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Miola A, Trevisan N, Salvucci M, Minerva M, Valeggia S, Manara R, Sambataro F. Network dysfunction of sadness facial expression processing and morphometry in euthymic bipolar disorder. Eur Arch Psychiatry Clin Neurosci 2024; 274:525-536. [PMID: 37498325 PMCID: PMC10995000 DOI: 10.1007/s00406-023-01649-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 07/07/2023] [Indexed: 07/28/2023]
Abstract
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.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
| | - Nicolò Trevisan
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
| | - Margherita Salvucci
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
| | - Matteo Minerva
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
| | - Silvia Valeggia
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
| | - Renzo Manara
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy
- Padova Neuroscience Center, University of Padova, Padua, Italy
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Via Giustiniani 5, Padua, Italy.
- Padova Neuroscience Center, University of Padova, Padua, Italy.
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Gorrino I, Rossetti MG, Girelli F, Bellani M, Perlini C, Mattavelli G. A critical overview of emotion processing assessment in non-affective and affective psychoses. Epidemiol Psychiatr Sci 2024; 33:e8. [PMID: 38356360 PMCID: PMC10894699 DOI: 10.1017/s204579602400009x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 01/08/2024] [Accepted: 01/21/2024] [Indexed: 02/16/2024] Open
Abstract
AIMS Patients with affective and non-affective psychoses show impairments in both the identification and discrimination of facial affect, which can significantly reduce their quality of life. The aim of this commentary is to present the strengths and weaknesses of the available instruments for a more careful evaluation of different stages of emotion processing in clinical and experimental studies on patients with non-affective and affective psychoses. METHODS We reviewed the existing literature to identify different tests used to assess the ability to recognise (e.g. Ekman 60-Faces Test, Facial Emotion Identification Test and Penn Emotion Recognition Test) and to discriminate emotions (e.g. Face Emotion Discrimination Test and Emotion Differentiation Task). RESULTS The current literature revealed that few studies combine instruments to differentiate between different levels of emotion processing disorders. The lack of comprehensive instruments that integrate emotion recognition and discrimination assessments prevents a full understanding of patients' conditions. CONCLUSIONS This commentary underlines the need for a detailed evaluation of emotion processing ability in patients with non-affective and affective psychoses, to characterise the disorder at early phases from the onset of the disease and to design rehabilitation treatments.
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Affiliation(s)
- Irene Gorrino
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
| | - Maria Gloria Rossetti
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Francesca Girelli
- UOC Psychiatry, Azienda Ospedaliera Universitaria Integrata (AOUI), Verona, Italy
| | - Marcella Bellani
- Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cinzia Perlini
- Section of Clinical Psychology, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICoN) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy
- Cognitive Neuroscience Laboratory of Pavia Institute, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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3
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Guo YB, Jiao Q, Zhang XT, Xiao Q, Wu Z, Cao WF, Cui D, Yu GH, Dou RH, Su LY, Lu GM. Increased regional Hurst exponent reflects response inhibition related neural complexity alterations in pediatric bipolar disorder patients during an emotional Go-Nogo task. Cereb Cortex 2024; 34:bhad442. [PMID: 38031362 PMCID: PMC10793568 DOI: 10.1093/cercor/bhad442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/28/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Fractal patterns have been shown to change in resting- and task-state blood oxygen level-dependent signals in bipolar disorder patients. However, fractal characteristics of brain blood oxygen level-dependent signals when responding to external emotional stimuli in pediatric bipolar disorder remain unclear. Blood oxygen level-dependent signals of 20 PBD-I patients and 17 age- and sex-matched healthy controls were extracted while performing an emotional Go-Nogo task. Neural responses relevant to the task and Hurst exponent of the blood oxygen level-dependent signals were assessed. Correlations between clinical indices and Hurst exponent were estimated. Significantly increased activations were found in regions covering the frontal lobe, parietal lobe, temporal lobe, insula, and subcortical nuclei in PBD-I patients compared to healthy controls in contrast of emotional versus neutral distractors. PBD-I patients exhibited higher Hurst exponent in regions that involved in action control, such as superior frontal gyrus, inferior frontal gyrus, inferior temporal gyrus, and insula, with Hurst exponent of frontal orbital gyrus correlated with onset age. The present study exhibited overactivation, increased self-similarity and decreased complexity in cortical regions during emotional Go-Nogo task in patients relative to healthy controls, which provides evidence of an altered emotional modulation of cognitive control in pediatric bipolar disorder patients. Hurst exponent may be a fractal biomarker of neural activity in pediatric bipolar disorder.
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Affiliation(s)
- Yi-Bing Guo
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
- Brain and Mind Center, The University of Sydney, Sydney, NSW 2008, Australia
| | - Qing Jiao
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Xiao-Tong Zhang
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Qian Xiao
- Mental Health Centre of Xiangya Hospital, Central South University, Changsha 410083, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing 210097, China
| | - Wei-Fang Cao
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Dong Cui
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Guang-Hui Yu
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Ru-Hai Dou
- School of Radiology, Shandong First Medical University and Shandong Academy of Medical Sciences, Tai’an 271000, China
| | - Lin-Yan Su
- Mental Health Institute of the Second Xiangya Hospital, Central South University, Changsha 410083, China
| | - Guang-Ming Lu
- Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing 210023, China
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4
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Zhang L, Liang H, Bjureberg J, Xiong F, Cai Z. The Association Between Emotion Recognition and Internalizing Problems in Children and Adolescents: A Three-Level Meta-Analysis. J Youth Adolesc 2024; 53:1-20. [PMID: 37991601 DOI: 10.1007/s10964-023-01891-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/17/2023] [Indexed: 11/23/2023]
Abstract
Numerous studies have explored the link between how well youth recognize emotions and their internalizing problems, but a consensus remains elusive. This study used a three-level meta-analysis model to quantitatively synthesize the findings of existing studies to assess the relationship. A moderation analysis was also conducted to explore the sources of research heterogeneity. Through a systematic literature search, a total of 42 studies with 201 effect sizes were retrieved for the current meta-analysis, and 7579 participants were included. Emotion recognition was negatively correlated with internalizing problems. Children and adolescents with weaker emotion recognition skills were more likely to have internalizing problems. In addition, this meta-analysis found that publication year had a significant moderating effect. The correlation between emotion recognition and internalizing problems decreased over time. The degree of internalizing problems was also found to be a significant moderator. The correlation between emotion recognition and internalizing disorders was higher than the correlation between emotion recognition and internalizing symptoms. Deficits in emotion recognition might be relevant for the development and/or maintenance of internalizing problems in children and adolescents. The overall effect was small and future research should explore the clinical relevance of the association.
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Affiliation(s)
- Lin Zhang
- School of Psychology, Central China Normal University, Wuhan, China.
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China.
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China.
| | - Heting Liang
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
| | - Johan Bjureberg
- Centre for Psychiatry Research, Karolinska Institutet and Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Fen Xiong
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
| | - Zhihui Cai
- School of Psychology, Central China Normal University, Wuhan, China
- Key Laboratory of Adolescent Cyberpsychology and Behavior, Ministry of Education, Wuhan, China
- Key Laboratory of Human Development and Mental Health of Hubei Province, Wuhan, China
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5
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Li M, Zhang J, Jiang C, Wang J, Sun R, Jin S, Zhang N, Zhou Z. The Neural Correlates of the Recognition of Emotional Intensity Deficits in Major Depression: An ERP Study. Neuropsychiatr Dis Treat 2023; 19:117-131. [PMID: 36660318 PMCID: PMC9842523 DOI: 10.2147/ndt.s393264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023] Open
Abstract
PURPOSE Deficits in facial emotional intensity recognition have been associated with social cognition in patients with major depression. The study examined multiple event-related potential (ERP) components in patients with major depression and investigated the relationships between ERPs, social cognition, and clinical features. PARTICIPANTS AND METHODS Thirty-one patients met DSM-IV diagnosis of depression and 31 healthy participants completed the emotion intensity recognition task (EIRT), while ERPs were recorded. Data on ERP components (P100, N170, P200, and P300) were analyzed. RESULTS The behavioral results showed that patients with major depression performed worse on EIRT, including all six categories of emotions (sadness, disgust, happiness, surprise, anger, and fear), compared to healthy participants. The ERP results showed that patients with major depression exhibited higher P100 amplitudes for sad and happy faces than healthy participants; P300 amplitudes induced by sad and surprise faces were also higher than in healthy participants, mainly in the central and temporal lobes. A positive correlation was found between sadness intensity scores and P100 amplitudes in patients with major depression. CONCLUSION Patients with major depression are biased in their identification of facial expressions indicating emotional intensity. Specifically, they have emotional biases in the early and late stages of cognitive processing, mainly in the form of sensitivity to sad stimuli. It may lead to a persistent rumination of sadness that is detrimental to the remission of depression. Additionally, patients with major depression devote different amounts of cognitive resources for different intensities of sad faces during the preconscious stage of cognitive processing. The more intense their perception of sadness, the more cognitive resources they devote. Therefore, the assessment of the intensity of facial expressions is an important research topic, with clinical implications on social cognitive function in patients with major depression.
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Affiliation(s)
- Miao Li
- Department of Psychology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, People's Republic of China.,Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, People's Republic of China
| | - Jiazhao Zhang
- Grade 2019 Class 6, Basic Medicine College of Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Chenguang Jiang
- Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, People's Republic of China.,Department of Psychosomatics and Psychiatry, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, People's Republic of China
| | - Jun Wang
- Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, People's Republic of China
| | - Ruhong Sun
- Department of Psychiatry, Nanjing Medical University Graduate School, Nanjing, People's Republic of China
| | - Shayu Jin
- Department of Psychiatry, Nanjing Medical University Graduate School, Nanjing, People's Republic of China
| | - Ning Zhang
- Department of Psychology, Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhenhe Zhou
- Department of Psychiatry, The Affiliated Wuxi Mental Health Center of Jiangnan University, Wuxi Central Rehabilitation Hospital, Wuxi, People's Republic of China
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6
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Real-time facial emotion recognition deficits across the psychosis spectrum: A B-SNIP Study. Schizophr Res 2022; 243:489-499. [PMID: 34887147 PMCID: PMC9236198 DOI: 10.1016/j.schres.2021.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022]
Abstract
Affective and non-affective psychotic disorders are associated with variable levels of impairment in affective processing, but this domain typically has been examined via presentation of static facial images. We compared performance on a dynamic facial expression identification task across six emotions (sad, fear, surprise, disgust, anger, happy) in individuals with psychotic disorders (bipolar with psychotic features [PBD] = 113, schizoaffective [SAD] = 163, schizophrenia [SZ] = 181) and healthy controls (HC; n = 236) derived from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). These same individuals with psychotic disorders were also grouped by B-SNIP-derived Biotype (Biotype 1 [B1] = 115, Biotype 2 [B2] = 132, Biotype 3 [B3] = 158), derived from a cluster analysis applied to a large biomarker panel that did not include the current data. Irrespective of the depicted emotion, groups differed in accuracy of emotion identification (P < 0.0001). The SZ group demonstrated lower accuracy versus HC and PBD groups; the SAD group was less accurate than the HC group (Ps < 0.02). Similar overall group differences were evident in speed of identifying emotional expressions. Controlling for general cognitive ability did not eliminate most group differences on accuracy but eliminated almost all group differences on reaction time for emotion identification. Results from the Biotype groups indicated that B1 and B2 had more severe deficits in emotion recognition than HC and B3, meanwhile B3 did not show significant deficits. In sum, this characterization of facial emotion recognition deficits adds to our emerging understanding of social/emotional deficits across the psychosis spectrum.
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7
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Neuromodulation of facial emotion recognition in health and disease: A systematic review. Neurophysiol Clin 2022; 52:183-201. [DOI: 10.1016/j.neucli.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 11/20/2022] Open
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8
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Visual Event-Related Potentials under External Emotional Stimuli in Bipolar I Disorder with and without Hypersexuality. Brain Sci 2022; 12:brainsci12040441. [PMID: 35447973 PMCID: PMC9032653 DOI: 10.3390/brainsci12040441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 03/17/2022] [Accepted: 03/24/2022] [Indexed: 12/10/2022] Open
Abstract
Hypersexuality is related to functions of personality and emotion and is a salient symptom of bipolar I disorder especially during manic episode. However, it is uncertain whether bipolar I disorder with (BW) and without (BO) hypersexuality exhibits different cerebral activations under external emotion stimuli. In 54 healthy volunteers, 27 BW and 26 BO patients, we administered the visual oddball event-related potentials (ERPs) under external emotions of Disgust, Erotica, Fear, Happiness, Neutral, and Sadness. Participants’ concurrent states of mania, hypomania, and depression were also evaluated. The N1 latencies under Erotica and Happiness were prolonged, and the P3b amplitudes under Fear and Sadness were decreased in BW; the P3b amplitudes under Fear were increased in BO. The parietal, frontal, and occipital activations were found in BW, and the frontal and temporal activations in BO under different external emotional stimuli, respectively. Some ERP components were correlated with the concurrent affective states in three groups of participants. The primary perception under Erotica and Happiness, and voluntary attention under Fear and Sadness, were impaired in BW, while the voluntary attention under Fear was impaired in BO. Our study indicates different patterns of visual attentional deficits under different external emotions in BW and BO.
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Escelsior A, Amadeo MB, Esposito D, Rosina A, Trabucco A, Inuggi A, Pereira da Silva B, Serafini G, Gori M, Amore M. COVID-19 and psychiatric disorders: The impact of face masks in emotion recognition face masks and emotion recognition in psychiatry. Front Psychiatry 2022; 13:932791. [PMID: 36238943 PMCID: PMC9551300 DOI: 10.3389/fpsyt.2022.932791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/26/2022] [Indexed: 11/13/2022] Open
Abstract
Since the outbreak of the COVID-19 pandemic, reading facial expressions has become more complex due to face masks covering the lower part of people's faces. A history of psychiatric illness has been associated with higher rates of complications, hospitalization, and mortality due to COVID-19. Psychiatric patients have well-documented difficulties reading emotions from facial expressions; accordingly, this study assesses how using face masks, such as those worn for preventing COVID-19 transmission, impacts the emotion recognition skills of patients with psychiatric disorders. To this end, the current study asked patients with bipolar disorder, major depressive disorder, schizophrenia, and healthy individuals to identify facial emotions on face images with and without facial masks. Results demonstrate that the emotion recognition skills of all participants were negatively influenced by face masks. Moreover, the main insight of the study is that the impairment is crucially significant when patients with major depressive disorder and schizophrenia had to identify happiness at a low-intensity level. These findings have important implications for satisfactory social relationships and well-being. If emotions with positive valence are hardly understood by specific psychiatric patients, there is an even greater requirement for doctor-patient interactions in public primary care.
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Affiliation(s)
- Andrea Escelsior
- Applied Neurosciences for Technological Advances in Rehabilitation Systems (ANTARES) Joint Lab, Clinica Psichiatrica ed SPDC, Largo Rosanna Benzi, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maria Bianca Amadeo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,U-VIP Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Davide Esposito
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,U-VIP Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Anna Rosina
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Alice Trabucco
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
| | - Alberto Inuggi
- Applied Neurosciences for Technological Advances in Rehabilitation Systems (ANTARES) Joint Lab, Clinica Psichiatrica ed SPDC, Largo Rosanna Benzi, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Beatriz Pereira da Silva
- Applied Neurosciences for Technological Advances in Rehabilitation Systems (ANTARES) Joint Lab, Clinica Psichiatrica ed SPDC, Largo Rosanna Benzi, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy.,U-VIP Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Gianluca Serafini
- Applied Neurosciences for Technological Advances in Rehabilitation Systems (ANTARES) Joint Lab, Clinica Psichiatrica ed SPDC, Largo Rosanna Benzi, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Monica Gori
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,U-VIP Unit for Visually Impaired People, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Mario Amore
- Applied Neurosciences for Technological Advances in Rehabilitation Systems (ANTARES) Joint Lab, Clinica Psichiatrica ed SPDC, Largo Rosanna Benzi, Genoa, Italy.,Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy.,IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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10
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Gori M, Schiatti L, Amadeo MB. Masking Emotions: Face Masks Impair How We Read Emotions. Front Psychol 2021; 12:669432. [PMID: 34113297 PMCID: PMC8185341 DOI: 10.3389/fpsyg.2021.669432] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/09/2021] [Indexed: 01/11/2023] Open
Abstract
To date, COVID-19 has spread across the world, changing our way of life and forcing us to wear face masks. This report demonstrates that face masks influence the human ability to infer emotions by observing facial configurations. Specifically, a mask obstructing a face limits the ability of people of all ages to infer emotions expressed by facial features, but the difficulties associated with the mask’s use are significantly pronounced in children aged between 3 and 5 years old. These findings are of essential importance, as they suggest that we live in a time that may potentially affect the development of social and emotion reasoning, and young children’s future social abilities should be monitored to assess the true impact of the use of masks.
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Affiliation(s)
- Monica Gori
- Unit for Visually Impaired People (U-VIP), Istituto Italiano di Tecnologia, Genova, Italy
| | - Lucia Schiatti
- Unit for Visually Impaired People (U-VIP), Istituto Italiano di Tecnologia, Genova, Italy
| | - Maria Bianca Amadeo
- Unit for Visually Impaired People (U-VIP), Istituto Italiano di Tecnologia, Genova, Italy
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11
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Khafif TC, Rotenberg LDS, Nascimento C, Beraldi GH, Lafer B. Emotion regulation in pediatric bipolar disorder: A meta-analysis of published studies. J Affect Disord 2021; 285:86-96. [PMID: 33639359 DOI: 10.1016/j.jad.2021.02.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 01/14/2021] [Accepted: 02/01/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Emotion regulation is a relatively recent topic in psychiatry, and has only recently begun to be tested across Pediatric Bipolar Disorder (PBD). To date, no meta-analysis has investigated the presence of emotion regulation deficits in PBD patients. OBJECTIVES The aim of this study is to understand where the literature stands on this topic, as well as how different researchers are measuring and grasping the concept of emotion regulation in pediatric bipolar disorders. METHODS A systematic search of trials using the terms ("Pediatric Bipolar Disorder") AND ("Emotion Regulation" OR "Affect Regulation" OR "Mood Lability" OR "Mood Instability" OR "Irritability") was conducted using PubMed, Google Scholar, ResearchGate, Web of Science and Psych Info databases. Of the initial 366 articles identified, 8 met eligibility criteria for the meta-analysis and were included in this study. RESULTS There is a statistically significant difference in Accuracy in Emotion Regulation tasks, with a tendency for lower accuracy in PBD patients; however, both groups did not differ statistically regarding Response Time. CONCLUSION Our data suggests that PBD patients do present emotion regulation deficits, particularly regarding facial emotion recognition and affective language interference tasks mediated by cognitive assignments. These results have important implications in developing novel psychotherapeutic interventions for this population.
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Affiliation(s)
- Tatiana Cohab Khafif
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil.
| | - Luisa de Siqueira Rotenberg
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Camila Nascimento
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Gabriel Henrique Beraldi
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovídio Pires de Campos, 785, São Paulo, Brazil
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12
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Ünal-Aydın P, Obuća F, Aydın O, Spada MM. The role of metacognitions and emotion recognition in problematic SNS use among adolescents. J Affect Disord 2021; 282:1-8. [PMID: 33387741 DOI: 10.1016/j.jad.2020.12.103] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/13/2020] [Accepted: 12/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Problematic social networking sites (SNS) use is associated with important psychological problems among adolescents. Nevertheless, research on the aetiology of problematic SNS use is limited. Our aim was to investigate the role of metacognitions and emotion recognition in predicting problematic SNS use during the late adolescence period. METHODS Eight hundred and sixty-one high school students were recruited for the study. Participants completed the Bergen Social Media Addiction Scale (BSMAS), the Metacognitions Questionnaire for Children (MCQ-C), and the Children's Version of Reading the Mind in the Eyes Test (RMET). RESULTS A stepwise multiple linear regression analysis showed that all subdimensions of metacognitions (positive meta-worry, negative meta-worry, superstition, punishment, and responsibility beliefs, and cognitive monitoring), but not emotion recognition, independently predicted the BSMAS total score controlling for daily SNS use. CONCLUSIONS Our findings indicate that maladaptive metacognitions are associated, independently frequency of daily SNS use, to problematic SNS use among late adolescents. Interventions targeting dysfunctional metacognitions may aid adolescents who suffer from the detrimental effects of problematic SNS use.
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Affiliation(s)
- Pınar Ünal-Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Faruk Obuća
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Orkun Aydın
- Department of Psychology, Faculty of Arts and Science, International University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Marcantonio M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.
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13
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Schenkel LS, Towne TL. Errors in identifying emotion in body postures and facial expressions among pediatric patients with bipolar disorder. J Clin Exp Neuropsychol 2020; 42:735-746. [DOI: 10.1080/13803395.2020.1799946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Lindsay S. Schenkel
- Department of Psychology, Rochester Institute of Technology, Rochester, NY, USA
| | - Terra L. Towne
- Department of Psychology, Rochester Institute of Technology, Rochester, NY, USA
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14
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Lee P, Van Meter A. Emotional body language: Social cognition deficits in bipolar disorder. J Affect Disord 2020; 272:231-238. [PMID: 32553363 DOI: 10.1016/j.jad.2020.03.114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/03/2020] [Accepted: 03/29/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Research suggests that people with bipolar disorder (BD), like individuals with autism spectrum disorders or schizophrenia (among other forms of psychopathology), often have social cognition deficits that negatively impact relationships and quality of life. Studies of social cognition largely focus on face emotion recognition. However, relying solely on faces is not ecologically valid - other cues are available outside of a lab environment. If the ability to correctly interpret other emotion cues is intact, people with face emotion recognition deficits could learn to rely on other cues in order to make inferences about peoples' emotional states. This study explored whether both facial emotion and emotional body language (EBL) recognition are impaired in people with BD. METHOD We measured the performance of individuals with BD relative to community controls on a computer-based emotion recognition task that isolated participants' ability to interpret emotions in faces, bodies without faces, and in bodies with faces. RESULTS Results indicated that the BD group was significantly less accurate on face emotion recognition (Cohen's d = -0.87, p = .023), and was more likely to misidentify neutral stimuli as sad (Cohen's d = -0.58, p = .030). Emotion identification accuracy was equivalent across groups when the body (not just face) was visible. CONCLUSION People with BD experience deficits in face emotion recognition, and their emotional state may influence their interpretation of others' emotions. However, recognition of EBL seems largely intact in this population. Paying attention to EBL may help people with BD to compensate for face emotion processing deficits and improve social functioning.
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Affiliation(s)
- Patricia Lee
- Ferkauf Graduate School of Psychology, Yeshiva University, United States
| | - Anna Van Meter
- Ferkauf Graduate School of Psychology, Yeshiva University, United States; Feinstein Institutes for Medical Research, Behavior Science, United States; Department of Psychiatry Research, The Zucker Hillside Hospital, 75-59 263rd Street, Glen Oaks, NY 11004, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, United States.
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15
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Facial emotion recognition deficits in patients with bipolar disorder and their healthy parents. Gen Hosp Psychiatry 2020; 65:9-14. [PMID: 32361661 DOI: 10.1016/j.genhosppsych.2020.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/17/2020] [Accepted: 04/20/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is evidence on deficits in facial emotion recognition (FER) in patients with bipolar disorder (BD), and these deficits may be present in individuals with genetic risk for BD. This study investigated facial emotion identification and discrimination abilities in patients with BD, their parents, and healthy controls. MATERIALS AND METHODS This study included 38 patients with bipolar I disorder and 30 healthy controls for patients as well as 30 healthy mothers and 30 healthy fathers of these patients and 30 healthy controls who matched the mothers and fathers for age, gender, and education (total 188 participants). Facial Emotion Identification and Discrimination Tests were applied to all participants; the Hamilton Depression Rating Scale and Young Mania Rating Scale were applied to patients and their control group. RESULTS Facial Emotion Identification and Discrimination Test scores of patients and their parents were reasonably lower than their matching control groups. Moreover, we found that difficulty in FER affected more emotions in mothers than in fathers and mothers performed significantly worse than patients in the identification of angry and embarrassed faces. CONCLUSION These findings indicate that parents of patients with BD have impairment with recognizing facial emotions and suggest that there may be an association between FER of patients with BD and that of their mothers.
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16
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Wang C, Shao X, Jia Y, Ho RC, Harris KM, Wang W. Peripherally Physiological Responses to External Emotions and Their Transitions in Bipolar I Disorder With and Without Hypersexuality. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1345-1354. [PMID: 32133544 DOI: 10.1007/s10508-019-01615-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/28/2019] [Accepted: 12/17/2019] [Indexed: 06/10/2023]
Abstract
Hypersexuality is associated with psychiatric disorders such as mania; however, it remains unclear whether bipolar I disorder with (BW) or without (BO) hypersexuality demonstrates different responses to external emotional stimuli and their transitions that were composed of pictures and sounds of same domain. In 21 BW patients, 20 BO patients, and 41 healthy volunteers, we administered polygraph tests (electrocardiogram, electromyogram, electrooculogram, and galvanic skin response) to measure transitions from a primer emotion (i.e., external disgust, erotica, fear, happiness, neutral, and sadness) to a noncongruent emotion (out of the remaining five) and to the primer emotion again (repeat-primer). We also evaluated participants' concurrent states of mania, hypomania, and depression. With neutral as the noncongruent emotion, the heart rate difference in BW was greater than in controls when responses to the primer erotica were subtracted from responses to the repeat-primer erotica, or when to the primer sadness were subtracted from the repeat-primer sadness. The difference of the masseter electromyographic activity in BW was lower than in BO and controls when responses to the noncongruent happiness were subtracted from responses to the repeat-primer neutral, and was lower than in BO when to the noncongruent neutral were subtracted from the repeat-primer erotica. The eyeball movement difference was greater in BW than in BO and controls when responses to the noncongruent sadness were subtracted from responses to the repeat-primer neutral. The heart rate difference when responses to the primer happiness were subtracted from responses to the noncongruent neutral was negatively correlated with mania in BO. BW and BO patients behaved differently to external emotions and their transitions, particularly regarding erotica and sadness, which might characterize unique pathophysiological processes of the two bipolar I disorder subtypes.
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Affiliation(s)
- Chu Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Xu Shao
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Yanli Jia
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Roger C Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Keith M Harris
- School of Psychology, Charles Sturt University, Port Macquarie, NSW, Australia
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
- Department of Psychology, Norwegian University of Science and Technology, NO-7491, Trondheim, Norway.
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17
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Fijtman A, Bücker J, Strange BA, Martins DS, Passos IC, Hasse-Sousa M, Lima FM, Kapczinski F, Yatham L, Kauer-Sant'Anna M. Emotional memory in bipolar disorder: Impact of multiple episodes and childhood trauma. J Affect Disord 2020; 260:206-213. [PMID: 31505398 DOI: 10.1016/j.jad.2019.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/07/2019] [Accepted: 09/01/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Emotional memory is a critical amygdala-dependent cognitive function characterized by enhanced memory for emotional events coupled with retrograde amnesia. Our study aims to assess the influence of bipolar disorder (BD), trauma, and the number of mood episodes on emotional memory. METHODS 53 subjects (33 euthymic patients with BD and 20 healthy controls) answered a clinical assessment, childhood trauma questionnaire (CTQ), and an emotional memory test composed of lists of nouns, including neutral words, one emotional (E), one preceding (E-1) and one following word (E + 1). We assessed for the influence of type, position, diagnosis, trauma, and number of mood episodes in word recall using generalized estimating equations. RESULTS Controlling for neutral words, BD had a higher recall for E-1 (p = 0.038) and a trend for a higher recall of E (p = 0.055). There was no difference between patients with and without trauma. Patients with BD who suffered multiple mood episodes had a higher recall of E compared to patients with fewer episodes (p = 0.016). LIMITATIONS Cross-sectional design and small sample size. CONCLUSION Our results indicate dysfunction in emotional memory in patients with BD, particularly after multiple mood episodes. While we expected an impaired emotional memory, patients with BD showed an increased recall for emotional stimuli and events preceding them. Childhood trauma does not seem to interfere with emotional memory changes in patients with BD. Emotional memory enhancement seems to be a promising marker of progression in BD.
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Affiliation(s)
- Adam Fijtman
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
| | - Joana Bücker
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Bryan A Strange
- Laboratory for Clinical Neuroscience, Centre for Biomedical Technology, Universidad Politécnica de Madrid, Spain
| | - Dayane Santos Martins
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Ives Cavalcante Passos
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Mathias Hasse-Sousa
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavia Moreira Lima
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Flavio Kapczinski
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Neuroscience Graduate Program, McMaster University, 100 West Fifth Street, Hamilton, ON, Canada
| | - Lakshmi Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Márcia Kauer-Sant'Anna
- Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre (HCPA), Federal University of Rio Grande do Sul, Porto Alegre, Brazil; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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18
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Shiota MN, Simpson ML, Kirsch HE, Levenson RW. Emotion recognition in objects in patients with neurological disease. Neuropsychology 2019; 33:1163-1173. [PMID: 31478721 PMCID: PMC6823118 DOI: 10.1037/neu0000587] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Considerable research indicates that individuals with dementia have deficits in the ability to recognize emotion in other people. The present study examined ability to detect emotional qualities of objects. METHOD Fifty-two patients with frontotemporal dementia (FTD), 20 patients with Alzheimer's disease (AD), 18 patients awaiting surgery for intractable epilepsy, and 159 healthy controls completed a newly developed test of ability to recognize emotional qualities of art (music and paintings), and pleasantness in simple sensory stimuli (tactile, olfactory, auditory), and to make aesthetic judgments (geometric shapes, room décor). A subset of participants also completed a test of ability to recognize emotions in other people. RESULTS Patients with FTD showed a marked deficit in ability to recognize the emotions conveyed in art, compared with both healthy individuals and patients with AD (relative to controls, deficits in patients with AD only approached significance). This deficit remained robust after controlling for FTD patients' ability to recognize pleasantness in simple sensory stimuli, make aesthetic judgments, identify odors, and identify emotions in other people. Neither FTD nor AD patients showed deficits in recognizing pleasant sensory stimuli or making aesthetic judgments. Exploratory analysis of patients with epilepsy revealed no deficits in any of these domains. CONCLUSION Patients with FTD (but not AD) showed a significant, specific deficit in ability to interpret emotional messages in art, echoing FTD-related deficits in recognizing emotions in other people. This finding adds to our understanding of the impact these diseases have on the lives of patients and their caregivers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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19
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Mitrovic M, Ristic M, Dimitrijevic B, Hadzi Pesic M. Facial Emotion Recognition and Persecutory Ideation in Paranoid Schizophrenia. Psychol Rep 2019; 123:1099-1116. [PMID: 31092137 DOI: 10.1177/0033294119849016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The recognition of facial signals has a crucial role in social interaction. It is well known that people suffering from paranoid schizophrenia have problems in the social domain, predominantly related to misinterpreting the intentions, emotions, and actions of others. The aim of this study was to examine whether there are differences in facial emotion recognition between people with paranoid schizophrenia and healthy controls. In addition, we examined the correlation between facial emotion recognition and the expression of persecutory ideation in people suffering from paranoid schizophrenia. The study involved 60 participants, 30 of whom suffered from paranoid schizophrenia and 30 healthy controls, equalized by gender, age, and education. The following instruments were used: Japanese and Caucasian Facial Expressions of Emotion and Neutral Faces and the Persecutory Ideation Questionnaire. Compared with the controls, people suffering from paranoid schizophrenia were significantly less accurate in recognizing the following emotions: surprise, contempt, sadness, disgust, and emotionally neutral faces. Since the attribution of emotions to emotionally neutral faces is an important finding that could be linked with the social (dis)functionality of people suffering from paranoid schizophrenia, we analyzed and compared the wrong answers given by the two groups and found some differences between them. The results show that persecutory ideation has a statistically significant negative correlation with the successful recognition of emotionally neutral faces. All of the findings lead to the conclusion that paranoid schizophrenia, and within it the existence of persecutory ideation, leads to problems in recognizing the basic facial signals that form the foundation of everyday social interaction.
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Affiliation(s)
| | - Milica Ristic
- Pedagogical Faculty in Vranje, University of Nis, Serbia
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20
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Meluken I, Ottesen NM, Harmer CJ, Scheike T, Kessing LV, Vinberg M, Miskowiak KW. Is aberrant affective cognition an endophenotype for affective disorders? - A monozygotic twin study. Psychol Med 2019; 49:987-996. [PMID: 29962367 DOI: 10.1017/s0033291718001642] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Identification of endophenotypes can improve prevention, detection and development of new treatments. We therefore investigated whether aberrant affective cognition constitutes an endophenotype for affective disorders by being present in monozygotic (MZ) twins with unipolar or bipolar disorder in partial remission (i.e. affected) and their unaffected co-twins (i.e. high-risk) relative to twins with no family history of affective disorder (i.e. low-risk). METHODS We conducted an assessor blind cross-sectional study from 2014 to 2017 of MZ twins using Danish population-based registers in recruitment. Twins attended one test session involving neurocognitive testing, clinical ratings and questionnaires. Main outcomes were attention to and recognition of emotional facial expressions, the memory of emotional self-referential words, emotion regulation and coping strategies. RESULTS Participants were 103 affected, 44 high-risk and 36 low-risk MZ twins. Groups were demographically well-balanced and showed comparable non-affective cognitive performance. We observed no aberrant affective cognition in affected and high-risk relative to low-risk twins. However, high-risk twins displayed attentional avoidance of emotional faces (ps ⩽ 0.009) and more use of task-oriented coping strategies (p = 0.01) compared with affected twins. In contrast did affected twins show more emotion-oriented coping than high- and low-risk twins (ps ⩽ 0.004). CONCLUSIONS Our findings provide no support of aberrant affective cognition as an endophenotype for affective disorders. High-risk twins' attentional avoidance of emotional faces and greater use of task-oriented coping strategies may reflect compensatory mechanisms.
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Affiliation(s)
- I Meluken
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen,Denmark
| | - N M Ottesen
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen,Denmark
| | - C J Harmer
- Department of Psychiatry,University of Oxford,UK
| | - T Scheike
- Section of Biostatistics,University of Copenhagen,Denmark
| | - L V Kessing
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen,Denmark
| | - M Vinberg
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen,Denmark
| | - K W Miskowiak
- Copenhagen Affective Disorder Research Centre (CADIC), Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, University of Copenhagen,Denmark
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21
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Kling LR, Bessette KL, DelDonno SR, Ryan KA, Drevets WC, McInnis MG, Phillips ML, Langenecker SA. Cluster analysis with MOODS-SR illustrates a potential bipolar disorder risk phenotype in young adults with remitted major depressive disorder. Bipolar Disord 2018; 20:697-707. [PMID: 30294823 PMCID: PMC6319908 DOI: 10.1111/bdi.12693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Delays in the diagnosis and detection of bipolar disorder can lead to adverse consequences, including improper treatment and increased suicide risk. The Mood Spectrum Self-Report Measure (MOODS-SR) was designed to capture the full spectrum of lifetime mood symptomology with factor scores for depression and mania symptom constellations. The utility of the MOODS-SR as a tool to investigate homogeneous subgroups was examined, with particular focus on a possible bipolar risk subgroup. Moreover, potential patterns of differences in MOODS-SR subtypes were probed using cognitive vulnerabilities, neuropsychological functioning, and ventral striatum connectivity. METHODS K-mean cluster analysis based on factor scores of MOODS-SR was used to determine homogeneous subgroupings within a healthy and remitted depressed young adult sample (N = 86). Between-group comparisons (based on cluster subgroupings) were conducted on measures of cognitive vulnerabilities, neuropsychological functioning, and ventral striatum rs-fMRI connectivity. RESULTS Three groups of participants were identified: one with minimal symptomology, one with moderate primarily depressive symptomology, and one with more severe manic and depressive symptomology. Differences in impulsivity, neuroticism, conscientiousness, facial perception accuracy, and rs-fMRI connectivity exist between moderate and severe groups. CONCLUSIONS Within a sample of people with and without depression histories, a severe subgroup was identified with potentially increased risk of developing bipolar disorder through use of the MOODS-SR. This small subgroup had higher levels of lifetime depression and mania symptoms. Additionally, differences in traits, affective processing, and connectivity exist between those with a more prototypic unipolar subgrouping and those with potential risk for developing bipolar disorder.
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Affiliation(s)
| | | | | | - Kelly A Ryan
- University of Michigan Medical Center, Ann Arbor, MI,
USA
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22
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Hua AY, Sible IJ, Perry DC, Rankin KP, Kramer JH, Miller BL, Rosen HJ, Sturm VE. Enhanced Positive Emotional Reactivity Undermines Empathy in Behavioral Variant Frontotemporal Dementia. Front Neurol 2018; 9:402. [PMID: 29915557 PMCID: PMC5994409 DOI: 10.3389/fneur.2018.00402] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/15/2018] [Indexed: 12/12/2022] Open
Abstract
Behavioral variant frontotemporal dementia (bvFTD) is a neurodegenerative disease characterized by profound changes in emotions and empathy. Although most patients with bvFTD become less sensitive to negative emotional cues, some patients become more sensitive to positive emotional stimuli. We investigated whether dysregulated positive emotions in bvFTD undermine empathy by making it difficult for patients to share (emotional empathy), recognize (cognitive empathy), and respond (real-world empathy) to emotions in others. Fifty-one participants (26 patients with bvFTD and 25 healthy controls) viewed photographs of neutral, positive, negative, and self-conscious emotional faces and then identified the emotions displayed in the photographs. We used facial electromyography to measure automatic, sub-visible activity in two facial muscles during the task: Zygomaticus major (ZM), which is active during positive emotional reactions (i.e., smiling), and Corrugator supercilii (CS), which is active during negative emotional reactions (i.e., frowning). Participants rated their baseline positive and negative emotional experience before the task, and informants rated participants' real-world empathic behavior on the Interpersonal Reactivity Index. The majority of participants also underwent structural magnetic resonance imaging. A mixed effects model found a significant diagnosis X trial interaction: patients with bvFTD showed greater ZM reactivity to neutral, negative (disgust and surprise), self-conscious (proud), and positive (happy) faces than healthy controls. There was no main effect of diagnosis or diagnosis X trial interaction on CS reactivity. Compared to healthy controls, patients with bvFTD had impaired emotion recognition. Multiple regression analyses revealed that greater ZM reactivity predicted worse negative emotion recognition and worse real-world empathy. At baseline, positive emotional experience was higher in bvFTD than healthy controls and also predicted worse negative emotion recognition. Voxel-based morphometry analyses found that smaller volume in the thalamus, midcingulate cortex, posterior insula, anterior temporal pole, amygdala, precentral gyrus, and inferior frontal gyrus—structures that support emotion generation, interoception, and emotion regulation—was associated with greater ZM reactivity in bvFTD. These findings suggest that dysregulated positive emotional reactivity may relate to reduced empathy in bvFTD by making patients less likely to tune their reactions to the social context and to share, recognize, and respond to others' feelings and needs.
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Affiliation(s)
- Alice Y Hua
- Department of Psychology, University of California, Berkeley, Berkeley, CA, United States
| | - Isabel J Sible
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - David C Perry
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Katherine P Rankin
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Bruce L Miller
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Howard J Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
| | - Virginia E Sturm
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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23
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Fernandes FBF, Rocca CC, Gigante AD, Dottori-Silva PR, Gerchmann L, Rossini D, Sato R, Lafer B, Nery FG. The association between social skills deficits and family history of mood disorder in bipolar I disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2018; 40:244-248. [PMID: 29590265 PMCID: PMC6899394 DOI: 10.1590/1516-4446-2017-2313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 07/28/2017] [Indexed: 11/21/2022]
Abstract
Objective: To compare social skills and related executive functions among bipolar disorder (BD) patients with a family history of mood disorders (FHMD), BD patients with no FHMD and healthy control (HCs). Methods: We evaluated 20 euthymic patients with FHMD, 17 euthymic patients without FHMD, and 31 HCs using the Social Skills Inventory (SSI) and a neuropsychological battery evaluating executive function, inhibitory control, verbal fluency and estimated intelligence. Results: Both BD groups had lower SSI scores than controls. Scores for one subfactor of the social skills questionnaire, conversational skills and social performance, were significantly lower among patients with FHMD than among patients without FHMD (p = 0.019). Both groups of BD patients exhibited significant deficits in initiation/inhibition, but only BD patients with FHMD had deficits in verbal fluency, both compared to HC. There were no associations between social skills questionnaire scores and measures of cognitive function. Conclusion: Euthymic BD patients have lower social skills and executive function performance than HC. The presence of FHMD among BD patients is specifically associated with deficits in conversational and social performance skills, in addition to deficits in verbal fluency. Both characteristics might be associated with a common genetically determined pathophysiological substrate.
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Affiliation(s)
- Francy B F Fernandes
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Serviço de Psicologia e Neuropsicologia, Instituto de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Cristiana C Rocca
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Serviço de Psicologia e Neuropsicologia, Instituto de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Alexandre D Gigante
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Paola R Dottori-Silva
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Luciana Gerchmann
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Danielle Rossini
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Rodrigo Sato
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Beny Lafer
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Institute & Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Fabiano G Nery
- Programa de Transtorno Bipolar (PROMAN), Instituto de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Institute & Departamento de Psiquiatria, Faculdade de Medicina, USP, São Paulo, SP, Brazil.,Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Ohio, USA
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Branco LD, Cotrena C, Ponsoni A, Salvador-Silva R, Vasconcellos SJL, Fonseca RP. Identification and Perceived Intensity of Facial Expressions of Emotion in Bipolar Disorder and Major Depression. Arch Clin Neuropsychol 2017; 33:491-501. [DOI: 10.1093/arclin/acx080] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 08/22/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- L D Branco
- Department of Psychology, Pontifícal Catholic University of Rio Grande do Sul. Porto Alegre, RS, Brazil
| | - C Cotrena
- Department of Psychology, Pontifícal Catholic University of Rio Grande do Sul. Porto Alegre, RS, Brazil
| | - A Ponsoni
- Department of Psychology, Pontifícal Catholic University of Rio Grande do Sul. Porto Alegre, RS, Brazil
| | - R Salvador-Silva
- Department of Psychology, Pontifícal Catholic University of Rio Grande do Sul. Porto Alegre, RS, Brazil
| | - S J L Vasconcellos
- Department of Psychology, Federal University of Santa Maria. Santa Maria, RS, Brazil
| | - R P Fonseca
- Department of Psychology, Pontifícal Catholic University of Rio Grande do Sul. Porto Alegre, RS, Brazil
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25
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Kim SM, Kwon YJ, Jung SY, Kim MJ, Cho YS, Kim HT, Nam KC, Kim H, Choi KH, Choi JS. Development of the Korean Facial Emotion Stimuli: Korea University Facial Expression Collection 2nd Edition. Front Psychol 2017; 8:769. [PMID: 28553255 PMCID: PMC5427125 DOI: 10.3389/fpsyg.2017.00769] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/26/2017] [Indexed: 11/28/2022] Open
Abstract
Background: Developing valid emotional facial stimuli for specific ethnicities creates ample opportunities to investigate both the nature of emotional facial information processing in general and clinical populations as well as the underlying mechanisms of facial emotion processing within and across cultures. Given that most entries in emotional facial stimuli databases were developed with western samples, and given that very few of the eastern emotional facial stimuli sets were based strictly on the Ekman’s Facial Action Coding System, developing valid emotional facial stimuli of eastern samples remains a high priority. Aims: To develop and examine the psychometric properties of six basic emotional facial stimuli recruiting professional Korean actors and actresses based on the Ekman’s Facial Action Coding System for the Korea University Facial Expression Collection-Second Edition (KUFEC-II). Materials And Methods: Stimulus selection was done in two phases. First, researchers evaluated the clarity and intensity of each stimulus developed based on the Facial Action Coding System. Second, researchers selected a total of 399 stimuli from a total of 57 actors and actresses, which were then rated on accuracy, intensity, valence, and arousal by 75 independent raters. Conclusion: The hit rates between the targeted and rated expressions of the KUFEC-II were all above 80%, except for fear (50%) and disgust (63%). The KUFEC-II appears to be a valid emotional facial stimuli database, providing the largest set of emotional facial stimuli. The mean intensity score was 5.63 (out of 7), suggesting that the stimuli delivered the targeted emotions with great intensity. All positive expressions were rated as having a high positive valence, whereas all negative expressions were rated as having a high negative valence. The KUFEC II is expected to be widely used in various psychological studies on emotional facial expression. KUFEC-II stimuli can be obtained through contacting the corresponding authors.
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Affiliation(s)
- Sun-Min Kim
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Ye-Jin Kwon
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Soo-Yun Jung
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Min-Ji Kim
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Yang Seok Cho
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Hyun Taek Kim
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Ki-Chun Nam
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Hackjin Kim
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - Kee-Hong Choi
- Department of Psychology, Korea UniversitySeoul, South Korea
| | - June-Seek Choi
- Department of Psychology, Korea UniversitySeoul, South Korea
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26
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Bodnar A, Rybakowski JK. Increased affective empathy in bipolar patients during a manic episode. ACTA ACUST UNITED AC 2017; 39:342-345. [PMID: 28300949 PMCID: PMC7111408 DOI: 10.1590/1516-4446-2016-2101] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 11/07/2016] [Indexed: 11/22/2022]
Abstract
Objective: To assess both cognitive and affective empathy in patients with bipolar disorder (BD) during an acute manic or depressive episode. Methods: The study included 25 patients with BD (aged 35±14 years) during an acute manic episode, 25 bipolar patients (aged 41±14 years) during a depressive episode, and 25 healthy control subjects (aged 36±11 years). Cognitive and affective empathy were assessed using the Multifaceted Empathy Test. Results: In both manic and depressive patients, a significant deficit in cognitive empathy was demonstrated. However, indices of affective empathy were significantly higher in the manic group than in depressed and control subjects. In the depressed patients, indices did not differ from those of healthy controls. For affective empathy, a significant positive correlation was found with intensity of manic symptoms and a negative correlation was found with intensity of depressive symptoms. No such correlations were observed with cognitive empathy. Conclusion: We found evidence of increased affective empathy (overempathizing) during a manic episode in bipolar patients. This phenomenon may be connected with disturbances in emotion inhibition related to anastrophic thinking and associated with increased activity of mirror neurons, all of which occur during a manic episode.
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Affiliation(s)
- Anna Bodnar
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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Lagerberg TV, Aminoff SR, Aas M, Bjella T, Henry C, Leboyer M, Pedersen G, Bellivier F, Icick R, Andreassen OA, Etain B, Melle I. Alcohol use disorders are associated with increased affective lability in bipolar disorder. J Affect Disord 2017; 208:316-324. [PMID: 27810713 DOI: 10.1016/j.jad.2016.09.062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 08/15/2016] [Accepted: 09/05/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Affective dysregulation is a core feature of bipolar disorder (BD), and inter-episodic affect lability is associated with more severe outcomes including comorbidity. Rates of daily tobacco smoking and substance use disorders in BD are high. Knowledge regarding relationships between affective lability and abuse of the most commonly used substances such as tobacco, alcohol and cannabis in BD is limited. METHODS We investigated whether dimensions of inter-episodic affective lability as measured with the Affective Lability Scale - short form (ALS-SF) were associated with lifetime daily tobacco use or alcohol (AUD) or cannabis use disorders (CUD) in a sample of 372 French and Norwegian patients with BD I and II. RESULTS ALS-SF total score and all sub-dimensions (anxiety-depression, depression-elation and anger) were significantly associated with AUD, while only the depression-elation sub-dimension was associated with CUD, after controlling for possible confounders such as gender, age at interview, age at illness onset, BD subtype, duration of illness and other substance use disorders. Daily tobacco smoking was not significantly associated with affective lability. LIMITATIONS Data for recent substance use or psychiatric comorbidities such as personality or hyperkinetic disorders were not available, and could have mediated the relationships. CONCLUSION AUD is associated with several dimensions of inter-episodic affective lability in BD, while CUD is associated with increased oscillations between depression and elation only. Increased affective lability may partly explain the increased illness severity of patients with BD and AUD or CUD. Affective lability should be treated in order to prevent these comorbidities.
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Affiliation(s)
- Trine Vik Lagerberg
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Sofie Ragnhild Aminoff
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Specialized Inpatient Treatment, Division of Mental Health Services, Akershus University Hospital, Norway
| | - Monica Aas
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Thomas Bjella
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Chantal Henry
- AP-HP, Hôpital H. Mondor - A. Chenevier, DHU Pepsy, Pôle de Psychiatry, Créteil 94000, France; Inserm, U955, Créteil 94000, France; Institut Pasteur, Unité Perception et Mémoire, F-75015 Paris, France; ENBREC, European Network of Bipolar Research Expert Centres, Paris, France
| | - Marion Leboyer
- AP-HP, Hôpital H. Mondor - A. Chenevier, DHU Pepsy, Pôle de Psychiatry, Créteil 94000, France; Inserm, U955, Créteil 94000, France; ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; Fondation FondaMental, Créteil, France
| | - Geir Pedersen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Oslo University Hospital, Department of Personality Psychiatry, Division of Mental Health and Addiction, Oslo, Norway
| | - Frank Bellivier
- ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Romain Icick
- AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Ole A Andreassen
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Fondation FondaMental, Créteil, France
| | - Bruno Etain
- ENBREC, European Network of Bipolar Research Expert Centres, Paris, France; AP-HP, GH Saint-Louis - Lariboisière - F. Widal, Pôle de Psychiatrie et de Médecine Addictologique, 75475 Paris Cedex 10, France; Inserm, U1144, Paris F-75006, France; Université Paris Descartes, UMR-S 1144, Paris F-75006, France; Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1144, Paris F-75013, France
| | - Ingrid Melle
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Iakimova G, Moriano C, Farruggio L, Jover F. Socio-demographic and Clinical Correlates of Facial Expression Recognition Disorder in the Euthymic Phase of Bipolar Patients. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2016; 61:633-42. [PMID: 27310226 PMCID: PMC5348087 DOI: 10.1177/0706743716639927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Bipolar patients show social cognitive disorders. The objective of this study is to review facial expression recognition (FER) disorders in bipolar patients (BP) and explore clinical heterogeneity factors that could affect them in the euthymic phase: socio-demographic level, clinical and changing characteristics of the disorder, history of suicide attempt, and abuse. METHOD Thirty-four euthymic bipolar patients and 29 control subjects completed a computer task of explicit facial expression recognition and were clinically evaluated. RESULTS Compared with control subjects, BP patients show: a decrease in fear, anger, and disgust recognition; an extended reaction time for disgust, surprise and neutrality recognition; confusion between fear and surprise, anger and disgust, disgust and sadness, sadness and neutrality. In BP patients, age negatively affects anger and neutrality recognition, as opposed to education level which positively affects recognizing these emotions. The history of patient abuse negatively affects surprise and disgust recognition, and the number of suicide attempts negatively affects disgust and anger recognition. CONCLUSIONS Cognitive heterogeneity in euthymic phase BP patients is affected by several factors inherent to bipolar disorder complexity that should be considered in social cognition study.
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Affiliation(s)
- Galina Iakimova
- Université de Nice Sophia Antipolis, Laboratoire d'Anthropologie et de Psychologie cognitives et sociales (LAPCOS, EA 7278), Nice, France
| | | | - Lisa Farruggio
- Université de Nice Sophia Antipolis, Laboratoire d'Anthropologie et de Psychologie cognitives et sociales (LAPCOS, EA 7278), Nice, France
| | - Frédéric Jover
- Clinique de psychiatrie et de psychologie médicale, CHU de Nice, avenue de la Voie Romaine, Nice cedex, France
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de Brito Ferreira Fernandes F, Gigante AD, Berutti M, Amaral JA, de Almeida KM, de Almeida Rocca CC, Lafer B, Nery FG. Facial emotion recognition in euthymic patients with bipolar disorder and their unaffected first-degree relatives. Compr Psychiatry 2016; 68:18-23. [PMID: 27234178 DOI: 10.1016/j.comppsych.2016.03.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/02/2016] [Accepted: 03/08/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Facial emotion recognition (FER) is an important task associated with social cognition because facial expression is a significant source of non-verbal information that guides interpersonal relationships. Increasing evidence suggests that bipolar disorder (BD) patients present deficits in FER and these deficits may be present in individuals at high genetic risk for BD. The aim of this study was to evaluate the occurrence of FER deficits in euthymic BD patients, their first-degree relatives, and healthy controls (HC) and to consider if these deficits might be regarded as an endophenotype candidate for BD. METHODS We studied 23 patients with DSM-IV BD type I, 22 first-degree relatives of these patients, and 27 HC. We used the Penn Emotion Recognition Tests to evaluate tasks of FER, emotion discrimination, and emotional acuity. Patients were recruited from outpatient facilities at the Institute of Psychiatry of the University of Sao Paulo Medical School, or from the community through media advertisements, had to be euthymic, with age above 18years old and a diagnosis of DSM-IV BD type I. RESULTS Euthymic BD patients presented significantly fewer correct responses for fear, and significantly increased time to response to recognize happy faces when compared with HC, but not when compared with first-degree relatives. First-degree relatives did not significantly differ from HC on any of the emotion recognition tasks. CONCLUSION Our results suggest that deficits in FER are present in euthymic patients, but not in subjects at high genetic risk for BD. Thus, we have not found evidence to consider FER as an endophenotype candidate for BD.
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Affiliation(s)
- Francy de Brito Ferreira Fernandes
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010; Psychology and Neuropsychology Units, Institute of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil, 05403-010.
| | - Alexandre Duarte Gigante
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010.
| | - Mariangeles Berutti
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010.
| | - José Antônio Amaral
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010.
| | - Karla Mathias de Almeida
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010.
| | - Cristiana Castanho de Almeida Rocca
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010; Psychology and Neuropsychology Units, Institute of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil, 05403-010.
| | - Beny Lafer
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010.
| | - Fabiano Gonçalves Nery
- Bipolar Disorder Program (PROMAN), Institute & Department of Psychiatry, University of São Paulo Medical School, Rua Dr. Ovidio Pires de Campos, 785, Sao Paulo, SP, Brazil 05403-010; Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Stetson Building 260 Stetson Street Suite 3200, Cincinnati, OH 45219, USA.
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Lee SA, Kim CY, Lee SH. Non-Conscious Perception of Emotions in Psychiatric Disorders: The Unsolved Puzzle of Psychopathology. Psychiatry Investig 2016; 13:165-73. [PMID: 27081376 PMCID: PMC4823191 DOI: 10.4306/pi.2016.13.2.165] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/13/2015] [Accepted: 05/29/2015] [Indexed: 11/19/2022] Open
Abstract
Psychophysiological and functional neuroimaging studies have frequently and consistently shown that emotional information can be processed outside of the conscious awareness. Non-conscious processing comprises automatic, uncontrolled, and fast processing that occurs without subjective awareness. However, how such non-conscious emotional processing occurs in patients with various psychiatric disorders requires further examination. In this article, we reviewed and discussed previous studies on the non-conscious emotional processing in patients diagnosed with anxiety disorder, schizophrenia, bipolar disorder, and depression, to further understand how non-conscious emotional processing varies across these psychiatric disorders. Although the symptom profile of each disorder does not often overlap with one another, these patients commonly show abnormal emotional processing based on the pathology of their mood and cognitive function. This indicates that the observed abnormalities of emotional processing in certain social interactions may derive from a biased mood or cognition process that precedes consciously controlled and voluntary processes. Since preconscious forms of emotional processing appear to have a major effect on behaviour and cognition in patients with these disorders, further investigation is required to understand these processes and their impact on patient pathology.
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Affiliation(s)
- Seung A Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
| | - Chai-Youn Kim
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Republic of Korea
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
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Distinct Roles of Emotion Reactivity and Regulation in Depressive and Manic Symptoms Among Euthymic Patients. COGNITIVE THERAPY AND RESEARCH 2015. [DOI: 10.1007/s10608-015-9738-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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A voxel-based morphometry study of gray matter correlates of facial emotion recognition in bipolar disorder. Psychiatry Res 2015; 233:158-64. [PMID: 26123449 DOI: 10.1016/j.pscychresns.2015.05.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 11/07/2014] [Accepted: 05/17/2015] [Indexed: 01/23/2023]
Abstract
Facial emotion recognition (FER) is one of the many cognitive deficits reported in bipolar disorder (BD) patients. The aim of this study was to investigate neuroanatomical correlates of FER impairments in BD type I (BD-I). Participants comprised 21 euthymic BD-I patients without Axis I DSM IV-TR comorbidities and 21 healthy controls who were assessed using magnetic resonance imaging and the Penn Emotion Recognition Test (ER40). Preprocessing of images used DARTEL (diffeomorphic anatomical registration through exponentiated Lie algebra) for optimized voxel-based morphometry in SPM8. Compared with healthy subjects, BD-I patients performed poorly in on the ER40 and had reduced gray matter volume (GMV) in the left orbitofrontal cortex, superior portion of the temporal pole and insula. In the BD-I group, the statistical maps indicated a direct correlation between FER on the ER40 and right middle cingulate gyrus GMV. Our findings are consistent with the previous studies regarding the overlap of multiple brain networks of social cognition and BD neurobiology, particularly components of the anterior-limbic neural network.
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Goodkind MS, Sturm VE, Ascher EA, Shdo SM, Miller BL, Rankin KP, Levenson RW. Emotion recognition in frontotemporal dementia and Alzheimer's disease: A new film-based assessment. ACTA ACUST UNITED AC 2015; 15:416-27. [PMID: 26010574 DOI: 10.1037/a0039261] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Deficits in recognizing others' emotions are reported in many psychiatric and neurological disorders, including autism, schizophrenia, behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). Most previous emotion recognition studies have required participants to identify emotional expressions in photographs. This type of assessment differs from real-world emotion recognition in important ways: Images are static rather than dynamic, include only 1 modality of emotional information (i.e., visual information), and are presented absent a social context. Additionally, existing emotion recognition batteries typically include multiple negative emotions, but only 1 positive emotion (i.e., happiness) and no self-conscious emotions (e.g., embarrassment). We present initial results using a new task for assessing emotion recognition that was developed to address these limitations. In this task, respondents view a series of short film clips and are asked to identify the main characters' emotions. The task assesses multiple negative, positive, and self-conscious emotions based on information that is multimodal, dynamic, and socially embedded. We evaluate this approach in a sample of patients with bvFTD, AD, and normal controls. Results indicate that patients with bvFTD have emotion recognition deficits in all 3 categories of emotion compared to the other groups. These deficits were especially pronounced for negative and self-conscious emotions. Emotion recognition in this sample of patients with AD was indistinguishable from controls. These findings underscore the utility of this approach to assessing emotion recognition and suggest that previous findings that recognition of positive emotion was preserved in dementia patients may have resulted from the limited sampling of positive emotion in traditional tests.
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Affiliation(s)
- Madeleine S Goodkind
- Mental Illness Research, Education, and Clinical Center, Veterans Affairs Palo Alto Health Care System
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Tsitsipa E, Fountoulakis KN. The neurocognitive functioning in bipolar disorder: a systematic review of data. Ann Gen Psychiatry 2015; 14:42. [PMID: 26628905 PMCID: PMC4666163 DOI: 10.1186/s12991-015-0081-z] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 11/18/2015] [Indexed: 12/21/2022] Open
Abstract
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.
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Affiliation(s)
| | - Konstantinos N Fountoulakis
- Division of Neurosciences, 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, 6, Odysseos street (1st Parodos, Ampelonon str.) 55536 Pournari Pylaia, Thessaloniki, Greece
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Rubin LH, Carter CS, Bishop JR, Pournajafi-Nazarloo H, Drogos LL, Hill SK, Ruocco AC, Keedy SK, Reilly JL, Keshavan MS, Pearlson GD, Tamminga CA, Gershon ES, Sweeney JA. Reduced levels of vasopressin and reduced behavioral modulation of oxytocin in psychotic disorders. Schizophr Bull 2014; 40:1374-84. [PMID: 24619535 PMCID: PMC4193712 DOI: 10.1093/schbul/sbu027] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Oxytocin (OT) and arginine vasopressin (AVP) exert robust influence on social affiliation and specific cognitive processes in healthy individuals. Abnormalities in these neuroendocrine systems have been observed in psychotic disorders, but their relation to impairments in behavioral domains that these endocrines modulate is not well understood. We compared abnormalities of OT and AVP serum concentrations in probands with schizophrenia (n = 57), schizoaffective disorder (n = 34), and psychotic bipolar disorder (n = 75); their first-degree relatives without a history of psychosis (n = 61, 43, 91, respectively); and healthy controls (n = 66) and examined their association with emotion processing and cognition. AVP levels were lower in schizophrenia (P = .002) and bipolar probands (P = .03) and in relatives of schizophrenia probands (P = .002) compared with controls. OT levels did not differ between groups. Familiality estimates were robust for OT (h(2) = 0.79, P = 3.97e-15) and AVP (h(2) = 0.78, P = 3.93e-11). Higher levels of OT were associated with better emotion recognition (β = 0.40, P < .001) and general neuropsychological function (β = 0.26, P = .04) in healthy controls as expected but not in any proband or relative group. In schizophrenia, higher OT levels were related to greater positive symptom severity. The dissociation of OT levels and behavioral function in all proband and relative groups suggests that risk and illness factors associated with psychotic disorders are not related to reduced OT levels but to a disruption in the ability of physiological levels of OT to modulate social cognition and neuropsychological function. Decreased AVP levels may be a marker of biological vulnerability in schizophrenia because alterations were seen in probands and relatives, and familiality was high.
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Affiliation(s)
- Leah H Rubin
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL;
| | - C Sue Carter
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC
| | - Jeffrey R Bishop
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL; Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL
| | | | - Lauren L Drogos
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL
| | - S Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | | | - Sarah K Keedy
- Department of Psychiatry, University of Chicago, Chicago, IL
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, IL
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Godfrey D Pearlson
- Department of Psychiatry and Neurobiology, Yale University and Olin Neuropsychiatric Research Center, Hartford, CT
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
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Facial emotion recognition in first-episode schizophrenia and bipolar disorder with psychosis. Schizophr Res 2014; 153:32-7. [PMID: 24457036 PMCID: PMC3959580 DOI: 10.1016/j.schres.2014.01.009] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/03/2014] [Accepted: 01/06/2014] [Indexed: 11/22/2022]
Abstract
Patients with schizophrenia and bipolar disorder have difficulties recognizing facial expressions of emotion. Differences in deficits between these disorders and the effects of treating acute symptoms of illness with antipsychotic medication on these deficits are not well characterized. First-episode patients with schizophrenia (n=24) and psychotic bipolar I disorder (n=16) were compared to a healthy control group (n=32) on the Penn Emotional Acuity Test. Patients were studied during an acute psychotic episode and after seven weeks of treatment with antipsychotic medication. During acute psychosis, bipolar patients showed deficits recognizing subtle facial expressions of happiness and sadness, and this deficit did not resolve with treatment. Schizophrenia patients similarly had difficulty recognizing subtle happy faces during acute illness that also did not resolve with treatment. In addition, problems recognizing subtle expressions of sadness among schizophrenia patients were apparent after treatment. Poorer emotion recognition at follow-up was related to negative symptom severity for schizophrenia patients. These findings highlight the severity and persistence of emotion recognition deficits early in the course of psychotic bipolar disorder and schizophrenia, and demonstrate an association of emotion processing deficits to negative symptoms in schizophrenia during periods of relative clinical stability.
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David DP, Soeiro-de-Souza MG, Moreno RA, Bio DS. Facial emotion recognition and its correlation with executive functions in bipolar I patients and healthy controls. J Affect Disord 2014; 152-154:288-94. [PMID: 24211178 DOI: 10.1016/j.jad.2013.09.027] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 09/06/2013] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The ability to recognize facial emotions is altered in patients with Bipolar Disorder (BD) during mood episodes and even in euthymia, while cognitive functioning is similarly impaired. This recognition is considered a fundamental skill for successful social interaction. However, it is unclear whether the ability to recognize facial emotions is correlated with the cognitive deficits observed in BD. OBJECTIVE The objective of this study was to evaluate Facial Emotion Recognition (FER) and its correlation with executive function (EF) in BD I patients during mania, depression and euthymia compared to healthy controls. MATERIAL AND METHODS A total of 110 patients with BD I, 18-40 years old were included (41 in manic episode; 31 in depressive episode and 38 euthymic). Patients were assessed for FER and EF (Wisconsin card sorting test - WCST), along with 96 healthy volunteers (18-40 years old) recruited from the University of São Paulo. RESULTS The results showed that BD I patients had lower FER performance compared to controls on fear subtests, happiness, the surprise test, and FER total scores. Moreover, BD I manic patients showed poorer performance for EF compared to controls. Six out of the seven variables of the WCST correlated with FER in both healthy controls and BD euthymic subjects but not in BD patients during mood episodes. CONCLUSION Cognitive deficits and difficulties recognizing facial emotions are present in all mood episodes in BD I patients, even during remission. Although FER is not considered a cognitive domain, these results suggest that, along with EF, it has a complementary function. Hence, further studies should investigate this issue in larger samples and verify whether these similarities also occur at a neurobiological level.
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Affiliation(s)
- Denise Petresco David
- Mood Disorders Unit (GRUDA), Department and Institute of Psychiatry, School of Medicine, University of São Paulo (IPQ HC-FMUSP), Brazil.
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Benito A, Lahera G, Herrera S, Muncharaz R, Benito G, Fernández-Liria A, Montes JM. Deficits in recognition, identification, and discrimination of facial emotions in patients with bipolar disorder. BRAZILIAN JOURNAL OF PSYCHIATRY 2013; 35:435-8. [DOI: 10.1590/1516-4446-2013-1086] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 05/06/2013] [Indexed: 11/22/2022]
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Pan YJ, Tseng HH, Liu SK. Affect recognition across manic and euthymic phases of bipolar disorder in Han-Chinese patients. J Affect Disord 2013; 151:791-794. [PMID: 23871128 DOI: 10.1016/j.jad.2013.06.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/15/2013] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
Abstract
Patients with bipolar disorder (BD) have affect recognition deficits. Whether affect recognition deficits constitute a state or trait marker of BD has great etiopathological significance. The current study aims to explore the interrelationships between affect recognition and basic neurocognitive functions for patients with BD across different mood states, using the Diagnostic Analysis of Non-Verbal Accuracy-2, Taiwanese version (DANVA-2-TW) as the index measure for affect recognition. To our knowledge, this is the first study examining affect recognition deficits of BPD across mood states in the Han Chinese population. Twenty-nine manic patients, 16 remitted patients with BD, and 40 control subjects are included in the study. Distinct association patterns between affect recognition and neurocognitive functions are demonstrated for patients with BD and control subjects, implicating alternations in emotion associated neurocognitive processing. Compared to control subjects, manic patients but not remitted subjects perform significantly worse in the recognition of negative emotions as a whole and specifically anger, after adjusting for differences in general intellectual ability and basic neurocognitive functions. Affect recognition deficit may be a relatively independent impairment in BD rather than consequences arising from deficits in other basic neurocognition. The impairments of manic patients in the recognition of negative emotions, specifically anger, may further our understanding of core clinical psychopathology of BD and have implications in treating bipolar patients across distinct mood phases.
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Affiliation(s)
- Yi-Ju Pan
- Far Eastern Memorial Hospital, Taipei, Taiwan; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shi-Kai Liu
- Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Centre for Addiction and Mental Health, Toronto, ON, Canada.
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40
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Van Rheenen TE, Rossell SL. Is the non-verbal behavioural emotion-processing profile of bipolar disorder impaired? A critical review. Acta Psychiatr Scand 2013; 128:163-78. [PMID: 23550737 DOI: 10.1111/acps.12125] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2013] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Growing evidence suggests that patients with bipolar disorder (BD) are impaired in their ability to process non-verbal emotion, although few comprehensive reviews of the behavioural literature exist, and there has been little consideration of methodological issues that may account for discrepant empirical findings. This review examines the behavioural facial, prosodic and multimodal processing literature in BD and discusses methodological issues in the context of this evidence. METHOD Major computer databases including Google Scholar and PsychINFO were consulted to conduct a comprehensive review of quantitative behavioural differences in the emotion-processing literature in BD. Articles were accepted only if the target population sample met criteria for a DSM-III, DSM-IV or ICD-10 diagnosis, and they contained a healthy control group. RESULTS The current literature suggests that facial emotion processing is impaired, and there is preliminary evidence for some behavioural impairment in the processing of emotional prosody. CONCLUSION The specificity or generalisability of impairments in facial emotion processing and the effects of mood state are unclear. Similarly, the lack of clarity around the impact of auditory processes on emotional prosody processing warrants a comprehensive examination of the auditory profile in BD.
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Affiliation(s)
- T E Van Rheenen
- Brain and Psychological Sciences Research Centre, Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Vic., Australia.
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Loi F, Vaidya JG, Paradiso S. Recognition of emotion from body language among patients with unipolar depression. Psychiatry Res 2013; 209:40-9. [PMID: 23608159 PMCID: PMC3935379 DOI: 10.1016/j.psychres.2013.03.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 02/20/2013] [Accepted: 03/02/2013] [Indexed: 10/26/2022]
Abstract
Major depression may be associated with abnormal perception of emotions and impairment in social adaptation. Emotion recognition from body language and its possible implications to social adjustment have not been examined in patients with depression. Three groups of participants (51 with depression; 68 with history of depression in remission; and 69 never depressed healthy volunteers) were compared on static and dynamic tasks of emotion recognition from body language. Psychosocial adjustment was assessed using the Social Adjustment Scale Self-Report (SAS-SR). Participants with current depression showed reduced recognition accuracy for happy stimuli across tasks relative to remission and comparison participants. Participants with depression tended to show poorer psychosocial adaptation relative to remission and comparison groups. Correlations between perception accuracy of happiness and scores on the SAS-SR were largely not significant. These results indicate that depression is associated with reduced ability to appraise positive stimuli of emotional body language but emotion recognition performance is not tied to social adjustment. These alterations do not appear to be present in participants in remission suggesting state-like qualities.
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Affiliation(s)
- Felice Loi
- Millharbour PICU, Tower Hamlets Centre for Mental Health, Mile End Hospital, London, UK
| | - Jatin G. Vaidya
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Sergio Paradiso
- Una Mano per la Vita, Association of Families and their Doctors, via Cristoforo Colombo n. 13, San Giovanni La Punta (CT) 95030, Italy
- Psychology & Neuroscience, Division of Humanities & Social Sciences, California Institute of Technology, Pasadena, CA, USA
- Universidad Diego Portales, Santiago, Chile
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Hukic DS, Frisén L, Backlund L, Lavebratt C, Landén M, Träskman-Bendz L, Edman G, Schalling M, Ösby U. Cognitive manic symptoms in bipolar disorder associated with polymorphisms in the DAOA and COMT genes. PLoS One 2013; 8:e67450. [PMID: 23861766 PMCID: PMC3702534 DOI: 10.1371/journal.pone.0067450] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Accepted: 05/17/2013] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Bipolar disorder is characterized by severe mood symptoms including major depressive and manic episodes. During manic episodes, many patients show cognitive dysfunction. Dopamine and glutamate are important for cognitive processing, thus the COMT and DAOA genes that modulate the expression of these neurotransmitters are of interest for studies of cognitive function. METHODOLOGY Focusing on the most severe episode of mania, a factor was found with the combined symptoms of talkativeness, distractibility, and thought disorder, considered a cognitive manic symptoms (CMS) factor. 488 patients were genotyped, out of which 373 (76%) had talkativeness, 269 (55%) distractibility, and 372 (76%) thought disorder. 215 (44%) patients were positive for all three symptoms, thus showing CMS (Table 1). As population controls, 1,044 anonymous blood donors (ABD) were used. Case-case and case-control design models were used to investigate genetic associations between cognitive manic symptoms in bipolar 1 disorder and SNPs in the COMT and DAOA genes. [Table: see text]. RESULTS The finding of this study was that cognitive manic symptoms in patients with bipolar 1 disorder was associated with genetic variants in the DAOA and COMT genes. Nominal association for DAOA SNPs and COMT SNPs to cognitive symptoms factor in bipolar 1 disorder was found in both allelic (Table 2) and haplotypic (Table 3) analyses. Genotypic association analyses also supported our findings. However, only one association, when CMS patients were compared to ABD controls, survived correction for multiple testing by max (T) permutation. Data also suggested interaction between SNPs rs2391191 in DAOA and rs5993883 in COMT in the case-control model. [Table: see text] [Table: see text]. CONCLUSION Identifying genes associated with cognitive functioning has clinical implications for assessment of prognosis and progression. Our finding are consistent with other studies showing genetic associations between the COMT and DAOA genes and impaired cognition both in psychiatric disorders and in the general population.
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Affiliation(s)
- Dzana Sudic Hukic
- Neurogenetics Unit, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
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43
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Emotion perception abnormalities across sensory modalities in bipolar disorder with psychotic features and schizophrenia. Schizophr Res 2013; 147:287-92. [PMID: 23611243 DOI: 10.1016/j.schres.2013.04.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2012] [Revised: 03/28/2013] [Accepted: 04/01/2013] [Indexed: 11/24/2022]
Abstract
Emotion perception deficits are a well-established feature of schizophrenia (SZ). Individuals with SZ have difficulty labeling emotional stimuli across auditory, visual, and audio-visual modalities and also misattribute threat towards neutral stimuli. The relationship between a history of psychosis and similar abnormalities in bipolar disorder (BD) is less clear. The current study set out to examine emotion perception across sensory modalities in a sample of 24 stabilized individuals meeting criteria for SZ, 24 remitted individuals meeting criteria for BD with psychotic features, 24 remitted individuals meeting criteria for BD without psychotic features, and 24 healthy controls. Results indicated that the bipolar with psychotic features group had intermediary performance between the SZ group and the other two groups for auditory, visual, and audio-visual items, with particularly poor performance in identifying angry stimuli. The SZ group misattributed neutral stimuli as negative when they were in visual format, but as positive when they were in auditory or audio-visual formats. The bipolar with psychotic features group had a trend towards misattributing more neutral visual stimuli as negative. These findings indicate that emotion perception deficits are present in BD with psychotic features and comparatively spared in BD without psychotic features, and that a similar bias of misattributing negative emotions to neutral visual stimuli may be present across diagnostic boundaries.
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Goghari VM, Sponheim SR. More pronounced deficits in facial emotion recognition for schizophrenia than bipolar disorder. Compr Psychiatry 2013; 54:388-97. [PMID: 23218816 PMCID: PMC3600398 DOI: 10.1016/j.comppsych.2012.10.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 10/16/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022] Open
Abstract
Schizophrenia and bipolar disorder are typically separated in diagnostic systems. Behavioral, cognitive, and brain abnormalities associated with each disorder nonetheless overlap. We evaluated the diagnostic specificity of facial emotion recognition deficits in schizophrenia and bipolar disorder to determine whether select aspects of emotion recognition differed for the two disorders. The investigation used an experimental task that included the same facial images in an emotion recognition condition and an age recognition condition (to control for processes associated with general face recognition) in 27 schizophrenia patients, 16 bipolar I patients, and 30 controls. Schizophrenia and bipolar patients exhibited both shared and distinct aspects of facial emotion recognition deficits. Schizophrenia patients had deficits in recognizing angry facial expressions compared to healthy controls and bipolar patients. Compared to control participants, both schizophrenia and bipolar patients were more likely to mislabel facial expressions of anger as fear. Given that schizophrenia patients exhibited a deficit in emotion recognition for angry faces, which did not appear due to generalized perceptual and cognitive dysfunction, improving recognition of threat-related expression may be an important intervention target to improve social functioning in schizophrenia.
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Affiliation(s)
- Vina M Goghari
- Departments of Psychology and Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada T2N 1N4.
| | - Scott R Sponheim
- Minneapolis Veteran’s Affairs Healthcare System and Departments of Psychiatry and Psychology, University of Minnesota
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45
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Collin L, Bindra J, Raju M, Gillberg C, Minnis H. Facial emotion recognition in child psychiatry: a systematic review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:1505-1520. [PMID: 23475001 DOI: 10.1016/j.ridd.2013.01.008] [Citation(s) in RCA: 101] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 01/13/2013] [Accepted: 01/17/2013] [Indexed: 06/01/2023]
Abstract
This review focuses on facial affect (emotion) recognition in children and adolescents with psychiatric disorders other than autism. A systematic search, using PRISMA guidelines, was conducted to identify original articles published prior to October 2011 pertaining to face recognition tasks in case-control studies. Used in the qualitative synthesis were: 2 studies on schizophrenia, 18 on mood disorders, 16 on anxiety disorders, 4 on eating disorders, 14 on ADHD and 9 on conduct disorder. Our review suggests that there are abnormalities in facial emotion recognition in a wide range of child psychiatric disorders and that these are likely to have a negative effect on both family and peer relationships. Scope for further research has been identified.
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Affiliation(s)
- Lisa Collin
- NHS Greater Glasgow and Clyde, United Kingdom
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Mercer L, Becerra R. A unique emotional processing profile of euthymic bipolar disorder? A critical review. J Affect Disord 2013; 146:295-309. [PMID: 23218848 DOI: 10.1016/j.jad.2012.10.030] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 10/24/2012] [Accepted: 10/24/2012] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To undertake a critical review of the literature on emotional processing (EP) in bipolar patients in remission. This literature review focuses on a number of dimensions of EP including facial emotion recognition, emotional memory, affective theory of mind (ToM), affective attention and affective auditory information processing. METHODS A systematic search was conducted through PsychINFO and Medline databases to obtain relevant literature. Studies that include behavioural measures of EP were included. RESULTS The findings from this review demonstrate that bipolar disorder (BD) patients continue to exhibit some EP deficits during euthymic phases. A number of factors believed to contribute to such findings have been highlighted. CONCLUSIONS This review has shed light on some of the conflicting findings reported in the literature and thus offers a more comprehensive profile of euthymic bipolar patients' EP abilities. This information could enrich clinicians' therapeutic efforts to minimise relapse by attending to euthymic bipolar patients' specific emotional processing difficulties.
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Affiliation(s)
- L Mercer
- Edith Cowan University, Perth, Western Australia, Australia
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Dean AM, Goodby E, Ooi C, Nathan PJ, Lennox BR, Scoriels L, Shabbir S, Suckling J, Jones PB, Bullmore ET, Barnes A. Speed of facial affect intensity recognition as an endophenotype of first-episode psychosis and associated limbic-cortical grey matter systems. Psychol Med 2013; 43:591-602. [PMID: 22703698 DOI: 10.1017/s0033291712001341] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psychotic disorders are highly heritable such that the unaffected relatives of patients may manifest characteristics, or endophenotypes, that are more closely related to risk genes than the overt clinical condition. Facial affect processing is dependent on a distributed cortico-limbic network that is disrupted in psychosis. This study assessed facial affect processing and related brain structure as a candidate endophenotype of first-episode psychosis (FEP). METHOD Three samples comprising 30 FEP patients, 30 of their first-degree relatives and 31 unrelated healthy controls underwent assessment of facial affect processing and structural magnetic resonance imaging (sMRI) data. Multivariate analysis (partial least squares, PLS) was used to identify a grey matter (GM) system in which anatomical variation was associated with variation in facial affect processing speed. RESULTS The groups did not differ in their accuracy of facial affect intensity rating but differed significantly in speed of response, with controls responding faster than relatives, who responded faster than patients. Within the control group, variation in speed of affect processing was significantly associated with variation of GM density in amygdala, lateral temporal cortex, frontal cortex and cerebellum. However, this association between cortico-limbic GM density and speed of facial affect processing was absent in patients and their relatives. CONCLUSIONS Speed of facial affect processing presents as a candidate endophenotype of FEP. The normal association between speed of facial affect processing and cortico-limbic GM variation was disrupted in FEP patients and their relatives.
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Affiliation(s)
- A M Dean
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, UK.
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Deficits in emotion recognition in pediatric bipolar disorder: the mediating effects of irritability. J Affect Disord 2013; 144:134-40. [PMID: 22963899 PMCID: PMC3513629 DOI: 10.1016/j.jad.2012.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Accepted: 06/12/2012] [Indexed: 02/01/2023]
Abstract
BACKGROUND Pediatric Bipolar Disorder (PBD) is a debilitating condition associated with impairment in many domains. Social functioning is one of the disorder's most notable areas of impairment and this deficit may be in part due to difficulties recognizing affect in others. METHODS In the present study, medication naïve youth with PBD were compared to age-matched healthy controls on their ability to (a) distinguish between categorical emotions, such as happiness, anger, and sadness on the Emotion Recognition Test (ER-40) and (b) differentiate between levels of emotional intensity on an adapted version of the Penn Emotional Acuity Task (Chicago-PEAT). RESULTS Results indicated that PBD youth misidentified sad, fearful, and neutral faces more often than controls, and PBD girls mislabeled 'very angry' faces more often than healthy girls. A mediation analyses indicated that these diagnostic group differences on emotion recognition were significantly mediated by irritability. LIMITATIONS The Chicago-PEAT only examined variations in emotional intensity for the emotions happy and anger. Additionally, all results are correlational; therefore causal inferences cannot be made. CONCLUSIONS Supporting previous literature, the present findings highlight the importance of emotion recognition deficits in PBD individuals. Additionally, the irritability associated with PBD may be an important mechanism of this deficit and may thus represent an important target for treatment.
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Bio DS, Soeiro de-Souza MG, Otaduy MCG, Machado-Vieira R, Moreno RA. The impact of limbic system morphology on facial emotion recognition in bipolar I disorder and healthy controls. Neuropsychiatr Dis Treat 2013; 9:743-51. [PMID: 23723706 PMCID: PMC3666908 DOI: 10.2147/ndt.s41896] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Impairments in facial emotion recognition (FER) have been reported in bipolar disorder (BD) subjects during all mood states. This study aims to investigate the impact of limbic system morphology on FER scores in BD subjects and healthy controls. MATERIAL AND METHODS Thirty-nine euthymic BD I (type I) subjects and 40 healthy controls were subjected to a battery of FER tests and examined with 3D structural imaging of the amygdala and hippocampus. RESULTS The volume of these structures demonstrated a differential pattern of influence on FER scores in BD subjects and controls. In our control sample, larger left and right amygdala demonstrated to be associated to less recognition of sadness faces. In BD group, there was no impact of amygdala volume on FER but we observed a negative impact of the left hippocampus volume in the recognition of happiness while the right hippocampus volume positively impacted on the scores of happiness. CONCLUSION Our results indicate that amygdala and hippocampus volumes have distinct effects on FER in BD subjects compared to controls. Knowledge of the neurobiological basis of the illness may help to provide further insights on the role of treatments and psychosocial interventions for BD. Further studies should explore how these effects of amygdala and hippocampus volumes on FER are associated with social networks and social network functioning.
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Fakra E, Dubois M, Adida M, Corréard N, Kaladjian A, Mazzola P, Belzeaux R, Cermolacce M, Azorin JM. Les endophénotypes émotionnels dans les troubles bipolaires et la schizophrénie. Encephale 2012; 38 Suppl 3:S93-7. [DOI: 10.1016/s0013-7006(12)70085-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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