in attention deficit hyperactive disorder (ADHD) especially hyperactive and combined subtypes. It is known that children with ADHD show a high rate of social cognitive problems regarding emotion recognition. Oxytocin was assumed to play a role in the emergence of social cognition deficits in ADHD. Aim of this study is to assess social cognition (emotion recognition) deficits in relation to oxytocin level in different subtypes of ADHD among the study group. Forty male patients with ADHD were recruited from psychiatric outpatient clinic of Fayoum University Hospital, were diagnosed according to DSM-5, and were assessed using Conner’s parent rating scale–revised (L). Social cognition measured by CANTAB emotion recognition task (ERT) and the level of salivary oxytocin was measured by ELISA technique.
Results
Combined subtype had been lower in correctly detecting the emotions of fear and anger. Predominately, hyperactive impulsive ADHD subtype was more rapid while detecting the emotions of surprise and disgust. There was significant negative correlation between age of onset of ADHD and errors in detecting the emotion of anger and positive correlation between age of onset of ADHD and errors in detecting the emotion of surprise. Correct detection of the emotion of happiness was associated with increased oxytocin level but the correct detection of the emotion of fear was inversely related to oxytocin level. No statistically significant difference between different subtypes of ADHD regarding salivary oxytocin level.
Conclusion
Oxytocin may play a role in social cognitive deficits in ADHD. The presence of social cognitive deficits in ADHD prompts further investigations to focus on the specificity of these deficits and in turn identify ways of managing them. Studying oxytocin in this population and its relation to social cognitive deficits can support the notion that oxytocin is a biological marker for ADHD.
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Recognition of emotional facial expressions in adolescents with attention deficit/hyperactivity disorder. J Adolesc 2020; 82:1-10. [PMID: 32442797 DOI: 10.1016/j.adolescence.2020.04.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/21/2020] [Accepted: 04/26/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Attention Deficit/Hyperactivity Disorder (ADHD) is associated with impaired social competencies, due in part to an inability to determine emotional states through facial expressions. Social interactions are a critical component of adolescence, which raises the question of how do adolescents with ADHD cope with this impairment. Yet, previous reviews do not distinguish between children and adolescents. This review focuses on the ability of adolescents (defined by the World Health Organization as 10-19 years old) with ADHD to recognize emotional facial expressions, when compared to their typically-developing peers. METHODS Comprehensive database search and analysis yielded 9 relevant studies published between 2008 and 2018. RESULTS The studies reviewed here examined recognition of emotional facial expressions in adolescents with ADHD. Behavioral measures (reaction time, reaction time variance and recognition accuracy) show no statistically significant differences between adolescents with ADHD and their typically-developing peers. However, neural responses as recorded using functional Magnetic Resonance Imaging (fMRI) or Event Related Potentials (ERP) find differences in brain activity and the temporal evolution of the reaction between the two groups. CONCLUSIONS Studies of children and of adults with ADHD find deficiencies in the recognition of emotional facial expressions. However, this review shows that adolescents with ADHD perform comparably to their peers on accuracy and rate, although their neural processing is different. This suggests that the methodologies employed by the ADHD and typically-developing adolescents to asses facial expressions are different. Further study is needed to determine what these may be.
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Kobayashi M, Ikeda T, Tokuda T, Monden Y, Nagashima M, Mizushima SG, Inoue T, Shimamura K, Ujiie Y, Arakawa A, Kuroiwa C, Ishijima M, Kishimoto Y, Kanazawa S, Yamagata T, Yamaguchi MK, Sakuta R, Dan I. Acute administration of methylphenidate differentially affects cortical processing of emotional facial expressions in attention-deficit hyperactivity disorder children as studied by functional near-infrared spectroscopy. NEUROPHOTONICS 2020; 7:025003. [PMID: 32377545 PMCID: PMC7201297 DOI: 10.1117/1.nph.7.2.025003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 04/16/2020] [Indexed: 06/11/2023]
Abstract
Significance: It has been reported that children with attention-deficit hyperactivity disorder (ADHD) have impairment in the recognition of angry but not of happy facial expressions, and they show atypical cortical activation patterns in response to facial expressions. However, little is known about neural mechanisms underlying the impaired recognition of facial expressions in school-aged children with ADHD and the effects of acute medication on their processing of facial expressions. Aim: We aimed to investigate the possibility that acute administration of methylphenidate (MPH) affects processing of facial expressions in ADHD children. Approach: We measured the hemodynamic changes in the bilateral temporo-occipital areas of ADHD children observing the happy and angry facial expressions before and 1.5 h after MPH or placebo administration in a randomized, double-blind, placebo-controlled, crossover design study. Results: We found that, regardless of medication, happy expressions induced increased oxyhemoglobin (oxy-Hb) responses in the right inferior occipital region but not in the superior temporal region. For angry expressions, oxy-Hb responses increased after MPH administration, but not after placebo administration, in the left inferior occipital area, whereas there was no significant activation before MPH administration. Conclusions: Our results suggest that (1) ADHD children consistently recruit the right inferior occipital regions to process happy expressions and (2) MPH administration to ADHD children enhances cortical activation in the left inferior occipital regions when they process angry expressions.
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Affiliation(s)
- Megumi Kobayashi
- Institute for Developmental Research, Aichi Developmental Disability Center, Department of Functioning and Disability, Kagiya-cho, Kasugai, Aichi, Japan
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
| | - Takahiro Ikeda
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Jichi Medical University, Department of Pediatrics, Yakushiji, Shimotsuke, Tochigi, Japan
| | - Tatsuya Tokuda
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Chuo University, Applied Cognitive Neuroscience Laboratory, Kasuga, Bunkyo, Tokyo, Japan
| | - Yukifumi Monden
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Jichi Medical University, Department of Pediatrics, Yakushiji, Shimotsuke, Tochigi, Japan
- Chuo University, Applied Cognitive Neuroscience Laboratory, Kasuga, Bunkyo, Tokyo, Japan
- International University of Health and Welfare, Department of Pediatrics, Iguchi, Nasushiobara, Tochigi, Japan
| | - Masako Nagashima
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Jichi Medical University, Department of Pediatrics, Yakushiji, Shimotsuke, Tochigi, Japan
| | - Sakae G. Mizushima
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Chuo University, Applied Cognitive Neuroscience Laboratory, Kasuga, Bunkyo, Tokyo, Japan
| | - Takeshi Inoue
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Dokkyo Medical University, Child Development and Psychosomatic Medicine Center, Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Keiichi Shimamura
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Dokkyo Medical University, Child Development and Psychosomatic Medicine Center, Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Yuta Ujiie
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Chuo University, Research and Development Initiative, Kasuga, Bunkyo, Tokyo, Japan
| | - Akari Arakawa
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Dokkyo Medical University, Child Development and Psychosomatic Medicine Center, Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Chie Kuroiwa
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Dokkyo Medical University, Child Development and Psychosomatic Medicine Center, Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Mayuko Ishijima
- Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, Japan
| | - Yuki Kishimoto
- Chuo University, Applied Cognitive Neuroscience Laboratory, Kasuga, Bunkyo, Tokyo, Japan
| | - So Kanazawa
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Japan Women’s University, Department of Psychology, Nishi-Ikuta, Tama, Kawasaki, Kanagawa, Japan
| | - Takanori Yamagata
- Jichi Medical University, Department of Pediatrics, Yakushiji, Shimotsuke, Tochigi, Japan
| | - Masami K. Yamaguchi
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Chuo University, Department of Psychology, Higashinakano, Hachioji, Tokyo, Japan
| | - Ryoichi Sakuta
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Dokkyo Medical University, Child Development and Psychosomatic Medicine Center, Minamikoshigaya, Koshigaya, Saitama, Japan
| | - Ippeita Dan
- RISTEX (Research Institute of Science and Technology for Society) Group, Kasuga, Bunkyo, Tokyo, Japan
- Chuo University, Applied Cognitive Neuroscience Laboratory, Kasuga, Bunkyo, Tokyo, Japan
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Golubchik P, Weizman A. Poor performance of the 'child Reading the Mind in the Eyes Test' correlates with poorer social-emotional functioning in children with attention-deficit/hyperactivity disorder. Int Clin Psychopharmacol 2020; 35:105-108. [PMID: 32000178 DOI: 10.1097/yic.0000000000000299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The performance of the 'child Reading the Mind in the Eyes Test' (cRMET), a measure of Theory of Mind (ToM), was assessed in children with attention-deficit/hyperactivity disorder (ADHD) with relation to social-emotional functioning and ADHD severity. The impact of a single dose of methylphenidate on cRMET performance was evaluated. A group of 25 children aged 7-17 years diagnosed with ADHD were assessed at baseline by cRMET, the Strengths and Difficulties Questionnaire (SDQ) and the ADHD-rating scale. cRMET assessment was repeated after administration of a single dose of methylphenidate. Significant correlation was found between the age of the participant and baseline cRMET levels (r = 0.56; P = 0.0037). Significant correlation was found between poorer cRMET performance and worse socioemotional functioning, as reflected by higher baseline SDQ scores (r = -0.39, P = 0.048). No significant correlations were found at baseline between cRMET scores and ADHD severity. No significant improvement in cRMET was detected following administration of a single methylphenidate dose. Poor baseline ToM functioning is associated with lower social-emotional functioning. The ToM functioning improves with age in children with ADHD, but is not affected by a single methylphenidate administration.
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Affiliation(s)
- Pavel Golubchik
- Child and Adolescent Outpatient Clinic, Geha Mental Health Center, Petah Tikva
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Abraham Weizman
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
- Research Unit, Geha Mental Health Center
- Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Petah Tikva, Israel
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Romani M, Vigliante M, Faedda N, Rossetti S, Pezzuti L, Guidetti V, Cardona F. Face memory and face recognition in children and adolescents with attention deficit hyperactivity disorder: A systematic review. Neurosci Biobehav Rev 2018; 89:1-12. [PMID: 29604300 DOI: 10.1016/j.neubiorev.2018.03.026] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/11/2018] [Accepted: 03/23/2018] [Indexed: 12/21/2022]
Abstract
This review focuses on facial recognition abilities in children and adolescents with attention deficit hyperactivity disorder (ADHD). A systematic review, using PRISMA guidelines, was conducted to identify original articles published prior to May 2017 pertaining to memory, face recognition, affect recognition, facial expression recognition and recall of faces in children and adolescents with ADHD. The qualitative synthesis based on different studies shows a particular focus of the research on facial affect recognition without paying similar attention to the structural encoding of facial recognition. In this review, we further investigate facial recognition abilities in children and adolescents with ADHD, providing synthesis of the results observed in the literature, while detecting face recognition tasks used on face processing abilities in ADHD and identifying aspects not yet explored.
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Affiliation(s)
- Maria Romani
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza - University of Rome, Via dei Sabelli, 108 - 00185, Rome, Italy.
| | - Miriam Vigliante
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza - University of Rome, Via dei Sabelli, 108 - 00185, Rome, Italy.
| | - Noemi Faedda
- PhD program in Behavioral Neuroscience, Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza - University of Rome, Via dei Sabelli, 108 - 00185, Rome, Italy.
| | - Serena Rossetti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 108 - 00185, Rome, Italy.
| | - Lina Pezzuti
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Via degli Apuli, 108 - 00185, Rome, Italy.
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza - University of Rome, Via dei Sabelli, 108 - 00185, Rome, Italy.
| | - Francesco Cardona
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, Sapienza - University of Rome, Via dei Sabelli, 108 - 00185, Rome, Italy.
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Borhani K, Nejati V. Emotional face recognition in individuals withattention-deficit/hyperactivity disorder: a review article. Dev Neuropsychol 2018; 43:256-277. [PMID: 29461118 DOI: 10.1080/87565641.2018.1440295] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This review focuses on facial emotion recognition (FER) in individuals with attention- deficit/hyperactivity disorder (ADHD). Behavioral studies of FER in ADHD have resulted in inconsistent findings. Here, we discuss the factors that vary across studies and the way that they influence FER processes in ADHD. Across reviewed studies, fear was the most deficient facial expression to be recognized. Our review suggested that FER deficit in ADHD does not alleviate across development and is partially distinct from ADHD symptoms. In conclusion, assessment of FER in ADHD and targeting that in interventional plans could lead to social skills improvement in ADHD.
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Affiliation(s)
- Khatereh Borhani
- a Institute for Cognitive and Brain Sciences , Shahid Beheshti University , Tehran , Iran
| | - Vahid Nejati
- b Faculty of Education and Psychology, Department of Psychology , Shahid Beheshti University , Tehran , Iran
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Sturman N, Deckx L, van Driel ML. Methylphenidate for children and adolescents with autism spectrum disorder. Cochrane Database Syst Rev 2017; 11:CD011144. [PMID: 29159857 PMCID: PMC6486133 DOI: 10.1002/14651858.cd011144.pub2] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Children with autistic spectrum disorder (ASD) frequently present with inattention, impulsivity and hyperactivity, which are the cardinal symptoms of attention deficit hyperactivity disorder (ADHD). The effectiveness of methylphenidate, a commonly used ADHD treatment, is therefore of interest in these children. OBJECTIVES To assess the effects of methylphenidate for symptoms of ADHD (inattention, impulsivity and hyperactivity) and ASD (impairments in social interaction and communication, and repetitive, restricted or stereotypical behaviours) in children and adolescents aged 6 to 18 years with ASD. SEARCH METHODS In November 2016, we searched CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, 11 other databases and two trials registers. We also checked reference lists and contacted study authors and pharmaceutical companies. SELECTION CRITERIA Randomised controlled trials (RCTs) that investigated the effect of methylphenidate versus placebo on the core symptoms of ASD or ADHD-like symptoms, or both, in children aged 6 to 18 years who were diagnosed with ASD or pervasive developmental disorder. The primary outcome was clinical efficacy, defined as an improvement in ADHD-like symptoms (inattention, impulsivity and hyperactivity) and in the core symptoms of ASD (impaired social interaction, impaired communication, and stereotypical behaviours), and overall ASD. Secondary outcomes examined were: rate of adverse events; caregiver well-being; need for institutionalisation, special schooling or therapy to achieve learning outcomes; and overall quality of life. DATA COLLECTION AND ANALYSIS We used standard Cochrane methodological procedures. We combined outcome measures that used different psychometric scales, where clinically appropriate. We used a coefficient of 0.6 to calculate standard deviations and adjust for the studies' cross-over design. We considered a standardised mean difference (SMD) of 0.52 as the minimum clinically relevant inter-treatment difference. We applied the GRADE rating for strength of evidence for each outcome. MAIN RESULTS The studies: we included four cross-over studies, with a total of 113 children aged 5 to 13 years, most of whom (83%) were boys. We included two studies with five-year-old children since we were unable to obtain the disaggregated data for those aged six years and above, and all other participants were in our target age range. All participants resided in the USA. The duration of treatment in the cross-over phase was one week for each dose of methylphenidate. Studies used a range of outcome scales, rated by parents, teachers or both; clinicians; or programme staff. We report parent-rated outcomes separately. Risk of bias: we considered three trials to be at high risk of bias due to selective reporting and all trials to be at unclear risk of bias for blinding of participants and assessors, due to the potential for recognising the side effects of methylphenidate. We judged all trials to be at low or unclear risk of bias for other items. Primary outcomes: the meta-analysis suggested that high-dose methylphenidate (0.43 mg/kg/dose to 0.60 mg/kg/dose) had a significant and clinically relevant benefit on hyperactivity, as rated by teachers (SMD -0.78, 95% confidence interval (CI) -1.13 to -0.43; 4 studies, 73 participants; P < 0.001; low-quality evidence) and parents (mean difference (MD) -6.61 points, 95% CI -12.19 to -1.03, rated on the hyperactivity subscale of the Aberrant Behviour Checklist, range 0 to 48; 2 studies, 71 participants; P = 0.02; low-quality evidence). Meta-analysis also showed a significant but not clinically relevant benefit on teacher-rated inattention (MD -2.72 points, 95% CI -5.37 to -0.06, rated on the inattention subscale of the Swanson, Nolan and Pelham, Fourth Version questionnaire, range 0 to 27; 2 studies, 51 participants; P = 0.04; low-quality evidence). There were inadequate data to conduct a meta-analysis on the symptom of impulsivity. There was no evidence that methylphenidate worsens the core symptoms of ASD or benefits social interaction (SMD -0.51, 95% CI -1.07 to 0.05; 3 studies, 63 participants; P = 0.07; very low-quality evidence), stereotypical behaviours (SMD -0.34, 95% CI -0.84 to 0.17; 3 studies, 69 participants; P = 0.19; low-quality evidence), or overall ASD (SMD -0.53, 95% CI -1.26 to 0.19; 2 studies, 36 participants; P = 0.15; low-quality evidence), as rated by teachers. There were inadequate data to conduct a meta-analysis on the symptom of impaired communication. SECONDARY OUTCOMES no data were available for the secondary outcomes of caregiver well-being; need for institutionalisation, special schooling options or therapy to achieve learning outcomes; or overall quality of life. No trials reported serious adverse events. The only adverse effect that was significantly more likely with treatment was reduced appetite as rated by parents (risk ratio 8.28, 95% CI 2.57 to 26.73; 2 studies, 74 participants; P < 0.001; very low-quality evidence). Subgroup analysis by dose did not identify any significant differences in effect on our primary outcomes between low-, medium- or high-dose ranges. AUTHORS' CONCLUSIONS We found that short-term use of methylphenidate might improve symptoms of hyperactivity and possibly inattention in children with ASD who are tolerant of the medication, although the low quality of evidence means that we cannot be certain of the true magnitude of any effect. There was no evidence that methylphenidate has a negative impact on the core symptoms of ASD, or that it improves social interaction, stereotypical behaviours, or overall ASD. The evidence for adverse events is of very low quality because trials were short and excluded children intolerant of methylphenidate in the test-dose phase. Future RCTs should consider extending the duration of treatment and follow-up. The minimum clinically important difference also needs to be confirmed in children with ASD using outcome scales validated for this population.
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Affiliation(s)
- Nancy Sturman
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
| | - Laura Deckx
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
| | - Mieke L van Driel
- The University of QueenslandPrimary Care Clinical Unit, Faculty of MedicineHerstonBrisbaneQueenslandAustralia4029
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Coutinho TV, Reis SPS, da Silva AG, Miranda DM, Malloy-Diniz LF. Deficits in Response Inhibition in Patients with Attention-Deficit/Hyperactivity Disorder: The Impaired Self-Protection System Hypothesis. Front Psychiatry 2017; 8:299. [PMID: 29403397 PMCID: PMC5786525 DOI: 10.3389/fpsyt.2017.00299] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 12/14/2017] [Indexed: 12/24/2022] Open
Abstract
Problems in inhibitory control are regarded in Psychology as a key problem associated with attention-deficit/hyperactivity disorder (ADHD). They, however, might not be primary deficits, but instead a consequence of inattention. At least two components have been identified and dissociated in studies in regards to inhibitory control: interference suppression, responsible for controlling interference by resisting irrelevant or misleading information, and response inhibition, referring to withholding a response or overriding an ongoing behavior. Poor error awareness and self-monitoring undermine an individual's ability to inhibit inadequate responses and change course of action. In non-social contexts, an individual depends on his own cognition to regulate his mistakes. In social contexts, however, there are many social cues that should help that individual to perceive his mistakes and inhibit inadequate responses. The processes involved in perceiving and interpreting those social cues are arguably part of a self-protection system (SPS). Individuals with ADHD not only present impulsive behaviors in social contexts, but also have difficulty perceiving their inadequate responses and overriding ongoing actions toward more appropriate ones. In this paper, we discuss that those difficulties are arguably a consequence of an impaired SPS, due to visual attention deficits and subsequent failure in perceiving and recognizing accurately negative emotions in facial expressions, especially anger. We discuss evidence that children with ADHD exhibit problems in a series of components involved in the activation of that system and advocate that the inability to identify the anger expressed by others, and thus, not experiencing the fear response that should follow, is, ultimately, what prevents them from inhibiting the ongoing inappropriate behavior, since a potential threat is not registered. Getting involved in high-risk situations, such as reckless driving, could also be a consequence of not registering a threat and thus, not experiencing fear.
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Affiliation(s)
- Thales Vianna Coutinho
- Laboratório de Investigações em Neurociência CLínica, Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,iLumina Neurociências, Belo Horizonte, Brazil
| | - Samara Passos Santos Reis
- Quantitative Methods and Predictive Psychometrics Laboratory, Department of Psychology, Universidade Federal da Bahia, Salvador, Brazil
| | | | | | - Leandro Fernandes Malloy-Diniz
- Laboratório de Investigações em Neurociência CLínica, Department of Mental Health, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,iLumina Neurociências, Belo Horizonte, Brazil
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