Interpretation of ambiguous facial affect in adults with attention-deficit/hyperactivity disorder.

In addition to impairments in cognitive functioning, attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in interpersonal functioning as well which are assumed to stem from a distorted perception or interpretation of affective information. While previous research suggests that the decoding of negatively valenced facial stimuli is impaired, less is known about the potential interpretation biases in ADHD which are linked to other externalizing psychopathologies. The present study investigated interpretation biases in adults with ADHD (N = 65) and controls (N = 49) using ambiguous facial stimuli (angry/happy, angry/fearful, fearful/happy blends) with different proportions of each emotion. Participants indicated the dominant emotion and rated the perceived intensity of each image. While impaired processing of fearful expressions was evident in the ADHD group, the results of the current study do not provide support for an interpretation bias in adults with ADHD. These findings suggest that interpretation biases may be restricted to aggressive psychopathology and cannot be generalized to individuals with ADHD.

Behavioral and electrophysiological responses to fairness norm violations in antisocial offenders.

Antisocial personality disorder is characterized by a stable, lifelong pattern of disregard for and violation of others' rights. Disruptions in the representation of fairness norms may represent a key mechanism in the development and maintenance of this disorder. Here, we investigated fairness norm considerations and reactions to their violations. To examine electrophysiological correlates, we assessed the medial frontal negativity (MFN), an event-related potential previously linked to violations of social expectancy and norms. Incarcerated antisocial violent offenders (AVOs, n = 25) and healthy controls (CTLs, n = 24) acted as proposers in the dictator game (DG) and ultimatum game (UG) and received fair vs. unfair UG offers from either another human (social context) or a computer (non-social context). Results showed that AVOs made lower offers in the DG but not the UG, indicating more rational and strategic behavior. Most importantly, when acting as recipients in the UG, acceptance rates were modulated by social context in CTLs, while AVOs generally accepted more offers. Correspondingly, ERP data indicated pronounced MFN amplitudes following human offers in CTLs, whereas MFN amplitudes in AVOs were generally reduced. The current data suggest intact fairness norm representations but altered reactions to their violation in antisocial personality disorder.

Does Social Exclusion Alter Sensory and Pain Thresholds in Children and Adolescents with Functional Abdominal Pain? - Results from a Preliminary Study.

OBJECTIVE: Functional abdominal pain (AP) is a prevalent issue in childhood and adolescence. The contribution of psychosocial factors in the development and maintenance of this health problem is rather unclear, and experimental studies about underlying mechanisms are lacking. This study investigates whether experimentally induced social exclusion decreases sensory and pain thresholds in children suffering from AP. SUBJECTS: Twenty children/adolescents with AP and 22 healthy controls. METHODS: Children/adolescents participated in the Cyberball paradigm, which affects an experience of social exclusion. Thermal sensory and pain thresholds were measured before and after Cyberball. RESULTS: Children/adolescents with AP showed a divergent reaction regarding their sensory threshold after social exclusion: The control group exhibited a tendency toward a decreased sensory threshold whereas the AP group remained stable. Concerning the pain threshold, no effect of social exclusion could be identified. The increase of both thresholds ("numbing") after Cyberball was positively correlated with symptoms of mental health issues. CONCLUSIONS: This is the first study to investigate changes in sensory and pain thresholds following painful social interactions in a sample of children/adolescents with a chronic pain condition. Results suggest that AP and control children differ in their reaction of sensory thresholds, which might indicate an altered processing of social exclusion. Replication and further methodological improvements are needed.

Binocular rivalry transitions predict inattention symptom severity in adult ADHD.

Attention deficit and hyperactivity disorder (ADHD) is a prevalent childhood disorder that is often maintained throughout the development and persists into adulthood. Established etiology models suggest that deficient inhibition underlies the core ADHD symptoms. While experimental evidence for impaired motor inhibition is overwhelming, little is known about the sensory inhibition processes, their changes throughout the development, and the relationship to ADHD symptoms. Here, we used the well-established binocular rivalry (BR) paradigm to investigate for the very first time the inhibitory processes related to visual perception in adults with ADHD. In BR, perception alternates between two dichoptically presented images throughout the viewing period, with shorter dominant percept durations and longer transition periods indicating poorer suppression/inhibition. Healthy controls (N = 28) and patients with ADHD (N = 32) were presented with two dissimilar images (orthogonal gratings) separately to each eye through a mirror stereoscope and asked to report their perceptual experiences. There were no differences between groups in any of the BR markers. However, an association between transition durations and symptom severity emerged in the ADHD group. Importantly, an exploratory multiple regression analysis revealed that inattention symptoms were the sole predictor for the duration of transition periods. The lack of impairments to sensory inhibition in adult, but not pediatric ADHD may reflect compensatory changes associated with development, while a correlation between inhibition and inattention symptoms may reveal an invariant core of the disorder.

Impaired social cognition in violent offenders: perceptual deficit or cognitive bias?

Aggressive behavior is assumed to be associated with certain patterns of social information processing. While some theories link aggression to a tendency to interpret ambiguous stimuli as hostile (i.e., enhanced sensitivity to anger), others assume an insufficient ability to perceive emotional expressions, particularly fear. Despite compelling evidence to support both theories, no previous study has directly investigated the predictions made by these two accounts in aggressive populations. The aim of the current study was to test processing patterns for angry and fearful facial expressions in violent offenders (VOs) and healthy controls (CTLs) and their association with self-reported aggression and psychopathy scores. In Experiment 1, we assessed perceptual sensitivity to neutral-emotional (angry, fearful, happy) blends in a task which did not require categorization, but an indication whether the stimulus is neutral or emotional. In Experiment 2, we assessed categorization performance for ambiguous fearful-happy and angry-happy blends. No group differences were revealed in Experiment 1, while Experiment 2 indicated a deficit in the categorization of ambiguous fearful blends in the VO group. Importantly, this deficit was associated with both self-reported psychopathy and aggression in the VO, but not the CTL group. The current study provides evidence for a deficient categorization of fearful expressions and its association with self-reported aggression and psychopathy in VOs, but no support for heightened sensitivity to anger. Furthermore, the current findings indicate that the deficit is tied to categorization but not detection stages of social information processing.

Smooth criminal: convicted rule-breakers show reduced cognitive conflict during deliberate rule violations.

Classic findings on conformity and obedience document a strong and automatic drive of human agents to follow any type of rule or social norm. At the same time, most individuals tend to violate rules on occasion, and such deliberate rule violations have recently been shown to yield cognitive conflict for the rule-breaker. These findings indicate persistent difficulty to suppress the rule representation, even though rule violations were studied in a controlled experimental setting with neither gains nor possible sanctions for violators. In the current study, we validate these findings by showing that convicted criminals, i.e., individuals with a history of habitual and severe forms of rule violations, can free themselves from such cognitive conflict in a similarly controlled laboratory task. These findings support an emerging view that aims at understanding rule violations from the perspective of the violating agent rather than from the perspective of outside observer.

Theory of mind abilities in patients with psychogenic nonepileptic seizures.

BACKGROUND: Psychogenic nonepileptic seizures (PNES) have been frequently linked to deficits in affect regulation and altered processing of emotionally salient information. However, less is known about how patients suffering from PNES actually process and interpret affective social stimuli. Thus, the present study aimed to investigate basal facial affect recognition as well as mind-reading skills in a sample of patients with PNES and matched control subjects. METHODS: Patients with PNES (N=15) and healthy controls (N=15) completed self-report questionnaires that measured alexithymia and perceived stress vulnerability. Affect perception was tested using a series of computerized movies of models whose facial expressions slowly change from neutral to full-blown emotions (anger, fear, sadness, happiness, disgust, and surprise), allowing for a fine-grained assessment of facial emotion recognition impairments. Further, all participants were presented with the Movie for the Assessment of Social Cognition, a well-validated video-based test for the evaluation of subtle mind-reading deficits. RESULTS: Data analyses revealed increased alexithymic traits and, impaired mentalizing skills in individuals with PNES, while basal facial expression recognition was not compromised. DISCUSSION: The present findings are the first to demonstrate that patients with PNES exhibit several deficits in reasoning about their own and other people's mental states. Patients with PNES may benefit from psychotherapeutic interventions that focus on disturbed affect regulation and aim to enhance emotional awareness.

Investigation of the hostile attribution bias toward ambiguous facial cues in antisocial violent offenders.

Aggressive individuals exhibit a strong tendency to attribute hostile intent to the behavior of others, which may lead to provocation and aggravation of socially inappropriate reactions. Limited research has investigated the hostile attribution bias in the perception of facial affect. This study examined a hostile response bias to emotionally ambiguous faces in a population of 55 incarcerated antisocial violent offenders as compared to matched control subjects. Results suggest that aggression is associated with a strong preference to interpret ambiguous stimuli containing proportions of an angry expression as hostile, while there was no evidence for a generally biased interpretation of distress cues under conditions of uncertainty. Thus, the tendency to misinterpret nonverbal cues in social interactions may at least partly underlie aggressive-impulsive behavior in susceptible individuals.

Depression, posttraumatic stress, and risk factors following spinal cord injury.

BACKGROUND: Chronic depression and posttraumatic stress have been frequently observed in populations of accident victims with spinal cord injuries. Studies suggest that various risk factors contribute to the development and maintenance of these symptoms. PURPOSE: This study assessed psychopathology around 4 years post-discharge in a German sample of 102 participants with spinal cord injuries. METHODS: A wide range of sociodemographic, clinical, and psychological variables was investigated with regard to their association with psychopathology. RESULTS: Approximately half of the patients (46.1 %) retrospectively reported clinically relevant depressive symptoms immediately post-discharge and 12.7 % exhibited scores indicative of a present depressive disorder. In addition, 8.8 % retrospectively reported clinically relevant symptoms of posttraumatic stress disorder (PTSD) after discharge from the hospital and 2 % were currently identified with chronic PTSD symptomatology. Time since injury and negative trauma-related appraisals of the self were strongly related to current psychopathology. CONCLUSION: Depressive reactions and posttraumatic distress may commonly occur after spinal injuries but will usually improve over time. It might be useful to routinely arrange follow-up contacts post-discharge in order to timely identify patients who are at risk of developing chronic psychopathology and require intervention.

Intact prioritization of fearful faces during continuous flash suppression in psychopathy.

Affective state recognition and in particular the identification of fear is known to be impaired in psychopathy. It is unclear, however, whether this reflects a deficit in basic perception ('fear blindness') or a deficit in later cognitive processing. To test for a perceptual deficit, 63 male incarcerated offenders, assessed with the Hare Psychopathy Checklist-Revised (PCL-R), detected fearful, neutral, and happy facial expressions rendered invisible through continuous flash suppression (CFS). Fearful faces were detected faster than neutral and happy faces. There was no reduction of the fear advantage in the 20 offenders diagnosed with psychopathy according to the PCL-R, and there was no correlation between the fear advantage and PCL-R scores. Deficits in the processing of fearful facial expressions in psychopathy may thus not reflect fear blindness, but impairments at later postperceptual processing stages. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Early predictors of posttraumatic stress in accident victims.

This study investigated the predictive value of pretraumatic and peritraumatic variables and early PTSD-like symptoms (within 48 h post-event) in determining the severity of posttraumatic stress in accident victims. Symptom development appears to be related to initial PTSD-like reactions, while demographic variables play a role in predicting symptom severity 6 months post-event.

Eye contact during live social interaction in incarcerated psychopathic offenders.

Psychopathy is characterized by a lack of empathy, callousness, and a range of severe antisocial behaviors. A deficit to accurately process social cues, which has been widely documented in psychopathic populations, is assumed to underlie their pathological development. Impaired attention to socially salient cues, such as the eyes of an interaction partner, is a possible mechanism compromising the development of social cognition. Preliminary evidence from static facial stimuli suggests that psychopathy is indeed linked to reduced eye gaze. However, no study to date has investigated whether these mechanisms apply to naturalistic interactions. This study is the first to examine patterns of visual attention during live social interactions and their association with symptom clusters of psychopathy. Eye contact was assessed in a sample of incarcerated offenders (N = 30) during semistructured face-to-face interactions with a mobile eye-tracking headset and analyzed using a novel automated areas of interest (e.g., eye region) labeling technique. The interactions included an exchange on neutral predetermined topics and included a condition in which the participants were active (talking) and passive (listening). The data reveal that across both listening and talking conditions higher affective psychopathy is a significant predictor of reduced eye contact (listening: r = -.39; talking: r = -.43). The present findings are in line with previous research suggesting impaired attention to social cues in psychopathy. This study is the first to document these deficits in naturalistic, live social interaction and therefore provides important evidence for their relevance to real-life behavior. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Designing Visual-Arts Education Programs for Transfer Effects: Development and Experimental Evaluation of (Digital) Drawing Courses in the Art Museum Designed to Promote Adolescents' Socio-Emotional Skills.

An active engagement with arts in general and visual arts in particular has been hypothesized to yield beneficial effects beyond arts itself. So-called cognitive and socio-emotional "transfer" effects into other domains have been claimed. However, the empirical basis of these hopes is limited. This is partly due to a lack of experimental comparisons, theory-based designs, and objective measurements in the literature on transfer effects of arts education. Therefore, the aim of the present study was to design and experimentally investigate a theory-based visual-arts education program for adolescents aged between 12 and 19 years (M age = 15.02, SD age = 1.75). The program was delivered in a museum context in three sessions and was expected to yield specific and objectively measurable transfer effects. To conduct a randomized field trial, three strictly parallelized and standardized art courses were developed, all of which addressed the topic of portrait drawing. The courses mainly differed regarding their instructional focus, which was either on periods of art history, on the facial expression of emotions, or on the self-perception of a person in the context of different social roles. In the first and more "traditional" course portrait drawing was used to better understand how portraits looked like in former centuries. The two other courses were designed in a way that the artistic engagement in portrait drawing was interwoven with practicing socio-emotional skills, namely empathy and emotion recognition in one course and understanding complex self-concept structures in the other. We expected positive socio-emotional transfer effects in the two "psychological" courses. We used an animated morph task to measure emotion recognition performance and a self-concept task to measure the self-complexity of participants before and after all three courses. Results indicate that an instructional focus on drawing the facial expressions of emotions yields specific improvements in emotion recognition, whereas drawing persons in different social roles yields a higher level of self-complexity in the self-concept task. In contrast, no significant effects on socio-emotional skills were found in the course focussing on art history. Therefore, our study provides causal evidence that visual-arts programs situated in an art-museum context can advance socio-emotional skills, when designed properly.

Risky business! Behavioral bias and motivational salience of rule-violations in children with conduct disorder.

Conduct disorder is characterized by both habitual aggression as well as non-aggressive rule-breaking behavior. While a large body of research has focused on aggressive behavior to date, the subtype of non-aggressive rule-breaking behavior is poorly understood. The current study represents a first attempt to directly assess decision biases toward rule-breaking behavior, their motivational salience, and the association with interpersonal factors in conduct disorder. Participants (n = 20 children with conduct disorder and n = 20 healthy controls) played a video game with the goal to deliver a hot pizza by bicycle to a marked location on a two-dimensional city map. In each trial, participants decided whether to use the regular route (streets) or opt for a potential shortcut that was either permitted (bicycle lane) or prohibited (park). The efficiency of the shortcut was parametrically varied to assess individual decision functions. Consistent with our hypotheses, group differences emerged only when taking a shortcut represented a rule violation (park condition), with the conduct disorder group committing significantly more rule violations than controls. Furthermore, conduct disorder children showed a substantial frequency of rule violations even in the absence of shortcut related gains, indicating a pronounced insensitivity towards sanctions. Importantly, this tendency was associated with self-reported impulsivity and rule violations in real life.

Impaired attention toward the eyes in psychopathic offenders: Evidence from an eye tracking study.

Attention orienting to socially salient cues, such as the eyes of interaction partners, is assumed to be crucial for the development of intact social cognition. Dysfunctions in such basic processes that guide the perception of social cues have been suggested to play a role in the development of psychopathy. The present study investigated gaze patterns in two groups of incarcerated psychopathic and non-psychopathic offenders. While recording their eye movements, participants were asked to categorize either gender (task 1) or emotional expression (task 2) of facial images. Psychopaths exhibited significantly reduced attention orienting toward the eyes, as indicated by absolute dwell time as well as frequency of the initial fixation on the eye region. This pattern was evident across all emotional expressions and independent of the task. The present results suggest a pervasive impairment to attention orienting toward the eyes in psychopaths compared to non-psychopathic offenders. This impairment appears to affect not only general attention but also early attention shifts. Thus, our findings provide evidence that these dysfunctions might particularly contribute to the development of psychopathy instead of antisocial behavior per se. Future studies should further examine the origin, emergence, and consequences of these impairments in order to develop targeted interventions.

Processing of Dynamic Affective Information in Adults With ADHD.

OBJECTIVE: ADHD has been repeatedly linked to problems in social functioning. Although some theories assume that the emotion recognition deficits are explained by general attentional deficits, mounting evidence suggests that they may actually constitute a distinct impairment. However, it remains unclear whether the deficient processing affects specific emotional categories or may generalize to all basic emotions. The present study aims to investigate these questions by assessing the sensitivity to all six basic emotions in adults with ADHD. METHOD: The participants judged the emotion onset in animated morph clips displaying facial expressions that slowly changed from neutral to emotional. RESULTS: ADHD participants exhibited an impaired recognition of sad and fearful facial expressions. CONCLUSION: The present findings indicate that ADHD is possibly associated with a specific deficit in the recognition of facial emotions signaling negative social feedback.

Investigating social-contextual determinants of cooperation in incarcerated violent offenders.

Antisocial and psychopathic personality traits constitute a severe and treatment resistant form of externalizing psychopathology. While deficits in social information processing have been extensively investigated in these individuals, less is known about their capacity for altruism and cooperation. In particular, no studies to date have investigated whether established social-contextual determinants of cooperation, e.g., group affiliation and number of expected interactions, can motivate cooperative behaviour in antisocial individuals. The present study compared cooperative behaviour of incarcerated violent offenders (N = 52) and controls (N = 46) by using an established social interaction paradigm (Give Some Dilemma) where two players divide monetary units between themselves and the counterpart. Group affiliation (in- vs. out-group) and number of expected interactions (single-trial vs. repeated-trial interactions) were manipulated. Violent offenders as compared to controls shared less monetary units with their counterparts, indicating an overall reduced cooperation. Both groups showed increased cooperation rates towards in-group members and in repeated interactions. Higher psychopathic traits were associated with lower cooperation in single-trial interactions in the violent offender group. Although cooperation was comparably reduced in violent offenders, behaviour in both groups was determined by the number of expected interactions as well as group affiliation, thus providing evidence for equivalent social-contextual determinants.

Distraction by salient stimuli in adults with attention-deficit/hyperactivity disorder: Evidence for the role of task difficulty in bottom-up and top-down processing.

The cognitive mechanisms of increased distractibility in attention-deficit/hyperactivity disorder (ADHD) are poorly understood. The current study investigated the influence of two major modulating factors (emotional saliency, task difficulty) on behavioral and electrophysiological parameters underlying distractibility in ADHD. In addition, the attentional focus (indirect and direct processing of distractors) was examined. Thirty-six adults with ADHD and 37 healthy controls completed two experimental tasks while electroencephalography (EEG) data was collected. Task 1 assessed indirect processing of emotional or neutral distractors during a perceptual judgment task with varying task difficulty. Task 2 measured direct processing of the emotional or neutral stimuli and required participants to rate the stimuli regarding valence and arousal. Results showed that adults with ADHD exhibited generally higher behavioral distractibility than healthy controls. Furthermore, the ADHD group exhibited an enhanced bottom-up processing [increased early posterior negativity (EPN) amplitudes] of distractors in trials with high task difficulty as well as enhanced top-down processing [increased late positive potential (LPP) amplitudes] in trials with low task difficulty. However, no group differences were evident in the neural processing of emotional content or between attentional focus conditions. These findings support the notion that distractibility in ADHD results from impairments to both top-down as well as bottom-up processes and underscore the importance of task difficulty as a modulating factor.

Frontal alpha asymmetry and callous-unemotional traits in imprisoned violent offenders: A pilot study.

Based on the approach-withdrawal model of hemispheric asymmetry, anger and aggression have been linked to an approach-related pattern, characterized by stronger relative left-hemispheric anterior cortical activity. Recent work suggests that also in individuals with extremely violent tendencies, such as imprisoned offenders, approach-related asymmetry may be associated with self-reported trait anger and aggression. A putative association between alpha asymmetry and further characteristics relevant for aggression, such as callous-unemotional (CU) traits, remains to be explored. CU traits may increase the probability of aggressive behavior; nevertheless, they may also enable individuals to inhibit and postpone the overt display of aggression until circumstances grant its strongest impact. In the current exploratory study, we measured trait aggression, CU traits, and resting-state EEG asymmetry in the alpha band (8-13 Hz) in imprisoned violent offenders in a German high security prison. Results revealed that particularly trait callousness was associated with stronger relative right-hemispheric anterior cortical activity (i.e., a withdrawal-related pattern). An association between alpha asymmetry and aggression was not replicated. These preliminary findings suggest that, due to the involved emotional and interpersonal detachment, callousness might be withdrawal related, despite its potential to bring about aggressive behavior. They also imply that the identification of putative clinical subtypes in prisoners is required, as varying psychopathology might undermine an association between alpha asymmetry and aggression.

Empathy and altruistic behavior in antisocial violent offenders with psychopathic traits.

Deficiencies in empathic functioning are considered a core characteristic of violent behavior. Enhancing empathy in aggressive populations may thus represent a promising intervention target. Hence, the aims of the present work were two-fold: First, we wanted to thoroughly assess empathic competencies and second, we aimed to investigate effects of an empathy induction on experienced empathy levels and prosocial behavior in a sample of violent offenders relative to matched controls. Empathy was assessed using both self-report as well as objective measures. For the empathy induction, participants were presented with empathy inducing and control videos. To assess the effects of the empathy induction on behavior, participants played a dictator game indicative of prosocial behavior after every video. Violent offenders showed no systematic impairment in empathy measures. Despite lower shares in the dictator game across conditions, the empathy induction led to a substantial increase in prosocial behavior in both groups. Importantly, high psychopathy scores were distinctively associated with lower self-reported empathy levels, an attenuated affective responsiveness to the empathy induction, and less altruistic behavior. Treatment programs aiming to improve empathy should take individual characteristics into account and may be applied to distinctive subgroups rather than to violent offenders per se.