ADHD News & Research

Study: Negative Attention Bias in Adults with ADHD Could Indicate Comorbid Depression

A small study of adults from the Netherlands found that depressive symptoms explained the loss of positive attention bias in patients with ADHD.

January 7, 2022

A pattern of negative attention bias in adults with attention deficit hyperactivity disorder (ADHD) likely indicates comorbid depression, according to a Journal of Attention Disorders study.1 Attentional bias refers to the tendency to pay attention to certain stimuli while simultaneously ignoring others. “Negative attention bias in depression can be described as longer and more frequent attention allocation toward negative opposed to positive or neutral information.”

The researchers compared the attention paid to emotional faces in patients with depression, ADHD, comorbid ADHD and depression, and neither condition. Gaze duration, number of revisits, and location and duration of first fixation were recorded for each patient.

As hypothesized, non-psychiatric controls revisited the happy faces more than they did the other expressions. Patients in both the depression and the comorbid (ADHD and depression) group had significantly less recurring attendance to the happy facial expression when compared to the ADHD-only and control groups. After controlling for depression symptom severity, the groups did not differ. These findings indicate that adults with ADHD alone may demonstrate a relatively positive processing style, revisiting the happy faces more often, and that depression leads to less frequent processing of positive faces, or a relatively negative attention bias.

The risk of developing a depressive disorder is four times greater for adults with ADHD compared to those without ADHD. The overlap in symptoms (namely attention deficits) leads to misdiagnosis and inaccurate treatment when both ADHD and depression co-occur. The researchers concluded that comorbidities could influence the processing of emotional information and perhaps neurocognitive functioning more broadly. The eye-tracking system used in this study could be used as a diagnostic marker for acute depressive symptoms.


1Schuthof CC, Tendolkar I, Bergman MA, et al. Depressive Symptoms Account for Loss of Positive Attention Bias in ADHD Patients: An Eye-Tracking Study. Journal of Attention Disorders. December 2022. doi:10.1177/10870547211063640