Understanding of Mental States in Children with ADHD

Objectives: The theory of mind broadly defined refers to the understanding of one's self and others as mental beings who have beliefs, desires, emotions and intentions, as well as the understanding that an individual's behavior is motivated by these mental states. In the present study, we investigated whether children with attention deficit hyperactivity disorder (ADHD) were able to understand a story character's mental state. Methods: Twelve children with ADHD (age 8; 9-13; 0) and 12 typically developing children (age 8; 4-12; 6) participated in the study. The two groups were matched by age, nonverbal intelligence and vocabulary ability. Twelve stories were prepared for this research with four comprehension questions for each story. The questions were divided into two types: questions about literal comprehension and questions about a character's mental state. Each story contained a different mental state element: white lies, double bluffs, false beliefs, misunderstandings, faux pas or irony. The children were read a story and then asked two literal and two mental state questions. All stories were administered in the same way. Results: A repeated two-way ANOVA of group (2) x question type (2) revealed that the children with ADHD had significantly more difficulty understanding a character's mental state, especially with regards to a double bluff or faux pas. Conclusion: The results indicated that children with ADHD may have some difficulties in understanding the mental states of others, especially in complex or ambiguous contexts. It is suggested that the ability to understand mental states be considered carefully when evaluating the social communication skills of children with ADHD.