Impaired empathy but no theory of mind deficits in adult attention deficit hyperactivity disorder

Abstract

Objective

The cognitive capacity to change perspective is referred to as theory of mind (ToM). ToM deficits are detectable in a variety of psychiatric and neurological disorders. Since executive abilities are closely associated with ToM skills, we suspected that due to a common neuropsychological basis, ToM deficits exist in treatment‐naïve adults with attention‐deficit/hyperactivity disorder (ADHD).

Methods

Performance of treatment‐naïve adults with ADHD ( N = 30) in tasks assessing executive functions (Trail Making Test, Stroop color–word test, and Test Battery for Attentional Performance), empathy skills (Cambridge Behaviour Scale), and ToM (Movie for Assessment of Social Cognition) was compared with that of a healthy control group ( N = 30) matched according to basic demographic variables.

Results

Compared to healthy controls, treatment‐naïve adults with ADHD showed deficits in various executive functions and the ability to empathize (all p < .05). However, no performance differences were found with regard to ToM (all n.s.).

Conclusions

Since studies in juveniles with ADHD often show impaired ToM performance, it is conceivable that ToM deficits may become attenuated due to neuronal development in adolescence. Furthermore, our findings imply that ToM impairments, even when present in adult ADHD, appear to be independent of executive deficits and might be explained by comorbid disorders.

Abstract

This study explored the extent to which social interaction problems of treatment‐naïve adults with ADHD can be attributed to deficits in theory of mind using established neuropsychological tests. The results revealed that adults with ADHD showed impairment in various executive functions and the ability to empathize but no theory of mind deficits. Our findings imply that ToM impairments, even when present in adult ADHD, appear to be independent of executive deficits and might be explained by comorbid disorders.