Exploring the relationship between empathy and executive functions in adults with ADHD

Abstract

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with impairments in executive functions (EF) and interpersonal difficulties, with studies suggesting diminished empathic responsiveness in this population. Although theoretical models suggest that variations in empathic abilities may be explained by executive function deficits, empirical evidence in adults with ADHD remains scarce. Objective: To explore the relationship between empathy and executive functions in adults with ADHD, utilizing both self-reported measures and objective neuropsychological performance. Methods: This descriptive cross-sectional study included 17 adults (52.9% male; M = 35.59 years, SD = 11.05, range: 19–55) receiving specialized outpatient care for ADHD. Data collection is ongoing, with a planned total sample of 30 participants. Inclusion required a Full-Scale IQ > 70, as verified by the Wechsler Abbreviated Scale of Intelligence (WASI). The assessment protocol encompassed both self-reported executive functioning (EF), measured using the Barkley Deficits in Executive Functioning Scale (BDEFS), and objective neuropsychological performance, including the Digit Span (working memory) and the Five Digit Test (inhibitory control and cognitive flexibility). Empathy was evaluated using the Interpersonal Reactivity Index (IRI). Data were analyzed using Spearman’s correlation coefficients. Results: Executive dysfunction subscales showed moderate to strong positive correlations with each other (ρ = 0,59 a 0,82; p < 0,05). However, no significant correlations were observed between empathy and self-reported executive dysfunction (ρ = 0,13 a 0,29; p > 0,05), nor between empathy and objective executive function measures. Notably, a significant negative correlation was observed between IQ and the BDEFS Organization/Problem Solving subscale (ρ = -0,51; p = 0,036), suggesting that higher intellectual functioning may mitigate the impact of executive deficits. Conclusion: Preliminary findings suggest that executive functioning may not be a direct predictor of empathic abilities in adults with ADHD. Although these results offer useful initial insights, they should be interpreted with caution given the limited sample size. Future analyses will include an expanded sample to strengthen the robustness and generalizability of the findings.