Social cognition and dysmorphology in gifted children

Introduction: It has been known that gifted children have different social and emotional characteristics compared to their peers and are at risk for mental health. In order for gifted children to become biopsychosocially healthy adults, it is important to determine the levels of intelligence at an early age, to maintain appropriate education for superior intelligence, to guide their emotional needs, and to inform parents and teachers. Social cognition provides a perspective on how people (sosyal ortamda bilgiyi nasıl işledikleri). There are limited number of studies on social cognition in gifted children. Since morphological structure and central nervous system originate from ectoderm, it is suggested that some differences may be seen morphologically in subjects with neurodevelopmental disorders. When the literature is reviewed, there is no research evaluating dysmorphology and social cognition of gifted children. Objective: The primary objective of this study was to compare social cognitive skills and dysmorphological features in children aged 8-16 years with healthy controls in similar age and gender, with no similar psychiatric diagnoses and having normal mental capacity. The second aim of this study was to evaluate the distribution and frequency of psychiatric diagnoses in gifted children sample. In addition, it was aimed to evaluate the broad phenotypic autistic features of parents of gifted children. Method: The sample of our study was composed of the children aged between 8 and 16 years, who applied to Ege University Faculty of Medicine, Department of Child and Adolescent Psychiatry Outpatient Clinic, whether with psychiatric problem sor for determination of mental capacity and found to have high intellectual capacity according to Wechsler Intelligence Scale for Children-revised version test results. The healthy control group of normal intelligence was composed of children who did not have any previous psychiatric diagnose or complaint; in similar age, gender and socioeconomic status. Sociodemographic data form was applied to all patients. The psychiatric evaluation of the subjects were performed by using The Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version, (KSADS-PL). The Child Behavior Check List and the DSM-IV-based Screening and Rating Scale for Disruptive Behavior Disorders were used in all cases. Social cognitive skills were evaluated by the Faces Test, Reading the Mind in the Eyes Test, Comprehension Test. Emotion regulation skills were determined by the Difficulties in Emotion Regulation Scale (DDRS). Autism Spectrum Screening Questionnaire (ASSQ) and Social Responsiveness Scale (SRS) were used to determine autistic features. Autism Spectrum Questionnaire was used to evaluate the autistic features of the parents. All cases were examined by a pediatric genetics specialist for dysmorphological findings. Minor physical anomalies were examined in detail according to the Phenotypic Abnormalities: Terminology and Classification list of Mercks et al (2016). Our study was performed with 29 gifted children having psychopathology (GP), 22 gifted healthy children without psychopathology (GH) and 29 healthy controls with normal mental capacity (HC). The mean age of GH group was 11.4 (SD: 2.1) years, the mean age of GP group was 10.8 (SD: 2.5) years, and the mean age of HC group was 9.3 (SD: 1.2) years. Although there was no significant statistical difference between the groups in terms of gender and sociodemographic characteristics; there was a significant difference in educational status of parents. In terms of social cognition tests; there were no statistically significant differences between the total and the subscale total scores of the faces test in all three groups (UH, US and SC) (p> 0.05). In both the reading the minds in the eyes test (p=0.039) and the comprehension test (p<0.001), GP and GH group scores were significantly higher than HC group, while there was no statistically significant difference between GP and GH groups (p> 0.05). ASSQ scores were statistically similar in all 3 groups; SRS scores of GP and GH groups were similar and higher than those of HCs (p<0.001). In order to evaluate emotion regulation skills, DERS was used and all three groups scores were similar, except for the awareness subscale in which GP group score was significantly higher than that of GH and HC group (p=0.004). Autism Spectrum Questionnaire scores of the mothers in all three groups were statistically similar but fathers of HC received higher scores compared to that of the fathers in GP and GH groups (p=0.013). In both GH and GP group, the frequency of minor physical anomalies were detected higher than HCs with normal mental capacity (p<0.001). Key words: gifted children, social cognition, theory of mind, minor physical anomalies, emotional regulation, autism spectrum disorders