Neuropsychological investigations have suggested a contribution of right hemisphere dysfunction in attention-deficit hyperactivity disorder (ADHD). Right hemisphere dysfunction has been implicated in deficits of attention, motor impersistence, and processing emotion-laden stimuli. The current study investigated the ability of ADHD children to perceive emotional stimuli in the form of facial expressions and speech intonation. The subjects consisted of 37 ADHD and 37 control children aged 7 to 12 years. ANCOVA analysis indicated that ADHD children demonstrate mild-to-moderate deficits in the perception of affect. Furthermore, deficits in attention may contribute to inaccurate or incomplete encoding of stimulus properties. The results lend tentative support for the notion that the right cerebral hemisphere may play a critical role in ADHD.
In an effort to objectify neuropsychologic evaluations, consideration of a patient's emotional behavior has often been neglected. An extensive literature review is undertaken in an effort to document lateralized emotional behaviors commonly found in brain injury populations. This evidence is contrasted with the psychiatric symptoms and lateralized neuropsychologic impairments seen in major depression and schizophrenia. A theoretical model is then proposed that attempts to integrate these "functional" vs. "organic" symptoms based upon reciprocal inhibition of lateralized emotional functioning in brain injury and psychiatric disorders. This opponent process model not only seems to account for some of the discrepant findings in the literature, but additionally provides a cogent and useful marker to neurophychologically differentiate "neuronal" vs. "metabolic" disorders. The model further suggests new ways of envisioning treatment and recovery from both psychiatric illness and brain injury.
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