Psychological and neural mechanisms of social-cognitive deficits in ADHD

项目摘要 注意力缺陷多动障碍（ADHD）在儿童早期和中期普遍存在，导致 严重扰乱了受影响儿童沿着同龄人和父母的日常生活。虽然主要 被认为是一种执行功能障碍，在青少年中存在大量的社会认知缺陷， ADHD会进一步破坏孩子在关键领域的发展，如同理心，情绪识别， 心理理论这些损害往往在患有ADHD和共病对立情绪的青少年中加剧。 挑衅性障碍（ODD），表现出各种挑衅、攻击和敌对行为。的程度 ADHD青少年的哪些社会认知缺陷代表了一种明显的损害尚不清楚： 注意到社会线索可能会导致社会认知的缺陷。虽然注意力问题与社会有关， 然而，我们不知道执行功能障碍是否是导致社会认知问题的具体原因。 此外，虽然ADHD的神经影像学研究在很大程度上揭示了前额叶功能障碍， 白色物质成熟，很少有研究探讨大脑功能在社会认知过程中。 为了填补这些研究空白，这项研究将采用虚拟现实（VR）和神经成像技术， 在童年中期（9-12岁）的青少年匹配组：典型的发展中的青少年，患有ADHD但没有 共病ODD（ADHD-ODD）和患有ADHD和共病ODD（ADHD+ODD）的青少年。我们将依靠 我们正在进行的VR和神经成像研究，以研究如何消除背景音频和视觉刺激， 现实场景改变ADHD青少年的社会认知技能我们将测量同理心，敌意偏见， 以及在具有不同级别的视听背景刺激的虚拟场景期间的情感识别， 把注意力从社交线索上引开随后，在功能磁共振成像中，我们将研究社交脑回路是如何 在共情决策过程中消除视觉干扰的影响。通过这种设计，我们努力 实现以下具体目标：检查是否减少背景干扰，在一个自然 虚拟环境与ADHD-ODD和ADHD+ODD青少年的社会认知有关（目的1）; 在患有ADHD-ODD和ADHD+ODD的青少年中， 决策受到视觉干扰的影响，以及白色物质的微观结构如何与 认知和情感同理心（目标2）。我们假设背景视听水平的降低 刺激将改善ADHD青少年对社会线索的注意力，改善社会认知的测量， 注意力缺陷多动障碍（ADHD）和注意力缺陷多动障碍（ADHD+ODD）青少年的社交脑区参与。这将指示 不能正确地注意到社会线索是导致社会认知缺陷的原因。然而，如果注意力缺陷 并没有导致ADHD+ODD青少年的社交障碍，去除分心物对 共情或敌意归因偏见的测量。这些信息将有助于形成 治疗策略，以改善每个ADHD亚组的社交技能，包括基于VR的干预措施。

Project Summary Attention-deficit hyperactivity disorder (ADHD) is prevalent during early and middle childhood, causing substantial disruptions to everyday life of afflicted children, along with their peers and parents. While primarily recognized as an executive functioning disorder, there are substantial social-cognitive deficits in youth with ADHD that can further disrupt the child's development in key areas such as empathy, emotion recognition, and theory of mind. These impairments are often exacerbated in youth with ADHD and comorbid oppositional defiant disorder (ODD), who demonstrate a variety of defiant, aggressive, and hostile behaviors. The degree to which social-cognitive deficits in youth with ADHD represent a distinct impairment is unclear: an inability to attend to social cues may drive deficits in social cognition. While attention problems are related to social deficits, we do not know whether executive dysfunction is specifically driving social cognition problems. Moreover, while neuroimaging research of ADHD has largely revealed prefrontal dysfunction and delayed white matter maturation, very little research has examined brain function during social cognitive processing. To fill these research gaps, this investigation will employ virtual reality (VR) and neuroimaging with three matched groups of youth in middle childhood (ages 9-12): typical developing youth, youth with ADHD but no comorbid ODD (ADHD-ODD), and youth with ADHD and comorbid ODD (ADHD+ODD). We will build upon our ongoing VR and neuroimaging research to examine how removing background audio and visual stimuli in realistic scenes modifies social cognitive skills in youth with ADHD. We will measure empathy, hostility biases, and emotion recognition during virtual scenes with distinct levels of audiovisual background stimuli that may draw attention away from social cues. Subsequently, during fMRI, we will examine how social brain circuitry is impacted by the removal of visual distracters during empathic decision making. With this design, we strive to achieve the following specific aims: to examine whether decreasing background distractions in a naturalistic virtual environment is related to social cognition in youth with ADHD-ODD and ADHD+ODD (Aim 1); and to characterize, in youth with ADHD-ODD and ADHD+ODD, how brain mechanisms underlying empathic decision making are impacted by visual interference and how white matter microstructure is associated with cognitive and emotional empathy (Aim 2). We hypothesize that decreasing levels of background audiovisual stimuli will improve attention to social cues in youth with ADHD, improving measures of social cognition and engagement of social brain regions in both youth with ADHD-ODD and ADHD+ODD. This would indicate that an inability to properly attend to social cues is driving social cognition deficits. However, if attention deficits are not driving social impairments in youth with ADHD+ODD, removing distracters will have little impact on measures of empathy or hostile attribution biases in this group. This information will be valuable in forming treatment strategies to improve social skills in each ADHD subgroup, including VR-based interventions.