Skip to main content

Advertisement

SpringerLink
Log in

Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

The ability to recognize emotions evident in people’s faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6–14 years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Baron-Cohen S, Wheelwright S, Spong A et al (2001) Are intuitive physics and intuitive psychology independent? A test with children with Asperger Syndrome. J Dev Learn Disord 5:47–78

    Google Scholar 

  2. Bühler E, Bachmann C, Goyert H et al (2011) Differential diagnosis of autism spectrum disorder and attention deficit hyperactivity disorder by means of inhibitory control and “theory of mind.” J Autism Dev Disord 41:1718–1726. https://doi.org/10.1007/s10803-011-1205-1

    Article  PubMed  Google Scholar 

  3. Romani M, Vigliante M, Faedda N et al (2018) Face memory and face recognition in children and adolescents with attention deficit hyperactivity disorder: a systematic review. Neurosci Biobehav Rev 89:1–12. https://doi.org/10.1016/j.neubiorev.2018.03.026

    Article  PubMed  Google Scholar 

  4. Baribeau DA, Doyle-Thomas KAR, Dupuis A et al (2015) Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders. J Am Acad Child Adolesc Psychiatry 54:479–486. https://doi.org/10.1016/j.jaac.2015.03.016

    Article  PubMed  Google Scholar 

  5. Quintero J, Ramos-Quiroga JA, Sebastián JS et al (2018) Health care and societal costs of the management of children and adolescents with attention-deficit/hyperactivity disorder in Spain: a descriptive analysis. BMC Psychiatry 18:40. https://doi.org/10.1186/s12888-017-1581-y

    Article  PubMed  PubMed Central  Google Scholar 

  6. Noordermeer SDS, Luman M, Buitelaar JK et al (2020) Neurocognitive deficits in attention-deficit/hyperactivity disorder with and without comorbid oppositional defiant disorder. J Atten Disord 24:1317–1329. https://doi.org/10.1177/1087054715606216

    Article  PubMed  Google Scholar 

  7. Hobson CW, Scott S, Rubia K (2011) Investigation of cool and hot executive function in ODD/CD independently of ADHD. J Child Psychol Psychiatry Allied Discip 52:1035–1043. https://doi.org/10.1111/j.1469-7610.2011.02454.x

    Article  Google Scholar 

  8. Brotman MA, Kircanski K, Leibenluft E (2017) Irritability in children and adolescents. Annu Rev Clin Psychol 13:317–341. https://doi.org/10.1146/annurev-clinpsy-032816-044941

    Article  PubMed  Google Scholar 

  9. Stringaris A, Goodman R (2009) Longitudinal outcome of youth oppositionality: Irritable, headstrong, and hurtful behaviors have distinctive predictions. J Am Acad Child Adolesc Psychiatry 48:404–412. https://doi.org/10.1097/CHI.0b013e3181984f30

    Article  PubMed  Google Scholar 

  10. Sobanski E, Banaschewski T, Asherson P et al (2010) Emotional lability in children and adolescents with attention deficit/hyperactivity disorder (ADHD): Clinical correlates and familial prevalence. J Child Psychol Psychiatry Allied Discip 51:915–923. https://doi.org/10.1111/j.1469-7610.2010.02217.x

    Article  Google Scholar 

  11. Shaw P, Stringaris A, Nigg J, Leibenluft E (2014) Emotion dysregulation in attention deficit hyperactivity disorder. Am J Psychiatry 171:276–293. https://doi.org/10.1176/appi.ajp.2013.13070966

    Article  PubMed  PubMed Central  Google Scholar 

  12. Qian Y, Chang WL, He X et al (2016) Emotional dysregulation of ADHD in childhood predicts poor early-adulthood outcomes: a prospective follow up study. Res Dev Disabil 59:428–436. https://doi.org/10.1016/j.ridd.2016.09.022

    Article  PubMed  Google Scholar 

  13. Wehmeier PM, Schacht A, Barkley RA (2010) Social and emotional impairment in children and adolescents with ADHD and the impact on quality of life. J Adolesc Heal 46:209–217. https://doi.org/10.1016/j.jadohealth.2009.09.009

    Article  Google Scholar 

  14. Guyer AE, McClure EB, Adler AD et al (2007) Specificity of facial expression labeling deficits in childhood psychopathology. J Child Psychol Psychiatry Allied Discip 48:863–871. https://doi.org/10.1111/j.1469-7610.2007.01758.x

    Article  Google Scholar 

  15. Stoddard J, Tseng WL, Kim P et al (2017) Association of irritability and anxiety with the neural mechanisms of implicit face emotion processing in youths with psychopathology. JAMA Psychiat 74:95–103. https://doi.org/10.1001/jamapsychiatry.2016.3282

    Article  Google Scholar 

  16. Kim P, Arizpe J, Rosen BH et al (2013) Impaired fixation to eyes during facial emotion labelling in children with bipolar disorder or severe mood dysregulation. J Psychiatry Neurosci 38:407–416. https://doi.org/10.1503/jpn.120232

    Article  PubMed  PubMed Central  Google Scholar 

  17. Rich BA, Grimley ME, Schmajuk M et al (2008) Face emotion labeling deficits in children with bipolar disorder and severe mood dysregulation. Dev Psychopathol 20:529–546. https://doi.org/10.1017/S0954579408000266

    Article  PubMed  PubMed Central  Google Scholar 

  18. Weyandt LL (2007) Book review: Barkley RA (2006). Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment, 3rd edn. Guilford, New York

    Google Scholar 

  19. Demirci E, Erdogan A (2016) Is emotion recognition the only problem in ADHD? Effects of pharmacotherapy on face and emotion recognition in children with ADHD. ADHD Atten Deficit Hyperact Disord 8:197–204. https://doi.org/10.1007/s12402-016-0201-x

    Article  Google Scholar 

  20. Corbett BA, Constantine LJ, Hendren R et al (2009) Examining executive functioning in children with autism spectrum disorder, attention deficit hyperactivity disorder and typical development. Psychiatry Res 166:210–222. https://doi.org/10.1016/j.psychres.2008.02.005

    Article  PubMed  PubMed Central  Google Scholar 

  21. Da Fonseca D, Seguier V, Santos A et al (2009) Emotion understanding in children with ADHD. Child Psychiatry Hum Dev 40:111–121. https://doi.org/10.1007/s10578-008-0114-9

    Article  PubMed  Google Scholar 

  22. Pelc K, Kornreich C, Foisy ML, Dan B (2006) Recognition of emotional facial expressions in attention-deficit hyperactivity disorder. Pediatr Neurol 35:93–97. https://doi.org/10.1016/j.pediatrneurol.2006.01.014

    Article  PubMed  Google Scholar 

  23. Singh SD, Ellis CR, Winton ASW et al (1998) Recognition of facial expressions of emotion by children with attention-deficit hyperactivity disorder. Behav Modif 22:128–142. https://doi.org/10.1177/01454455980222002

    Article  CAS  PubMed  Google Scholar 

  24. Cadesky EB, Mota VL, Schachar RJ (2000) Beyond words: How do children with ADHD and/or conduct problems process nonverbal information about affect? J Am Acad Child Adolesc Psychiatry 39:1160–1167. https://doi.org/10.1097/00004583-200009000-00016

    Article  CAS  PubMed  Google Scholar 

  25. Jusyte A, Gulewitsch MD, Schönenberg M (2017) Recognition of peer emotions in children with ADHD: evidence from an animated facial expressions task. Psychiatry Res 258:351–357. https://doi.org/10.1016/j.psychres.2017.08.066

    Article  PubMed  Google Scholar 

  26. Hommer RE, Meyer A, Stoddard J et al (2014) Attention bias to threat faces in severe mood dysregulation. Depress Anxiety 31:559–565. https://doi.org/10.1002/da.22145

    Article  PubMed  Google Scholar 

  27. Thomas LA, Brotman MA, Muhrer EJ et al (2012) Parametric modulation of neural activity by emotion in youth with bipolar disorder, youth with severe mood dysregulation, and healthy volunteers. Arch Gen Psychiatry 69:1257–1266. https://doi.org/10.1001/archgenpsychiatry.2012.913

    Article  PubMed  PubMed Central  Google Scholar 

  28. Brotman MA, Rich BA, Guyer AE et al (2010) Amygdala activation during emotion processing of neutral faces in children with severe mood dysregulation versus ADHD or bipolar disorder. Am J Psychiatry 167:61–69. https://doi.org/10.1176/appi.ajp.2009.09010043

    Article  PubMed  Google Scholar 

  29. Tottenham N, Phuong J, Flannery J et al (2013) A negativity bias for ambiguous facial-expression valence during childhood: converging evidence from behavior and facial corrugator muscle responses. Emotion 13:92–103. https://doi.org/10.1037/A0029431

    Article  PubMed  Google Scholar 

  30. Storebø OJ, Andersen ME, Skoog M et al (2019) Social skills training for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD008223.PUB3

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tremblay LK, Hammill C, Ameis SH et al (2020) Tracking inhibitory control in youth with ADHD: a multi-modal neuroimaging approach. Front Psychiatry 11:831. https://doi.org/10.3389/FPSYT.2020.00831/BIBTEX

    Article  Google Scholar 

  32. Peñuelas-Calvo I, Sareen A, Sevilla-Llewellyn-Jones J, Fernández-Berrocal P (2019) The “reading the mind in the eyes” test in autism-spectrum disorders comparison with healthy controls: a systematic review and meta-analysis. J Autism Dev Disord 49:1048–1061. https://doi.org/10.1007/s10803-018-3814-4

    Article  PubMed  Google Scholar 

  33. Peterson E, Miller SF (2012) The eyes test as a measure of individual differences: how much of the variance reflects verbal IQ? Front Psychol 3:220. https://doi.org/10.3389/FPSYG.2012.00220/BIBTEX

    Article  PubMed  PubMed Central  Google Scholar 

  34. Burton CL, Wright L, Shan J et al (2019) SWAN scale for ADHD trait-based genetic research: a validity and polygenic risk study. J Child Psychol Psychiatry Allied Discip 60:988–997. https://doi.org/10.1111/jcpp.13032

    Article  Google Scholar 

  35. Renaud B, Buda M, Lewis BD, Pujol JF (1975) Effects of 5,6-dihydroxytryptamine on tyrosine-hydroxylase activity in central catecholaminergic neurons of the rat. Biochem Pharmacol 24:1739–1742. https://doi.org/10.1016/0006-2952(75)90018-0

    Article  CAS  PubMed  Google Scholar 

  36. Evans SC, Bonadio FT, Bearman SK et al (2020) Assessing the irritable and defiant dimensions of youth oppositional behavior using CBCL and YSR items. J Clin Child Adolesc Psychol 49:804–819. https://doi.org/10.1080/15374416.2019.1622119

    Article  PubMed  Google Scholar 

  37. Harrison PL, Oakland T (2018) Adaptive behavior assessment system: third edition. Encycl Clin Neuropsychol 57–60. https://doi.org/10.1007/978-3-319-57111-9_1506

  38. Girli A (2014) Psychometric properties of the Turkish child and adult form of “Reading the Mind in the Eyes Test.” Psychology 05:1321–1337. https://doi.org/10.4236/psych.2014.511143

    Article  Google Scholar 

  39. Vellante M, Baron-Cohen S, Melis M et al (2013) The “reading the Mind in the Eyes” test: systematic review of psychometric properties and a validation study in Italy. Cogn Neuropsychiatry 18:326–354. https://doi.org/10.1080/13546805.2012.721728

    Article  PubMed  Google Scholar 

  40. Ros R, Graziano PA (2018) Social functioning in children with or at risk for attention deficit/hyperactivity disorder: a meta-analytic review. J Clin Child Adolesc Psychol 47:213–235. https://doi.org/10.1080/15374416.2016.1266644

    Article  PubMed  Google Scholar 

  41. Murray-Close D, Hoza B, Hinshaw SP et al (2010) Developmental processes in peer problems of children with attention-deficit/hyperactivity disorder in the multimodal treatment study of children with ADHD: developmental cascades and vicious cycles. Dev Psychopathol 22:785–802. https://doi.org/10.1017/S0954579410000465

    Article  PubMed  PubMed Central  Google Scholar 

  42. Rinke L, Candrian G, Loher S et al (2017) Facial emotion recognition deficits in children with and without attention deficit hyperactivity disorder: a behavioral and neurophysiological approach. NeuroReport 28:917–921. https://doi.org/10.1097/WNR.0000000000000858

    Article  PubMed  Google Scholar 

  43. Shankman SA, Lewinsohn PM, Klein DN et al (2009) Subthreshold conditions as precursors for full syndrome disorders: a 15-year longitudinal study of multiple diagnostic classes. J Child Psychol Psychiatry 50:1485–1494. https://doi.org/10.1111/J.1469-7610.2009.02117.X

    Article  PubMed  PubMed Central  Google Scholar 

  44. Norén Selinus E, Molero Y, Lichtenstein P et al (2016) Subthreshold and threshold attention deficit hyperactivity disorder symptoms in childhood: psychosocial outcomes in adolescence in boys and girls. Acta Psychiatr Scand 134:533–545. https://doi.org/10.1111/ACPS.12655

    Article  PubMed  PubMed Central  Google Scholar 

  45. Schiavone N, Virta M, Leppämäki S et al (2019) ADHD and subthreshold symptoms in childhood and life outcomes at 40 years in a prospective birth-risk cohort. Psychiatry Res 281:112574. https://doi.org/10.1016/J.PSYCHRES.2019.112574

    Article  PubMed  Google Scholar 

  46. Cassels TG, Birch SAJ (2014) Comparisons of an open-ended vs. forced-choice “mind reading” task: implications for measuring perspective-taking and emotion recognition. PLoS ONE 9(12):e93653. https://doi.org/10.1371/JOURNAL.PONE.0093653

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This research was conducted with the support of the Ontario Brain Institute (POND, PIs: Anagnostou/Lerch), an independent non-profit corporation, funded partially by the Ontario government. The opinions, results and conclusions are those of the authors and no endorsement by the Ontario Brain Institute is intended or should be inferred.

Author information

Authors and Affiliations

  1. Department of Psychiatry, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada

    Tomer Levy, Jennifer Crosbie & Russell James Schachar

  2. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Tomer Levy, Brendan F. Andrade, Jennifer Crosbie & Russell James Schachar

  3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Annie Dupuis

  4. Centre for Addiction and Mental Health, Toronto, ON, Canada

    Brendan F. Andrade

  5. Department of Psychology and Center for Neuroscience Studies, Queen’s University, Kingston, ON, Canada

    Elizabeth Kelley

  6. Department of Psychiatry, Lawson Health Research Institute, University of Western Ontario, London, ON, Canada

    Rob Nicolson

Authors
  1. Tomer Levy
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Annie Dupuis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brendan F. Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Crosbie
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elizabeth Kelley
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rob Nicolson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Russell James Schachar
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomer Levy.

Ethics declarations

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

This study has been approved by the Internal Review Board of our institution and was performed in accordance with the ethical standards of the Declaration of Helsinki.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 28 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Levy, T., Dupuis, A., Andrade, B.F. et al. Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability. Eur Child Adolesc Psychiatry 32, 2271–2280 (2023). https://doi.org/10.1007/s00787-022-02033-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-022-02033-3

Keywords

Search

Navigation