Casula Antony, Belluardo Giulia, Antenucci Carmine, Bianca Federica, Corallo Francesco, Ferraioli Francesca, Gargano Domenica, Giuffrè Salvatore, Giunta Alice Lia Carmen, La Torre Antonella, Massimino Simona, Mirabile Alessio, Parisi Giuliana, Pizzuto Cono Daniele, Spartà Maria Cristina, Tartaglia Alessia, Tomaiuolo Francesco, Culicetto Laura
Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, 98122 Messina, Italy.
International School of Advanced Studies, Center for Neuroscience, University of Camerino, 62032 Camerino, Italy.
Medicina (Kaunas). 2025 Mar 15;61(3):505. doi: 10.3390/medicina61030505.
Theory of mind (ToM) deficits in children with ADHD are closely related to social difficulties and problems in interpersonal interactions. Evidence suggests that these cognitive deficits negatively affect the ability to understand and respond to others' emotions and intentions, thus contributing to social isolation and a lower quality of life. However, the findings across studies vary, indicating that ADHD subtype and comorbidities, such as anxiety and mood disorders, can significantly influence sociocognitive deficits, modulating the extent of social problems. This review examines the relationship among ADHD, ToM, and empathy, analyzing studies comparing children with ADHD with peers with typical development or other neurodevelopmental conditions. A search in PubMed, Scopus, and the Cochrane Library prior to January 10, without time restrictions, using "ADHD", "Cognitive Empathy", and "Theory of Mind" identified relevant studies assessing these abilities through neuropsychological tests or questionnaires. Of the initial 243 studies, 23 studies met the inclusion criteria. Children with ADHD exhibited significant impairments in ToM and empathy, affecting social cognition and interpersonal understanding. Various assessment tools revealed difficulties in understanding beliefs, emotions, and intentions, with executive function deficits playing a crucial role in shaping these social challenges. This review highlights the need for targeted therapeutic interventions that not only address cognitive deficits but consider emotional and metacognitive aspects, such as emotion regulation and self-awareness. Future research should focus on integrating executive function training with approaches that develop metacognitive and emotional skills, thus providing more comprehensive support.
注意力缺陷多动障碍（ADHD）儿童的心理理论（ToM）缺陷与社交困难及人际互动问题密切相关。有证据表明，这些认知缺陷会对理解和回应他人情绪及意图的能力产生负面影响，进而导致社会孤立和生活质量下降。然而，各项研究的结果存在差异，这表明ADHD的亚型及共病情况，如焦虑和情绪障碍，会显著影响社会认知缺陷，调节社会问题的严重程度。本综述考察了ADHD、ToM和同理心之间的关系，分析了比较ADHD儿童与发育正常的同龄人或其他神经发育状况儿童的研究。于1月10日前在PubMed、Scopus和Cochrane图书馆进行检索，检索无时间限制，使用“ADHD”“认知同理心”和“心理理论”等关键词，筛选出通过神经心理学测试或问卷评估这些能力的相关研究。在最初的243项研究中，有23项研究符合纳入标准。ADHD儿童在ToM和同理心方面表现出显著损伤，影响社会认知和人际理解。各种评估工具都显示出他们在理解信念、情绪和意图方面存在困难，执行功能缺陷在形成这些社会挑战中起着关键作用。本综述强调需要有针对性的治疗干预措施，这些措施不仅要解决认知缺陷，还要考虑情绪和元认知方面，如情绪调节和自我意识。未来的研究应侧重于将执行功能训练与培养元认知和情绪技能的方法相结合，从而提供更全面的支持。
