Initial Orientation of Attention towards Emotional Faces in Children with Attention Deficit Hyperactivity Disorder

By Ahmadi, Mehrnoosh; Judi, Mitra et al. | Iranian Journal of Psychiatry, Summer 2011 | Go to article overview
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Initial Orientation of Attention towards Emotional Faces in Children with Attention Deficit Hyperactivity Disorder


Ahmadi, Mehrnoosh, Judi, Mitra, Khorrami, Anahita, Mahmoudi-Gharaei, Javad, Tehrani-Doost, Mehdi, Iranian Journal of Psychiatry


Objective: Early recognition of negative emotions is considered to be of vital importance. It seems that children with attention deficit hyperactivity disorder have some difficulties recognizing facial emotional expressions, especially negative ones. This study investigated the preference of children with attention deficit hyperactivity disorder for negative (angry, sad) facial expressions compared to normal children.

Method: Participants were 35 drug naive boys with ADHD, aged between 6-11 years ,and 31 matched healthy children. Visual orientation data were recorded while participants viewed face pairs (negative-neutral pairs) shown for 3000ms. The number of first fixations made to each expression was considered as an index of initial orientation.

Results: Group comparisons revealed no difference between attention deficit hyperactivity disorder group and their matched healthy counterparts in initial orientation of attention. A tendency towards negative emotions was found within the normal group, while no difference was observed between initial allocation of attention toward negative and neutral expressions in children with ADHD .

Conclusion: Children with attention deficit hyperactivity disorder do not have significant preference for negative facial expressions. In contrast, normal children have a significant preference for negative facial emotions rather than neutral faces.

Keywords: Attention, Attention deficit disorder with hyperactivityr, Child, Eye movement, Facial expression

Iran J Psychiatry 2011; 6:87-91

Attention deficit hyperactivity disorder(ADHD) is a common neurobehavioral syndrome characterized by inattentiveness, and hyperactivity/impulsivity (1). Numerous studies have confirmed social incompetence in children with ADHD (2,3). These children have difficulties in interpretation of social situations, and are often rejected by their peers (2,4).

Recognition of emotional expressions, as the main component of nonverbal processing ability, is critical to effective social interactions (5). Adolescents and children with ADHD have impaired social and emotional capabilities and have difficulties appraising others' emotional states (6,7,8,9) A study done by Cadesky, Mota, and Schachar showed that children with ADHD made more mistakes in recognizing emotions, although their errors seemed to be random compared to children with conduct problems, which shows no bias in their emotional misrecognition. They stated that children with ADHD had deficits in encoding rather than specific bias in emotion interpretation (10). Singh et al. showed that children with ADHD had more difficulties in recognizing emotions, especially anger expression compared with normal population (11).

In normal population, negative facial expressions compared to neutral ones attract attention preferentially and elicit enhanced event related potential (ERP) activity as early as 80-100ms (12, 13,14,15,16,17,18,19). From an evolutionary viewpoint, this preference is essential to detect potential dangers in our environment (15,20,21,22,23,24). ADHD children in comparison with healthy individuals are significantly less accurate in identifying emotional expressions, especially negative (fear, anger, sadness) expressions (10,11,25). This deficit seems to be related to their failure to attend to emotional cues due to impaired encoding of such signals. This is in line with cognitive-behavioral theories which propose that children with ADHD have impairments in selective attention and inhibition of irrelevant information (26,27,28,29).

Most studies conducted on emotion recognition in children with ADHD have focused on behavioral measures such as visual probe reaction time (RT) studies. These methods have some limitations: first, behavioral measures evaluate attention through an indirect way in which the results can be influenced by other cognitive states. Second, these measures can only provide a snapshot of attention allocation at one point of time, and cannot detect sustained attention.

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Initial Orientation of Attention towards Emotional Faces in Children with Attention Deficit Hyperactivity Disorder
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