Biased Recognition of Facial Affect in Patients with Major Depressive Disorder Reflects Clinical State

Abstract

Cognitive theories of depression posit that perception is negatively biased in depressive disorder. Previous studies have provided empirical evidence for this notion, but left open the question whether the negative perceptual bias reflects a stable trait or the current depressive state. Here we investigated the stability of negatively biased perception over time. Emotion perception was examined in patients with major depressive disorder (MDD) and healthy control participants in two experiments. In the first experiment subjective biases in the recognition of facial emotional expressions were assessed. Participants were presented with faces that were morphed between sad and neutral and happy expressions and had to decide whether the face was sad or happy. The second experiment assessed automatic emotion processing by measuring the potency of emotional faces to gain access to awareness using interocular suppression. A follow-up investigation using the same tests was performed three months later. In the emotion recognition task, patients with major depression showed a shift in the criterion for the differentiation between sad and happy faces: In comparison to healthy controls, patients with MDD required a greater intensity of the happy expression to recognize a face as happy. After three months, this negative perceptual bias was reduced in comparison to the control group. The reduction in negative perceptual bias correlated with the reduction of depressive symptoms. In contrast to previous work, we found no evidence for preferential access to awareness of sad vs. happy faces. Taken together, our results indicate that MDD-related perceptual biases in emotion recognition reflect the current clinical state rather than a stable depressive trait.

Neurocognitive performance as an endophenotype for mood disorder subgroups

“…The association between MDD and enhanced social cognition, as measured by an emotion recognition task, is contrary to theory and meta-analytic results suggesting that emotion recognition is typically impaired in depression (Dalili et al, 2015; Demenescu et al, 2010; Kohler et al, 2011). This effect does appear to be moderated by clinical state or symptom severity (Munkler et al, 2015) and medication use. For example, fluoxetine administration has been shown to inhibit emotion recognition (Capitao et al, 2015).…”

“…For example, fluoxetine administration has been shown to inhibit emotion recognition (Capitao et al, 2015). In addition, previous research offers conflicting information about which specific emotions are impaired (Bourke et al, 2010; Dalili et al, 2015), or how much emotional intensity was required to identify a difference (Munkler et al, 2015). …”

“…Numerous studies have also examined the influence of current clinical state on cognitive performance in mood disorders (Bourne et al, 2013; Porter et al, 2015), with greater impairment among more severe and acute cases (Munkler et al, 2015). Several recent studies have controlled for clinical state and shown that some of the findings dissipate after controlling for state.…”

“…Impairments in social cognition have also been reported in both MDD and BPD, specifically for facial emotional identification and differentiation, as reported in a meta-analysis (Kohler et al, 2011). Studies of the extent to which these measures reflect current state versus trait (Robinson et al, 2015; Van Rheenen and Rossell, 2014) or severity (Munkler et al, 2015) have been inconsistent. Among patients with depression, a recent meta-analysis showed impaired recognition of emotion for angry, disgusted, fearful, happy and surprised faces, but not sad faces (Dalili et al, 2015).…”

The Comparison of Facial Emotion Recognition Ability in Women with and without Premenstrual Syndrome

“…Bu çalışmada, sağlıklılarla karşılaştırıldığında, major depresyonu olan hastaların mutlu bir yüzü mutlu olarak tanıması için duygunun daha yoğun gösterilmesine ihtiyaç duydukları gösterilmiştir. Üstelik üç ay sonra depresif belirtilerin azalmasıyla birlikte bu ihtiyaç da azalmıştır (Münkler 2015). Ayrıca bu duygudurumla uyumlu hatalar PMS'nin ağır formu olan premenstrüel disforik bozuklukta da (Rubinow ve ark.…”