Children with disruptive-mood-dysregulation disorder and ADHD process facial affect less efficiently than those with ADHD and healthy controls

Abstract

Children with disruptive mood dysregulation disorder (DMDD) and ADHD demonstrate difficulty attributing emotions to facial expressions. We investigated how facial emotion judgments are psycho-mechanistically altered in DMDD+ADHD ( N = 18) compared to age-matched children with ADHD ( N = 15) and healthy controls (HC; N = 19). The participants’ ages ranged between 6 and 15. Participants distinguished the valence of facial expressions when feedback was congruent versus incongruent. The DMDD+ADHD group exhibited difficulty in differentiating affective stimuli compared to the ADHD and HC groups. Drift-diffusion modelling revealed that the information-processing efficiency of children with DMDD+ADHD for angry faces was insensitive to the type of feedback. Notably, regardless of feedback type and facial expression valence, children with DMDD+ADHD exhibited reduced efficiency in integrating evidence compared to HCs. The ADHD group demonstrated greater efficiency in processing angry facial expressions with congruent feedback than the DMDD+ADHD group. These results demonstrate impaired decision processes in DMDD+ADHD, characterized by inefficient cue integration, specifically in response to negative emotional stimuli, and by the insensitivity of the DMDD+ADHD group’s performance to feedback type.