Assessment of the relationship between social cognition and alexithymia in children and adolescents with attention deficit hyperactivity disorder

Introduction: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. It is known that children with ADHD have difficulties in catching social clues and their cognitive and emotional empathy and social cognitive skills are less developed. In this study, it was aimed to assess the social cognition, empathy, alexithymic properties and the electronic media use in children and adolescents with ADHD. Methods: Children (8-16 years old) and their parents with ADHD (n = 40) and without any diagnosis (n =40) were recruited from the outpatient clinic of Child and Adolescent Psychiatry in Adnan Menderes University in between September 2017 and April 2018. All the partipicants in this study were evaluated according to Schedule for Affective Disorders and Schizophrenia for School Age Children- Present and Lifetime Version (K-SADS-PL) and DSM-5 based clinical interview. The participants filled the Alexithymia Questionnaire for Children (AQC), KASİ-empathic tendency scale and the Reading the Mind in the Eyes Test (RMET). All the parents filled out Toronto Alexithymia Scale-20 (TAS), DSM-IV-Based Screening and Assessment Scale for Behavioral Disorders in Children and Adolescents and Strength and Difficulties Questionniare (SDQ). Data were analyzed using the IBM SPSS 23.0 statistical program. Results: In our study, children and adolescents in the ADHD and control groups were similar in terms of sociodemographic characteristics (p>0.05). The rate of males in ADHD group was 82.5% (n=33) and the male/ female ratio was 4.71. The mean age of the ADHD group was 10.7±2 years, the mean age of the control group was 11.3 ± 2 years (p>0.05). The duration of electronic media use was higher in the ADHD group (p<0.05). Number of correct answers in RMET was lower in ADHD group(p<0,05). In both groups correct RMET scores were increased with age(p<0,05). There were no differences in participants in empathy levels and parents alexithymia levels (p>0.05). There were no differences in RMET, AQC, TAS, and KASİ empathic tendency scores (p>0.05) in subtypes of ADHD. In the ADHD group, there was a negative correlation between the AQC and RMET total score (p<0,05). For the whole study group, there was a positive correlation between AQC difficulty in identifying feelings score and TAS total score and TAS difficulty in describing feelings, and also there was a negative correlation was found between AQC difficulty identifying feelings subscale and TAS difficulty identifying feelings subscale( p<0,05). Discussion: Children and adolescents with ADHD have less social cognitive abilities compared to healthy controls, but the empathy and alexithymia levels are similar. Besides, social cognitive skills are decreased when the alexythymic features are increased. Additional to the pharmacological treatment of ADHD, the assessment of social cognition and related factors and therapeutic interventions for these areas may contribute to the improvement of ADHD.