Impaired recognition of affect in facial expression in depressed patients

Evaluative conditioning as a source gut feelings and its potential for behavioral nudging

The theme of limited resources pervades the mental health landscape. Practitioners often lack adequate resources to provide interventions for all who could benefit from them, and potential beneficiaries often lack adequate cognitive, financial, and temporal resources to make use of them. Even under rare conditions of bounty, many intensive interventions show small, fleeting effects. Such a landscape begs a space for behavioral nudges: cheap, easily implementable tweaks to people's decision environments aimed at improving health while preserving autonomy. Although existing nudges can be effective, they have their own limitations. Here we explore the case for Evaluative Conditioning (EC) as a largely overlooked yet potentially effective kind of behavioral nudge that can reap nudges' benefits while addressing some of their limitations.

Preclinical models for evaluating psychedelics in the treatment of major depressive disorder

Psychedelic drugs have seen a resurgence in interest as a next generation of psychiatric medicines with potential as rapid-acting antidepressants (RAADs). Despite promising early clinical trials, the mechanisms which underlie the effects of psychedelics are poorly understood. For example, key questions such as whether antidepressant and psychedelic effects involve related or independent mechanisms are unresolved. Preclinical studies in relevant animal models are key to understanding the pharmacology of psychedelics and translating these findings to explain efficacy and safety in patients. Understanding the mechanisms of action associated with the behavioural effects of psychedelic drugs can also support the identification of novel drug targets and more effective treatments. Here we review the behavioural approaches currently used to quantify the psychedelic and antidepressant effects of psychedelic drugs. We discuss conceptual and methodological issues, the importance of using clinically relevant doses and the need to consider possible sex differences in preclinical psychedelic studies.

Longitudinal Pathways from Parent Internalizing Symptoms to Parent and Youth Emotion Functioning

The current study utilized mediation analyses to examine how parental symptoms of depression and anxiety impact child emotion regulation (ER) and emotion stability (ES) through parent emotion functioning, parenting, and the coparent relationship. 564 parents of children between 3 and 17 years (Mage = 9.47; 54.4% male) were recruited via Amazon's Mechanical Turk across three time points: baseline (Wave 1), 4 months (Wave 2), 8 months (Wave 3). Mediation results demonstrated that symptoms of parent depression at Wave 1 predicted worse coparent relationships and decreases in parents' ability to identify their own emotions at Wave 2. Symptoms of parental anxiety at Wave 1 predicted decreases in positive parenting and an increased tendency to have negative secondary emotional responses, impulse-control difficulties, and difficulty accessing emotion-regulation strategies at Wave 2. Additionally, symptoms of parental anxiety at Wave 1 directly predicted lower child ER and ES at Wave 3. However, no significant indirect pathways were identified between parent symptoms and child ER and ES. Sensitivity analyses examined the effects of three youth developmental stages (i.e., early and middle childhood and adolescence), as well as parent gender (i.e., mother and father), and found no significant differences across groups. Thus, even at non-clinical levels, parental symptoms of anxiety and depression may negatively impact parenting, parent regulation, and the coparent relationship, while parental anxiety symptoms may contribute to lower child ER and ES.

Attention modulates facial expression processing in subsyndromal depression: A behavioral and ERP study

Impaired facial expression perception is a core element in depression, but the underlying mechanism remains controversial. This event-related potential study investigated how attention modulates facial expression perception in depression using a nonclinical sample. A group of healthy controls (HC, N = 39) and a group of individuals with subsyndromal depression (SD, N = 39) categorized faces based on either facial expression (happy vs. sad) or gender (male vs. female). Behaviorally, the SD group was less sensitive to the emotional valence of facial expression than the HC group when their attention was directed to facial expression, as revealed by comparable subjective ratings and accuracy rates in response to facial expressions. When attention was directed towards facial gender, the SD group versus the HC group showed a negative bias, as revealed by a faster N170 for sad faces than happy faces. Together, our findings suggest that attention plays a role in understanding the relationship between depression and facial expression perception.

Neural and affective responses to prolonged eye contact with parents in depressed and nondepressed adolescents

Eye contact improves mood, facilitates connectedness, and is assumed to strengthen the parent-child bond. Adolescent depression is linked to difficulties in social interactions, the parent-child bond included. Our goal was to elucidate adolescents' affective and neural responses to prolonged eye contact with one's parent in nondepressed adolescents (HC) and how these responses are affected in depressed adolescents. While in the scanner, 59 nondepressed and 19 depressed adolescents were asked to make eye contact with their parent, an unfamiliar peer, an unfamiliar adult, and themselves by using videos of prolonged direct and averted gaze, as an approximation of eye contact. After each trial, adolescents reported on their mood and feelings of connectedness, and eye movements and BOLD-responses were assessed. In HCs, eye contact boosted mood and feelings of connectedness and increased activity in inferior frontal gyrus (IFG), temporal pole, and superior frontal gyrus. Unlike HCs, eye contact did not boost the mood of depressed adolescents. While HCs reported increased mood and feelings of connectedness to the sight of their parent versus others, depressed adolescents did not. Depressed adolescents exhibited blunted overall IFG activity. These findings show that adolescents are particularly sensitive to eye contact and respond strongly to the sight of their parents. This sensitivity seems to be blunted in depressed adolescents. For clinical purposes, it is important to gain a better understanding of how the responsivity to eye contact in general and with their parents in particular, can be restored in adolescents with depression.

Network dysfunction of sadness facial expression processing and morphometry in euthymic bipolar disorder

Facial emotion recognition (FER), including sadness, is altered in bipolar disorder (BD). However, the relationship between this impairment and the brain structure in BD is relatively unexplored. Furthermore, its association with clinical variables and with the subtypes of BD remains to be clarified. Twenty euthymic patients with BD type I (BD-I), 28 BD type II (BD-II), and 45 healthy controls completed a FER test and a 3D-T1-weighted magnetic resonance imaging. Gray matter volume (GMV) of the cortico-limbic regions implicated in emotional processing was estimated and their relationship with FER performance was investigated using network analysis. Patients with BD-I had worse total and sadness-related FER performance relative to the other groups. Total FER performance was significantly negatively associated with illness duration and positively associated with global functioning in patients with BD-I. Sadness-related FER performance was also significantly negatively associated with the number of previous manic episodes. Network analysis showed a reduced association of the GMV of the frontal-insular-occipital areas in patients with BD-I, with a greater edge strength between sadness-related FER performance and amygdala GMV relative to controls. Our results suggest that FER performance, particularly for facial sadness, may be distinctively impaired in patients with BD-I. The pattern of reduced interrelationship in the frontal-insular-occipital regions and a stronger positive relationship between facial sadness recognition and the amygdala GMV in BD may reflect altered cortical modulation of limbic structures that ultimately predisposes to emotional dysregulation. Future longitudinal studies investigating the effect of mood state on FER performance in BD are warranted.

Detecting depression based on facial cues elicited by emotional stimuli in video

Recently, depression research has received considerable attention and there is an urgent need for objective and validated methods to detect depression. Depression detection based on facial expressions may be a promising adjunct to depression detection due to its non-contact nature. Stimulated facial expressions may contain more information that is useful in detecting depression than natural facial expressions. To explore facial cues in healthy controls and depressed patients in response to different emotional stimuli, facial expressions of 62 subjects were collected while watching video stimuli, and a local face reorganization method for depression detection is proposed. The method extracts the local phase pattern features, facial action unit (AU) features and head motion features of a local face reconstructed according to facial proportions, and then fed into the classifier for classification. The classification accuracy was 76.25%, with a recall of 80.44% and a specificity of 83.21%. The results demonstrated that the negative video stimuli in the single-attribute stimulus analysis were more effective in eliciting changes in facial expressions in both healthy controls and depressed patients. Fusion of facial features under both neutral and negative stimuli was found to be useful in discriminating between healthy controls and depressed individuals. The Pearson correlation coefficient (PCC) showed that changes in the emotional stimulus paradigm were more strongly correlated with changes in subjects' facial AU when exposed to negative stimuli compared to stimuli of other attributes. These results demonstrate the feasibility of our proposed method and provide a framework for future work in assisting diagnosis.

Characteristics of healthy Japanese young adults with respect to recognition of facial expressions: a preliminary study

BACKGROUND

Emotional cognitive impairment is a core phenotype of the clinical symptoms of psychiatric disorders. The ability to measure emotional cognition is useful for assessing neurodegenerative conditions and treatment responses. However, certain factors such as culture, gender, and generation influence emotional recognition, and these differences require examination. We investigated the characteristics of healthy young Japanese adults with respect to facial expression recognition.

METHODS

We generated 17 models of facial expressions for each of the six basic emotions (happiness, sadness, anger, fear, disgust, and surprise) at three levels of emotional intensity using the Facial Acting Coding System (FACS). Thirty healthy Japanese young adults evaluated the type of emotion and emotional intensity the models represented to them.

RESULTS

Assessment accuracy for all emotions, except fear, exceeded 60% in approximately half of the videos. Most facial expressions of fear were rarely accurately recognized. Gender differences were observed with respect to both faces and participants, indicating that expressions on female faces were more recognizable than those on male faces, and female participants had more accurate perceptions of facial emotions than males.

CONCLUSION

The videos used may constitute a dataset, with the possible exception of those that represent fear. The subject's ability to recognize the type and intensity of emotions was affected by the gender of the portrayed face and the evaluator's gender. These gender differences must be considered when developing a scale of facial expression recognition.

The impact of emotional stimuli on response inhibition in an inpatient and day-hospital patient psychosomatic cohort

Objectives

To correctly recognize and respond to your counterpart's emotion is essential for a successful get-together. To ensure this, emotional processes and inhibitory control are linked and interact with each other. However, this interaction can be altered in several mental disorders. In a group of psychosomatic patients, we investigated possible differences in the response inhibition between neutral and emotional stimuli and whether a psychosomatic inpatient and day-hospital patient treatment influences response inhibition profiles.

Methods

One hundred and one patients, diagnosed with different psychiatric diagnoses (77 women, 41.43 ± 13.13 years), completed an emotional stop-signal task (ESST) and an impulsive behavior scale upon admission in an inpatient and day-hospital patient treatment on a psychosomatic ward (T0) and at discharge (T1). Patients with depressive disorders completed the test again after 1 year (follow-up measurement T2, n = 22). Emotional stimuli were angry and neutral faces. Stop-signal reaction time (SSRT) and stop-signal delay (SSD) were calculated as the main behavioral parameters.

Results

We found a significantly higher SSRT for neutral than angry faces at both admission (8.538 ms, p < 0.001) and discharge (11.142 ms, p < 0.001), with a matching higher SSD for angry than neutral faces at both timepoints (T0: 8.360 ms, p < 0.001, T1: (6.950 ms, p < 0.001). The SSRT for angry faces significantly decreased after treatment (-8.485 ms, p = 0.0110). For neutral faces, the decrease failed to reach significance (-5.881 ms, p = 0.250). A significant decrease in SSRT for neutral faces in patients with depressive disorders was found 1 year after discharge compared with admission (-19.040 ms, p = 0.0380).

Conclusion

Our data demonstrate a decreased response inhibition for neutral compared with emotional stimuli and an improved response inhibition for angry faces after discharge in a psychosomatic inpatient and day-hospital patient cohort. Additionally, patients with depressive disorders displayed a significantly better response inhibition for neutral faces 1 year after discharge compared with the baseline measurement. With this study, we provide more evidence for altered emotional response inhibition in different mental disorders and a hint that psychosomatic inpatient and day-hospital patient treatment may help to normalize it, even if the effects remained small and it needs further research to prove causality.

Reduced eye gaze during facial emotion recognition in chronic depression: Effects of intranasal oxytocin

Chronic depression disorders (CDD) are characterized by impaired social cognitive functioning. Visual attention during social perception is altered in clinical depression and is known to be sensitive to intranasal treatment with oxytocin (OT). The present study thus investigated potential alterations in gaze preferences during a standardized facial emotion recognition (FER) task using remote eye tracking in patients with CDD and the effect of a single dose of intranasal OT (compared to placebo). In emotion recognition, CDD patients were not more impaired than healthy controls, and there was no OT effect. However, CDD patients (with placebo) demonstrated less attentional preference for the eye region during FER than healthy controls, which was not apparent in the CDD group after OT treatment. Our results suggest that despite largely preserved basic facial emotions recognition, attention in social perception may be altered in CDD, and that this bias may be sensitive to OT treatment. These findings highlight OTs potential as a means of augmenting psychotherapy.

Emotional context effect on recognition of varying facial emotion expression intensities in depression

BACKGROUND

Previous research has indicated that Major Depressive Disorder (MDD) patients have deficits in the process of facial emotion recognition. In most of these studies, isolated emotional faces were used, and the effect of the surrounding context of the face was neglected. We aimed to investigate how context emotion (sad or happy) affects facial emotion recognition and whether this effect is different in depressive individuals compared to the control group.

METHODS

Happy, sad, neutral facial expressions with congruent and incongruent visual contexts were presented to 51 MDD patients and 42 matched healthy controls. Emotional facial expressions are presented as morphs gradually expressing happiness or sadness with 40% and 80% intensity levels. Mean reaction time, mean accuracy rate, and mean emotion intensity rating score was calculated for each condition.

RESULTS

The performances on facial emotion intensity rating and accuracy rate were similar between MDD patients and controls. MDD patients were slower to recognize all facial emotions and to recognize facial emotions with emotionally incongruent backgrounds compared to congruent ones.

LIMITATIONS

Antidepressant therapy of patients might have affected our results.

CONCLUSIONS

Emotional contextual features have an important role in facial emotion recognition but this effect is independent of depression. Longer reaction time in depression may be related to some cognitive impairments.

AU-Guided Unsupervised Domain-Adaptive Facial Expression Recognition

Domain diversities, including inconsistent annotation and varied image collection conditions, inevitably exist among different facial expression recognition (FER) datasets, posing an evident challenge for adapting FER models trained on one dataset to another one. Recent works mainly focus on domain-invariant deep feature learning with adversarial learning mechanisms, ignoring the sibling facial action unit (AU) detection task, which has obtained great progress. Considering that AUs objectively determine facial expressions, this paper proposes an AU-guided unsupervised domain-adaptive FER (AdaFER) framework to relieve the annotation bias between different FER datasets. In AdaFER, we first leverage an advanced model for AU detection on both a source and a target domain. Then, we compare the AU results to perform AU-guided annotating, i.e., target faces that own the same AUs as source faces would inherit the labels from the source domain. Meanwhile, to achieve domain-invariant compact features, we utilize an AU-guided triplet training, which randomly collects anchor–positive–negative triplets on both domains with AUs. We conduct extensive experiments on several popular benchmarks and show that AdaFER achieves state-of-the-art results on all these benchmarks.

Neuromolecular Underpinnings of Negative Cognitive Bias in Depression

This selective review aims to summarize the recent advances in understanding the neuromolecular underpinnings of biased cognition in depressive disorder. We begin by considering the cognitive correlates of depressed mood and the key brain systems implicated in its development. We then review the core findings across two domains of biased cognitive function in depression: pessimistic judgment bias and abnormal response to negative feedback. In considering their underlying substrates, we focus on the neurochemical mechanisms identified by genetic, molecular and pharmacological challenge studies. We conclude by discussing experimental approaches to the treatment of depression, which are derived largely from an improved understanding of its cognitive substrates.

Facial emotion recognition in major depressive disorder: A meta-analytic review

BACKGROUND

Major depressive disorder (MDD) has been associated with difficulties in social and interpersonal functioning. Deficits in emotion processing may contribute to the development and maintenance of interpersonal difficulties in MDD. Although some studies have found that MDD is associated with deficits in recognition of emotion in faces, other studies have failed to find any impairment.

METHODS

The present meta-analysis of 23 studies, with 516 dysthymic/depressed participants and 614 euthymic control participants, examined facial emotion recognition accuracy in MDD. Several potential moderators were investigated, including type of emotion, symptom severity, patient status, method of diagnosis, type of stimulus, and stimulus duration.

RESULTS

Results showed that participants with MDD in inpatient settings (Hedges' g = -0.35) and with severe levels of symptom severity (g = -0.42) were less accurate in recognizing happy facial expressions of emotion (g = -0.25) compared to participants in outpatient settings (g = -0.24) and with mild symptoms of depression (g = -0.17). Studies that presented stimuli for longer durations (g = -0.26) tended to find lower accuracy levels in dysthymic/depressed, relative to euthymic, participants.

LIMITATIONS

Limitations include a lack of studies which examined gender identity, as well as other potential moderators.

CONCLUSIONS

Results of the current study support the existence of a broad facial emotion recognition deficit in individuals suffering from unipolar depression. Clinicians should be mindful of this and other research which suggests broad-based deficits in various forms of information processing, including attention, perception, and memory in depression.

Test-Retest Reliability of Frontal and Parietal Alpha Asymmetry during Presentation of Emotional Face Stimuli in Healthy Subjects

Resting-state and event-related frontal alpha asymmetry have been suggested as potential neurobiological biomarkers for depression and other psychiatric conditions. To be used as such, sufficient test-retest reliability needs to be demonstrated. However, test-retest reliability is underinvestigated for event-related alpha asymmetry. The objective of this study was to examine both short-term within-session and long-term between-session reliability of stimulus-related medial and lateral frontal as well as parietal alpha EEG asymmetry in healthy subjects during a simple emotional face processing task. Twenty-three healthy adults participated in two sessions with a test-retest interval of about 1 week. Reliability was estimated with Pearson's correlation coefficient and paired t test. Results revealed moderate to high within-session reliability of stimulus-related alpha asymmetry for all electrode sites and both conditions. Alpha asymmetry mean values did not change significantly within sessions. Between-session reliability was fair for frontomedial and moderate for frontolateral stimulus-related asymmetry. Exploratory exclusion of subjects with unstable between-session self-rating scores of emotional state and empathy toward stimuli resulted in some higher reliability values. Our results indicate that stimulus-related alpha asymmetry may serve as a useful electrophysiological tool given its adequate within-session reliability. However, long-term stability of stimulus-related frontal alpha asymmetry over 1 week was comparatively low and varied depending on electrode position. Influencing state factors during EEG recording, such as current mood or stimulus engagement, should be considered in future study designs and analyses. Further, we recommend to analyze alpha asymmetry from both frontomedial and frontolateral sites.

Interpreting Depression From Question-wise Long-term Video Recording of SDS Evaluation

Self-Rating Depression Scale (SDS) questionnaire has frequently been used for efficient depression preliminary screening. However, the uncontrollable self-administered measure can be easily affected by insouciantly or deceptively answering, and producing the different results with the clinician-administered Hamilton Depression Rating Scale (HDRS) and the final diagnosis. Clinically, facial expression (FE) and actions play a vital role in clinician-administered evaluation, while FE and action are underexplored for self-administered evaluations. In this work, we collect a novel dataset of 200 subjects to evidence the validity of self-rating questionnaires with their corresponding question-wise video recording. To automatically interpret depression from the SDS evaluation and the paired video, we propose an end-to-end hierarchical framework for the long-term variable-length video, which is also conditioned on the questionnaire results and the answering time. Specifically, we resort to a hierarchical model which utilizes a 3D CNN for local temporal pattern exploration and a redundancy-aware self-attention (RAS) scheme for question-wise global feature aggregation. Targeting for the redundant long-term FE video processing, our RAS is able to effectively exploit the correlations of each video clip within a question set to emphasize the discriminative information and eliminate the redundancy based on feature pair-wise affinity. Then, the question-wise video feature is concatenated with the questionnaire scores for final depression detection. Our thorough evaluations also show the validity of fusing SDS evaluation and its video recording, and the superiority of our framework to the conventional state-of-the-art temporal modeling methods.

Facial Emotion Recognition in Schizophrenia

Deficits in facial emotion recognition are one of the most common cognitive impairments, and they have been extensively studied in various psychiatric disorders, especially in schizophrenia. However, there is still a lack of conclusive evidence about the factors associated with schizophrenia and impairment at each stage of the disease, which poses a challenge to the clinical management of patients. Based on this, we summarize facial emotion cognition among patients with schizophrenia, introduce the internationally recognized Bruce-Young face recognition model, and review the behavioral and event-related potential studies on the recognition of emotions at each stage of the face recognition process, including suggestions for the future direction of clinical research to explore the underlying mechanisms of schizophrenia.

Potent and Quick Responses to Conspecific Faces and Snakes in the Anterior Cingulate Cortex of Monkeys

Appropriate processing of others' facial emotions is a fundamental ability of primates in social situations. Several moods and anxiety disorders such as depression cause a negative bias in the perception of facial emotions. Depressive patients show abnormalities of activity and gray matter volume in the perigenual portion of the anterior cingulate cortex (ACC) and an increase of activation in the amygdala. However, it is not known whether neurons in the ACC have a function in the processing of facial emotions. Furthermore, detecting predators quickly and taking avoidance behavior are important functions in a matter of life and death for wild monkeys. the existence of predators in their vicinity is life-and-death information for monkeys. In the present study, we recorded the activity of single neurons from the monkey ACC and examined the responsiveness of the ACC neurons to various visual stimuli including monkey faces, snakes, foods, and artificial objects. About one-fourth of the recorded neurons showed a significant change in activity in response to the stimuli. The ACC neurons exhibited high selectivity to certain stimuli, and more neurons exhibited the maximal response to monkey faces and snakes than to foods and objects. The responses to monkey faces and snakes were faster and stronger compared to those to foods and objects. Almost all of the neurons that responded to video stimuli responded strongly to negative facial stimuli, threats, and scream. Most of the responsive neurons were located in the cingulate gyrus or the ventral bank of the cingulate sulcus just above or anterior to the genu of the corpus callosum, that is, the perigenual portion of the ACC, which has a strong mutual connection with the amygdala. These results suggest that the perigenual portion of the ACC in addition to the amygdala processes emotional information, especially negative life-and-death information such as conspecifics' faces and snakes.

Feeling addressed! The neural processing of social communicative cues in patients with major depression

The feeling of being addressed is the first step in a complex processing stream enabling successful social communication. Social impairments are a relevant characteristic of patients with major depressive disorder (MDD). Here, we investigated a mechanism which—if impaired—might contribute to withdrawal or isolation in MDD, namely, the neural processing of social cues such as body orientation and gesture. During funtional magnetic resonance imaging (fMRI) data acquisition, 33 patients with MDD and 43 healthy control subjects watched video clips of a speaking actor: one version with a gesture accompanying the speech and one without gesture. Videos were filmed simultaneously from two different viewpoints: one with the actor facing the viewer head‐on (frontal) and one side‐view (lateral). After every clip, the participants were instructed to evaluate whether they felt addressed or not. Despite overall comparable addressment ratings and a large overlap in activation patterns in MDD and healthy subjects for gesture processing, the anterior cingulate cortex, bilateral superior/middle frontal cortex, and right angular gyrus were more strongly activated in patients than in healthy subjects for the frontal conditions. Our analyses revealed that patients showed specifically higher activation than healthy subjects for the frontal condition without gesture in regions including the posterior cingulate cortex, left prefrontal cortex, and the left hippocampus. We conclude that MDD patients can recognize and interpret social cues such as gesture or body orientation; however, they seem to require more neural resources. This additional effort might affect successful communication and contribute to social isolation in MDD.

A Deep Learning Approach for Mild Depression Recognition Based on Functional Connectivity Using Electroencephalography

Early detection remains a significant challenge for the treatment of depression. In our work, we proposed a novel approach to mild depression recognition using electroencephalography (EEG). First, we explored abnormal organization in the functional connectivity network of mild depression using graph theory. Second, we proposed a novel classification model for recognizing mild depression. Considering the powerful ability of CNN to process two-dimensional data, we applied CNN separately to the two-dimensional data form of the functional connectivity matrices from five EEG bands (delta, theta, alpha, beta, and gamma). In addition, inspired by recent breakthroughs in the ability of deep recurrent CNNs to classify mental load, we merged the functional connectivity matrices from the three EEG bands that performed the best into a three-channel image to classify mild depression-related and normal EEG signals using the CNN. The results of the graph theory analysis showed that the brain functional network of the mild depression group had a larger characteristic path length and a lower clustering coefficient than the healthy control group, showing deviation from the small-world network. The proposed classification model obtained a classification accuracy of 80.74% for recognizing mild depression. The current study suggests that the combination of a CNN and functional connectivity matrix may provide a promising objective approach for diagnosing mild depression. Deep learning approaches such as this might have the potential to inform clinical practice and aid in research on psychiatric disorders.

Escitalopram ameliorates differences in neural activity between healthy comparison and major depressive disorder groups on an fMRI Emotional conflict task: A CAN-BIND-1 study

BACKGROUND

Identifying objective biomarkers can assist in predicting remission/non-remission to treatment, improving remission rates, and reducing illness burden in major depressive disorder (MDD).

METHODS

Sixteen MDD 8-week remitters (MDD-8), twelve 16-week remitters (MDD-16), 14 non-remitters (MDD-NR) and 30 healthy comparison participants (HC) completed a functional magnetic resonance imaging emotional conflict task at baseline, prior to treatment with escitalopram, and 8 weeks after treatment initiation. Patients were followed 16 weeks to assess remitter status.

RESULTS

All groups demonstrated emotional Stroop in reaction time (RT) at baseline and Week 8. There were no baseline differences between HC and MDD-8, MDD-16, or MDD-NR in RT or accuracy. By Week 8, MDD-8 demonstrated poorer accuracy compared to HC. Compared to HC, the baseline blood-oxygen level dependent (BOLD) signal was decreased in MDD-8 in brain-stem and thalamus; in MDD-16 in lateral occipital cortex, middle temporal gyrus, and cuneal cortex; in MDD-NR in lingual and occipital fusiform gyri, thalamus, putamen, caudate, cingulate gyrus, insula, cuneal cortex, and middle temporal gyrus. By Week 8, there were no BOLD activity differences between MDD groups and HC.

LIMITATIONS

The Emotional Conflict Task lacks a neutral (non-emotional) condition, restricting interpretation of how mood may influence perception of non-emotionally valenced stimuli.

CONCLUSIONS

The Emotional Conflict Task is not an objective biomarker for remission trajectory in patients with MDD receiving escitalopram treatment. Escitalopram may have influenced emotion recognition in MDD groups in terms of augmented accuracy and BOLD signal in response to an Emotional Conflict Task, following 8 weeks of escitalopram treatment.

The role of the right prefrontal cortex in recognition of facial emotional expressions in depressed individuals: fNIRS study

BACKGROUND

Depressed individuals often perceive neutral facial expressions as emotional. Neurobiological underpinnings of this effect remain unclear. We investigated the differences in prefrontal cortical (PFC) activation in depressed individuals vs. healthy controls (HC) during recognition of emotional and neutral facial expressions using functional near infrared spectroscopy (fNIRS).

METHOD

In Experiment 1, 33 depressed individuals and 20 HC performed the Emotion Intensity Rating task in which they rated intensity of facial emotional expressions. In Experiment 2, a different set of participants (18 depressed individuals and 16 HC) performed the same task while their PFC activation was measured using fNIRS.

RESULTS

Both experiments showed that depressed individuals were slower and less accurate in recognizing neutral, but not happy or fearful, facial emotional expressions. Experiment 2 revealed that lower accuracy for neutral facial emotional expressions was associated with lower right PFC activation in depressed individuals, but not HC. In addition, depressed individuals, compared to HC, had lower right PFC activation during recognition of happy facial expressions.

LIMITATIONS

Relatively small sample size CONCLUSIONS: Recognition of neutral facial expressions is impaired in depressed individuals. Greater impairment corresponds to lower right PFC activation during neutral face processing. Recognition of happy facial expressions is comparable for depressed individuals and HC, but the former have significantly lower right PFC activation. Taken together, these findings suggest that the ability of depressed individuals to discriminate neutral and emotional signals in the environment may be affected by aberrant functioning of right PFC.

Investigation of an emotion perception test using functional magnetic resonance imaging

BACKGROUND AND OBJECTIVE

Patients with mood disorders are known to have an emotion recognition deficit in facial emotion processing. Emotion perception involves two systems of cognitive and affective processes associated with brain activation in the fusiform gyrus and prefrontal cortices. To overcome the limitations of existing emotion perception tests, we designed an emotion perception index to assess the individuals' mood status.

METHODS

We selected 66 emotional faces (22 pleasant, 22 unpleasant, and 22 neutral) for the emotion perception test and recruited 40 healthy participants to verify the test. The participants completed a demographic data questionnaire and were administered the Beck Depressive Inventory (BDI). They were also scanned to assess the brain functional connectivity (FC) between seeds of the fusiform gyrus and other brain regions using resting-state functional magnetic resonance imaging (rs-fMRI). After rs-fMRI scanning, the participants were administered the emotion perception test on a computer.

RESULTS

In response to 108 questions regarding emotional face differentiation, the study group showed an average correct-answer rate of 90.7 ± 6.4% and a mean reaction time of 1.4 ± 0.4 s. We created an emotion perception index from the calculation of correct rate, number of correct responses, and reaction time in response to 108 questions; the mean of the emotion perception index in the study group was 3.8 ± 0.2. The emotion perception index was positively correlated with the BDI scores (r = 0.4, p = 0.01); further, it was positively correlated with the FC from the fusiform gyrus to the left superior frontal gyrus (FDRq < 0.01), left medial frontal gyrus (FDRq < 0.01), left frontal precentral gyrus (FDRq = 0.02), left insula (FDRq < 0.01), and left occipital cuneus (FDRq = 0.01). The FC from the fusiform gyrus to the left insula was positively correlated with the BDI scores (r = 0.59, p < 0.001).

CONCLUSIONS

The emotion perception index designed in this study may correctly indicate the mood status of individuals. In addition, the emotion perception test was associated with brain FC from the fusiform gyrus to the frontal and insular cortices.

Reduced accuracy accompanied by reduced neural activity during the performance of an emotional conflict task by unmedicated patients with major depression: A CAN-BIND fMRI study

METHODS

We studied 48 MDD and 30 HC who performed an emotional conflict task in a functional magnetic resonance imaging (fMRI) scanner.

RESULTS

On the emotional conflict task, MDD and HC demonstrated a robust emotional Stroop effect in reaction time and accuracy. Overall, accuracy was lower in MDD compared to HC with no significant reaction time differences. The fMRI data indicated lower BOLD activation in MDD compared to HC on comparisons of all trials, congruent, incongruent, and incongruent > congruent trials in regions including right inferior temporal gyrus, lateral occipital cortex, and occipital fusiform gyrus. Behavioural and neuroimaging data indicated no group differences in fearful versus happy face processing.

LIMITATIONS

Inclusion of a neutral condition may have provided a valuable contrast to how MDD and HC process stimuli without emotional valence compared to stimuli with a strong emotional valence.

CONCLUSIONS

MDD and HC demonstrated a robust emotional Stroop effect. Compared to HC, MDD demonstrated an overall reduced accuracy on the emotional conflict task and reduced BOLD activity in regions important for face perception and emotion information processing, with no differences in responding to fearful versus happy faces. These findings provide support for the theory of emotion context insensitivity in individuals with depression.

Using computer-vision and machine learning to automate facial coding of positive and negative affect intensity

Facial expressions are fundamental to interpersonal communication, including social interaction, and allow people of different ages, cultures, and languages to quickly and reliably convey emotional information. Historically, facial expression research has followed from discrete emotion theories, which posit a limited number of distinct affective states that are represented with specific patterns of facial action. Much less work has focused on dimensional features of emotion, particularly positive and negative affect intensity. This is likely, in part, because achieving inter-rater reliability for facial action and affect intensity ratings is painstaking and labor-intensive. We use computer-vision and machine learning (CVML) to identify patterns of facial actions in 4,648 video recordings of 125 human participants, which show strong correspondences to positive and negative affect intensity ratings obtained from highly trained coders. Our results show that CVML can both (1) determine the importance of different facial actions that human coders use to derive positive and negative affective ratings when combined with interpretable machine learning methods, and (2) efficiently automate positive and negative affect intensity coding on large facial expression databases. Further, we show that CVML can be applied to individual human judges to infer which facial actions they use to generate perceptual emotion ratings from facial expressions.

Variation of temporal order reveals deficits in categorisation of facial expressions in patients afflicted with depression

INTRODUCTION

It is well established that depressive disorders are associated with abnormalities in the processing of affective information. However, type of stimuli, perceptual complexity and cognitive demand are important factors in evaluating these findings. In particular, processing mechanisms of perceptual boundaries in ecologically valid face stimuli are largely unknown in depression.

METHODS

In the current study, intensity-ordered frame sequences provided a dynamic visualisation of happy or sad facial expressions fading from or to neutral expressions. Patients (n = 20) with major depression (MD) disorder and controls (n = 20) indicated their perceptual boundaries between neutral and emotional face depending on direction and emotion. The averaged time of the perceptual boundary entered a group × condition ANOVA and regression analysis.

RESULTS

MD group did not systematically shift perceptual boundaries in the dynamic emotional faces but yielded altered statistics in information processing. The Gaussian distribution of boundary judgements was disturbed in depression, increasing goodness-of-fit errors in disappearing emotions. Goodness-of-fit correlated with depression symptom score (Beck Depression Inventory-II (BDI-II)) in the MD group during the disappearing sad (r(18) = 46, p = 0.04) and happy (r(18) = 51, p = 0.02) conditions.

CONCLUSION

We evaluated detection of appearing and disappearing emotions in dynamic faces. A deviant distribution of categorisation responses emerged in the MD group, which was not emotion-specific. Such a perceptional uncertainty can impede individuals' functioning in interpersonal interaction.

Pupil mimicry and trust - Implication for depression

Individuals suffering from depression often have difficulty trusting others. Previous research has shown a relationship between trust formation and pupil mimicry - the synchronization of pupil sizes between individuals. The current study therefore examined whether pupil mimicry is weaker in depressed individuals and an underlying factor of their low levels of trust. Forty-two patients with major depressive disorder (MDD) and 40 healthy control subjects played trust games with virtual partners. Images of these partners' eye regions were presented to participants before they had to make a monetary investment decision. Partners' pupils either dilated, constricted, or remained static over the course of 4-s interactions. During the task, participants' pupil sizes were recorded with eye-tracking equipment to assess mimicry. The results confirm that patients with MDD were somewhat less trusting than controls and used another's pupillary cues differently when deciding to trust. Specifically, whereas healthy controls trusted partners with dilating pupils more than partners with constricting pupils, patients with MDD particularly trusted partners whose pupils changed in size less, regardless of whether partners' pupils were dilating or constricting. This difference in investment behavior was unrelated to differences in pupil mimicry, which was equally apparent in both groups and fostered trust to the same extent. Whereas lower levels of trust observed in patients with MDD could not be explained by differences in pupil mimicry, our data show that pupil dilation mimicry might help people to trust. These findings provide further evidence for the important role of pupil size and pupil mimicry in interpersonal trust formation and shed light on the pathophysiology of clinically low trust in patients with MDD.

Neural systems underlying affective disorders

Three main approaches are used to explore the neural correlates of mood disorder: neuropsychological studies, neuroimaging studies and post-mortem investigations. Lesion studies implicate disturbances in the frontal lobe, basal ganglia, striatum and anterior temporal cortex. Early neurocognitive and neuropathological investigations led to a ‘hypofrontality’ hypothesis of unipolar and bipolar depression, but functional neuroimaging has revealed a more complex picture. Thus, increased metabolism may occur in the subgenual anterior cingulate gyrus in resting-state studies of depression and sad-mood induction. Antidepressants may reduce this activity. Amygdala hyperactivation also is associated with affective disorders. Task-related studies reveal abnormal biases in memory, the experience of pleasure and the perception of emotional facial expressions. There is still little clarity whether the abnormalities in brain activation represent state or trait characteristics of affective disorders.

Facial emotion recognition, theory of mind and the role of facial mimicry in depression

BACKGROUND

This study examined whether acutely (aMDD) and remitted depressed patients (rMDD) show deficits in the two aspects of social cognition - facial emotion recognition (FER) and reasoning - when using ecologically valid material. Furthermore, we examined whether reduced facial mimicry mediates the association between depressive symptoms and FER, and whether FER deficits and reasoning deficits are associated.

METHOD

In 42 aMDD, 43 rMDD, and 39 healthy controls (HC) FER was assessed using stimuli from the Amsterdam Dynamic Facial Expression Set, reasoning by the Movie for the Assessment of Social Cognition. Furthermore, the activity of Zygomaticus Major and Corrugator supercilii were recorded.

RESULTS

aMDD recognized happy faces less accurately, were less confident recognizing happiness and anger and found it more difficult to recognize happiness, anger and fear than HC. rMDD were less confident recognizing anger and found it more difficult to recognize happiness, anger and fear than HC. Reduced mimicry did not explain FER deficits. aMDD but not rMDD showed impaired reasoning.

LIMITATIONS

The stimulus material was comparably easy to decode. Therefore, it is possible that the FER deficits of aMDD and rMDD patients are more pronounced than demonstrated in this study.

CONCLUSIONS

aMDD show deficits in FER and reasoning, whereas rMDD only show mild impairments in the recognition of emotional expressions. There must be other processes - besides mimicry - that serve the accurate recognition of emotional facial expressions.

Altered patterns of association between cortical thickness and subcortical volume in patients with first episode major depressive disorder: A structural MRI study

Depressed individuals may exhibit changes in cortical thickness and subcortical volume. However, we know little about their associated connection patterns in the brain's neural circuits. This study explored correlations between overall cortical thickness and the volume of several subcortical structures in first episode major depressive disorder (MDD) patients. Thirty-six untreated individuals experiencing their first episode of MDD were compared with healthy controls (n=41). Their brains were imaged by T1-weighted MRI, allowing the measurement of cortical thickness and the volume of subcortical structures. We found that in MDD patients, the cortex was thinner in four of the measured regions (frontal, temporal, parietal and insula) and the volume of the putamen and amygdala tended to be smaller compared with controls. Furthermore, the ratio of the volume of the four measured subcortical structures (left pallidum, left putamen, left amygdala and right caudate) to cortical thickness (measured in 11 regions)was significantly larger in the MDD group compared with controls. These results show that there are different relationships between subcortical volume and cortical thickness inearly-stage MDD and control subjects.

The influence of cooperation and defection on social decision making in depression: A study of the iterated Prisoner's Dilemma Game

This study evaluated the influence of self-reported levels of depression on interpersonal strategic decision making when interacting with partners who differed in their predetermined tendency to cooperate in three separate computerized iterated Prisoner's Dilemma Games (iPDGs). Across 29 participants, cooperation was lowest when interacting with a predominantly defecting partner and highest when interacting with a predominantly cooperating partner. Greater depression severity was related to steadier and continued cooperation over trials with the cooperating partner, seeming to reflect a prosocial response tendency when interacting with this partner. With the unbiased partner, depression severity was associated with a more volatile response pattern in reaction to cooperation and defection by this partner. Severity of depression did not influence cooperation with a defecting partner or expectations about partner cooperation reported before the task began. Taken together, these data appear to show that in predominately positive interactions, as in the cooperating partner condition, depression is associated with less volatile, more consistent cooperation. When such clear feedback is absent, as in the unbiased partner condition, depression is associated with more volatile behavior. Nonetheless, participants were generally able to adapt their behavior accordingly in this dynamic interpersonal decision making context.

Recognition of emotional facial expressions in anxious and nonanxious depression

BACKGROUND

Anxiety and depression have each been independently associated with impairments in emotional face recognition. However, little is known about the nature of these impairments when anxiety and depression co-occur.

METHODS

This post-hoc analysis evaluated the relationship between anxiety status and performance on the Emotional Expression Multimorph Task within a clinical sample of individuals with major depressive disorder (MDD).

RESULTS

Participants with anxious depression (n=14) and nonanxious depression (n=14) completed the Emotional Expression Multimorph Task. Those with anxious depression required greater intensity of emotion to identify both happy (p=.01) and sad (p=.04) facial expressions than those with nonanxious depression. Severity of anxiety also correlated with greater intensity of emotion required to detect sad faces. Contrary to prediction, hypervigilance to angry and fearful facial expressions was not observed in anxious depression.

LIMITATIONS

The present study did not include an anxiety-only group for comparison, and did not assess state anxiety at time of administration. In addition, the extent to which the experimental task correlates with social functioning is not fully understood.

CONCLUSIONS

These findings suggest a diminished sensitivity to happy and sad facial expressions specific to anxious depression, but not a hypervigilance toward threatening facial expressions. Further research on the nature of emotion recognition in anxiety and depression may inform improved clinical interventions.

Amygdala and dorsomedial hyperactivity to emotional faces in youth with remitted Major Depression

We present neuroimaging markers of the remitted state of major depressive disorder (rMDD) during facial emotion perception in 84 individuals during fMRI. Participants comprised 47 individuals (aged 18-23) diagnosed with rMDD and 37 healthy controls (HCs). Participants classified emotional faces or animals (control condition) in the Facial Emotion Perception Test (FEPT) during fMRI. Behavioural performance on the FEPT did not differ significantly between groups. During fMRI, both groups demonstrated significant blood oxygen level-dependent (BOLD) activity in bilateral inferior frontal gyri for the faces minus animals (F-A) contrast. The rMDD group additionally showed BOLD activity during F-A in numerous regions, including the bilateral paracingulate gyri, middle temporal gyri and right amygdala. The rMDD group exhibited significantly greater activity than the HC group in regions including the bilateral middle temporal gyri and left superior frontal gyrus. Although the rMDD group did not manifest the behavioural performance deficits on facial emotion recognition tasks that have been observed in actively depressed individuals, the rMDD group nevertheless showed increased BOLD activity compared with never-depressed controls during F-A in multiple posterior brain regions, suggesting that persistent effects of illness or possible trait vulnerabilities may distinguish individuals with rMDD from never-depressed controls.

A review of fMRI studies during visual emotive processing in major depressive disorder

OBJECTIVES

This review synthesized literature on brain activity, indexed by functional magnetic resonance imaging (fMRI), during visual affective information processing in major depressive disorder (MDD). Activation was examined in regions consistently implicated in emotive processing, including the anterior cingulate cortex (ACC), prefrontal cortex (PFC), amygdala, thalamus/basal ganglia and hippocampus. We also reviewed the effects of antidepressant interventions on brain activity during emotive processing.

METHODS

Sixty-four fMRI studies investigating neural activity during visual emotive information processing in MDD were included.

RESULTS

Evidence indicates increased ventro-rostral ACC activity to emotive stimuli and perhaps decreased dorsal ACC activity in MDD. Findings are inconsistent for the PFC, though medial PFC hyperactivity tends to emerge to emotive information processing in the disorder. Depressed patients display increased amygdala activation to negative and arousing stimuli. MDD may also be associated with increased activity to negative, and decreased activity to positive, stimuli in basal ganglia/thalamic structures. Finally, there may be increased hippocampus activation during negative information processing. Typically, antidepressant interventions normalize these activation patterns.

CONCLUSION

In general, depressed patients have increased activation to emotive, especially negative, visual stimuli in regions involved in affective processing, with the exception of certain PFC regions; this pattern tends to normalize with treatment.

Biased recognition of facial affect in patients with major depressive disorder reflects clinical state

Cognitive theories of depression posit that perception is negatively biased in depressive disorder. Previous studies have provided empirical evidence for this notion, but left open the question whether the negative perceptual bias reflects a stable trait or the current depressive state. Here we investigated the stability of negatively biased perception over time. Emotion perception was examined in patients with major depressive disorder (MDD) and healthy control participants in two experiments. In the first experiment subjective biases in the recognition of facial emotional expressions were assessed. Participants were presented with faces that were morphed between sad and neutral and happy expressions and had to decide whether the face was sad or happy. The second experiment assessed automatic emotion processing by measuring the potency of emotional faces to gain access to awareness using interocular suppression. A follow-up investigation using the same tests was performed three months later. In the emotion recognition task, patients with major depression showed a shift in the criterion for the differentiation between sad and happy faces: In comparison to healthy controls, patients with MDD required a greater intensity of the happy expression to recognize a face as happy. After three months, this negative perceptual bias was reduced in comparison to the control group. The reduction in negative perceptual bias correlated with the reduction of depressive symptoms. In contrast to previous work, we found no evidence for preferential access to awareness of sad vs. happy faces. Taken together, our results indicate that MDD-related perceptual biases in emotion recognition reflect the current clinical state rather than a stable depressive trait.

Early effects of duloxetine on emotion recognition in healthy volunteers

The serotonin-noradrenaline reuptake inhibitor (SNRI) duloxetine is an effective treatment for major depression and generalised anxiety disorder. Neuropsychological models of antidepressant drug action suggest therapeutic effects might be mediated by the early correction of maladaptive biases in emotion processing, including the recognition of emotional expressions. Sub-chronic administration of duloxetine (for two weeks) produces adaptive changes in neural circuitry implicated in emotion processing; however, its effects on emotional expression recognition are unknown. Forty healthy participants were randomised to receive either 14 days of duloxetine (60 mg/day, titrated from 30 mg after three days) or matched placebo (with sham titration) in a double-blind, between-groups, repeated-measures design. On day 0 and day 14 participants completed a computerised emotional expression recognition task that measured sensitivity to the six primary emotions. Thirty-eight participants (19 per group) completed their course of tablets and were included in the analysis. Results provide evidence that duloxetine, compared to placebo, may reduce the accurate recognition of sadness. Drug effects were driven by changes in participants' ability to correctly detect subtle expressions of sadness, with greater change observed in the placebo relative to the duloxetine group. These effects occurred in the absence of changes in mood. Our preliminary findings require replication, but complement recent evidence that sadness recognition is a therapeutic target in major depression, and a mechanism through which SNRIs could resolve negative biases in emotion processing to achieve therapeutic effects.

Meta-analysis of emotion recognition deficits in major depressive disorder

BACKGROUND

Many studies have explored associations between depression and facial emotion recognition (ER). However, these studies have used various paradigms and multiple stimulus sets, rendering comparisons difficult. Few studies have attempted to determine the magnitude of any effect and whether studies are properly powered to detect it. We conducted a meta-analysis to synthesize the findings across studies on ER in depressed individuals compared to controls.

METHOD

Studies of ER that included depressed and control samples and published before June 2013 were identified in PubMed and Web of Science. Studies using schematic faces, neuroimaging studies and drug treatment studies were excluded.

RESULTS

Meta-analysis of k = 22 independent samples indicated impaired recognition of emotion [k = 22, g = -0.16, 95% confidence interval (CI) -0.25 to -0.07, p < 0.001]. Critically, this was observed for anger, disgust, fear, happiness and surprise (k's = 7-22, g's = -0.42 to -0.17, p's < 0.08), but not sadness (k = 21, g = -0.09, 95% CI -0.23 to +0.06, p = 0.23). Study-level characteristics did not appear to be associated with the observed effect. Power analysis indicated that a sample of approximately 615 cases and 615 controls would be required to detect this association with 80% power at an alpha level of 0.05.

CONCLUSIONS

These findings suggest that the ER impairment reported in the depression literature exists across all basic emotions except sadness. The effect size, however, is small, and previous studies have been underpowered.

Measuring cognitive function in MDD: emerging assessment tools

Cognitive impairment is emerging as an important therapeutic target in patients with psychiatric illnesses, including major depressive disorder (MDD). The objective of this general overview is to briefly review the evidence for cognitive impairment in MDD and to summarize a representative sample of cognitive assessment tools currently available to assess cognitive function in depressed patients. Study results in MDD patients with cognitive dysfunction are somewhat inconsistent, likely due to the heterogeneity of the disorder as well as the use of diverse assessment tools. Measuring cognitive changes in this population is challenging. Cognitive symptoms are typically less severe than in patients with schizophrenia and bipolar disorder, requiring greater sensitivity than afforded by existing tools. Preliminary evidence suggests antidepressant treatments may improve cognitive functioning as a direct result of ameliorating depressive symptoms; however, any procognitive effects have not been elucidated. To evaluate antidepressant efficacy in MDD patients with cognitive dysfunction, a standardized cognitive battery for use in clinical trials is essential.

The neurocognitive functioning in bipolar disorder: a systematic review of data

BACKGROUND

During the last decades, there have been many different opinions concerning the neurocognitive function in Bipolar disorder (BD). The aim of the current study was to perform a systematic review of the literature and to synthesize the data in a comprehensive picture of the neurocognitive dysfunction in BD.

METHODS

Papers were located with searches in PubMed/MEDLINE, through June 1st 2015. The review followed a modified version of the recommendations of the Preferred Items for Reporting of Systematic Reviews and Meta-Analyses statement.

RESULTS

The initial search returned 110,403 papers. After the deletion of duplicates, 11,771 papers remained for further evaluation. Eventually, 250 were included in the analysis.

CONCLUSION

The current review supports the presence of a neurocognitive deficit in BD, in almost all neurocognitive domains. This deficit is qualitative similar to that observed in schizophrenia but it is less severe. There are no differences between BD subtypes. Its origin is unclear. It seems it is an enduring component and represents a core primary characteristic of the illness, rather than being secondary to the mood state or medication. This core deficit is confounded (either increased or attenuated) by the disease phase, specific personal characteristics of the patients (age, gender, education, etc.), current symptomatology and its treatment (especially psychotic features) and long-term course and long-term exposure to medication, psychiatric and somatic comorbidity and alcohol and/or substance abuse.

Visual perception during mirror-gazing at one's own face in patients with depression

In normal observers, gazing at one's own face in the mirror for a few minutes, at a low illumination level, produces the apparition of strange faces. Observers see distortions of their own faces, but they often see hallucinations like monsters, archetypical faces, faces of relatives and deceased, and animals. In this research, patients with depression were compared to healthy controls with respect to strange-face apparitions. The experiment was a 7-minute mirror-gazing test (MGT) under low illumination. When the MGT ended, the experimenter assessed patients and controls with a specifically designed questionnaire and interviewed them, asking them to describe strange-face apparitions. Apparitions of strange faces in the mirror were very reduced in depression patients compared to healthy controls. Depression patients compared to healthy controls showed shorter duration of apparitions; minor number of strange faces; lower self-evaluation rating of apparition strength; lower self-evaluation rating of provoked emotion. These decreases in depression may be produced by deficits of facial expression and facial recognition of emotions, which are involved in the relationship between the patient (or the patient's ego) and his face image (or the patient's bodily self) that is reflected in the mirror.

[Expression, identification and experience of emotions in mental diseases. An overview]

Several studies in clinical neuroscience have focused on the analysis of expression of emotions, identification of emotions and experience of emotions. These empirical studies produced certain insights into emotional competency in different mental diseases, most of them in schizophrenia. The current article gives a description of the scientific data about alterations in emotional competency in several mental diseases (e.g. schizophrenia, depression, bipolar and borderline diseases) and links the data, if possible, with clinical relevance with a special focus on emotional competency in prodromal schizophrenia.

Emotion recognition processing as early predictor of response to 8-week citalopram treatment in late-life depression

BACKGROUND

In subjects with depression, exposure to antidepressants improves recognition of positive emotions. This phenomenon, which occurs early in the course of treatment, has been proposed as the initial step in the mechanism of action to subsequent therapeutic effects of antidepressants. To this date, it has not been well examined among older depressed patients.

METHOD

Older subjects with non-psychotic major depressive disorder were treated with citalopram in an 8-week open-label study. The main predictor of response and remission was the change in emotion recognition between baseline and day 7. Covariates included executive functions, baseline anxiety level, medical comorbidity, level of subjective stress, serum citalopram level, and level of social support.

RESULTS

Twenty-seven patients were considered for final analysis. Overall, accuracy of emotion recognition significantly improved between baseline (75%) and day 7 (83%) (X(2)  = 34.50, df = 1, p < 0.001). Improvement to identify happy expressions occurred at 25% and 50% intensity with ceiling effect at 0%, 75%, and 100%. Change in emotion processing was marginally significant in predicting antidepressant response at day 56. Multivariate analysis showed that emotion processing is a significant predictor of response and remission when considered along with perceived level of social support.

CONCLUSIONS

Recognition of mildly intense happy expression, which improved early in the course of citalopram treatment, predicts subsequent antidepressant response and remission when considered along with perception of social support. Further studies would be necessary to examine specific neural substrates in the affective network involved in the acute therapeutic action of antidepressant in late-life depression.

Emotion recognition in preschool children: associations with maternal depression and early parenting

Emotion knowledge in childhood has been shown to predict social functioning and psychological well-being, but relatively little is known about parental factors that influence its development in early childhood. There is some evidence that both parenting behavior and maternal depression are associated with emotion recognition, but previous research has only examined these factors independently. The current study assessed auditory and visual emotion recognition ability among a large sample of preschool children to examine typical emotion recognition skills in children of this age, as well as the independent and interactive effects of maternal and paternal depression and negative parenting (i.e., hostility and intrusiveness). Results indicated that children were most accurate at identifying happy emotional expressions. The lowest accuracy was observed for neutral expressions. A significant interaction was found between maternal depression and negative parenting behavior: children with a maternal history of depression were particularly sensitive to the negative effects of maladaptive parenting behavior on emotion recognition ability. No significant effects were found for paternal depression. These results highlight the importance of examining the effects of multiple interacting factors on children's emotional development and provide suggestions for identifying children for targeted preventive interventions.

Intact anger recognition in depression despite aberrant visual facial information usage

BACKGROUND

Previous literature has indicated abnormalities in facial emotion recognition abilities, as well as deficits in basic visual processes in major depression. However, the literature is unclear on a number of important factors including whether or not these abnormalities represent deficient or enhanced emotion recognition abilities compared to control populations, and the degree to which basic visual deficits might impact this process.

METHODS

The present study investigated emotion recognition abilities for angry versus neutral facial expressions in a sample of undergraduate students with Beck Depression Inventory-II (BDI-II) scores indicative of moderate depression (i.e., ≥20), compared to matched low-BDI-II score (i.e., ≤2) controls via the Bubbles Facial Emotion Perception Task.

RESULTS

Results indicated unimpaired behavioural performance in discriminating angry from neutral expressions in the high depressive symptoms group relative to the minimal depressive symptoms group, despite evidence of an abnormal pattern of visual facial information usage.

LIMITATIONS

The generalizability of the current findings is limited by the highly structured nature of the facial emotion recognition task used, as well as the use of an analog sample undergraduates scoring high in self-rated symptoms of depression rather than a clinical sample.

CONCLUSIONS

Our findings suggest that basic visual processes are involved in emotion recognition abnormalities in depression, demonstrating consistency with the emotion recognition literature in other psychopathologies (e.g., schizophrenia, autism, social anxiety). Future research should seek to replicate these findings in clinical populations with major depression, and assess the association between aberrant face gaze behaviours and symptom severity and social functioning.

[Social cognition in patients with mood disorders: part I: major depressive disorder : a comprehensive review of the literature]

OBJECTIVE

Overview on the current knowledge regarding social cognition in patients with major depressive disorder.

METHODS

Selective literature research on deficits in social cognition intrinsic to major depressive disorders, their occurrence and effects.

RESULTS

Deficits in social cognition are considered to be core features of major depressive disorder. They are apparent during acute episodes of the disorders, endure when patients are in remission and have a significant negative impact on the patients' psychosocial outcomes.

CONCLUSIONS

It is important to consider deficits in social cognition as an integral part of a treatment approach to achieve mental stabilization in patients with major depressive disorder.