Emotion perception in adult attention-deficit hyperactivity disorder

Abstract

This study examined identification of emotional information in facial expression, prosody, and their combination in 23 adult patients with combined attention deficit-hyperactivity disorder (ADHD) versus 31 healthy controls (HC) matched for gender, age, and education. We employed a stimulus set which was carefully balanced for valence as well as recognizability of the expressed emotions as determined in an independent sample of HC to avoid potential biases due to different levels of task difficulty. ADHD patients were characterized by impaired recognition of all employed categories (neutral, happiness, eroticism, disgust, anger). Basic cognitive functions as assessed by neuropsychological testing, such as sustained attention, constancy of alertness, and verbal intelligence partially explained lower recognition rates. Removal of the correlated variance by means of regression analyses did not abolish lower performance in ADHD indicating deficits in social cognition independent of these neuropsychological factors (p < 0.05). Lower performance correlated with self-rated emotional intelligence (r = 0.38, p < 0.05) indicating that adults with ADHD are aware of their problems in emotion perception. ADHD patients could partly compensate their deficit in unimodal emotion perception by audiovisual integration as revealed by larger gains in emotion recognition accuracy during bimodal presentation (p < 0.05) as compared to HC. These behavioral results can serve as foundation for future neuroimaging studies and point rather towards sensory-specific regions than audiovisual integration areas in perception of emotional information in adult ADHD.

Impaired empathy but no theory of mind deficits in adult attention deficit hyperactivity disorder

“…Recent studies investigating adult patients with ADHD and their ability to perceive prosody and emotional faces showed that they displayed impaired performance, especially in the perception of angry emotional statements. These results were independent of executive skills (Bisch et al, 2016;Kis et al, 2017). Nevertheless, studies investigating social cognition in adults with ADHD (Uekermann et al, 2010), especially the association between social cognition and executive functions in adults with ADHD, are still rare.…”

“…A distinction is made between three subtypes: inattentive subtype, hyperactive-impulsive subtype, and mixed subtype. These results were independent of executive skills (Bisch et al, 2016;Kis et al, 2017). There is a series of studies in children with ADHD that showed that ADHD is often accompanied by impairments in social cognition (Pineda-Alhucema, Aristizabal, Escudero-Cabarcas, Acosta-Lopez, & Velez, 2018).…”

Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis

“…Cavelti et al [46] and Irastorza & Bellon [49] additionally provided information on the specific facets of negative emotional responses and emotion recognition. The measures used by Bisch et al [37], Miller et al [41] and Rapport et al [50] match the facet of emotion recognition. Mitchell et al [41], Richard-Lepouriel et al [45] and Skirrow & Asherson [8] operationalized ED by using scales that assessed the facets of emotional lability and negative emotional responses.…”

Emotion dysregulation in adults suffering from attention deficit hyperactivity disorder (ADHD), a comparison with borderline personality disorder (BPD)

“…Although several hypotheses explaining ED in ADHD have been suggested, including executive function deficits, social cognitions deficit, impaired emotional perception/processing, lack of empathy and impairment in first and second order theory of mind and poor mentalizing capacities [14,[23][24][25][26][27][28][29][30][31], less is known about the efficiency of cognitive emotion regulation strategies used by ADHD patients to cope with emotional outbursts. Some studies on adults suffering from ADHD have associated ED and poor emotional regulation strategies such as less use of 'cognitive reappraisal' and more use of 'suppression' [32].…”