OBJECTIVE Conduct disorder (CD) is associated with impairments in facial emotion recognition. However, CD commonly co-occurs with attention-deficit/hyperactivity disorder (ADHD); thus, it is unclear whether these impairments are explained by ADHD or by one of its core features-inattention. We explored whether emotion recognition impairments are specific to individuals with ADHD and comorbid CD while also examining the mechanisms that might explain such deficits. METHOD A total of 63 male and female adolescents with ADHD (mean age = 14.2 years, age range = 11-18 years) and with (ADHD+CD) or without (ADHD) comorbid CD, and 41 typically developing controls (healthy controls [HC]; mean age = 15.5, age range = 11-18 years) performed an emotion recognition task with concurrent eye-tracking. RESULTS Participants with ADHD+CD were less accurate at recognizing fear and neutral faces, and more likely to confuse fear with anger than participants with ADHD alone and HC. Both ADHD subgroups fixated the eye region less than HC. Although there was a negative correlation between ADHD symptom severity and eye fixation duration, only CD severity was inversely related to emotion recognition accuracy. CONCLUSION Only ADHD participants with comorbid CD showed impairments in emotion recognition, suggesting that these deficits are specific to individuals with conduct problems. However, lack of attention to the eye region of faces appears to be a characteristic of ADHD. These findings suggest that emotion recognition impairments in those with ADHD+CD are related to misinterpretation rather than poor attention, offering interesting opportunities for intervention.

中文翻译：

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注意缺陷/多动障碍有或没有共病行为障碍时的面部情绪识别和视线凝视。

目的行为障碍（CD）与面部情绪识别障碍有关。但是，CD通常与注意力缺陷/多动症（ADHD）并发。因此，尚不清楚这些缺陷是由ADHD还是其核心特征之一引起的。我们探讨了情绪识别障碍是否特定于患有ADHD和共病CD的个体，同时还研究了可能解释这种缺陷的机制。方法共有63名患有ADHD（平均年龄= 14.2岁，年龄范围= 11-18岁）且患有（ADHD + CD）或不患有（ADHD）合并CD的男女青少年，以及41名通常发展为对照者（健康对照者[ HC]；平均年龄= 15.5，年龄范围= 11-18岁）执行了同时进行眼动追踪的情感识别任务。结果与仅患有ADHD和HC的参与者相比，患有ADHD + CD的参与者在识别恐惧和中性面孔时不那么准确，并且更有可能将恐惧与愤怒相混淆。两个多动症亚组的眼睛区域固定都比HC少。尽管多动症症状严重程度与注视持续时间之间呈负相关，但只有CD严重程度与情绪识别的准确性呈负相关。结论只有患有CD合并症的ADHD参与者在情绪识别方面表现出障碍，这表明这些缺陷是行为障碍患者所特有的。但是，缺乏对面部眼部区域的关注似乎是ADHD的特征。这些发现表明，患有ADHD + CD的人的情绪识别障碍与误解有关，而不是注意力不集中，