The association between PTSD and facial affect recognition

The Importance of the Morel Emotional Numbing Test Instructions: A Diagnosis Threat Induction Study

OBJECTIVE

Marketed as a validity test that detects feigning of posttraumatic stress disorder (PTSD), the Morel Emotional Numbing Test for PTSD (MENT) instructs examinees that PTSD may negatively affect performance on the measure. This study explored the potential that MENT performance depends on inclusion of "PTSD" in its instructions and the nature of the MENT as a performance validity versus a symptom validity test (PVT/SVT).

METHOD

358 participants completed the MENT as a part of a clinical neuropsychological evaluation. Participants were either administered the MENT with the standard instructions (SIs) that referenced "PTSD" or revised instructions (RIs) that did not. Others were administered instructions that referenced "ADHD" rather than PTSD (AI). Comparisons were conducted on those who presented with concerns for potential traumatic-stress related symptoms (SI vs. RI-1) or attention deficit (AI vs. RI-2).

RESULTS

Participants in either the SI or AI condition produced more MENT errors than those in their respective RI conditions. The relationship between MENT errors and other S/PVTs was significantly stronger in the SI: RI-1 comparison, such that errors correlated with self-reported trauma-related symptoms in the SI but not RI-1 condition. MENT failure also predicted PVT failure at nearly four times the rate of SVT failure.

CONCLUSIONS

Findings suggest that the MENT relies on overt reference to PTSD in its instructions, which is linked to the growing body of literature on "diagnosis threat" effects. The MENT may be considered a measure of suggestibility. Ethical considerations are discussed, as are the construct(s) measured by PVTs versus SVTs.

Impact of mothers' IPV-PTSD on their capacity to predict their child's emotional comprehension and its relationship to their child's psychopathology

BACKGROUND

Previous studies demonstrated that when the violence-exposed child becomes a mother and interacts with her own child during early sensitive periods for social-emotional development, she may have difficulties providing sensitive responsiveness to the child's emotional communication. Such difficulties place the child's development of emotional comprehension (EC) and related self-regulation at risk. The aim of this study was to examine how mothers' interpersonal violence-related posttraumatic disorder (IPV-PTSD) would affect their children's EC and their own ability to predict their children's EC. We also investigated how mothers' predictive ability would correlate with child psychopathology.

METHODS

Sixty-one mother-child dyads (36 with IPV-PTSD) participated in this study. Children's (mean age = 7.0 years, SD = 1.1) EC was assessed with the Test of Emotion Comprehension (child TEC) and their psychopathology as reported by the mother was assessed with the Child Behaviour Checklist (CBCL) and as evaluated by a clinician using selected modules of the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS). Mothers were measured for IPV-PTSD with the Clinician Administered PTSD Scale (CAPS) and for their capacity to predict their child's emotional comprehension (mother-responding-as-child TEC; mTEC).

RESULTS

We found no significant between-group differences in children's level of EC. Maternal PTSD was associated with lower scores on the mTEC, however. Reduced maternal scores on the mTEC were significantly associated with maternal report of increased aggressive child behaviour and with depression symptoms on the K-SADS. Further, scores on the mTEC interacted with maternal report of child aggression on child oppositional defiant disorder (ODD) symptoms on the K-SADS.

CONCLUSION

These findings support that improving maternal emotional comprehension may help reduce child risk for psychiatric morbidity in this population.

Lifetime PTSD is associated with impaired emotion recognition in veterans and their offspring

PTSD is associated with emotion dysregulation. Studies have found inconsistent impaired facial emotion recognition ability (ERA) in patients with PTSD and intergenerational transmission of PTSD has been reported, although no studies exist regarding ERA. Our objective was to characterise the facial ERA of a group of traumatised war veterans with, and without lifetime PTSD, and also of their respective adult offspring. Sixty-one veterans with, and without lifetime PTSD and 73 offspring were tested for ERA of seven basic facial emotions expressions, 40 years after veterans had been exposed to war-related trauma. Veterans with lifetime PTSD showed impairment of recognition of all emotions, irrespective of the type, when compared with veterans without PTSD. This result was maintained after adjusting for potential confounders-including depressive symptoms. Offspring of veterans with lifetime PTSD also showed impaired recognition of all emotions, including after adjustment for the same variables. Offspring of veterans with lifetime PTSD also showed specific impairment in recognising the emotions of happiness and disgust. These results confirm that PTSD has negative effects with regards to emotion regulation and also on the next generation. This could result in this population being at increased risk of suffering from relationship problems and psychopathology.