Reduced gaze-cueing effect with neutral and emotional faces in adults with attention deficit/hyperactivity disorder

This study examined whether gaze shift of neutral and emotional faces triggers reflexive attention orienting in 45 adults with attention deficit/hyperactivity disorder (ADHD) and 45 age-, sex-, and intelligence quotient-matched typically developing (TD) adults. The cues changed from neutral to anger, fearful, or happy expressions under the emotional face condition. Participants were asked to detect a target that appeared to the left or right of the cue stimuli, as rapidly and accurately as possible. The results revealed a gaze-cueing effect, where the reaction time to the target was shorter under the "gaze-at-target" condition than under the "non-gaze-at-target" condition in both groups. Facial expressions did not modulate the gaze-cueing effect in either group. However, the magnitude of the gaze-cueing effect was smaller in the ADHD group than in the TD group. Contrary to our expectations, a larger gaze-cueing effect was observed in individuals with ADHD who exhibited more severe inattention. Our results suggest that adults with ADHD ineffectively orient their attention toward another's gaze. Moreover, difficulty with sustained and selective attention may be associated with a larger influence of gaze direction; this difficulty may play a role in social interaction problems.