Socio-demographic and Clinical Correlates of Facial Expression Recognition Disorder in the Euthymic Phase of Bipolar Patients

Reduced eye gaze fixation during emotion recognition among patients with temporal lobe epilepsy

OBJECTIVES

To investigate the facial scan patterns during emotion recognition (ER) through the dynamic facial expression task and the awareness of social interference test (TASIT) using eye tracking (ET) technology, and to find some ET indicators that can accurately depict the ER process, which is a beneficial supplement to existing ER assessment tools.

METHOD

Ninety-six patients with TLE and 88 healthy controls (HCs) were recruited. All participants watched the dynamic facial expression task and TASIT including a synchronized eye movement recording and recognized the emotion (anger, disgust, happiness, or sadness). The accuracy of ER was recorded. The first fixation time, first fixation duration, dwell time, and fixation count were selected and analyzed.

RESULTS

TLE patients exhibited ER impairment especially for disgust (Z =  - 3.391; p = 0.001) and sadness (Z =  - 3.145; p = 0.002). TLE patients fixated less on the face, as evidenced by the reduced fixation count (Z =  - 2.549; p = 0.011) of the face and a significant decrease in the fixation count rate (Z =  - 1.993; p = 0.046). During the dynamic facial expression task, TLE patients focused less on the eyes, as evidenced by the decreased first fixation duration (Z =  - 4.322; p = 0.000), dwell time (Z =  - 4.083; p = 0.000), and fixation count (Z =  - 3.699; p = 0.000) of the eyes.

CONCLUSION

TLE patients had ER impairment, especially regarding negative emotions, which may be attributable to their reduced fixation on the eyes during ER, and the increased fixation on the mouth could be a compensatory effect to improve ER performance. Eye-tracking technology could provide the process indicators of ER, and is a valuable supplement to traditional ER assessment tasks.

Individual differences in spontaneous facial expressions in people with visual impairment and blindness

People can visualize their spontaneous and voluntary emotions via facial expressions, which play a critical role in social interactions. However, less is known about mechanisms of spontaneous emotion expressions, especially in adults with visual impairment and blindness. Nineteen adults with visual impairment and blindness participated in interviews where the spontaneous facial expressions were observed and analyzed via the Facial Action Coding System (FACS). We found a set of Action Units, primarily engaged in expressing the spontaneous emotions, which were likely to be affected by participants’ different characteristics. The results of this study could serve as evidence to suggest that adults with visual impairment and blindness show individual differences in spontaneous facial expressions of emotions.

Emotion Processing Deficit in Euthymic Bipolar Disorder: A Potential Endophenotype

BACKGROUND

Emotion processing deficits have been described in patients with bipolar disorder (BD) and are considered one of the core cognitive abnormalities in BD with endophenotype potential. However, the literature on specific impairments in emotion processing cognitive strategies (directive/cortical/higher versus intuitive/limbic/lower) in euthymic adult BD patients and healthy first-degree relatives/high-risk (HR) subjects in comparison with healthy controls (HCs) is sparse.

METHODS

We examined facial emotion recognition deficits (FERD) in BD (N = 30), HR (N = 21), and HC (N = 30) matched for age (years), years of education, and sex using computer-administered face emotions-Matching And Labeling Task (eMALT).

RESULTS

The three groups were significantly different based on labeling accuracy scores for fear and anger (FA) (P < 0.001) and sad and disgust (SD) (P < 0.001). On post-hoc analysis, HR subjects exhibited a significant deficit in the labeling accuracy of FA facial emotions (P < 0.001) compared to HC. The BD group was found to have significant differences in all FA (P = 0.004) and SD (P = 0.003) emotion matching as well as FA (P = 0.001) and SD (P < 0.001) emotion labeling accuracy scores.

CONCLUSIONS

BD in remission exhibits FERD in general, whereas specific labeling deficits of fear and anger emotions, indicating impaired directive higher order aspect of emotion processing, were demonstrated in HR subjects. This appears to be a potential endophenotype. These deficits could underlie the pathogenesis in BD, with possible frontolimbic circuitry impairment. They may have potential implications in functional recovery and prognosis of BD.

Facial emotion recognition and its association with quality of life and socio-occupational functioning in patients with bipolar disorder and their first-degree relatives

INTRODUCTION

Facial emotion recognition deficits (FERD) are common even in the remitted phase of bipolar disorder (BD). Research regarding FERD in first-degree relatives is inconclusive. This study aimed to assess the facial emotion recognition in remitted patients of bipolar disorder and first-degree relatives(FDR) in comparison with healthy controls. Correlation between FERD and quality of life and socio-occupational functioning was also assessed.

METHODS

It was an observational, cross-sectional study done at a tertiary hospital in India. Study population (n = 75) included remitted patients of bipolar disorder (n = 27), first-degree relatives of BD patients (FDR) (n = 20) and healthy controls (HC) (n = 28). Facial emotion recognition, social and occupational functioning, and quality of life (QoL) was measured using Tool for Recognition of Emotions in Neuropsychiatric Disorders, Social & Occupational Functioning Assessment Scale and World Health Organization Quality of Life-Bref, respectively, in all the participants.

RESULTS

The BD group did significantly worse in facial emotion recognition in comparison to FDR and HC groups (p < 0.001). Emotion recognition of fear, anger, surprise, and happy were most affected. FDR did not vary significantly from HC in facial emotion recognition. Lower scores on facial emotion recognition were associated with lower QoL in the social domain(p = 0.006) and poorer socio- occupational functioning scores (p = 0.01), but it was not significant within the BD group.

CONCLUSION

FERD is seen in remitted patients of bipolar disorder but not in the first -degree relatives. FERD affects social quality of life and functioning. Poorer social functioning in remitted patients of bipolar disorder might be multifactorial and cannot be attributed solely to FERD.

Interpersonal beliefs related to suicide and facial emotion processing in psychotic disorders

Deficits in social cognition are present in psychotic disorders; moreover, maladaptive interpersonal beliefs have been posited to underlie risk of suicidal ideation and behavior. However, the association between social cognition and negative appraisals as potential risk factors for suicidal ideation and behavior in psychotic disorders has not been assessed. In a pilot study, we assessed accuracy and error biases in facial emotion recognition (Penn ER-40), maladaptive interpersonal beliefs as measured by the Interpersonal Needs Questionnaire (INQ), and current suicide ideation and history of past attempts in a sample of 101 outpatients with psychotic disorders (75 schizophrenia/schizoaffective; 26 bipolar disorder). INQ scores were positively associated with history of suicide attempts and current ideation. INQ scores were inversely related with emotion recognition accuracy yet positively correlated with bias toward perceiving anger in neutral expressions. The association between biases pertaining to anger and INQ scores persisted after adjusting for global cognitive ability and were more evident in schizophrenia than in bipolar disorder. The present findings suggest that maladaptive beliefs are associated with a tendency to misperceive neutral stimuli as threatening and are associated with suicidal ideation and behavior. Although better cognitive ability is associated with higher rates of suicide attempts in psychotic disorders, biases in misinterpreting anger in others may be a specific deficit related to formation of maladaptive beliefs about others, which, in turn, are associated with history of suicide attempts.