Delayed Recognition of Emotions Due to Mind Wandering Among Adults With Attention Deficit Hyperactivity Disorder

Illustration of person distracted
Illustration of person distracted
Attention deficit hyperactivity disorder and autism spectrum disorder in adults are often undiagnosed and overlap in psychopathology. In this study, the researchers investigated the transdiagnostic traits of emotion recognition and mind wandering in a sample of 103 adults.

Individuals with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) had a slower ability to recognize emotions due to differing mechanisms. These findings, from researchers at King’s College London, were published in the Journal of Psychiatric Research.

Volunteers (N=103) were recruited from 2 clinics in London. Participants were presented with 5 blocks of 42 images of faces. Half of the images in each block were of target emotions (anger, fear, surprise, or disgust) and the other half were random emotions. Participants were evaluated with the Barkley Adult ADHD Rating Scale (BAARS), Social Responsiveness Scale-Adult Version (SRS-2), and Mind Excessively Wandering Scale (MEWS) instruments.

Participants had ADHD (n=43), ASD (n=14), or were neurotypical controls (n=46) who were aged mean 37.16±10.06, 36.00±12.30, and 29.37±9.06 years and 27, 10, and 20 were men, respectively. Participants did not differ for average intelligence quotient (P =.945), but patients with ADHD and ASD scored higher for BAARS (P <.001), SRS-2 (P <.001), MEWS (P <.001), functional impairment (P <.001), emotional dysregulation (P <.001), controlling ADHD symptoms (P <.001), and controlling ASD symptoms (P <.001) assessments compared with controls.

The 3 cohorts did not have significant differences in their ability to correctly identify facial emotions. However, participants with ADHD and ASD required significantly longer periods of time to assess which emotion was depicted in the images (anger: P <.001; disgust: P <.003; fear: P <.008; P =.032).

After controlling for MEWS, adults with ADHD required more time to assess the anger (F[3,95], 7.215; P <.001; adjusted R2, 0.160) and fear (F[3,95], 3.911; P =.011; adjusted R2, 0.082) and adults with ASD required more time to assess disgust (F[3,95], 4.02; P =.010; adjusted R2, 0.085).

Controlling for MEWS did not alter global results (F[2,99], 8.374; P <.0001; partial h2, 0.145). Controlling for ASD symptom severity did alter global results, indicating mind wandering was more prevalent among patients with ADHD than ASD (mean difference, 13.10; 95% CI, 12.31-20.96; P <.001).

This study was limited by the low recruitment of patients with ASD and may be underpowered for the detection of ASD-specific group differences.

The study authors concluded that adults with ADHD and ASD had delayed identification of emotions. This delay in recognition was primarily due to mind wandering among patients with ADHD and processing speed among patients with ASD.

Disclosure: An author declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Helfer B, Boxhoorn S, Songa J, Steel C, Maltezos S, Asherson P. Emotion recognition and mind wandering in adults with attention deficit hyperactivity disorder or autism spectrum disorder. J Psychiatr Res. 2021;134:89-96. doi:10.1016/j.jpsychires.2020.12.059.