Emotion processing difficulties in ADHD: a Bayesian meta-analysis study
Emotion processing difficulties in ADHD: a Bayesian meta-analysis study
We investigated whether there is an emotional processing deficit in ADHD and whether this only applies to specific emotional categories. In this PRISMA-compliant systematic review based on a pre-registered protocol (https://osf.io/egp7d), we searched MEDLINE, PsycINFO, ERIC, Scopus and Web of Science databases until 3rd December 2023, to identify empirical studies comparing emotional processing in individuals meeting DSM (version III to 5-TR) or ICD (version 9 or 10) criteria for Attention Deficit/Hyperactivity Disorder (ADHD) and in a non-psychiatric control group. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Eighty studies were included and meta-analysed (encompassing 6191 participants and 465 observations). Bayesian meta-analyses were conducted to compare individuals with ADHD and non-psychiatric controls on overall emotional processing measures (meta-analysis 1) and across emotional categories (meta-analysis 2). The type of stimulus employed, outcome measurement reported, age, sex, and medication status were analysed as moderators. We found poorer performance in both overall emotion processing (g = -.65) and across emotional categories (anger g = -.37; disgust g = -.24; fear g = -.37; sadness g = -.34; surprise g = -.26; happiness/positive g = -.31; negative g = -.20; neutral g = -.25) for individuals with ADHD compared to non-psychiatric controls. Scales items and accuracy outcome being the most effective moderators in detecting such differences. No effects of age, sex, or medication status were found. Overall, these results show that impaired emotional processing is a relevant feature of ADHD and suggest that it should be systematically assessed in clinical practice.
ADHD, Emotional processing, Emotion recognition, meta-analysis, ADHD, Emotion recognition, Emotional processing, Meta-analysis
2369-2390
Soler-Gutiérrez, Ana-María
05942ecc-238e-404f-9a7c-c1fe88295cec
Sánchez-Carmona, Alberto J.
70daeda7-562f-4565-93c9-78f67d2ffd66
Albert, Jacobo
9dc976bd-5464-42be-8e31-2acdd8cc223c
Hinojosa, José Antonio
bed682be-bbc4-42bc-9369-ced969b20024
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Bellato, Alessio
0ee4c34f-3850-4883-8b82-5717b74990f7
Mayas, Julia
5bf28b51-4158-42e2-924f-a7f5b41b87db
August 2025
Soler-Gutiérrez, Ana-María
05942ecc-238e-404f-9a7c-c1fe88295cec
Sánchez-Carmona, Alberto J.
70daeda7-562f-4565-93c9-78f67d2ffd66
Albert, Jacobo
9dc976bd-5464-42be-8e31-2acdd8cc223c
Hinojosa, José Antonio
bed682be-bbc4-42bc-9369-ced969b20024
Cortese, Samuele
53d4bf2c-4e0e-4c77-9385-218350560fdb
Bellato, Alessio
0ee4c34f-3850-4883-8b82-5717b74990f7
Mayas, Julia
5bf28b51-4158-42e2-924f-a7f5b41b87db
Soler-Gutiérrez, Ana-María, Sánchez-Carmona, Alberto J., Albert, Jacobo, Hinojosa, José Antonio, Cortese, Samuele, Bellato, Alessio and Mayas, Julia
(2025)
Emotion processing difficulties in ADHD: a Bayesian meta-analysis study.
European Child & Adolescent Psychiatry, 34 (8), , [e0280131].
(doi:10.1007/s00787-025-02647-3).
Abstract
We investigated whether there is an emotional processing deficit in ADHD and whether this only applies to specific emotional categories. In this PRISMA-compliant systematic review based on a pre-registered protocol (https://osf.io/egp7d), we searched MEDLINE, PsycINFO, ERIC, Scopus and Web of Science databases until 3rd December 2023, to identify empirical studies comparing emotional processing in individuals meeting DSM (version III to 5-TR) or ICD (version 9 or 10) criteria for Attention Deficit/Hyperactivity Disorder (ADHD) and in a non-psychiatric control group. Study quality was assessed with the Appraisal tool for Cross-Sectional Studies (AXIS). Eighty studies were included and meta-analysed (encompassing 6191 participants and 465 observations). Bayesian meta-analyses were conducted to compare individuals with ADHD and non-psychiatric controls on overall emotional processing measures (meta-analysis 1) and across emotional categories (meta-analysis 2). The type of stimulus employed, outcome measurement reported, age, sex, and medication status were analysed as moderators. We found poorer performance in both overall emotion processing (g = -.65) and across emotional categories (anger g = -.37; disgust g = -.24; fear g = -.37; sadness g = -.34; surprise g = -.26; happiness/positive g = -.31; negative g = -.20; neutral g = -.25) for individuals with ADHD compared to non-psychiatric controls. Scales items and accuracy outcome being the most effective moderators in detecting such differences. No effects of age, sex, or medication status were found. Overall, these results show that impaired emotional processing is a relevant feature of ADHD and suggest that it should be systematically assessed in clinical practice.
Text
Emotion processing difficulties in ADHD a Bayesian meta-analysis study
- Accepted Manuscript
Text
s00787-025-02647-3
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Accepted/In Press date: 9 January 2025
e-pub ahead of print date: 24 January 2025
Published date: August 2025
Keywords:
ADHD, Emotional processing, Emotion recognition, meta-analysis, ADHD, Emotion recognition, Emotional processing, Meta-analysis
Identifiers
Local EPrints ID: 498278
URI: http://eprints.soton.ac.uk/id/eprint/498278
ISSN: 1018-8827
PURE UUID: 1c6058e2-47d1-4062-8444-679c63160255
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Date deposited: 13 Feb 2025 17:50
Last modified: 11 Sep 2025 03:37
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Author:
Ana-María Soler-Gutiérrez
Author:
Alberto J. Sánchez-Carmona
Author:
Jacobo Albert
Author:
José Antonio Hinojosa
Author:
Alessio Bellato
Author:
Julia Mayas
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