1
|
Nejati V, Estaji R. The impact of transcranial direct current stimulation on attention bias modification in children with ADHD. J Neural Transm (Vienna) 2024; 131:823-832. [PMID: 38643330 DOI: 10.1007/s00702-024-02775-1] [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: 01/13/2024] [Accepted: 03/30/2024] [Indexed: 04/22/2024]
Abstract
Individuals with attention deficit-hyperactivity disorder (ADHD) struggle with the interaction of attention and emotion. The ventromedial prefrontal cortex (vmPFC) and dorsolateral prefrontal cortex (dlPFC) are assumed to be involved in this interaction. In the present study, we aimed to explore the effect of stimulation applied over the dlPFC and vmPFC on attention bias in individuals with ADHD. Twenty-three children with ADHD performed the emotional Stroop and dot probe tasks during transcranial direct current stimulation (tDCS) in 3 conditions: anodal dlPFC (F3)/cathodal vmPFC (Fp2), anodal vmPFC (Fp2)/cathodal dlPFC (F3), and sham stimulation. Findings suggest reduction of attention bias in both real conditions based on emotional Stroop task and not dot probe task. These results were independent of emotional states. The dlPFC and vmPFC are involved in attention bias in ADHD. tDCS can be used for attention bias modification in children with ADHD.
Collapse
Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran.
| | - Reza Estaji
- Department of Psychology, Shahid Beheshti University, 1983969411, Tehran, Iran
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Metternich B, Gehrer N, Wagner K, Geiger MJ, Schütz E, Seifer B, Schulze-Bonhage A, Schönenberg M. Dynamic facial emotion recognition and affective prosody recognition are associated in patients with temporal lobe epilepsy. Sci Rep 2024; 14:3935. [PMID: 38366055 PMCID: PMC10873350 DOI: 10.1038/s41598-024-53401-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 01/31/2024] [Indexed: 02/18/2024] Open
Abstract
Deficits in facial emotion recognition have frequently been established in temporal lobe epilepsy (TLE). However, static, rather than dynamic emotion recognition paradigms have been applied. Affective prosody has been insufficiently studied in TLE, and there is a lack of studies investigating associations between auditory and visual emotion recognition. We wished to investigate potential deficits in a dynamic morph task of facial emotion recognition and in an affective prosody recognition task, as well as associations between both tasks. 25 patients with TLE and 24 healthy controls (CG) performed a morph task with faces continuously changing in their emotional intensity. They had to press a button, as soon as they were able to recognize the emotion expressed, and label it accordingly. In the auditory task, subjects listened to neutral sentences spoken in varying emotional tones, and labeled the emotions. Correlation analyses were conducted across both tasks. TLE patients showed significantly reduced prosody recognition compared to CG, and in the morph task, there was a statistical trend towards significantly reduced performance for TLE. Recognition rates in both tasks were significantly associated. TLE patients show deficits in affective prosody recognition, and they may also be impaired in a morph task with dynamically changing facial expressions. Impairments in basic social-cognitive tasks in TLE seem to be modality-independent.
Collapse
Affiliation(s)
- Birgitta Metternich
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany.
| | - Nina Gehrer
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| | - Kathrin Wagner
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Maximilian J Geiger
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Elisa Schütz
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Britta Seifer
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Andreas Schulze-Bonhage
- Epilepsy Center, Department of Neurosurgery, Medical Center, University of Freiburg, Breisacher Str. 64, 79106, Freiburg, Germany
| | - Michael Schönenberg
- Department of Psychiatry and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Walter A, Martz E, Weibel S, Weiner L. Tackling emotional processing in adults with attention deficit hyperactivity disorder and attention deficit hyperactivity disorder + autism spectrum disorder using emotional and action verbal fluency tasks. Front Psychiatry 2023; 14:1098210. [PMID: 36816409 PMCID: PMC9928945 DOI: 10.3389/fpsyt.2023.1098210] [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: 11/14/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Introduction Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) are two neurodevelopmental conditions with neuropsychological, social, emotional, and psychopathological similarities. Both are characterized by executive dysfunction, emotion dysregulation (ED), and psychiatric comorbidities. By focusing on emotions and embodied cognition, this study aims to improve the understanding of overlapping symptoms between ADHD and ASD through the use of verbal fluency tasks. Methods Fifty-two adults with ADHD, 13 adults with ADHD + ASD and 24 neurotypical (NT) participants were recruited in this study. A neuropsychological evaluation, including different verbal fluency conditions (e.g. emotional and action), was proposed. Subjects also completed several self-report questionnaires, such as scales measuring symptoms of ED. Results Compared to NT controls, adults with ADHD + ASD produced fewer anger-related emotions. Symptoms of emotion dysregulation were associated with an increased number of actions verbs and emotions produced in ADHD. Discussion The association between affective language of adults with ADHD and symptoms of emotion dysregulation may reflect their social maladjustment. Moreover, the addition of ADHD + ASD conditions may reflect more severe affective dysfunction.
Collapse
Affiliation(s)
- Amélia Walter
- Institut des Neurosciences Cellulaires et Intégratives, Centre National de la Recherche Scientifique (UPR 3212), Strasbourg University, Strasbourg, France
| | - Emilie Martz
- Institut National de la Santé et de la Recherche Médicale U1114, Strasbourg, France
| | - Sébastien Weibel
- Institut National de la Santé et de la Recherche Médicale U1114, Strasbourg, France
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
| | - Luisa Weiner
- Department of Psychiatry, University Hospital of Strasbourg, Strasbourg, France
- Laboratoire de Psychologie des Cognitions, University of Strasbourg, Strasbourg, France
| |
Collapse
|
6
|
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.
Collapse
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
| |
Collapse
|
7
|
Reisch LM, Wegrzyn M, Mielke M, Mehlmann A, Woermann FG, Bien CG, Kissler J. Face processing and efficient recognition of facial expressions are impaired following right but not left anteromedial temporal lobe resections: Behavioral and fMRI evidence. Neuropsychologia 2022; 174:108335. [PMID: 35863496 DOI: 10.1016/j.neuropsychologia.2022.108335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 07/04/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
Anteromedial temporal lobe structures seem to support processing of faces and facial expressions. However, differential effects of unilateral left or right temporal lobe resections (TLR) on face processing, recognition of facial expressions, and on BOLD response to faces in intact brain areas are not yet fully understood. Therefore, we compared 39 patients with unilateral TLR (18 left, 21 right) and 20 healthy controls regarding recognition of facial identity and emotional facial expressions as well as BOLD response to fearful and neutral faces. We found impaired recognition of facial identity following right TLR, which was paralleled by reduced BOLD response to faces irrespective of expression in the right fusiform and lingual gyrus in postsurgical fMRI. Right TLR patients also exhibited subtle impairments of emotion recognition as they needed higher intensity of facial expressions for correct responses in a morphing task. Accuracy of emotion recognition and subjective appraisals of facial expressions did not differ between groups. There was no specific reduction of BOLD response to fearful versus neutral faces in either patient group. Our results underline the specific role of the right anteromedial temporal lobe in processing of faces and facial expressions by showing changes in face processing following right TLR in behavioral as well as imaging data.
Collapse
Affiliation(s)
- Lea Marie Reisch
- Department of Psychology, Bielefeld University, Bielefeld, Germany; Department of Epileptology (Krankenhaus Mara), Bielefeld University, Campus Bielefeld-Bethel, Bielefeld, Germany.
| | - Martin Wegrzyn
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Malena Mielke
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | | | - Friedrich G Woermann
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Bielefeld University, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Johanna Kissler
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| |
Collapse
|
8
|
Morellini L, Ceroni M, Rossi S, Zerboni G, Rege-Colet L, Biglia E, Morese R, Sacco L. Social Cognition in Adult ADHD: A Systematic Review. Front Psychol 2022; 13:940445. [PMID: 35898990 PMCID: PMC9311421 DOI: 10.3389/fpsyg.2022.940445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/09/2022] [Indexed: 01/16/2023] Open
Abstract
The aim of this systematic review was to collect and align the research on social cognition impairments in adults with Attention-deficit/hyperactivity disorder (ADHD). In particular, we selected and analyzed papers on emotion recognition and processing, Theory of Mind (TOM), empathy, and other facets of social cognition as decision making. We identified 16 papers published between 2012 and 2022 which meet inclusion criteria. Papers search, selection, and extraction followed the PRISMA guidelines. In order to summarize data from papers, we used a narrative synthesis approach. Results show different evidence of impairment in social cognition domains in adults with ADHD. Our systematic review suggests the importance of promoting more research on this topic because it is essential to keep in mind that social cognition plays a central role in socialization and social relationships.
Collapse
Affiliation(s)
- Lucia Morellini
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
- *Correspondence: Lucia Morellini
| | - Martino Ceroni
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Stefania Rossi
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Giorgia Zerboni
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Laura Rege-Colet
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Elena Biglia
- Neuropsychology and Behavioral Neurology Research Unit, Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Rosalba Morese
- Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
- Faculty of Communication, Culture and Society, Università della Svizzera italiana, Lugano, Switzerland
- Rosalba Morese
| | - Leonardo Sacco
- Neuropsychological and Speech Therapy Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| |
Collapse
|
9
|
Zuberer A, Schwarz L, Kreifelts B, Wildgruber D, Erb M, Fallgatter A, Scheffler K, Ethofer T. Neural Basis of Impaired Emotion Recognition in Adult Attention-Deficit/Hyperactivity Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:680-687. [PMID: 33551283 DOI: 10.1016/j.bpsc.2020.11.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Deficits in emotion recognition have been repeatedly documented in patients diagnosed with attention-deficit/hyperactivity disorder (ADHD), but their neural basis is unknown so far. METHODS In the current study, adult patients with ADHD (n = 44) and healthy control subjects (n = 43) underwent functional magnetic resonance imaging during explicit emotion recognition of stimuli expressing affective information in face, voice, or face-voice combinations. The employed experimental paradigm allowed us to delineate areas for processing audiovisual information based on their functional activation profile, including the bilateral posterior superior temporal gyrus/middle temporal gyrus, amygdala, medial prefrontal cortex, and precuneus, as well as the right posterior thalamus. RESULTS As expected, unbiased hit rates for correct classification of the expressed emotions were lower in patients with ADHD than in healthy control subjects irrespective of the presented sensory modality. This deficit at a behavioral level was accompanied by lower activation in patients with ADHD versus healthy control subjects in the cortex adjacent to the right superior temporal gyrus/middle temporal gyrus and the right posterior thalamus, which represent key areas for processing socially relevant signals and their integration across modalities. A cortical region adjacent to the right posterior superior temporal gyrus was the only brain region that showed a significant correlation between brain activation and emotion identification performance. CONCLUSIONS Altogether, these results provide the first evidence for a potential neural substrate of the observed impairments in emotion recognition in adults with ADHD.
Collapse
Affiliation(s)
- Agnieszka Zuberer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - Lena Schwarz
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Benjamin Kreifelts
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Dirk Wildgruber
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Michael Erb
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Andreas Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Klaus Scheffler
- Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany; Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Thomas Ethofer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany; Department of Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| |
Collapse
|
10
|
Dysfunctional temporal stages of eye-gaze perception in adults with ADHD: a high-density EEG study. Biol Psychol 2022; 171:108351. [PMID: 35568095 DOI: 10.1016/j.biopsycho.2022.108351] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/03/2022] [Accepted: 05/07/2022] [Indexed: 11/21/2022]
Abstract
ADHD has been associated with social cognitive impairments across the lifespan, but no studies have specifically addressed the presence of abnormalities in eye-gaze processing in the adult brain. This study investigated the neural basis of eye-gaze perception in adults with ADHD using event-related potentials (ERP). Twenty-three ADHD and 23 controls performed a delayed face-matching task with neutral faces that had either direct or averted gaze. ERPs were classified using microstate analyses. ADHD and controls displayed similar P100 and N170 microstates. ADHD was associated with cluster abnormalities in the attention-sensitive P200 to direct gaze, and in the N250 related to facial recognition. For direct gaze, source localization revealed reduced activity in ADHD for the P200 in the left/midline cerebellum, as well as in a cingulate-occipital network at the N250. These results suggest brain impairments involving eye-gaze decoding in adults with ADHD, suggestive of neural signatures associated with this disorder in adulthood.
Collapse
|
11
|
ADHD patients with DIRAS2 risk allele need more thalamic activation during emotional face-voice recognition. Psychiatry Res 2022; 308:114355. [PMID: 34990989 DOI: 10.1016/j.psychres.2021.114355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
|
12
|
Viering T, Naaijen J, van Rooij D, Thiel C, Philipsen A, Dietrich A, Franke B, Buitelaar J, Hoekstra PJ. Amygdala reactivity and ventromedial prefrontal cortex coupling in the processing of emotional face stimuli in attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry 2022; 31:1895-1907. [PMID: 34120213 PMCID: PMC9663339 DOI: 10.1007/s00787-021-01809-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/21/2021] [Indexed: 01/26/2023]
Abstract
Impaired emotion recognition is common in individuals with attention-deficit/hyperactivity disorder (ADHD) and may, via deficient emotion self-regulation, relate to the frequently co-occurring affective and social problems. The present study used an emotional face-matching task and functional magnetic resonance imaging (fMRI) to investigate neural responses during the processing of angry and fearful faces and visuo-spatial control stimuli. Additionally, measures for emotion dysregulation, ADHD type, and age were investigated in relation to the behavioral and neural fMRI data. We utilized a sample of 61 adolescents/young adults with ADHD and 51 age-matched healthy controls (age range: 12-28 years). Participants with ADHD had higher emotion dysregulation scores than controls. They also reacted slower and less accurate in response to emotional but not visuo-spatial control stimuli. Neural response differences between emotional and visuo-spatial trials were significantly smaller in cases, particularly in the left amygdala. While coupling between the right amygdala and bilateral ventromedial prefrontal cortex was stronger for emotional than visuo-spatial stimuli in control subjects, levels of positive coupling between the trial types did not significantly differ in participants with ADHD. Neither emotion dysregulation scores, nor ADHD type or age were related to the behavioral and neural processing alterations during the emotional face-matching task. Results indicate that emotion recognition deficits in ADHD are particularly associated with lower amygdala activation to emotional stimuli and alterations in the functional connections of the amygdala to medial prefrontal areas. Emotion recognition deficits and associated neural alterations were unrelated to emotion dysregulation, ADHD type, or age.
Collapse
Affiliation(s)
- Tammo Viering
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-Von-Ossietzky Universität Oldenburg, Postfach 2503, 26111, Oldenburg, Germany. .,Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
| | - Jilly Naaijen
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,Centre for Cognitive Neuroimaging, Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Daan van Rooij
- Centre for Cognitive Neuroimaging, Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Christiane Thiel
- Biological Psychology, Department of Psychology, School of Medicine and Health Sciences, Carl-Von-Ossietzky Universität Oldenburg, Postfach 2503, 26111 Oldenburg, Germany ,Research Center Neurosensory Science, Carl-Von-Ossietzky Universität Oldenburg, Oldenburg, Germany ,Cluster of Excellence “Hearing4all”, Carl-Von-Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Andrea Dietrich
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,Department of Psychiatry, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Jan Buitelaar
- Department of Cognitive Neuroscience, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,Centre for Cognitive Neuroimaging, Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands ,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Pieter J. Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
13
|
Morphing Task: The Emotion Recognition Process in Children with Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413273. [PMID: 34948881 PMCID: PMC8702190 DOI: 10.3390/ijerph182413273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/24/2021] [Accepted: 12/06/2021] [Indexed: 12/01/2022]
Abstract
Recognizing a person’s identity is a fundamental social ability; facial expressions, in particular, are extremely important in social cognition. Individuals affected by autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) display impairment in the recognition of emotions and, consequently, in recognizing expressions related to emotions, and even their identity. The aim of our study was to compare the performance of participants with ADHD, ASD, and typical development (TD) with regard to both accuracy and speed in the morphing task and to determine whether the use of pictures of digitized cartoon faces could significantly facilitate the process of emotion recognition in ASD patients (particularly for disgust). This study investigated the emotion recognition process through the use of dynamic pictures (human faces vs. cartoon faces) created with the morphing technique in three pediatric populations (7–12 years old): ADHD patients, ASD patients, and an age-matched control sample (TD). The Chi-square test was used to compare response latency and accuracy between the three groups in order to determine if there were statistically significant differences (p < 0.05) in the recognition of basic emotions. The results demonstrated a faster response time in neurotypical children compared to ASD and ADHD children, with ADHD participants performing better than ASD participants on the same task. The overall accuracy parameter between the ADHD and ASD groups did not significantly differ.
Collapse
|
14
|
Helfer B, Boxhoorn S, Songa J, Steel C, Maltezos S, Asherson P. Emotion recognition and mind wandering in adults with attention deficit hyperactivity disorder or autism spectrum disorder. J Psychiatr Res 2021; 134:89-96. [PMID: 33373778 DOI: 10.1016/j.jpsychires.2020.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 11/19/2020] [Accepted: 12/19/2020] [Indexed: 11/18/2022]
Abstract
Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in adults are often undiagnosed and overlap in psychopathology. Here we investigated the transdiagnostic traits of emotion recognition and mind wandering in a sample of 103 adults (43 with ADHD and 14 with ASD). The ability to correctly identify a facial expression of anger, fear, disgust or surprise was no different between the adults with ADHD or ASD and neurotypical (NT) adults. However, adults with ADHD or ASD were on average almost 200 ms slower in making a correct decision, suggesting a larger speed-accuracy trade-off in facial emotion recognition compared to NT adults. General processing speed was associated with excessive mind wandering in adults with ADHD, but not with ASD. The deficits in emotional processing were independent from mind wandering in both adults with ADHD or ASD. Emotional dysregulation and functional impairment scales separated adults with ADHD and ASD from the NT adults, but not from each other. When controlling for self-reported ADHD and ASD symptom severity, mind wandering in ADHD was independent from both ADHD and ASD symptom severity. In ASD, mind wandering was related to ASD but not ADHD symptom severity. Our results suggest that ASD and ADHD share a slower ability to recognize emotions, which is exacerbated by excessive mind wandering in ADHD, and by decreased processing speed in ASD.
Collapse
Affiliation(s)
- Bartosz Helfer
- National Heart and Lung Institute, Faculty of Medicine, Imperial College London, United Kingdom; Institute of Psychology, University of Wroclaw, Poland; Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
| | - Sara Boxhoorn
- Department of Child and Adolescent Psychiatry, Goethe-Universität Frankfurt, Germany
| | - Joanna Songa
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Charlotte Steel
- Division of Psychiatry, Faculty of Brain Sciences, University College London, United Kingdom
| | - Stefanos Maltezos
- Adult Autism and ADHD Service, South London and Maudsley NHS Foundation Trust, London, United Kingdom; Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Philip Asherson
- Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| |
Collapse
|
15
|
Li M, Huang P. Assessing the product review helpfulness: Affective-Cognitive evaluation and the moderating effect of feedback mechanism. INFORMATION & MANAGEMENT 2020. [DOI: 10.1016/j.im.2020.103359] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
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.
Collapse
|
17
|
Interpretation of ambiguous facial affect in adults with attention-deficit/hyperactivity disorder. Eur Arch Psychiatry Clin Neurosci 2019; 269:657-666. [PMID: 29423564 DOI: 10.1007/s00406-018-0879-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 01/31/2018] [Indexed: 11/27/2022]
Abstract
In addition to impairments in cognitive functioning, attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in interpersonal functioning as well which are assumed to stem from a distorted perception or interpretation of affective information. While previous research suggests that the decoding of negatively valenced facial stimuli is impaired, less is known about the potential interpretation biases in ADHD which are linked to other externalizing psychopathologies. The present study investigated interpretation biases in adults with ADHD (N = 65) and controls (N = 49) using ambiguous facial stimuli (angry/happy, angry/fearful, fearful/happy blends) with different proportions of each emotion. Participants indicated the dominant emotion and rated the perceived intensity of each image. While impaired processing of fearful expressions was evident in the ADHD group, the results of the current study do not provide support for an interpretation bias in adults with ADHD. These findings suggest that interpretation biases may be restricted to aggressive psychopathology and cannot be generalized to individuals with ADHD.
Collapse
|
18
|
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: 44] [Impact Index Per Article: 7.3] [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.
Collapse
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
| |
Collapse
|
19
|
Impaired social cognition in violent offenders: perceptual deficit or cognitive bias? Eur Arch Psychiatry Clin Neurosci 2017; 267:257-266. [PMID: 27623869 DOI: 10.1007/s00406-016-0727-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 08/21/2016] [Indexed: 10/21/2022]
Abstract
Aggressive behavior is assumed to be associated with certain patterns of social information processing. While some theories link aggression to a tendency to interpret ambiguous stimuli as hostile (i.e., enhanced sensitivity to anger), others assume an insufficient ability to perceive emotional expressions, particularly fear. Despite compelling evidence to support both theories, no previous study has directly investigated the predictions made by these two accounts in aggressive populations. The aim of the current study was to test processing patterns for angry and fearful facial expressions in violent offenders (VOs) and healthy controls (CTLs) and their association with self-reported aggression and psychopathy scores. In Experiment 1, we assessed perceptual sensitivity to neutral-emotional (angry, fearful, happy) blends in a task which did not require categorization, but an indication whether the stimulus is neutral or emotional. In Experiment 2, we assessed categorization performance for ambiguous fearful-happy and angry-happy blends. No group differences were revealed in Experiment 1, while Experiment 2 indicated a deficit in the categorization of ambiguous fearful blends in the VO group. Importantly, this deficit was associated with both self-reported psychopathy and aggression in the VO, but not the CTL group. The current study provides evidence for a deficient categorization of fearful expressions and its association with self-reported aggression and psychopathy in VOs, but no support for heightened sensitivity to anger. Furthermore, the current findings indicate that the deficit is tied to categorization but not detection stages of social information processing.
Collapse
|
20
|
Vrijen C, Hartman CA, Lodder GMA, Verhagen M, de Jonge P, Oldehinkel AJ. Lower Sensitivity to Happy and Angry Facial Emotions in Young Adults with Psychiatric Problems. Front Psychol 2016; 7:1797. [PMID: 27920735 PMCID: PMC5118561 DOI: 10.3389/fpsyg.2016.01797] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 10/31/2016] [Indexed: 11/20/2022] Open
Abstract
Many psychiatric problem domains have been associated with emotion-specific biases or general deficiencies in facial emotion identification. However, both within and between psychiatric problem domains, large variability exists in the types of emotion identification problems that were reported. Moreover, since the domain-specificity of the findings was often not addressed, it remains unclear whether patterns found for specific problem domains can be better explained by co-occurrence of other psychiatric problems or by more generic characteristics of psychopathology, for example, problem severity. In this study, we aimed to investigate associations between emotion identification biases and five psychiatric problem domains, and to determine the domain-specificity of these biases. Data were collected as part of the ‘No Fun No Glory’ study and involved 2,577 young adults. The study participants completed a dynamic facial emotion identification task involving happy, sad, angry, and fearful faces, and filled in the Adult Self-Report Questionnaire, of which we used the scales depressive problems, anxiety problems, avoidance problems, Attention-Deficit Hyperactivity Disorder (ADHD) problems and antisocial problems. Our results suggest that participants with antisocial problems were significantly less sensitive to happy facial emotions, participants with ADHD problems were less sensitive to angry emotions, and participants with avoidance problems were less sensitive to both angry and happy emotions. These effects could not be fully explained by co-occurring psychiatric problems. Whereas this seems to indicate domain-specificity, inspection of the overall pattern of effect sizes regardless of statistical significance reveals generic patterns as well, in that for all psychiatric problem domains the effect sizes for happy and angry emotions were larger than the effect sizes for sad and fearful emotions. As happy and angry emotions are strongly associated with approach and avoidance mechanisms in social interaction, these mechanisms may hold the key to understanding the associations between facial emotion identification and a wide range of psychiatric problems.
Collapse
Affiliation(s)
- Charlotte Vrijen
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen Groningen, Netherlands
| | - Catharina A Hartman
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen Groningen, Netherlands
| | - Gerine M A Lodder
- Interuniversity Center for Social Science Theory and Methodology, Department of Sociology, University of Groningen Groningen, Netherlands
| | - Maaike Verhagen
- Behavioural Science Institute, Radboud University Nijmegen Nijmegen, Netherlands
| | - Peter de Jonge
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of GroningenGroningen, Netherlands; Developmental Psychology, University of GroningenGroningen, Netherlands
| | - Albertine J Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, University of Groningen Groningen, Netherlands
| |
Collapse
|
21
|
Bora E, Pantelis C. Meta-analysis of social cognition in attention-deficit/hyperactivity disorder (ADHD): comparison with healthy controls and autistic spectrum disorder. Psychol Med 2016; 46:699-716. [PMID: 26707895 DOI: 10.1017/s0033291715002573] [Citation(s) in RCA: 168] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Impairment in social cognition is an established finding in autism spectrum disorders (ASD). Emerging evidence suggests that attention-deficit/hyperactivity disorder (ADHD) might be also associated with deficits in theory of mind (ToM) and emotion recognition. However, there are inconsistent findings, and it has been debatable whether such deficits persist beyond childhood and how similar social cognitive deficits are in ADHD v. ASD. METHOD We conducted a meta-analysis of social cognition, including emotion recognition and ToM, studies in ADHD compared with healthy controls and ASD. The current meta-analysis involved 44 studies comparing ADHD (n = 1999) with healthy controls (n = 1725) and 17 studies comparing ADHD (n = 772) with ASD (n = 710). RESULTS Facial and vocal emotion recognition (d = 0.40-0.44) and ToM (d = 0.43) abilities were significantly impaired in ADHD. The most robust facial emotion recognition deficits were evident in anger and fear. Social cognitive deficits were either very subtle (emotion recognition) or non-significant (ToM) in adults with ADHD. Deficits in social cognition, especially ToM, were significantly more pronounced in ASD compared with ADHD. General cognitive impairment has contributed to social cognitive deficits in ADHD. CONCLUSIONS Performance of individuals with ADHD on social cognition lies intermediate between ASD and healthy controls. However, developmental trajectories of social cognition probably differ between ADHD and ASD as social cognitive deficits in ADHD might be improving with age in most individuals. There is a need for studies investigating a potential subtype of ADHD with persistent social cognitive deficits and exploring longitudinal changes in social cognition during development.
Collapse
Affiliation(s)
- E Bora
- Department of Psychiatry,Melbourne Neuropsychiatry Centre,University of Melbourne and Melbourne Health,Carlton South,Victoria 3053,Australia
| | - C Pantelis
- Department of Psychiatry,Melbourne Neuropsychiatry Centre,University of Melbourne and Melbourne Health,Carlton South,Victoria 3053,Australia
| |
Collapse
|
22
|
Schönenberg M, Jusyte A, Höhnle N, Mayer SV, Weber Y, Hautzinger M, Schell C. Theory of mind abilities in patients with psychogenic nonepileptic seizures. Epilepsy Behav 2015; 53:20-4. [PMID: 26515154 DOI: 10.1016/j.yebeh.2015.09.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 09/21/2015] [Accepted: 09/25/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Psychogenic nonepileptic seizures (PNES) have been frequently linked to deficits in affect regulation and altered processing of emotionally salient information. However, less is known about how patients suffering from PNES actually process and interpret affective social stimuli. Thus, the present study aimed to investigate basal facial affect recognition as well as mind-reading skills in a sample of patients with PNES and matched control subjects. METHODS Patients with PNES (N=15) and healthy controls (N=15) completed self-report questionnaires that measured alexithymia and perceived stress vulnerability. Affect perception was tested using a series of computerized movies of models whose facial expressions slowly change from neutral to full-blown emotions (anger, fear, sadness, happiness, disgust, and surprise), allowing for a fine-grained assessment of facial emotion recognition impairments. Further, all participants were presented with the Movie for the Assessment of Social Cognition, a well-validated video-based test for the evaluation of subtle mind-reading deficits. RESULTS Data analyses revealed increased alexithymic traits and, impaired mentalizing skills in individuals with PNES, while basal facial expression recognition was not compromised. DISCUSSION The present findings are the first to demonstrate that patients with PNES exhibit several deficits in reasoning about their own and other people's mental states. Patients with PNES may benefit from psychotherapeutic interventions that focus on disturbed affect regulation and aim to enhance emotional awareness.
Collapse
Affiliation(s)
- Michael Schönenberg
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany.
| | - Aiste Jusyte
- LEAD Graduate School, University of Tübingen, Germany
| | - Nina Höhnle
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
| | - Sarah Verena Mayer
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
| | - Yvonne Weber
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Tübingen, Germany
| | - Martin Hautzinger
- Department of Clinical Psychology and Psychotherapy, University of Tübingen, Germany
| | - Caroline Schell
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, Tübingen, Germany; Department of Neurology, Hospital Steinenberg, Reutlingen, Germany
| |
Collapse
|