Attention‐deficit/hyperactivity disorder and the encoding of emotional information

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by difficulties with sustaining attention, motor control, and impulsivity. Although rarely considered central to the disorder, deficits in the encoding of social information have been observed amongst boys with ADHD (and distinct from comorbid problems with aggression) as long ago as the late 1990s (1,2). In their seminal reformulation, Crick and Dodge (3) describe social information processing (SIP) as a cycle of six distinct processes: (i) encoding of cues, (ii) interpretation of cues, (iii) clarification of goals, (iv) response access or construction, (v) response decision, and (vi) behavioural enactment. SIP research has focused predominantly on aggressive children and has shed light on hostile attributions of intent (process ii) and aggressogenic response evaluation and decision-making (RED) processes (4,5). Little attention has been paid to encoding per se and the role of affective information in determining the encoding of social information either with ADHD or neurotypical populations. In the target paper, Kis and his colleagues have shown that—even as adults—people with ADHD can struggle with emotional SIP, in particular, the encoding of affective information derived from prosodic aspects of verbal communication. Moreover, patients with ADHD struggle with anger-signaling information in voices. Affective prosody reflects the emotional aspects of language and includes aspects such as pitch and timbre and is known to be deficient in people with ADHD (4). Affective or emotional aspects of language prevail over semantics where there is dissonance between the two. In other words, how something is said (tone, rhythm, loudness, etc.) has greater impact than the content. If this is then processed poorly either due to inattention or deficient encoding (as possibly is the case in patients with ADHD), there is potential for misinterpretation; this includes misinterpretations well documented under the banner of hostile intent attributions. Despite the wellrecognized social dysfunction in patients with ADHD, there is surprisingly little research to address the important clinical issue of emotional perception or affective prosody in patients with ADHD. The study by Kis et al. published in the current edition of the journal extends previous work indicating that adults with ADHD have trouble identifying prosodic affect cues for semantically incongruent statements (5), and helps to clarify that this deficit in not an artefact of problems with executive functioning. In conjunction with the recent paper by Bisch et al. (6), it also helps to clarify the nature of integrated multimodal processing of affective-laden social information. Unlike Bisch et al., who found no interaction between modality (auditory vs. visual) and group status (ADHD vs. neurotypical [NT] participants), the findings by Kis et al. point to a specific auditory processing deficit for adults with ADHD. As Kis et al. also used the German adaptation of the Florida Affective Battery, in contrast to the study by Bisch et al. (6), we await further studies to determine whether methodological differences account for the SIP findings. These studies represent a reinvigoration of the study of SIP and its role in patients with disruptive behaviour disorders and how this line of inquiry points toward important future directions. Several aspects of research on SIP may have impeded the development of the area. Following the lead of Kenneth Dodge and other pioneers, SIP-related research has been marked by an over-reliance on hypothetical vignettes and explicit self-report; development of more ecologically valid approaches including assessments of real-time and modalityspecific processing of social information has been slow. SIP research has been dominated by examination of interpretation (e.g., ‘why did that happen?’) as reflected by hostile attribution of intent, and response planning (e.g., ‘what would you do next?’), and comparatively little attention has been paid to other steps and to encoding in particular. Further limitations to the development are reflected in the limited conceptual toolbox that focused on hypothetical scenarios without analyses of specific modalities and a failure to interrogate