Controlling attention to gaze and arrows in attention deficit hyperactivity disorder

Social face processing in chronic severe traumatic brain injury: Altered decoding of emotions and mental states but preserved gaze cueing of attention

The processing of social information transmitted by facial stimuli is altered in individuals with traumatic brain injury (TBI). This study investigated whether these alterations also affect the mechanisms underlying the orienting of visual attention in response to eye-gaze signals. TBI patients and a control group of healthy individuals matched on relevant criteria completed a spatial cueing task. In this task, a lateral visual target was presented along with a task-irrelevant face, with the gaze averted to the left or right. Arrows pointing towards the left or right were also used as non-social control stimuli. Social cognition abilities were further investigated through tests based on decoding emotional expressions and mental states conveyed by facial stimuli. The decoding of emotions and mental states was worse in the TBI group than in the control group. However, both groups demonstrated reliable and comparable orienting of attention to both eye-gaze and arrow stimuli. Despite impairments in certain aspects of social face processing among TBI patients, gaze cueing of attention appears to be preserved in this neuropsychological population.

The reverse congruency effect elicited by eye-gaze as a function of attention-deficit/hyperactivity disorder symptoms

Individuals diagnosed with attention deficit/hyperactivity disorder (ADHD) have been found to have impairments in multiple aspects of social cognition, thus including the attentional processing of socially relevant stimuli such as eye-gaze. However, to date, it remains unclear whether only the social-specific but not the domain-general directional components, elicited by eye-gaze are affected by ADHD symptomatology. To address this issue, the present study aimed to investigate the impact of ADHD-like traits on the social-specific attentional processing of eye-gaze. To this purpose, we conducted an online experiment with a sample of 140 healthy undergraduate participants who completed two self-reported questionnaires designed to assess ADHD-like traits, and a social variant of an interference spatial task known to effectively isolate the social-specific component of eye-gaze. To make our research plan transparent, our hypotheses, together with the plans of analyses, were registered before data exploration. Results showed that while the social-specific component of eye-gaze was evident in the sample, no significant correlation was found between this component and the measured ADHD-like traits. These results appear to contradict the intuition that the attentional processing of the social-specific components of eye-gaze may be impaired by ADHD symptomatology. However, further research involving children and clinical populations is needed in order to clarify this matter.

Below average motor skills predict victimization from childhood bullies: A study of adults with ADHD

Children with ADHD are frequently clumsy and involved in bullying, both as victims and perpetrators. The relationship between motor skills and bully status is poorly understood. The aim of the current study was to evaluate the effect of motor skills in childhood on bully victimization/perpetration in those with ADHD. In this cross-sectional study, 403 adults diagnosed with ADHD filled out a questionnaire on their recall of bully victimization, bully perpetration, performance in physical education (PE) (defined as performance below average in i.e., ball dexterity, coordination or agility) as a proxy for motor skills, and academic skills at age 12, as compared to their peers. Of the current sample, 63% remembered being victimized and 31% noted they were perpetrators. Thirty-two percent recalled that they performed below average in PE. Being diagnosed with ADHD and having poor motor skills was strongly associated with bully victimization (OR = 2.63; 95% CI:1.62, 4.27, p < .001). Victimization was more common during all measured time periods, from nursery school until the age of 15, among those with poor performance in PE as compared to those without poor performance. No relationship was found between poor motor skills and bully perpetration. CONCLUSION: A crucial role of the cerebellum is coordination and the linking of sequenced motor actions through milli-second timing. Aberrations in this ability makes a person present as "different", which was stated as the most common reason for social exclusion by other children. Therefore, subtle clumsiness (presumed by poor performance in PE class) is suggested to mirror deficits in social skills, which is intuitively observed by peers, leading to victimization.

The Quality of Everyday Eye Contact in Williams Syndrome: Insights From Cross-Syndrome Comparisons

Past research shows that individuals with Williams syndrome (WS) have heightened and prolonged eye contact. Using parent report measures, we examined not only the presence of eye contact but also its qualitative features. Study 1 included individuals with WS (n = 22, ages 6.0-36.3). Study 2 included children with different neurodevelopmental (ND) conditions (WS, autism spectrum condition, fragile X syndrome, attention-deficit/hyperactivity disorder) and children with neurotypical development (NT; n = 262, ages 4.0-17.11). Unusual eye contact features, including staring, were found in approximately half of the WS samples. However, other features such as brief glances were frequently found in WS and in all ND conditions, but not NT. Future research in ND conditions should focus on qualitative as well as quantitative features of eye contact.

Disrupted Attention to Other's Eyes is Linked to Symptoms of ADHD in Childhood

Attention-deficit/hyperactivity disorder (ADHD) is associated with impaired social interaction. Other's eyes are important for understanding the social world. Here, we examined concurrent and longitudinal links between attention to other's eyes and symptoms of ADHD and comorbid externalizing and internalizing symptoms. Eighty-two 8 to 13-year-old children (40% with ADHD) participated. The latency to a first gaze shift to and away from the eye region of human faces, when primed to look at either the eyes or the mouth, was recorded with eye tracking. Parents rated ADHD, externalizing and internalizing symptoms at the time of testing and at 2-year follow-up. The results show that longer looking at the eyes before reorienting was specifically associated with concurrent and future symptoms of inattention, even when accounting for comorbid symptoms. We conclude that the temporal microstructure of attention to other's eyes is altered in children with symptoms of ADHD, which may contribute to social impairments.

Social and non-social gaze cueing in autism spectrum disorder, attention-deficit/hyperactivity disorder and a comorbid group

Recent trends in literature, along with the changes to the Diagnostic and Statistical Manual (DSM), make it imperative to study Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) together, in order to better understand potential aetiological commonalities between these highly comorbid disorders. The present study examines social cueing, a highly studied construct in ASD, and intra-subject variability (ISV), a potential endophenotype of ADHD, in four groups of typically developing (TD), ADHD, ASD- (ASD without ADHD), ASD+ (ASD with ADHD) participants (N = 85) aged 10-13 years. Results showed that social cueing is intact in the 'pure' ASD group when task expectations are clear. The ADHD group showed faster saccadic reaction times, no increased ISV and a pattern of viewing comparable to the TD group. However, the ASD + group showed a differences in processing style and ISV. A secondary analysis gives evidence of non-additive effects of the ASD and ADHD factors.

The Relationship between the Theory of Mind Skills and Disorder Severity among Adolescents with ADHD

OBJECTIVE

This study aimed to examine the sub-dimensions of the theory of mind (ToM) and to investigate the relationship between ToM skills and disorder severity by comparing adolescents with attention-deficit hyperactive disorder (ADHD) with healthy individuals.

METHODS

The study included 42 adolescents with ADHD and education- and age-matched 41 healthy volunteers. The Smarties test, ice cream truck test, faux pas recognition test, and eyes test were applied to all participants. Turgay Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV)-Based Child and Adolescent Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S) was applied to the group with ADHD to measure the disorder severity.

RESULTS

The group with ADHD was seen to have ToM skills impairment. There was a statistically significant difference between the groups in terms of the ice cream truck test, faux pas recognition test, and eyes test. A significant correlation was observed between the T-DSM-IV-S results and the eyes test results of the patients.

CONCLUSION

This study has shown that advanced ToM skills can be impaired in adolescents with ADHD and that impairment in skills is associated with disorder severity.

The Effect of Trust on Gaze-Mediated Attentional Orienting

The last two decades have witnessed growing interest in the study of social cognition and its multiple facets, including trust. Interpersonal trust is generally understood as the belief that others are not likely to harm you. When meeting strangers, judgments of trustworthiness are mostly based on fast evaluation of facial appearance, unless information about past behavior is available. In the past decade, studies have tried to understand the complex relationship between trust and gaze-cueing of attention (GCA) (i.e., attentional orienting following another person’s gaze). This review will focus on the studies that used a gaze-cueing paradigm to explore this relationship. While the predictivity of the gaze-cue seems to consistently influence trustworthiness judgments, the impact of trust on gaze-cueing is less clear. Four studies found enhanced gaze-cueing effects with trustworthy faces; one found stronger effects of gaze-cueing with faces associated with undesirable behavior, but only when the observer’s personal evaluations were taken into account. Four studies did not observe an effect of trust on gaze-cueing. Overall, studies have highlighted the complexity of this relationship, suggesting that multiple factors (including age, gender, the characteristics of the observer, and whether or not a threat is perceived) are likely to intervene in the interplay between trust and gaze-triggered attentional orienting. After discussing results in the context of existing theories of gaze-cueing and trust, we conclude that further investigation is needed to better understand this relationship and the contribution of social factors to attentional shifts guided by gaze.

Abnormal modulation of theta oscillations in children with attention-deficit/hyperactivity disorder

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We study frontal theta ERS and posterior theta lateralization in ADHD children.

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ADHD children show increased frontal theta ERS and posterior theta lateralization.

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Midfrontal theta ERS connects with right posterior theta modulation in ADHD children.

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Right posterior theta modulation is linked with RT variability in ADHD children.

Previous studies have found that theta activities exhibit posterior lateralized modulation as well as midfrontal event-related synchronization (ERS) during covert visual attention in adults. The present study investigated whether these theta modulations existed in children and whether they were associated with attentional problems in attention-deficit/hyperactivity disorder (ADHD). Electroencephalography signals were recorded from typically developing (TD) children and children with ADHD (TD: n = 24; ADHD: n = 22) while they performed a cued covert visual attention task. The participants responded to a target following a cue designed as human eyes that gazed to the left or right visual field (70% validity). Compared with the TD children, the children with ADHD showed increased midfrontal theta ERS and significant posterior theta lateralization in response to the cues. More importantly, we found that the stronger posterior theta lateralization in the right hemisphere exhibited a positive trial-based correlation with the larger midfrontal theta ERS and predicted lower RT variability at the trial level in the children with ADHD. We suggest that ADHD may be associated with some enhanced systems in the frontal and posterior areas via theta oscillations, which may be involved in the compensatory maturation for their attention deficits in childhood, thereby promoting the stability of behavioral responses.

Sex Differences in Attentional Selection Following Gaze and Arrow Cues

Although most studies on social attention have shown undistinguishable attentional effects in response to eye-gaze and arrow cues, recent research has found that whereas the orienting of attention triggered by eye-gaze is directed to the specific position, or part of the object looked at, arrows unselectively elicit attention toward parts of the environment. However, it is unclear whether this dissociation between gaze and arrow cues is related to social cognitive mechanisms such as mental state attribution (Theory of Mind, ToM). We aimed at replicating the dissociation between gaze and arrow cues and investigating if the attentional object selection elicited by these two types of stimuli differs depending on the sex of observers. To make our research plan transparent, our hypotheses, together with the plans of analyses, were registered before data exploration. While we replicated the arrow–gaze dissociation, this was equivalent in the male and female population. These results seem to contradict the intuition that ToM skills can be associated with the differences observed between orienting to eyes and arrows since greater ToM abilities have been generally shown in females. However, this conclusion must be interpreted with caution, since, in our sample, it was not possible to observe any differences in autistic quotient scores and ToM abilities between male and female participants. Further research is needed in order to clarify this issue.

Abnormal alpha modulation in response to human eye gaze predicts inattention severity in children with ADHD

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In response to the human eye gaze, compared with TD children, ADHD children showed a decreased alpha lateralization.

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The attenuation of alpha modulation in ADHD children was mainly manifested in the left hemisphere.

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The left hemisphere alpha modulation predicted higher inattentive severity and lower behavioural accuracy in ADHD children.

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Classification analysis showed the left alpha modulation has a high capability to recognize ADHD from TD children.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by problems in directing and sustaining attention. Recent behavioral studies indicated that children with ADHD are more likely to fail to show the orienting effect in response to human eye gaze. The present study aimed to identify the neurophysiological bases of attention deficits directed by social human eye gaze in children with ADHD, focusing on the relationship between alpha modulations and ADHD symptoms. The electroencephalography data were recorded from 8–13-year-old children (typically developing (TD): n = 24; ADHD: n = 21) while they performed a cued visuospatial covert attention task. The cues were designed as human eyes that might gaze to the left or right visual field. The results revealed that TD children showed a significant alpha lateralization in response to the gaze of human eyes, whereas children with ADHD showed an inverse pattern of alpha modulation in the left parieto-occipital area. Importantly, the abnormal alpha modulation in the left hemisphere predicted inattentive symptom severity and behavioral accuracy in children with ADHD. These results suggest that the dysfunction of alpha modulation in the left hemisphere in response to social cues might be a potential neurophysiologic marker of attention deficit in children with ADHD.

Facial Emotion Recognition and Eye Gaze in Attention-Deficit/Hyperactivity Disorder With and Without Comorbid Conduct Disorder

OBJECTIVE

Conduct disorder (CD) is associated with impairments in facial emotion recognition. However, CD commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD); thus, it is unclear whether these impairments are explained by ADHD or by one of its core features-inattention. We explored whether emotion recognition impairments are specific to individuals with ADHD and comorbid CD while also examining the mechanisms that might explain such deficits.

METHOD

A total of 63 male and female adolescents with ADHD (mean age = 14.2 years, age range = 11-18 years) and with (ADHD+CD) or without (ADHD) comorbid CD, and 41 typically developing controls (healthy controls [HC]; mean age = 15.5, age range = 11-18 years) performed an emotion recognition task with concurrent eye-tracking.

RESULTS

Participants with ADHD+CD were less accurate at recognizing fear and neutral faces, and more likely to confuse fear with anger than participants with ADHD alone and HC. Both ADHD subgroups fixated the eye region less than HC. Although there was a negative correlation between ADHD symptom severity and eye fixation duration, only CD severity was inversely related to emotion recognition accuracy.

CONCLUSION

Only ADHD participants with comorbid CD showed impairments in emotion recognition, suggesting that these deficits are specific to individuals with conduct problems. However, lack of attention to the eye region of faces appears to be a characteristic of ADHD. These findings suggest that emotion recognition impairments in those with ADHD+CD are related to misinterpretation rather than poor attention, offering interesting opportunities for intervention.