Brain response to facial expressions in adults with adolescent ADHD

Emotion Recognition Accuracy Among Individuals With ADHD: A Systematic Review

OBJECTIVE

The aim of the present systematic review was to consolidate findings related to emotion recognition accuracy among individuals with attention deficit hyperactivity disorder (ADHD). The review also examined emotion recognition accuracy assessment methods as well as the contribution of gender to emotional recognition accuracy.

METHOD

A total of 43 articles were identified based on inclusion criteria using PRISMA guidelines for article retrieval.

RESULTS

58% of retrieved articles reported significantly decreased emotion recognition accuracy among individuals with ADHD relative to neurotypical peers, with either global or emotion-specific differences identified. Notably, studies finding a significant difference in emotion recognition accuracy were of significantly lower quality according to a quality review checklist than the articles finding no difference (p < .001). For example, when use of control conditions and multiple measures of emotion recognition accuracy were employed, no study found a significant difference in emotion recognition accuracy between individuals with and without ADHD. Regarding potential gender differences, not a single study included gender diversity beyond sex assigned at birth. The majority (86%) of studies included a predominantly male sample, with 15% including only male participants. While differences in emotion recognition accuracy were found between male and female participants in 7% of cases, future research is needed to identify the contribution of gender diversity.

Establishing the Relationship Between Attention Deficit Hyperactivity Disorder and Emotional Facial Expression Recognition Deficit: A Systematic Review

OBJECTIVE

In this review, we examined if there is a deficit in facial recognition of emotion (FER) in children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD).

BACKGROUND

Emotional regulation is impaired in ADHD. Although a facial emotion recognition deficit has been described in this condition, the underlying causal mechanisms remain unclear.

METHODS

The search was performed in six databases in September 2022. Studies assessing children, adolescents, or adults with isolated or comorbid ADHD that evaluated participants using a FER task were included.

RESULTS

Twelve studies out of 385 were selected, with participants ranging in age from 6 to 37.1 years. A deficit in FER specific to ADHD, or secondary to comorbid autism spectrum disorder, anxiety, and oppositional symptoms, was found.

CONCLUSIONS

There is a FER deficit in patients with ADHD. Adults showed improved recognition accuracy, reflecting partial compensation. ADHD symptoms and comorbidities appear to influence FER deficits.

Neural Correlates of Reactive Aggression in Adult Attention-Deficit/Hyperactivity Disorder

Despite not being part of the core diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD), emotion dysregulation is a highly prevalent and clinically important component of (adult) ADHD. Emotionally dysregulated behaviors such as reactive aggression have a significant impact on the functional outcome in ADHD. However, little is known about the mechanisms underlying reactive aggression in ADHD. In this study, we aimed to identify the neural correlates of reactive aggression as a measure of emotionally dysregulated behavior in adults with persistent ADHD during implicit emotion regulation processes. We analyzed associations of magnetic resonance imaging-based whole-brain activity during a dynamic facial expression task with levels of reactive aggression in 78 adults with and 78 adults without ADHD, and also investigated relationships of reactive aggression with symptoms and impairments. While participants with ADHD had higher reactive aggression scores than controls, the neural activation patterns of both groups to processing of emotional faces were similar. However, investigating the brain activities associated with reactive aggression in individuals with and without ADHD showed an interaction of diagnosis and reactive aggression scores. We found high levels of activity in the right insula, the hippocampus, and middle and superior frontal areas to be particularly associated with high reactive aggression scores within the ADHD group. Furthermore, the limbic activity was associated with more hyperactivity/impulsivity symptoms. These results suggest a partly differential mechanism associated with reactive aggression in ADHD as compared to controls. Emotional hyper-reactivity in the salience network as well as more effortful top-down regulation from the self-regulation network might contribute to emotionally dysregulated behavior as measured by reactive aggression.

The effect of attention deficit hyperactivity disorder comorbidity on cognitive functions and severity of addiction in opioid use disorder

The aim of this study is to determine the changes in social cognition and other cognitive domains in ADHD comorbidity and to investigate the possible moderation role of these changes in OUD. A hundered inpatients with OUD were included in the study. Cognitive functions, severity of addiction and symptomatology of ADHD were evaluated. ASRS and API scores were in positive correlation and ASRS scores had a moderating effect on the relationship between craving score and emotion recognition. Our study shows that changes in social environment/cognition play an important role in the follow-up/treatment of patients.