Impaired fixation to eyes during facial emotion labelling in children with bipolar disorder or severe mood dysregulation

Mri findings, looking behaviour and affect recognition in very preterm children: A pilot study

Children born very preterm often exhibit atypical gaze behaviors, affect recognition difficulties and are at risk for cerebral white matter damage. This study explored links between these sequalae. In 24 12-year-old children born very preterm, ventricle size using Evans and posterior ventricle indices, and corpus callosum area were used to measure white matter thickness. The findings revealed a correlation between less attention towards the eyes and larger ventricle size. Ventricle and posterior corpus callosum sizes were correlated to affect-recognition proficiency. Findings suggest a link between white matter damage, gaze behavior, and affect recognition accuracy, emphasizing a relation with social perception.

Neuropsychological mechanisms of social difficulties in disruptive mood dysregulation disorder versus oppositional defiant disorder

Children with Disruptive Mood Dysregulation Disorder (DMDD) or Oppositional Defiant Disorder (ODD) are characterized by irritability and social difficulties. However, the mechanisms underlying these disorders could be different. This study explores differences in social cognition and executive function (EF) across DMDD and ODD and the influence of these factors and their interaction on social problems in both groups. Children with DMDD (n = 53, Mage = 9.3) or ODD (n = 39, Mage = 9.6) completed neuropsychological tasks measuring social cognition (Theory of Mind and Face-Emotion Recognition) and EF (cognitive flexibility, inhibition, and working memory). Parents reported social problems. More than one-third of the children with DMDD and almost two-thirds of those with ODD showed clear difficulties with Theory of Mind. Most children with DMDD (51-64%) or ODD (67-83%) showed difficulties with EF. In children with DMDD, worse EF (β = -.36) was associated with more social problems, whereas in children with ODD, better EF (β = .44) was associated with more social problems. In those with ODD, but not in those with DMDD, the interaction between social cognition and EF contributed to the explained variance of social problems (β = -1.97). Based on the observed interaction pattern, enhanced EF may lead to increased social problems among children with ODD who also exhibit social cognition difficulties. This study suggests the existence of distinct neuropsychological mechanisms underlying the social issues observed in children with DMDD versus those with ODD.

Facial emotion recognition in children and youth with attention-deficit/hyperactivity disorder and irritability

The ability to recognize emotions evident in people's faces contributes to social functioning and might be affected by ADHD and irritability. Given their high co-occurrence, we examined the relative contribution of ADHD and irritability to facial emotion recognition (FER). We hypothesized that irritability but not ADHD traits would predict increased likelihood of misrecognizing emotions as negative, and that FER performance would explain the association of ADHD and irritability traits with social skills. FER was measured using the Reading the Mind in the Eyes Test (RMET) in children (6-14 years old) referred for ADHD assessment (n = 304) and healthy controls (n = 128). ADHD, irritability and social skills were measured using parent ratings. We used repeated measure logistics regression, comparing the effects across emotion valence of images (i.e., neutral/positive/negative). High irritability but not ADHD diagnosis predicted lower RMET accuracy. ADHD traits predicted lower RMET accuracy in younger but not older participants, whereas irritability predicted poorer accuracy at all ages. ADHD traits predicted lower RMET accuracy across all emotion valences, whereas irritability predicted increased probability of misrecognizing neutral and positive but not negative emotions. Irritability did not increase the probability for erroneously recognizing emotions as negative. ADHD and irritability traits fully explained the association between RMET and social skills. ADHD and irritability traits might impact the ability to identify emotions portrayed in faces. However, irritability traits appear to selectively impair recognition of neutral and positive but not negative emotions. ADHD and irritability are important when examining the link between FER and social difficulties.

Mediating effect of amygdala activity on response to fear vs. happiness in youth with significant levels of irritability and disruptive mood and behavior disorders

Introduction

Irritability, characterized by a tendency to exhibit increased anger, is a common clinical problem in youth. Irritability is a significant clinical issue in youth with various psychiatric diagnoses, especially disruptive behavior, and mood disorders (Attention-Deficit/Hyperactivity Disorder, Oppositional Defiant Disorder, Conduct Disorder, and Disruptive Mood Dysregulation Disorder). Although there have been previous studies focusing on functional alteration in the amygdala related to irritability, there is no comprehensive model between emotional, neuronal, and behavioral characteristics.

Methods

Using an functional magnetic resonance imaging (fMRI) procedure, we investigated the relationships between behavioral irritability, selective impairments in processing facial emotions and the amygdala neural response in youth with increased irritability. Fifty-nine youth with disruptive mood and behavior disorder completed a facial expression processing task with an event-related fMRI paradigm. The severity of irritability was evaluated using the Affective Reactivity Index.

Results

In the result of behavioral data, irritability, and reaction time (RT) differences between interpreting negative (fear) and positive (happiness) facial expressions were positively correlated. In the fMRI result, youth showed higher activation in the right cingulate gyrus, bilateral cerebellum, right amygdala, right precuneus, right superior frontal gyrus, right middle occipital gyrus, and middle temporal gyrus, during the happiness condition vs. fear condition. No brain region exhibited greater activation in the fear than in the happiness conditions. In the result of the mediator analysis, increased irritability was associated with a longer RT toward positive vs. negative facial expressions. Irritability was also positively associated with the difference in amygdala blood oxygen level-dependent responses between the two emotional conditions (happiness > fear). This difference in amygdala activity mediated the interaction between irritability and the RT difference between negative and positive facial expressions.

Discussion

We suggest that impairment in the implicit processing of facial emotional expressions with different valences causes distinct patterns of amygdala response, which correlate with the level of irritability. These results broaden our understanding of the biological mechanism of irritability at the neural level and provide information for the future direction of the study.

Underlying mechanisms of disruptive mood dysregulation disorder in children: A systematic review by means of research domain criteria

Background

A systematic overview of underlying mechanisms in the new disruptive mood dysregulation disorder (DMDD) diagnosis is needed. The Research Domain Criteria (RDoC) represent a system of six domains of human functioning, which aims to structure the understanding of the nature of mental illnesses. By means of the RDoC framework, the objective of this systematic review is to synthesize available data on children and youths <18 years suffering from DMDD as reported in peer reviewed papers.

Methods

A literature search guided by PRISMA was conducted using Medline, PsychInfo, and Embase, while the RDoC domains were employed to systematize research findings. Risk of bias in the included studies was examined.

Results

We identified 319 studies. After study selection, we included 29 studies. Twenty-one of these had findings relating to >1 RDoC domain. The risk of bias assessment shows limitations in the research foundation of current knowledge on mechanisms of DMDD.

Discussion

Reviewing self-report, behavior and neurocircuit findings by means of RDoC domains, we suggest that DMDD youths have a negative interpretation bias in social processes and valence systems. In occurrence of a negative stimuli interpretation, aberrant cognitive processing may arise. However, current knowledge of DMDD is influenced by lack of sample diversity and open science practices.

Conclusion

We found the six RDoC domains useful in structuring current evidence of the underlying mechanisms of DMDD. Important opportunities for future studies in this field of research are suggested. In clinical practice, this comprehensive summary on DMDD mechanisms can be used in psychoeducation and treatment plans.

An Eye Tracking and Event-Related Potentials Study With Visual Stimuli for Adolescents Emotional Issues

BACKGROUND

Psychological issues are common among adolescents, which have a significant impact on their growth and development. However, the underlying neural mechanisms of viewing visual stimuli in adolescents are poorly understood.

MATERIALS AND METHODS

This study applied the Chinese version of the DSM-V self-assessment scales to evaluate 73 adolescents' psychological characteristics for depressive and manic emotional issues. Combined with eye-tracking and event-related potential (ERP), we explored the characteristics of their visual attention and neural processing mechanisms while freely viewing positive, dysphoric, threatening and neutral visual stimuli.

RESULTS

Compared to controls, adolescents with depressive emotional tendencies showed more concentrated looking behavior with fixation distribution index than the controls, while adolescents with manic emotional tendencies showed no such trait. ERP data revealed individuals with depressive tendencies showed lower arousal levels toward emotional stimuli in the early stage of cognitive processing (N1 amplitude decreased) and with prolonged reaction time (N1 latency increased) than the control group. We found no significant difference between the manic group and the control group. Furthermore, the depression severity scores of the individuals with depressive tendencies were negatively correlated with the total fixation time toward positive stimuli, were negatively correlated with the fixation distribution index toward threatening stimuli, and were positively correlated with the mean N1 amplitudes while viewing dysphoric stimuli. Also, for the individuals with depressive tendencies, there was a positive correlation between the mean N1 amplitudes and the fixation time on the area of interest (AOI) while viewing dysphoric stimuli. For the individuals with manic tendencies, the manic severity scores of the individuals with manic tendencies were positively correlated with the total fixation time toward the positive stimuli. However, no significant correlations were found between the manic severity scores and N1 amplitudes, and between N1 amplitudes and eye-tracking output variables.

CONCLUSION

This study proposes the application of eye-tracking and ERP to provide better biological evidence to alter the neural processing of emotional stimuli for adolescents with emotional issues.

Labeling Emotional Stimuli in Early Childhood Predicts Neural and Behavioral Indicators of Emotion Regulation in Late Adolescence

BACKGROUND

Effective emotion regulation (ER) may be supported by 1) accurate emotion identification, encoding, and maintenance of emotional states and related brain activity of regions involved in emotional response (i.e., amygdala, ventral/posterior insula) and 2) cognitive processes that implement reframing, supported by activation in cognitive control brain regions (e.g., frontal, insular, and parietal cortices). The purpose of this project was to examine how emotion labeling ability in early childhood is related to ER concurrently and prospectively.

METHODS

Data from a prospective longitudinal study of youths at risk for depression, including measures of emotion labeling (i.e., Facial Affect Comprehension Evaluation) and ER ability (i.e., Emotion Regulation Checklist) and strategy use (i.e., Cognitive Emotion Regulation Questionnaire, Children's Response Style Questionnaire), and functional magnetic resonance imaging data during a sadness ER task (N = 139) were examined.

RESULTS

Findings from multilevel modeling and linear regression suggested that greater emotion labeling ability of more difficult emotions in early childhood was associated with enhanced parent-reported ER in adolescence, but not with a tendency to engage in adaptive or maladaptive ER strategies. Recognition of fear and surprise predicted greater activation in cortical regions involved in cognitive control during an ER of sadness task, including in the insula, anterior cingulate cortex, dorsal medial prefrontal cortex, and inferior frontal gyrus.

CONCLUSIONS

These findings suggest that early ability to identify and label difficult facial emotions in early childhood is associated with better ER in adolescence and enhanced activity of cognitive control regions of the brain.

Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review

Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.

Sensory Processing Difficulties in Youths With Disruptive Mood Dysregulation Disorder

Difficulty modulating sensory information has been described in children with developmental disorders. However, the relation of sensory processing difficulties (SPD) to emotional regulation problems remains poorly understood. The aim of this study is to determine the rate and patterns of SPD in youth with disruptive mood dysregulation disorder (DMDD). Participants were DMDD patients aged 6-16 years presenting at a university hospital in outpatient or inpatient facilities (n = 30). For each participant, the parent-reported Sensory Profile, the Affective Lability Scale, the Beck Depression Inventory-Second Edition, the Child Behavior Checklist/4-18, and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version were completed. The scores of the Sensory Profile of the DMDD youths were compared to those obtained in a clinical control group and to the manual scores for same-age typically developing youths. SPD were reported in 53% of the subjects in the DMDD group compared to 33% in the clinical control group (p = 0.405). Youths with DMDD showed a significant difference on almost all items of the Sensory Profile compared to typically developing youth. The Sensory Profile was found to discriminate best between the participants with DMDD and those in the clinical control group with regard to the category "Behavioral outcomes of sensory processing" and the factor "Fine motor/perceptual behavior." All types of sensory processing patterns were reported in the DMDD youths: sensation avoiding (40%), low registration (27%), sensory sensitivity (20%), and sensation seeking (10%). As a group, youths with DMDD have significantly more SPD when compared to typical youths. Therefore, SPD could be an important factor to consider in youths with DMDD when providing comprehensive assessment and therapeutic interventions.

Meta-Analysis of the RDoC Social Processing Domain across Units of Analysis in Children and Adolescents

OBJECTIVE

This meta-analysis advances a framework to understand correspondence among units of analysis of the social processing construct within Research Domain Criteria (RDoC).

METHOD

As requested for this special issue, eligible studies cited an RDoC-initiative paper or mentioned RDoC in the abstract, title, or keywords were empirical and peer reviewed, and described a correlation or regression analysis (r, β, or odds ratio) between two different units of analysis in the social processing domain in youth. We examined the frequency (descriptive statistics) and magnitude of correspondence between unit-pairs (random effects models), and predefined moderators (meta-regression).

RESULTS

Eight of the twenty-eight possible unit-by-unit pairs were identified, with subjective-by-behavior units being the most common. Of those, only subjective-by-circuit had significant correspondence between units. Moderator analysis revealed that the age and diagnosis of generalized anxiety disorder moderated correspondence between subjective-by-circuit units of analysis, and that a diagnosis of autism spectrum disorder moderated correspondence between subjective-by-gene units of analysis. Younger ages and inclusion of either diagnostic group reduced correspondence.

CONCLUSIONS

These findings indicate that the RDoC initiative has generated limited research within the social processing domain across units of analysis in youth to date. Moreover, National Institute of Mental Health (NIMH)-funded studies do not appear to be biased toward supporting the RDoC framework. However, the limited number of included studies precludes the generalizability of these findings and underscores the need for further research. Despite this, results suggest that the NIMH model for providing standard batteries of measurement tools may effectively reduce spurious correlations between subjective-by-behavior units of analysis.

On Defining Irritability and its Relationship to Affective Traits and Social Interpretations

Irritability has gained recognition as a clinically significant trait in youth and adults that when persistent and severe, predicts poor outcomes throughout life. However, its definition, measurement, and relationship to similar constructs remain poorly understood. In a community sample of adults (N=458; 19-74 years; M=40.5), we sought to identify a unitary irritability factor from independently constructed self-reported measures of irritability distinct from the related constructs of aggression, depression, and anxiety, and whether it was associated with face emotion identification deficits and hostile interpretation biases previously established in clinical pediatric samples. The three measures of irritability generated a common factor characterized by a rapid, angry response to provocation. This irritability factor had unique associations with tendencies to judge ambiguous stimuli as reflecting hostility, but not with face emotion identification performance. These findings clarify the nature of irritability and its associations with neurocognitive phenomenon.

Deficits in emotion recognition are associated with depressive symptoms in youth with disruptive mood dysregulation disorder

BACKGROUND

Although severe irritability is a predictor of future depression according to recent meta-analytic evidence, other mechanisms for this developmental transition remain unclear. In this study, we test whether deficits in emotion recognition may partially explain this specific association in youth with severe irritability, defined as disruptive mood dysregulation disorder (DMDD).

METHODS

Participants aged 8-20 years (M = 13.3, SD = 2.8) included youth with DMDD, split by low depressive (DMDD/LD; n = 52) and high depressive (DMDD/HD; n = 25) symptoms, and healthy controls (HC; n = 39). A standardized computer task assessed emotion recognition of faces and voices of adults and children expressing happiness, fear, sadness, and anger. A Group (3) × Emotion (4) × Actor (2) × Modality (2) repeated measures analysis of covariance examined the number of errors and misidentification of emotions. Linear regression was then used to assess whether deficits in emotion recognition were predictive of depressive symptoms at a 1 year follow-up.

RESULTS

DMDD/HD youth were more likely to interpret happy stimuli as angry and fearful compared to DMDD/LD (happy as angry: p = 0.018; happy as fearful: p = 0.008) and HC (happy as angry: p = 0.014; happy as fearful: p = 0.024). In youth with DMDD, the misidentification of happy stimuli as fearful was associated with higher depressive symptoms at follow-up (β = 0.43, p = 0.017), independent of baseline depressive and irritability symptoms.

CONCLUSIONS

Deficits in emotion recognition are associated, cross-sectionally and longitudinally, with depressive symptoms in youth with severe irritability. Future studies should examine the neural correlates that contribute to these associations.

Irritability in child and adolescent psychopathology: An integrative review for ICD-11

In preparation for the World Health Organization's development of the Eleventh Revision of the International Classification of Diseases and Related Health Problems (ICD-11) chapter on Mental and Behavioral Disorders, this article reviews the literature pertaining to severe irritability in child and adolescent psychopathology. First, research on severe mood dysregulation suggests that youth with irritability and temper outbursts, among other features of hyperactivity and arousal, demonstrate cross-sectional correlates and developmental outcomes that distinguish them from youth with bipolar disorder. Second, other evidence points to an irritable dimension of Oppositional Defiant Disorder symptomatology, which is uniquely associated with concurrent and subsequent internalizing problems. In contrast to the Diagnostic and Statistical Manual of Mental Disorders' (5th ed.) Disruptive Mood Dysregulation Disorder, our review of the literature supports a different solution: a subtype, Oppositional Defiant Disorder with chronic irritability/anger (proposal included in Appendix). This solution is more consistent with the available evidence and is a better fit with global public health considerations such as harm/benefit potential, clinical utility, and cross-cultural applicability. Implications for assessment, treatment, and research are discussed.

The categories, frequencies, and stability of idiosyncratic eye-movement patterns to faces

The spatial pattern of eye-movements to faces considered typical for neurologically healthy individuals is a roughly T-shaped distribution over the internal facial features with peak fixation density tending toward the left eye (observer's perspective). However, recent studies indicate that striking deviations from this classic pattern are common within the population and are highly stable over time. The classic pattern actually reflects the average of these various idiosyncratic eye-movement patterns across individuals. The natural categories and respective frequencies of different types of idiosyncratic eye-movement patterns have not been specifically investigated before, so here we analyzed the spatial patterns of eye-movements for 48 participants to estimate the frequency of different kinds of individual eye-movement patterns to faces in the normal healthy population. Four natural clusters were discovered such that approximately 25% of our participants' fixation density peaks clustered over the left eye region (observer's perspective), 23% over the right eye-region, 31% over the nasion/bridge region of the nose, and 20% over the region spanning the nose, philthrum, and upper lips. We did not find any relationship between particular idiosyncratic eye-movement patterns and recognition performance. Individuals' eye-movement patterns early in a trial were more stereotyped than later ones and idiosyncratic fixation patterns evolved with time into a trial. Finally, while face inversion strongly modulated eye-movement patterns, individual patterns did not become less distinct for inverted compared to upright faces. Group-averaged fixation patterns do not represent individual patterns well, so exploration of such individual patterns is of value for future studies of visual cognition.

Proper Emotion Recognition, Dysfunctional Emotion Regulation

OBJECTIVE

A considerable number of adolescents exhibit severe self-regulation deficits in affect and behavior, which are referred to as affective dysregulation (AD). AD may be conceptualized as a dimensional trait that, in its extreme form, resembles the diagnostic categories of severe mood dysregulation (SMD) or disruptive mood dysregulation disorder (DMDD). Assuming a shared pathway of psychopathology in AD and SMD, similar underlying dysfunctional mechanisms in emotion processing, particularly emotion recognition (RECOG) and regulation (REGUL), may be postulated.

METHOD

Adolescent inpatients with AD (CAD, N = 35), without AD (CCG, N = 28), and nonclinical controls (NCG; N = 28) were administered a morphed facial recognition task (RECOG). REGUL abilities, levels of irritability as well as depressive symptoms were also assessed.

RESULTS

We found no significant group differences in accuracy and thresholds for RECOG abilities. Patients with AD reported more dysfunctional REGUL strategies than did CCG and NCG. Both depression and AD, but not irritability, influenced the overall degree of maladaptive REGUL.

CONCLUSION

The broad phenotype of AD does not involve the deficits in RECOG reported for adolescents with a narrow phenotype (SMD); regarding REGUL strategies, AD seems to be associated with specific impairments.

The Status of Irritability in Psychiatry: A Conceptual and Quantitative Review

OBJECTIVE

Research and clinical interest in irritability have been on the rise in recent years. Yet several questions remain about the status of irritability in psychiatry, including whether irritability can be differentiated from other symptoms, whether it forms a distinct disorder, and whether it is a meaningful predictor of clinical outcomes. In this article, we try to answer these questions by reviewing the evidence on how reliably irritability can be measured and its validity.

METHOD

We combine a narrative and systematic review and meta-analysis of studies. For the systematic review and meta-analysis, we searched studies in PubMed and Web of Science based on preselected criteria. A total of 163 articles were reviewed, and 24 were included.

RESULTS

We found that irritability forms a distinct dimension with substantial stability across time, and that it is specifically associated with depression and anxiety in longitudinal studies. Evidence from genetic studies reveals that irritability is moderately heritable, and its overlap with depression is explained mainly by genetic factors. Behavioral and neuroimaging studies show that youth with persistent irritability exhibit altered activations in the amygdala, striatum, and frontal regions compared with age-matched healthy volunteers. Most knowledge about the treatment of irritability is based on effects of treatment on related conditions or post hoc analyses of trial data.

CONCLUSION

We identify a number of research priorities including innovative experimental designs and priorities for treatment studies, and conclude with recommendations for the assessment of irritability for researchers and clinicians.

Neurocognitive impairments among youth with pediatric bipolar disorder: a systematic review of neuropsychological research

BACKGROUND

Pediatric bipolar disorder (PBD) has emerged as a field of research in which neuropsychological studies are continuously providing new empirical findings. Despite this, a comprehensive framework for neurocognitive impairments is still lacking, and most of the evidence remains unconnected. We addressed this question through a systematic review of neuropsychological research, with the aim of elucidating the main issues concerning this topic.

METHOD

A comprehensive search of databases (PubMed, PsycINFO) was performed. Published manuscripts between 1990 and January 2014 were identified. Overall, 124 studies fulfilled inclusion criteria. Methodological differences between studies required a descriptive review of findings.

RESULTS

Evidence indicates that verbal/visual-spatial memory, processing speed, working memory, and social cognition are neurocognitive domains impaired in PBD youth. Furthermore, these deficits are greater among those who suffer acute affective symptoms, PBD type I, and/or attention deficit hyperactivity disorder (ADHD) comorbidity. In addition, several neurocognitive deficits imply certain changes in prefrontal cortex activity and are somewhat associated with psychosocial and academic disabilities. Strikingly, these deficits are consistently similar to those encountered in ADHD as well as severe mood dysregulation (SMD). Besides, some neurocognitive impairments appear before the onset of the illness and tend to maintain stable across adolescence. Finally, any therapy has not yet demonstrated to be effective on diminishing these neurocognitive impairments.

LIMITATIONS

More prolonged follow-up studies aimed at delineating the course of treatment and the response to it are warranted.

CONCLUSIONS

Despite noteworthy research on the neurocognitive profile of PBD, our knowledge is still lagging behind evidence from adult counterparts.

Faces in the eye of the beholder: unique and stable eye scanning patterns of individual observers

Eye scanning patterns while viewing pictures have provided valuable information in many domains of visual cognition. Such patterns are determined by the type of image viewed (e.g., faces, scenes) as well as the task individuals are asked to perform (e.g., visual search, memory). Here we show that another key factor that significantly influences eye scanning patterns but has been mostly overlooked is the individual observer. During face viewing, we found that individuals showed diverse scanning patterns that, in many cases, were inconsistent with the typical triangular shape pattern that is commonly observed when eye scanning patterns are averaged across individuals. These idiosyncratic eye scanning patterns were not random but highly stable even when examined 18 months later. Interestingly, these eye-tracking patterns were not predictive of behavioral performance. Such stable and unique scanning patterns may represent a specific behavioral trait/signature and be formed early in development, reflecting idiosyncratic strategies for performing visual recognition tasks.

Fronto-limbic-striatal dysfunction in pediatric and adult patients with bipolar disorder: impact of face emotion and attentional demands

BACKGROUND

Research in bipolar disorder (BD) implicates fronto-limbic-striatal dysfunction during face emotion processing but it is unknown how such dysfunction varies by task demands, face emotion and patient age.

METHOD

During functional magnetic resonance imaging (fMRI), 181 participants, including 62 BD (36 children and 26 adults) and 119 healthy comparison (HC) subjects (57 children and 62 adults), engaged in constrained and unconstrained processing of emotional (angry, fearful, happy) and non-emotional (neutral) faces. During constrained processing, subjects answered questions focusing their attention on the face; this was processed either implicitly (nose width rating) or explicitly (hostility; subjective fear ratings). Unconstrained processing consisted of passive viewing.

RESULTS

Pediatric BD rated neutral faces as more hostile than did other groups. In BD patients, family-wise error (FWE)-corrected region of interest (ROI) analyses revealed dysfunction in the amygdala, inferior frontal gyrus (IFG), anterior cingulate cortex (ACC) and putamen. Patients with BD showed amygdala hyperactivation during explicit processing (hostility ratings) of fearful faces and passive viewing of angry and neutral faces but IFG hypoactivation during implicit processing of neutral and happy faces. In the ACC and striatum, the direction of dysfunction varied by task demand: BD demonstrated hyperactivation during unconstrained processing of angry or neutral faces but hypoactivation during constrained processing (implicit or explicit) of angry, neutral or happy faces.

CONCLUSIONS

Findings suggest amygdala hyperactivation in BD while processing negatively valenced and neutral faces, regardless of attentional condition, and BD IFG hypoactivation during implicit processing. In the cognitive control circuit involving the ACC and putamen, BD neural dysfunction was sensitive to task demands.