Misinterpreting Emotional Expressions in Attention-Deficit/Hyperactivity Disorder: Evidence for a Neural Marker and Stimulant Effects
Abstract
Background In addition to cognitive impairment, there are disruptions to mood and emotion processing in attention-deficit/hyperactivity disorder (ADHD) but little is known about their neural basis. We examined ADHD disturbances in mood and emotion recognition and underlying neural systems before and after treatment with stimulant medication.Methods Participants were 51 unmedicated ADHD adolescents and 51 matched healthy control subjects rated for depressed and anxious mood and accuracy for identifying facial expressions of basic emotion. Brain function was recorded using event-related potentials (ERPs) while subjects viewed these expressions. ADHD subjects were retested after 4 weeks, following treatment with methylphenidate (MPH).Results ADHD subjects showed a profile of emotion-related impairment: higher depression and anxiety, deficits in identifying threat-related emotional expressions in particular, and alterations in ERPs. There was a pronounced reduction in occipital activity during the early perceptual analysis of emotional expression (within 120 msec), followed by an exaggeration of activity associated with structural encoding (120-220 msec) and subsequent reduction and slowing of temporal brain activity subserving context processing (300-400 msec). Methylphenidate normalized neural activity and produced some improvement of emotion recognition but had no impact on negative mood. Improvements in neural activity with MPH were consistent predictors of improvement in clinical features of emotional lability and hyperactivity.Conclusions Objective behavioral and brain function measures of emotion processing may provide a valuable addition to the clinical armamentarium for assessing emotional disturbances in ADHD and the efficacy of stimulants for treating these disturbances.
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This behavioral normalization is accompanied by normalization of underlying neural activity.
“This behavioral normalization is accompanied by normalization of underlying neural activity (80, 82, 92).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [80]
These studies linked early processing deficits with self-rated emotional lability.
“These studies further linked these early processing deficits with self-rated emotional lability.”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [80]
Two studies found that the enhanced early sensory encoding of affectively charged stimuli is reduced in adults with ADHD when viewing positive, though not negative, stimuli.
“Two studies found that this effect is reduced in adults with ADHD when viewing positive, though not negative stimuli (80, 81); this would be expected to cause over-perception of negative stimuli.”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [80]
Among individuals with ADHD, psychostimulants also improve emotion recognition, and normalize both the startle modulation by affective stimuli and performance on the emotional Stroop task.
“Among individuals with ADHD, psychostimulants also improve emotion recognition (80), and normalize both the startle modulation by affective stimuli (82) and performance on the emotional Stroop task (92).”
From Emotion Dysregulation in Attention Deficit Hyperactivity Disorder (2014) · cites this paper as [80]
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- Authors
- Williams, L. M., Hermens, D. F., Palmer, D., Kohn, M., Clarke, S., Keage, H., Clark, C. R., & Gordon, E.
- Affiliations
- The University of Sydney (AU)
- Flinders University (AU)
- Corresponding author
- Williams, Leanne M.
- Venue
- Biological Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-05
- Volume
- 63
- Issue
- 10
- Pages
- 917-926
- ISSN
- 0006-3223 (ISSN-L)
- OpenAlex
- W2125473615
- Cited by
- 207
- References
- 53
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 8 · 2020: 18 · 2019: 15 · 2018: 15 · 2017: 18 · 2016: 11 · 2015: 15 · 2014: 20 · 2013: 15 · 2012: 13
- FWCI
- 8.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Keywords
- attention deficit hyperactivity disorder, emotion recognition, facial expression perception, methylphenidate, stimulant medication, depression, anxiety, event-related potentials, neural markers, adolescents, emotional lability, hyperactivity
- MeSH terms
- Adolescent, Central Nervous System Stimulants, Anxiety, Attention Deficit Disorder with Hyperactivity, Brain Mapping, Child, Depression, Electroencephalography, Emotions, Evoked Potentials, Visual, Facial Expression, Female, Humans, Male, Methylphenidate, Pattern Recognition, Visual, Photic Stimulation, Case-Control Studies
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