Understanding intentionality in children with attention-deficit/hyperactivity disorder

Abstract

One of the main aspects of theory of mind is intentionality which refers to recognizing other people's intentions in their behaviors. The aim of this study was to investigate intentionality in children with attention-deficit/hyperactivity disorder (ADHD). Thirty children with ADHD were compared to thirty age- and IQ-matched normal children. All participants were assessed using the moving shapes paradigm task which contains one large red and one small blue triangle moving around a black screen. They were asked to describe what the movements mean and how the triangles interact with each other. The answers were rated based on the accuracy, type of descriptions applied, mental states, and length of phrases. With regard to intentionality score, children with ADHD performed significantly worse than normal children (P < .05). Based on appropriateness score, the accuracy of patients' answers was lower in comparison with the control group. Children with ADHD used longer phrases as compared to controls. Children with ADHD can have problems with comprehending others' intentionality. This leads to impairment in social relationship.

Neural Correlates of Theory of Mind in Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder, and the Comorbid Condition

“…The task was also selected based on its frequent use in ToM investigation in ASD children and adult populations (21,24,27). A recent study furthermore reported ToM deficits in ADHD children using the same task (35). The task consists of twelve 26-48 s cartoons involving two triangles whose movements express: (1) ToM, e.g., persuading (length = 39.0±2.2s), (2) Goal-directed (GD) interaction, e.g., following (length = 39.5 ± 9.5 s), and (3) Random (RD) purposeless motions, e.g., floating (length = 39.8 ± 1.5 s) (71).…”

“…In ADHD, social cognition, and mentalizing deficits are increasingly reported, mostly in children (35)(36)(37)(38)(39) but also in adults (40)(41)(42)(43), albeit not as consistently as in ASD (8). For the adult age group particularly, recent studies have reported intact mentalizing in ADHD, who are instead impaired in empathy and in their ability for generating solutions for social problems (44,45).…”

“…Therefore, we directly compare hemodynamic response and FC in brain regions during ToM relative to non-ToM conditions across individuals with ADHD, ASD, ASD+ADHD, and typical development. To address the lack of investigation of brain function correlates of comorbidity in the adult population, this study focused on young adults using the Frith-Happé animated-triangle fMRI task that is frequently used for investigating ToM in ASD ( 21 , 24 , 27 ), which has also been shown to detect ToM deficits in ADHD, albeit in children ( 35 ). We aimed to investigate if ToM performance deficits are similar or different and are associated with similar or different neural correlates across the three clinical groups.…”

Children with Behavioural Problems Misinterpret the Emotions and Intentions of Others

“…ToM refers to the ability to represent and understand the mental states of others (Hein and Singer 2008) and one of the main aspects of ToM is understanding the intentions of others (Mohammadzadeh et al 2016). Mohammadzadeh et al (2016) suggest that displays of ASB may be due to the misinterpretation of another's intentions which then lead them to act inappropriately (i.e., aggressively). This may be reflective of a hostile attribution bias (HAB).…”

“…In line with previous literature, we expected children with behavioural problems to show an impairment in emotion recognition, specifically the recognition of negative emotions. Moreover, given the proposed role of misunderstanding intentions in the development of ASB (Mohammadzadeh et al 2016) we also expected children with behavioural problems to show a specific impairment in understanding intentionality. Given the previously reported relationship between emotion and intention recognition (Skuse 2003) we expected these constructs to be related, and hypothesised that difficulties in emotion and intention recognition would both be associated with severity of behaviour problems.…”