Response Patterns to Emotional Faces Among Adolescents Diagnosed With ADHD

Push-Pull Mechanism of Attention and Emotion in Children with Attention Deficit Hyperactivity Disorder

Background/Objectives: While deficits in executive attention and alerting systems in children with attention deficit hyperactivity disorder (ADHD) are well-documented, findings regarding orienting attention in ADHD have been inconsistent. The current study investigated the mechanism of attentional orienting in children with ADHD by examining their attentional bias towards threatening stimuli. Furthermore, we explored the modulating role of anxiety levels in ADHD on this attentional bias. Methods: In Experiment 1, 20 children with ADHD and 26 typically developing children (TDC) performed a continuous performance task that included task-irrelevant distractions consisting of angry faces and neutral places. In Experiment 2, 21 children with ADHD and 25 TDC performed the same task, but with angry and neutral faces as distractors. To measure children's anxiety levels, the State-Trait Anxiety Inventory was administered before each experiment. Results: In Experiment 1, results revealed no attentional bias effects in children with ADHD, whereas TDC exhibited attentional capture effects by both types of distractors. However, in Experiment 2, ADHD children demonstrated an attentional bias towards angry faces, which revealed a significant positive correlation with their trait anxiety levels (r = 0.61, p < 0.05). Further analyses combining all ADHD children showed that trait anxiety levels in Experiment 2 were significantly higher than those in Experiment 1. Finally, a significant positive correlation was found between anxiety levels and attentional bias towards angry faces in all ADHD children (r = 0.36, p < 0.01). Conclusions: Children with ADHD exhibited atypical attentional-orienting effects to threats, and their levels of trait anxiety appeared to modulate such attentional-orienting mechanisms.

Adolescents and young adults differ in their neural response to and recognition of adolescent and adult emotional faces

Peer relationships become increasingly important during adolescence. The success of these relationships may rely on the ability to attend to and decode subtle or ambiguous emotional expressions that are common in social interactions. However, most studies examining youths' processing and labeling of facial emotion have employed adult faces and faces that depict emotional extremes as stimuli. In this study, 40 adolescents and 40 young adults viewed blends of angry-neutral, fearful-neutral, and happy-neutral faces (e.g., 100% angry, 66% angry, 33% angry, neutral) portrayed by adolescent and adult actors as electroencephalogram (EEG) was recorded. Participants also labeled these faces according to the emotion expressed (i.e., angry, fearful, happy, or neutral). The Late Positive Potential (LPP), an event-related potential (ERP) component that reflects sustained attention to motivationally salient information, was scored from the EEG following face presentation. Among adolescents, as peer-age faces moved from ambiguous (33%) to unambiguous (100%) emotional expression, the LPP similarly increased. These effects were not found when adolescents viewed emotional face blends portrayed by adult actors. Additionally, while both adolescents and young adults showed greater emotion labeling accuracy as faces increased in emotional intensity from ambiguous to unambiguous emotional expression, adolescent participants did not show greater accuracy when labeling peer-compared to adult-age faces. Together, these data suggest that adolescents attend more to subtle differences in peer-age emotional faces, but they do not label these emotional expressions more accurately than adults.

Using Metacognitive Methods to Examine Emotion Recognition in Children With ADHD

Objective: This study investigated confidence accuracy associations for emotion recognition (ER) in children with ADHD and typically developing children (TD). Method: Thirty-nine children with ADHD and 42 TD (M = 9 years, 11 months, SD = 14.92 months, 26 females) completed an ER task. Intelligence and executive function task performance were also measured. Results: The ADHD group was more confident on ER compared with TD, but no group differences were found on their overall accuracy. Specifically, the ADHD group was more confident in its recognition of sad and angry faces compared with the TD group. On a metacognitive index, the ADHD group displayed lower resolution, suggesting that the TD group was better at discriminating correct from incorrect responses. Higher resolution was associated with lower ADHD symptoms. Conclusion: Confidence ratings with reference to performance on a specific task can provide an index of social-cognition in children with ADHD.

Recognition of emotional facial expressions in adolescents with attention deficit/hyperactivity disorder

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.

An emotion recognition subtyping approach to studying the heterogeneity and comorbidity of autism spectrum disorders and attention-deficit/hyperactivity disorder

Background

Emotion recognition dysfunction has been reported in both autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). This suggests that emotion recognition is a cross-disorder trait that may be utilised to understand the heterogeneous psychopathology of ASD and ADHD. We aimed to identify emotion recognition subtypes and to examine their relation with quantitative and diagnostic measures of ASD and ADHD to gain further insight into disorder comorbidity and heterogeneity.

Methods

Factor mixture modelling was used on speed and accuracy measures of auditory and visual emotion recognition tasks. These were administered to children and adolescents with ASD (N = 89), comorbid ASD + ADHD (N = 64), their unaffected siblings (N = 122), ADHD (N = 111), their unaffected siblings (N = 69), and controls (N = 220). Identified classes were compared on diagnostic and quantitative symptom measures.

Results

A four-class solution was revealed, with the following emotion recognition abilities: (1) average visual, impulsive auditory; (2) average-strong visual and auditory; (3) impulsive/imprecise visual, average auditory; (4) weak visual and auditory. The weakest performing class (4) contained the highest percentage of patients (66.07%) and the lowest percentage controls (10.09%), scoring the highest on ASD/ADHD measures. The best performing class (2) demonstrated the opposite: 48.98% patients, 15.26% controls with relatively low scores on ASD/ADHD measures.

Conclusions

Subgroups of youths can be identified that differ both in quantitative and qualitative aspects of emotion recognition abilities. Weak emotion recognition abilities across sensory domains are linked to an increased risk for ASD as well as ADHD, although emotion recognition impairments alone are neither necessary nor sufficient parts of these disorders.

Electronic supplementary material

The online version of this article (10.1186/s11689-018-9249-6) contains supplementary material, which is available to authorized users.

Emotional Face Recognition in Children With Attention Deficit/Hyperactivity Disorder: Evidence From Event Related Gamma Oscillation

Introduction

Children with attention-deficit/hyperactivity disorder (ADHD) have some impairment in emotional relationship which can be due to problems in emotional processing. The present study investigated neural correlates of early stages of emotional face processing in this group compared with typically developing children using the Gamma Band Activity (GBA).

Methods

A total of 19 children diagnosed with ADHD (Combined type) based on DSM-IV classification were compared with 19 typically developing children matched on age, gender, and IQ. The participants performed an emotional face recognition while their brain activities were recorded using an event-related oscillation procedure.

Results

The results indicated that ADHD children compared to normal group showed a significant reduction in the gamma band activity, which is thought to reflect early perceptual emotion discrimination for happy and angry emotions (P<0.05).

Conclusion

The present study supports the notion that individuals with ADHD have some impairments in early stage of emotion processing which can cause their misinterpretation of emotional faces.