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Child Neuropsychology
A Journal on Normal and Abnormal Development in Childhood and Adolescence
Volume 22, 2016 - Issue 3
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Original Articles

Executive and attentional contributions to Theory of Mind deficit in attention deficit/hyperactivity disorder (ADHD)

, , , , , & show all
Pages 345-365 | Received 30 Aug 2013, Accepted 22 Jan 2015, Published online: 12 Mar 2015
 

Abstract

Attention deficit/hyperactivity disorder (ADHD) in children has been associated with attentional and executive problems, but also with socioemotional difficulties possibly associated with deficits in Theory of Mind (ToM). Socioemotional problems in ADHD are associated with more negative prognoses, notably interpersonal, educational problems, and an increased risk of developing other psychiatric disorders that emphasize the need to clarify the nature of their ToM deficits. In this study, we hypothesized that ToM dysfunction in children with ADHD is largely attributable to their attentional and/or executive deficits. Thirty-one children with ADHD (8–12 years, IQ > 85) and 31 typically developing (TD) children were assessed using executive functions (inhibition, planning, and flexibility) and attentional tasks, as well as two advanced ToM tasks (Reading the Mind in the Eyes and Faux Pas) involving different levels of executive control. Children with ADHD performed more poorly than TD children in attentional, executive function, and ToM tasks. Linear regression analyses conducted in the ADHD group indicated that inhibition scores predicted performance on the “Faux Pas” task the best, while attention scores were the best for predicting performance on the Reading the Mind in the Eyes task. When controlled for inhibition and attentional variables, ToM performance in children with ADHD was actually similar to TD children. Contrarily, controlling for ToM scores did not normalize performance for inhibition and attentional tasks in children with ADHD. This unidirectional relationship suggests that deficits in the EF and attentional domains are responsible for ToM deficits in ADHD, which therefore may contribute to their socioemotional difficulties.

We warmly thank the children and their parents who kindly took part in this research, as well as the schools and the teachers who agreed to collaborate in this study. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors also thank Jeromy Hrabovecky for proofreading and language editing in this article.

Additional information

Funding

This research was partially supported by the Belgian National Fund for Scientific Research [Grant number FNRS 3.4.516.08 .F]. AM, IM and VD are supported by the Belgian National Fund for Scientific Research (FNRS).

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