An assessment of dynamic facial emotion recognition and theory of mind in children with ADHD: An eye-tracking study.

Deficits in social cognition in attention deficit hyperactivity disorder (ADHD) have been associated with difficulties in functioning. Since recognizing emotional facial expressions is essential for developing the perceptual components of the theory of mind (ToM), it is important to assess this relationship in children with ADHD. This study therefore compared the recognition of emotional stimuli and gaze patterns between children with ADHD and healthy children using eye-tracking with dynamic facial images. It also examined the relationship between facial emotion recognition accuracy, gaze patterns, ToM scores, and ADHD symptoms. Children with ADHD aged 8-13 (n = 47) and a control group (n = 38) completed a facial emotion recognition test, ToM tests, and the Conners' Parent Rating Scale. Participants' gaze patterns in response to dynamic facial emotion expressions were recorded using eye-tracking technology. Children with ADHD exhibited significantly lower accuracy in the recognition of the facial expressions of disgust and anger. The percentage fixation in the eye region was also significantly lower for happy, angry, sad, disgusted, and neutral emotions in the children with ADHD compared to the control group. No relationship was determined between the percentage of fixations on facial areas of interests and ADHD symptoms or ToM tests. This study provides evidence that children with ADHD experience deficits in visual attention to emotional cues. In addition, it suggests that facial emotion recognition deficits in children with ADHD represent a separate domain of social cognition that develops independently of ToM skills and core symptoms. Understanding and treating the social difficulties of individuals with ADHD may help improve their social functioning.

Social media addiction, escapism and coping strategies are associated with the problematic internet use of adolescents in Türkiye: a multi-center study.

Introduction: The literature highlighted that problematic internet use can have detrimental consequences on individuals' well-being. Social media addiction, escapism and coping skills are closely related to problematic internet use. However, no study has currently examined the relationship between problematic internet use and social media use, escapism and coping skills. Method: This multicenter cross-sectional designed study evaluated the relationships between problematic internet use and social media addiction, escapism, and coping skills in 508 adolescents (319 female) aged 14-18 years. In order to collect data, sociodemographic data form, Internet Addiction Scale, Social Media Addiction Scale, Escapism Scale and Kidcope Adolescent Version have been used. First, adolescents who scored ≥50 on the Internet Addiction Test were classified as the problematic internet use group; adolescents who scored <50 were classified as the control group. Then, the relationships between problematic internet use and social media addiction, escapism and coping skills were evaluated. Results: The results showed that problematic internet use was associated with duration of social media use, impairment in social media-related functionality, preferring virtual life, and virtual pleasure, escapism, avoidant and negative coping strategies. Conclusion: These findings may provide an empirical basis for problematic internet use prevention and intervention in adolescence.

The Relationship between Giftedness and Sex and Children's Theory of Mind Skills and Social Behavior.

BACKGROUND: Theory of mind (ToM), the ability to recognize the mental states and emotions of others, is central to effective social relationships. Measuring higher-order ToM skills in gifted children may be a useful way to identify the tendency to experience difficulties in social behavior. The aim of this study was to investigate the relationship between intelligence and sex in children using ToM and social behavior measures. METHODS: Children aged 10-12 years constituted both the gifted (n = 45) and non-gifted (n = 45) groups. The participants were assessed for prosocial behaviors and peer problems using the subscales of the Strength and Difficulties Questionnaire and in terms of ToM using the Reading the Mind in the Eyes Test-Child Version (RMET-C) and the Faux Pas Recognition Test-Child Version (FPRT-C). RESULTS: ToM test results were higher in gifted children and girls. Peer problems were lower in gifted children. Prosocial behavior was higher in girls. No relationship was determined between ToM tests and peer problems or prosocial behavior in gifted children, but such a relationship was observed in the non-gifted group. CONCLUSIONS: This study shows that gifted children with high cognitive skills also possess superior social cognition skills. Advanced ToM skills in gifted children may be important to supporting their social and cognitive development. The differences between boys and girls should be considered in educational interventions applied to children in the social sphere.

Objective Parameters in Attention Deficit Hyperactivity Disorder: Eye and Head Movements.

OBJECTIVE: We aimed to evaluate eye and head movements, which are objective parameters in ADHD. Method: While the children were watching the course video task, which included the relevant (teacher and smart board) and irrelevant (any regions outside the relevant area) areas of interest, their eye movements were evaluated through eye tracking, and video recordings were made simultaneous. Head position estimation was made using through video recordings. The proportion of total fixation duration on areas of interest (PFDAOI) and saccade count, amplitude, velocity for eye movements, number of total head movements and angular change of head movement in x-y-z axes for head movements were compared. RESULTS: Children with ADHD had lower PFDAOI on the relevant area, and had more saccade and head movements The angular change of head movement in the x-axis was higher in the ADHD group. CONCLUSION: In the assessment of ADHD, the eye and head movements may be particulary useful.

Continuation of Treatment in Children With ADHD: A Multicenter Turkish Sample Study.

OBJECTIVES: The aim of this study was to investigate the variables that may affect treatment continuation in children aged 6 to 12 years who were newly diagnosed with ADHD. METHODS: A total of 132 children diagnosed with ADHD and their parents participated in the study. Sociodemographic and clinical risk factors affecting continuation of treatment were examined using logistic regression analysis. RESULTS: Multiple model examination revealed that greater age increased the risk of treatment discontinuation 1.824 times (p = .003) while a lower total length of paternal education increased the risk of discontinuation (1/0.835) 1.198 times (p = .022). Other variables emerging as significant in the univariate model lost that significance in the multiple model. CONCLUSIONS: Understanding the variables associated with medication discontinuation in ADHD in different populations and taking these variables into account in the development of health policies, will be useful in improving the long-term devastating effects of the disorder.

The effect of methylphenidate on pain perception thresholds in children with attention deficit hyperactivity disorder.

BACKGROUND: Pain perception is important in children with attention deficit hyperactivity disorder (ADHD) since they are more likely to experience painful events due to increased accident rates. The aim of this study is to contribute to the literature concerning the relationship between ADHD diagnosis, methylphenidate (MPH) therapy, and pain thresholds, since findings regarding the change in pain perception in children with ADHD are scarce and inconsistent. METHODS: Children aged 8-13 years constituted both the ADHD group (n = 82) and the healthy controls (n = 41). The ADHD group was divided into two subgroups, ADHD without MPH (not treated pharmacologically) and ADHD with MPH (treated pharmacologically for at least three-months). The Conners' Parent Rating Scale-Revised: Short Form was employed to assess ADHD, a visual analog scale was applied to evaluate chronic pain severity, and a manual pressure algometer was used to assess pain thresholds. RESULT: Children with ADHD had lower pain thresholds than the healthy controls (P < 0.05). However, lower regional pain thresholds were observed in the ADHD group without MPH compared to both the healthy control and ADHD with MPH groups. Although pain thresholds in the ADHD with MPH group were regionally lower than in the healthy controls, low pain thresholds were found in fewer regions compared to the ADHD without MPH group. CONCLUSIONS: Children with ADHD are more sensitive to pain sensation, and MPH may help normalize these individuals' pain experiences by raising pain thresholds. Families and clinicians must be aware of situations that may cause pain in children with ADHD. In addition, these children's low threshold for pain may lead them to experience it more intensely.

Functional Impairments and Related Factors in Adolescents with Attention Deficit Hyperactivity Disorder During the COVID-19 Normalization Stage.

Background: Attention deficit hyperactivity disorder is a disorder associated with significant functional impairments that can have important consequences for the individual and the society. Those with attention deficit hyperactivity disorder were reported to be more vulnerable in the face of difficulties and experience more psychological problems during the coronavirus disease 2019 pandemic. It was shown that the psychological problems experienced during the pandemic could persist during the normalization stage. We aimed to assess functional impairment in adolescents with attention deficit hyperactivity disorder and the related factors during the normalization stage which involved the initiation of fully face-to-face schooling practices. Methods: This is a cross-sectional study including attention deficit hyperactivity disorder (n = 52) and a healthy control group (n = 52). Functional impairment was assessed using the Weiss functional impairment rating scale self and parent forms. We also examined the factors associated with functional impairment (internalizing-externalizing problems, parenting strategies, and perceived expressed emotion). Results: Adolescents with attention deficit hyperactivity disorder had higher functional impairment scores on Weiss functional impairment rating scale self and parent in all sub-domains and total. Weiss functional impairment rating scale self and parent total mean score had a positive correlation with negative parenting and externalizing-internalizing scores and a negative correlation with the positive parenting score. Weiss functional impairment rating scale-self total mean score was positively correlated with negative parenting and externalizing-internalizing scores and perceived expressed emotion scores. Conclusion: Our results suggest that the effects of the pandemic on children's functioning may persist in the normalization stage. For a comprehensive evaluation and effective intervention, it is important that comorbid symptoms, parenting strategies, and the perceived family climate are evaluated from the perspectives of both the parent and the adolescent.

The Relationship of Clinical Symptoms with Social Cognition in Children Diagnosed with Attention Deficit Hyperactivity Disorder, Specific Learning Disorder or Autism Spectrum Disorder.

OBJECTIVE: One of the areas of social cognition is Theory of Mind (ToM) is defined as the capacity to interpret, infer and explain mental states underlying the behavior of others. When social cognition studies on neurodevelopmental disorders are examined, it can be seen that this skill has not been studied sufficiently in children with Specific Learning Disorder (SLD). METHODS: In this study, social cognition skills in children diagnosed with attention deficit hyperactivity disorder (ADHD), SLD or Autism Spectrum Disorder (ASD) evaluated before puberty and compared with controls. To evaluate the ToM skills, the first and secondorder false belief tasks, the Hinting Task, the Faux Pas Test and the Reading the Mind in the Eyes Task were used. RESULTS: We found that children with neurodevelopmental disorders as ADHD, ASD, and SLD had ToM deficits independent of intelligence and language development. There was a significant correlation between social cognition deficits and problems experienced in many areas such as social communication and interaction, attention, behavior, and learning. CONCLUSION: Social cognition is an important area of impairment in SLD and there is a strong relationship between clinical symptoms and impaired functionality.

Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD.

OBJECTIVE: In literature, recent evidence has shown that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment. METHOD: The study group comprised 40 adolescents (age, 12-18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity. RESULTS: Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: -0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86). CONCLUSION: The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.