Threat processing in generalized social phobia: an investigation of interpretation biases in ambiguous facial affect

Anxious youth and adults share threat-biased interpretations of linguistic and visual ambiguity: A proof of concept study

Interpretation bias, or the threatening appraisal of ambiguous information, has been linked to anxiety disorder. Interpretation bias has been demonstrated for linguistic (e.g., evaluation of ambiguous sentences) and visual judgments (e.g., categorizing emotionally ambiguous facial expressions). It is unclear how these separate components of bias might be associated. We examined linguistic and visual interpretation biases in youth and emerging adults with (n = 44) and without (n = 40) anxiety disorder, and in youth-parent dyads (n = 40). Linguistic and visual biases were correlated with each other, and with anxiety. Compared to non-anxious participants, those with anxiety demonstrated stronger biases, and linguistic bias was especially predictive of anxiety symptoms and diagnosis. Age did not moderate these relationships. Parent linguistic bias was correlated with youth anxiety but not linguistic bias; parent and youth visual biases were correlated. Linguistic and visual interpretation biases are linked in clinically-anxious youth and emerging adults.

Reliability of an Interpretation Bias Task of Ambiguous Faces and Its Relationship with Social Anxiety, Depression, and Looming Maladaptive Style

Social anxiety (SA) and depression have been associated with negative interpretation biases of social stimuli. Studies often assess these biases with ambiguous faces, as people with SA and depression tend to interpret such faces negatively. However, the test–retest reliability of this type of task is unknown. Our objectives were to develop a new interpretation bias task with ambiguous faces and analyse its properties in terms of test–retest reliability and in relation to SA, depression, and looming maladaptive style (LMS). Eight hundred sixty-four participants completed a task in which they had to interpret morphed faces as negative or positive on a continuum between happy and angry facial expressions. In addition, they filled out scales on SA, depressive symptoms, and LMS. Eighty-four participants completed the task again after 1–2 months. The test–retest reliability was moderate (r = .57–.69). The data revealed a significant tendency to interpret faces as negative for people with higher SA and depressive symptoms and with higher LMS. Longer response times to interpret the happy faces were positively associated with a higher level of depressive symptoms. The reliability of the present task was moderate. The results highlight associations between the bias interpretation task and SA, depression, and LMS.

The Relations of Attention to and Clarity of Feelings With Facial Affect Perception

Attention to emotions and emotional clarity are core dimensions of individual differences in emotion awareness. Findings from prior research based on self-report indicate that attention to and recognition of one's own emotions are related to attention to and recognition of other people's emotions. In the present experimental study, we examined the relations of attention to and clarity of emotions with the efficiency of facial affect perception. Moreover, it was explored whether attention to and clarity of emotions are linked to negative interpretations of facial expressions. A perception of facial expressions (PFE) task based on schematic faces with neutral, ambiguous, or unambiguous emotional expressions and a gender decision task were administered to healthy individuals along with measures of emotion awareness, state and trait anxiety, depression, and verbal intelligence. Participants had to decide how much the faces express six basic affects. Evaluative ratings and decision latencies were analyzed. Attention to feelings was negatively correlated with evaluative decision latency, whereas clarity of feelings was not related to decision latency in the PFE task. Attention to feelings was positively correlated with the perception of negative affects in ambiguous faces. Attention to feelings and emotional clarity were not related to gender decision latency. According to our results, dispositional attention to feelings goes along with an enhanced efficiency of facial affect perception. Habitually paying attention to one's own emotions may facilitate processing of external emotional information. Preliminary evidence was obtained suggesting a relationship of dispositional attention to feelings with negative interpretations of facial expressions.

The Relationship Between Attention, Interpretation, and Memory Bias During Facial Perception in Social Anxiety

Although cognitive theories suggest the interactive nature of information processing biases in contributing to social anxiety, most studies to date have investigated these biases in isolation. This study aimed at (a) testing the association between social anxiety and each of the threat-related cognitive biases: attention, interpretation, and memory bias; and (b) examining the relationship between these cognitive biases in facial perception. We recruited an unselected sample of 188 adult participants and measured their level of social anxiety and cognitive biases using faces displaying angry, disgusted, happy, and ambiguous versions of these expressions. All bias tasks were assessed with the same set of facial stimuli. Regression analyses showed that social anxiety symptoms significantly predicted attention avoidance and poorer sensitivity in recognizing threatening faces. Social anxiety was, however, unrelated to interpretation bias in our sample. Results of path analysis suggested that attention bias influenced memory bias indirectly through interpretation bias for angry but not disgusted faces. Our findings suggest that, regardless of social anxiety level, when individuals selectively oriented to faces displaying anger, the faces were interpreted to be more negative. This, in turn, predicted better memory for the angry faces. The results provided further empirical support for the combined cognitive bias hypothesis.

Behavioral and neurophysiological correlates of emotional face processing in borderline personality disorder: are there differences between men and women?

Emotional dysregulation is a core feature of borderline personality disorder (BPD); it is, for example, known to influence one's ability to read other people's facial expressions. We investigated behavioral and neurophysiological foundations of emotional face processing in individuals with BPD and in healthy controls, taking participants' sex into account. 62 individuals with BPD (25 men, 37 women) and 49 healthy controls (20 men, 29 women) completed an emotion classification task with faces depicting blends of angry and happy expressions while the electroencephalogram was recorded. The cortical activity (late positive potential, P3/LPP) was evaluated using source modeling. Compared to healthy controls, individuals with BPD responded slower to happy but not to angry faces; further, they showed more anger ratings in happy but not in angry faces, especially in those with high ambiguity. Men had lower anger ratings than women and responded slower to angry but not happy faces. The P3/LPP was larger in healthy controls than in individuals with BPD, and larger in women than in men; moreover, women but not men produced enlarged P3/LPP responses to angry vs. happy faces. Sex did not interact with behavioral or P3/LPP-related differences between healthy controls and individuals with BPD. Together, BPD-related alterations in behavioral and P3/LPP correlates of emotional face processing exist in both men and women, supposedly without sex-related interactions. Results point to a general 'negativity bias' in women. Source modeling is well suited to investigate effects of participant and stimulus characteristics on the P3/LPP generators.

Attention orienting to the eyes in violent female and male offenders: An eye-tracking study

Attention to the eyes and eye contact form an important basis for the development of empathy and social competences including prosocial behavior. Thus, impairments in attention to the eyes of an interaction partner might play a role in the etiology of antisocial behavior and violence. For the first time, the present study extends investigations of eye gaze to a large sample (N = 173) including not only male but also female violent offenders and a control group. We assessed viewing patterns during the categorization of emotional faces via eye tracking. Our results indicate a reduced frequency of initial attention shifts to the eyes in female and male offenders compared to controls, while there were no general group differences in overall attention to the eye region (i.e., relative dwell time). Thus, we conclude that violent offenders might be able to compensate for deficits in spontaneous attention orienting during later stages of information processing.

ERP evidence for emotional sensitivity in social anxiety

BACKGROUND

Emotional sensitivity involves the ability to recognize and interpret facial expressions. This is very important for interpersonal communication. Previous studies found differences in emotional sensitivity between high social anxiety (HSA) individuals and low social anxiety (LSA) individuals. However, the underlying neural mechanisms are still unclear. The present study explored the effects of expression intensity and social anxiety on emotional sensitivity and their neural mechanisms.

METHODS

The HSA group (n = 20) and the LSA group (n = 20) were asked to recognize anger expressions with different intensities in an emotion recognition task. The hit rate, reaction time, early time window (P1, N170), and late time window (LPP) were recorded.

RESULTS

The results showed that individuals with HSA had a significantly higher hit rate and shorter reaction time than individuals with LSA (p < 0.01). Event-related potential (ERP) results showed that, compared to the LSA group, the HSA group exhibited significantly enhanced N170 and LPP amplitude (p < 0.01). However, the difference in P1 amplitude was not significant (p > 0.05).

LIMITATIONS

The participants in this study were a subclinical social anxiety sample, and the effects of other mood disorders were not excluded, partially limiting the generalizability of the results.

CONCLUSIONS

Our findings suggest that, compared to LSA individuals, HSA individuals are more sensitive to all presented faces. The ERP results indicated that HSA individuals' high sensitivity to threatening expressions is related to stronger structural encoding and fine processing.

Interpretation bias in social anxiety: A systematic review and meta-analysis

BACKGROUND

Interpretation bias, which involves interpreting ambiguous social events negatively and catastrophising even mildly negative social events, has been suggested as a key maintenance factor of Social Anxiety Disorder. Although some individual studies and narrative reviews have demonstrated a role for negative interpretation bias in social anxiety (disorder), findings have been mixed. Given the lack of a quantitative synthesis of the evidence, the current systematic review and meta-analysis examined the strength of the relationship between interpretation bias and social anxiety. It also investigated potential moderators of this relationship (i.e., types of measures and stimuli, samples, and study designs).

METHODS

Five databases (PsycINFO, PubMed, Medline, Scopus, and CINAHL) were searched. Of 46 studies identified, 44 were suitable for meta-analysis (N = 3859).

RESULTS

There was a large effect for the relationship between social anxiety and interpretation bias (g = 0.83). Types of measures (subjective versus objective) and stimuli (verbal versus visual) were identified as significant moderators, with subjective measures and verbal stimuli particularly adept at capturing interpretation bias in socially anxious individuals.

LIMITATIONS

The effect sizes displayed significant heterogeneity between studies, which likely reflects some publication bias, and thus, the overall effect size may be inflated.

CONCLUSION

Findings may help to refine clinical models and interventions for Social Anxiety Disorder, which in turn may maximise evidence-based interventions that target negative interpretation bias in this disorder.

Social anxiety and the interpretation of morphed facial expressions following exclusion and inclusion

BACKGROUND AND OBJECTIVES

Negative interpretation biases are postulated to play etiological and maintaining roles in social anxiety (SA). However, empirical support for interpretation biases of facial expression in SA is inconsistent. Given the importance of signals of (dis)approval in SA, our objective was to examine whether SA is associated with enhanced sensitivity to such signals especially following exclusion.

METHODS

In Study 1, participants (N = 139) underwent an exclusion/inclusion manipulation and were then presented with video clips of smiles gradually changing into disgust expressions (smile-to-disgust). In Study 2 (N = 203), participants saw smile-to-disgust as well as disgust-to-smile clips following an exclusion/inclusion manipulation. Participants' task in both studies was to detect the offset of the initial expression.

RESULTS

Results of Study 1 show that detection latency of smiles' disappearance is negatively associated with SA severity. The results of Study 2 suggest that this association is stronger following exclusion, and specific to the smile-to-disgust as opposed to the disgust-to-smile, transitions.

LIMITATIONS

Our studies did not examine whether the observed interpretation bias was specific to SA.

CONCLUSIONS

Our findings support and refine cognitive theories of SA, suggesting that interpretation biases for facial information in SA may be especially pronounced following exclusion.

Interpretation of ambiguous facial affect in adults with attention-deficit/hyperactivity disorder

In addition to impairments in cognitive functioning, attention-deficit/hyperactivity disorder (ADHD) is associated with deficits in interpersonal functioning as well which are assumed to stem from a distorted perception or interpretation of affective information. While previous research suggests that the decoding of negatively valenced facial stimuli is impaired, less is known about the potential interpretation biases in ADHD which are linked to other externalizing psychopathologies. The present study investigated interpretation biases in adults with ADHD (N = 65) and controls (N = 49) using ambiguous facial stimuli (angry/happy, angry/fearful, fearful/happy blends) with different proportions of each emotion. Participants indicated the dominant emotion and rated the perceived intensity of each image. While impaired processing of fearful expressions was evident in the ADHD group, the results of the current study do not provide support for an interpretation bias in adults with ADHD. These findings suggest that interpretation biases may be restricted to aggressive psychopathology and cannot be generalized to individuals with ADHD.

Social anxiety and sensitivity to social-rank features in male faces

BACKGROUND AND OBJECTIVES

Evolutionary theories propose that socially anxious individuals are especially sensitive to social-rank signals, presumably at the expense of the attunement to signals of affiliation. Despite this theoretical claim, few empirical attempts examined the association between social anxiety (SA) and sensitivity to specific features of social-rank and affiliation. This study aims to fill this gap.

METHOD

Participants (N = 67) completed two tasks in which two emotionally neutral computer-generated male faces of the same character were presented side-by-side. In the Social-Rank-Sensitivity Task, the faces within each pair differed in their level of dominance and, in the Affiliation-Sensitivity Task, the faces differed in their level of trustworthiness. The participants' task was to decide which of the two faces looked more dominant or friendly.

RESULTS

There were no differences in accuracy between high- and low-SA participants in the Affiliation-Sensitivity Task. In contrast, high-SA participants were more accurate than low-SA participants in the Social-Rank-Sensitivity Task. No group differences were found in decision latencies in either task.

LIMITATIONS

Limitations of the study are that a non-clinical sample was used and that only computer-generated male faces were considered.

CONCLUSIONS

Our findings suggest that SA is related to an enhanced ability to discriminate faces based on social-rank features. Examining sensitivity to facial cues signaling social-rank and affiliation may help to specify the nature of social threat sensitivity in SA.

The Influence of Anxiety on the Recognition of Facial Emotion Depends on the Emotion Category and Race of the Target Faces

The recognition of emotional facial expressions is critical for our social interactions. While some prior studies have shown that a high anxiety level is associated with more sensitive recognition of emotion, there are also reports supporting that anxiety did not affect or reduce the sensitivity to the recognition of facial emotions. To reconcile these results, here we investigated whether the effect of individual anxiety on the recognition of facial emotions is dependent on the emotion category and the race of the target faces. We found that, first, there was a significant positive correlation between the individual anxiety level and the recognition sensitivity for angry faces but not for sad or happy faces. Second, while the correlation was significant for both low- and high-intensity angry faces during the recognition of the observer's own-race faces, there was significant correlation only for low-intensity angry faces during the recognition of other-race faces. Collectively, our results suggest that the influence of anxiety on the recognition of facial emotions is flexible depending on the characteristics of the target face stimuli including emotion category and race.

Ruminative response style is associated with a negative bias in the perception of emotional facial expressions in healthy women without a history of clinical depression

BACKGROUND AND OBJECTIVES

Rumination has been shown to be an important cognitive vulnerability factor affecting development and maintenance of depression. Ruminative thinking can be divided into a self-focused component referring to persistent reflection about causes and consequences of depressed mood and a symptom-focused component characterized by repetitive thinking about depressive symptoms. Previous research on clinical depression has shown that rumination is associated with the perception of negative emotions in others' facial expressions. The present study was conducted to investigate the relation between habitual rumination and negative bias in face perception in healthy individuals.

METHODS

100 healthy young women without a history of clinical depression completed the Response Styles Questionnaire along with measures of depressive symptoms, dysfunctional attitudes, and anxiety. A computer-based version of the perception of facial expressions questionnaire using line drawings (schematic faces) was administered to assess perceived emotions in faces with ambiguous and unambiguous emotional expressions.

RESULTS

According to hierarchical regression analyses, symptom-based (but not self-focused) rumination predicted perceived negative emotions in ambiguous as well as in unambiguous negative faces after controlling for current depressive symptoms, state and trait anxiety, intelligence, and dysfunctional attitudes.

LIMITATIONS

Generalization of the present findings is limited by the fact that only women were included as study participants.

CONCLUSIONS

Habitual ruminating about depressive symptoms in healthy, never clinically depressed individuals goes along with a negative bias in the perception of others' facial expressions. Negatively biasing social perception might be one mechanism by which symptom-focused rumination might increase vulnerability for depression.

Applying a Cognitive Neuroscience Perspective to Disruptive Behavior Disorders: Implications for Schools

A cognitive neuroscience perspective seeks to understand behavior, in this case disruptive behavior disorders (DBD), in terms of dysfunction in cognitive processes underpinned by neural processes. While this type of approach has clear implications for clinical mental health practice, it also has implications for school-based assessment and intervention with children and adolescents who have disruptive behavior and aggression. This review articulates a cognitive neuroscience account of DBD by discussing the neurocognitive dysfunction related to emotional empathy, threat sensitivity, reinforcement-based decision-making, and response inhibition. The potential implications for current and future classroom-based assessments and interventions for students with these deficits are discussed.

Insula activation is modulated by attention shifting in social anxiety disorder

Social anxiety disorder (SAD) is characterized by exaggerated reactivity to social threat, often documented by biased attention to threatening information, and increased activation in brain regions involved in salience/threat processing. Attention training has been developed to ameliorate the attention bias documented in individuals with SAD, with mixed results. We investigated patterns of brain activation underlying acute attention modulation in 41 participants (29 with SAD and 12 health controls). We then investigated how brain activation changed over time in both groups in response to a 4-session attention training protocol (toward threat, away from threat, no-training control). Results revealed diminished pre-training deactivation in the insula in SAD participants during attention modulation. SAD participants also demonstrated an increase in insula deactivation over time, suggestive of an improvement in attention modulation of emotion, and this was associated with a decrease in symptom severity. Attention training did not, itself, lead to clinical improvement, though there was a trend level effect of training toward threat on increased insula deactivation over time. While deficits in attentional control and emotion modulation are documented in individuals with SAD, current attention training protocols are not robustly effective in ameliorating aberrant functioning. Pursuit of training protocols that have more robust impacts on the relevant neural circuitry may have some value.

Social anxiety and detection of facial untrustworthiness: Spatio-temporal oculomotor profiles

Cognitive models posit that social anxiety is associated with biased attention to and interpretation of ambiguous social cues as threatening. We investigated attentional bias (selective early fixation on the eye region) to account for the tendency to distrust ambiguous smiling faces with non-happy eyes (interpretative bias). Eye movements and fixations were recorded while observers viewed video-clips displaying dynamic facial expressions. Low (LSA) and high (HSA) socially anxious undergraduates with clinical levels of anxiety judged expressers' trustworthiness. Social anxiety was unrelated to trustworthiness ratings for faces with congruent happy eyes and a smile, and for neutral expressions. However, social anxiety was associated with reduced trustworthiness rating for faces with an ambiguous smile, when the eyes slightly changed to neutrality, surprise, fear, or anger. Importantly, HSA observers looked earlier and longer at the eye region, whereas LSA observers preferentially looked at the smiling mouth region. This attentional bias in social anxiety generalizes to all the facial expressions, while the interpretative bias is specific for ambiguous faces. Such biases are adaptive, as they facilitate an early detection of expressive incongruences and the recognition of untrustworthy expressers (e.g., with fake smiles), with no false alarms when judging truly happy or neutral faces.

Electrophysiological Evidence for Elimination of the Positive Bias in Elderly Adults with Depressive Symptoms

BACKGROUND

Depressed populations demonstrate a greater tendency to have negative interpretations on ambiguous situations. Cognitive theories concerning depression proposed that such a negative bias plays an important role in developing and maintaining depression. There is now fairly consistent evidence arising from different stimuli and assessment methods that depression is featured by such a bias. The current study aimed to explore the neural signatures associated with the interpretation bias in the elderly with depressive symptoms confronted with different facial expressions using event-related brain potentials (ERPs).

METHODS

Participants were 14 community-dwelling older adults with depressive symptoms assessed by the Center for Epidemiologic Studies Depression scale scores. We collected event-related potentials of their brain compared to that of 14 healthy aged-matched adults. The late positive potential (LPP) was used to examine cognitive-affective processes associated with judgment of emotional facial expressions between the two groups.

RESULTS

Old adults with depressive symptoms have much smaller amplitude than healthy older adults irrespective of the prime types. When processing the targets, the two groups showed different patterns regarding the LPP. The healthy control group revealed no differences between ambiguous and happy primes, irrespective of whether the targets were sad or happy facial expressions. However, significant differences were found between happy and sad and between ambiguous and sad primes. Such a pattern indicates a positive bias in healthy elderly adults. Regarding the elderly with depressive symptoms, there were no significant differences between ambiguous versus happy, ambiguous versus sad primes, and happy versus sad primes. Concerning reaction times, there was no group difference. Thus, the findings provide some support for cognitive theories of depression.

CONCLUSION

The current study shows that there is an association between interpretative biases and depressive symptoms in the elderly by using the neuroscientific method of ERPs. The results suggest that ERPs are sensitive to explore the interpretation bias in depressed populations.

Categorical perception of facial expressions in individuals with non-clinical social anxiety

BACKGROUND AND OBJECTIVES

According to the well-established categorical perception (CP) of facial expressions, we decode complicated expression signals into simplified categories to facilitate expression processing. Expression processing deficits have been widely described in social anxiety (SA), but it remains to be investigated whether CP of expressions are affected by SA. The present study examined whether individuals with SA had an interpretation bias when processing ambiguous expressions and whether the sensitivity of their CP was affected by their SA.

METHODS

Sixty-four participants (high SA, 30; low SA, 34) were selected from 658 undergraduates using the Interaction Anxiousness Scale (IAS). With the CP paradigm, specifically with the analysis method of the logistic function model, we derived the categorical boundaries (reflecting interpretation bias) and slopes (reflecting sensitivity of CP) of both high- and low-SA groups while recognizing angry-fearful, happy-angry, and happy-fearful expression continua.

RESULTS

Based on a comparison of the categorical boundaries and slopes between the high- and low-SA groups, the results showed that the categorical boundaries between the two groups were not different for any of the three continua, which means that the SA does not affect the interpretation bias for any of the three continua. The slopes for the high-SA group were flatter than those for the low-SA group for both the angry-fearful and happy-angry continua, indicating that the high-SA group is insensitive to the subtle changes that occur from angry to fearful faces and from happy to angry faces.

LIMITATIONS

Since participants were selected from a sample of undergraduates based on their IAS scores, the results cannot be directly generalized to individuals with clinical SA disorder.

CONCLUSIONS

The study indicates that SA does not affect interpretation biases in the processing of anger, fear, and happiness, but does modulate the sensitivity of individuals' CP when anger appears. High-SA individuals perceive angry expressions in a less categorical manner than the low-SA group, but no such difference was found in the perception of happy or fearful expressions.

Cognitive behavioural therapy attenuates the enhanced early facial stimuli processing in social anxiety disorders: an ERP investigation

Background

Previous studies of patients with social anxiety have demonstrated abnormal early processing of facial stimuli in social contexts. In other words, patients with social anxiety disorder (SAD) tend to exhibit enhanced early facial processing when compared to healthy controls. Few studies have examined the temporal electrophysiological event-related potential (ERP)-indexed profiles when an individual with SAD compares faces to objects in SAD. Systematic comparisons of ERPs to facial/object stimuli before and after therapy are also lacking. We used a passive visual detection paradigm with upright and inverted faces/objects, which are known to elicit early P1 and N170 components, to study abnormal early face processing and subsequent improvements in this measure in patients with SAD.

Methods

Seventeen patients with SAD and 17 matched control participants performed a passive visual detection paradigm task while undergoing EEG. The healthy controls were compared to patients with SAD pre-therapy to test the hypothesis that patients with SAD have early hypervigilance to facial cues. We compared patients with SAD before and after therapy to test the hypothesis that the early hypervigilance to facial cues in patients with SAD can be alleviated.

Results

Compared to healthy control (HC) participants, patients with SAD had more robust P1–N170 slope but no amplitude effects in response to both upright and inverted faces and objects. Interestingly, we found that patients with SAD had reduced P1 responses to all objects and faces after therapy, but had selectively reduced N170 responses to faces, and especially inverted faces. Interestingly, the slope from P1 to N170 in patients with SAD was flatter post-therapy than pre-therapy. Furthermore, the amplitude of N170 evoked by the facial stimuli was correlated with scores on the interaction anxiousness scale (IAS) after therapy.

Conclusions

Our results did not provide electrophysiological support for the early hypervigilance hypothesis in SAD to faces, but confirm that cognitive-behavioural therapy can reduce the early visual processing of faces. These findings have potentially important therapeutic implications in the assessment and treatment of social anxiety.

Trial registration HEBDQ2014021

Neural basis of negativity bias in the perception of ambiguous facial expression

Negativity bias, which describes the tendency to interpret ambiguous stimuli or events as negative, is often observed in patients with depression and may prevent psychological well-being. Here, we used ambiguous facial stimuli, with negative (sad) and positive (happy) emotions simultaneously accessible, to examine neural activation during perceptual decision-making in healthy participants. The negativity bias was positively correlated with the activity of the bilateral pregenual anterior cingulate cortex (pgACC) when ambiguous faces were perceived as sad versus happy. Additionally, the strength of the functional connectivity between the bilateral pgACC and the right dorsal ACC (dACC)/right thalamus was positively correlated with hopelessness, one of the core characteristics of depression. Given the role of the pgACC as a major site of depressive affect and the roles of the dACC and thalamus in conflict monitoring and vigilance, respectively, our results reveal valid and important neuroanatomical correlates of the association between negativity bias and hopelessness in the healthy individuals.

A Systematic Review of Experimental Paradigms for Exploring Biased Interpretation of Ambiguous Information with Emotional and Neutral Associations

Interpretation biases have been extensively explored in a range of populations, including patients with anxiety and depressive disorders where they have been argued to influence the onset and maintenance of such conditions. Other populations in which interpretation biases have been explored include patients with chronic pain, anorexia nervosa, and alcohol dependency among others, although this literature is more limited. In this research, stimuli with threatening/emotional and neutral meanings are presented, with participant responses indicative of ambiguity resolution. A large number of paradigms have been designed and implemented in the exploration of interpretation biases, some varying in minor features only. This article provides a review of experimental paradigms available for exploring interpretation biases, with the aim to stimulate and inform the design of future research exploring cognitive biases across a range of populations. A systematic search of the experimental literature was conducted in Medline, PsychINFO, Web of Science, CINAHL, and Cochrane Library databases. Search terms were information, stimuli, and ambiguous intersected with the terms interpretation and bias*. Forty-five paradigms were found, categorized into those using ambiguous words, ambiguous images, and ambiguous scenarios. The key features, strengths and limitations of the paradigms identified are discussed.

Adult age differences in the interpretation of surprised facial expressions

Research on adult age differences in the interpretation of facial expressions has yet to examine evaluations of surprised faces, which signal that an unexpected and ambiguous event has occurred in the expresser's environment. The present study examined whether older and younger adults differed in their interpretations of the affective valence of surprised faces. Specifically, we examined older and younger participants' evaluations of happy, angry, and surprised facial expressions. We predicted that, on the basis of age-related changes in the processing of emotional information, older adults would evaluate surprised faces more positively than would younger adults. The results indicated that older adults interpreted surprised faces more positively than did their younger counterparts. These findings reveal a novel age-related positivity effect in the interpretation of surprised faces, suggesting that older adults imbue ambiguous facial expressions-that is, expressions that lack either positive or negative facial actions-with positive meaning. (PsycINFO Database Record

Social anxiety and perception of (un)trustworthiness in smiling faces

In social environments the smile can be driven by different motives and convey different emotions. This makes a smiling face ambiguous and amenable to alternative interpretations. We investigated how social anxiety is related to trustworthiness evaluation of morphed dynamic smiling faces depending on changes in the eye expression. Socially anxious and non-anxious participants judged the un/trustworthiness of people with different smiles. Social anxiety was related to reduced trustworthiness of (a) faces with a neutral mouth unfolding to a smile when the eyes were neutral at the beginning or end of the dynamic sequence, and (b) faces with a smiling mouth when happy eyes slightly changed towards neutrality, surprise, fear, sadness, disgust, or anger. In contrast, social anxiety was not related to trustworthiness judgments for non-ambiguous expressions unfolding from neutral (eyes and mouth) to happy (eyes and mouth) or from happy to neutral. Socially anxious individuals are characterized by an interpretation bias towards mistrusting any ambiguous smile due to the presence of non-happy eyes.

Attention and interpretation processes and trait anger experience, expression, and control

This study explored attention and interpretation biases in processing facial expressions as correlates of theoretically distinct self-reported anger experience, expression, and control. Non-selected undergraduate students (N = 101) completed cognitive tasks measuring attention bias, interpretation bias, and Spielberger's State-Trait Anger Expression Inventory (STAXI-2). Attention bias toward angry faces was associated with higher trait anger and anger expression and with lower anger control-in and anger control-out. The propensity to quickly interpret ambiguous faces as angry was associated with greater anger expression and its subcomponent of anger expression-out and with lower anger control-out. Interactions between attention and interpretation biases did not contribute to the prediction of any anger component suggesting that attention and interpretation biases may function as distinct mechanisms. Theoretical and possible clinical implications are discussed.

Social anxiety and trustworthiness judgments of dynamic facial expressions of emotion

BACKGROUND AND OBJECTIVES

Perception of trustworthiness in other people is essential for successful social interaction. Facial expressions-as conveyers of feelings and intentions-are an important source of this information. We investigated how social anxiety is related to biases in the judgment of faces towards un/trustworthiness depending on type of emotional expression and expressive intensity.

METHODS

Undergraduates with clinical levels of social anxiety and low-anxiety controls were presented with 1-s video-clips displaying facial happiness, anger, fear, sadness, disgust, surprise, or neutrality, at various levels of emotional intensity. Participants judged how trustworthy the expressers looked like.

RESULTS

Social anxiety was associated with enhanced distrust towards angry and disgusted expressions, and this occurred at lower intensity thresholds, relative to non-anxious controls. There was no effect for other negative expressions (sadness and fear), basically ambiguous expressions (surprise and neutral), or happy faces.

LIMITATIONS

The social anxiety and the control groups consisted of more females than males, although this gender disproportion was the same in both groups. Also, the expressive speed rate was different for the various intensity conditions, although such differences were equated for all the expressions and for both groups.

CONCLUSIONS

Individuals with high social anxiety overestimate perceived social danger even from subtle facial cues, thus exhibiting a threat-related interpretative bias in the form of untrustworthiness judgments. Such a bias is, nevertheless, limited to facial expressions conveying direct threat such as hostility and rejection.

Angry-happy interpretations of ambiguous faces in social anxiety disorder

Social Anxiety Disorder (SAD) is characterized by a tendency to interpret ambiguous social cues as negative. Here we tested whether interpretation of ambiguous faces differs between participants with SAD and non-anxious controls. Twenty-seven individuals with SAD and 21 non-anxious control participants completed an emotion recognition task in which they judged ambiguous morphed faces as happy or angry. Participants with SAD judged a higher proportion of the faces as angry compared to non-anxious participants, and were slower to judge faces as angry compared to happy, while no such reaction time bias manifested in the control group. Finally, happy judgments were slower in the SAD group compared to the control group, while angry judgments were faster in the SAD group compared to the control group. These findings provide evidence for a negative bias in resolving emotional ambiguity in facial expressions among individuals with SAD.

Social Anxiety and Interpretation Bias

This study examined how positive-scale assessment of ambiguous social stimuli affects interpretation bias in social anxiety. Participants with high and low social anxiety ( N = 60) performed a facial expression discrimination task to assess interpretation bias. Participants were then randomly assigned to assess the emotion of briefly presented faces either on a negative or on a positive scale. They subsequently repeated the facial expression discrimination task. Participants with high versus low social anxiety made more negative interpretations of ambiguous facial expressions. However, those in the positive-scale assessment condition subsequently showed reduced negative interpretations of ambiguous facial expressions. These results suggest that interpretation bias in social anxiety could be mediated by positive priming rather than an outright negative bias.

Time course of facial emotion processing in women with borderline personality disorder: an ERP study

BACKGROUND

Borderline personality disorder (BPD) is characterized by a negative perception of others. Previous studies have revealed deficits and biases in facial emotion recognition. This study investigates the behavioural and electrophysiological correlates underlying facial emotion processing in individuals with BPD.

METHODS

The present study was conducted between July 2012 and May 2014. In an emotion classification task, unmedicated female patients with BPD as well as healthy women had to classify faces displaying blends of anger and happiness while the electroencephalogram was recorded. We analyzed visual event-related potentials (ERPs) reflecting early (P100), structural (N170) and categorical (P300) facial processing in addition to behavioural responses.

RESULTS

We included 36 women with BPD and 29 controls in our analysis. Patients with BPD were more likely than controls to classify predominantly happy faces as angry. Independent of facial emotion, women with BPD showed enhanced early occipital P100 amplitudes. Additionally, temporo-occipital N170 amplitudes were reduced at right hemispherical electrode sites. Centroparietal P300 amplitudes were reduced particularly for predominantly happy faces and increased for highly angry faces in women with BPD, whereas in healthy volunteers this component was modulated by both angry and happy facial affect.

LIMITATIONS

Our sample included only women, and no clinical control group was investigated.

CONCLUSION

Our findings suggest reduced thresholds for facial anger and deficits in the discrimination of facial happiness in individuals with BPD. This biased perception is associated with alterations in very early visual as well as deficient structural and categorical processing of faces. The current data could help to explain the negative perception of others that may be related to the patients' impairments in interpersonal functioning.