Emotional Face Processing among Treatment-Seeking Individuals with Alcohol Use Disorders: Investigating Sex Differences and Relationships with Interpersonal Functioning

Abstract

Background Individuals in treatment for alcohol use disorder (AUD) display deficits across a broad range of cognitive processes. Disruptions in affective processing are understudied, but may be particularly important for interpersonal functioning and post-treatment adaptation. In particular, the role of sex in AUD-associated emotion processing deficits remains largely unaddressed and was a focus of the current investigation. Methods Fifty-six treatment seekers with AUD and 54 healthy community controls (N = 110) were administered an emotional face discrimination task. Non-affective tasks included a sex-discrimination task and two brief measures of executive functioning. Two measures of interpersonal function were included. Results Emotion processing deficits were evident among women with AUD relative to other groups. This sex-contingent relationship was not observed in measures of executive function, sex-discrimination or interpersonal problems, although individuals with AUD performed more poorly on these measures. Conclusions Results were consistent with extant literatures examining cognitive, affective and interpersonal functioning among individuals with AUD, and provided novel evidence of vulnerability to alcohol-associated deficits in emotion processing among women. While similar sex-contingent effects were not apparent among other measures, results support modest interrelationships, specifically including the import of emotion processing to interpersonal functioning in AUD. These data offer guidance for further systematic investigation and highlight important considerations for future relapse-prevention and recovery-facilitation efforts.

Neurophysiological and Interpersonal Correlates of Emotional Face Processing in Alcohol Use Disorder

“…Consistent with the larger sample reported in Lewis and colleagues (), GLMM analysis revealed a significant effect of group ( F (1,71) = 4.03, p = 0.048, with less accurate EFE identification among AUDs relative to CCs. There was also a) an emotion main effect, F (2, 142) = 128.76, p < 0.001, with accuracy being the highest for happy stimuli and lowest for sad stimuli ( t s ≥ 118.19, p s < 0.001) and b) an effect of morph level with higher accuracy scores at the 95% morph, F (1, 71) = 15.30, p < 0.001.…”

“…As anticipated on the basis of the larger sample (Lewis et al., ), higher IIP‐64 total scores were obtained in the AUD versus CC group, F (1, 71) = 13.17, p < 0.001. Novel to the current study are analyses conducted to explore group differences across the individual subscales.…”

“…Given the focus on N170 and P3 in published EFE work and the overarching objective of the current investigation, we constrained analysis to these components. We predicted that the AUD group would exhibit altered neurophysiological responses as reflected in the N170 and/or P3, as well as previously reported behavioral compromise (Lewis et al., ). Given published inconsistencies, we posed no differential hypothesis regarding the 2 event related potential (ERP) components.…”

“…Participants ( N = 73, 78% White/Caucasian, 18% Black, and 4% Other; AUD and CC groups were equivalent) included 34 inpatient treatment seekers meeting criteria for current alcohol use disorder (AUD; 6 women) and 39 healthy community controls (CCs; 24 women). This sample constitutes a subset of those reported in our recent work (Lewis et al., ) for whom neurophysiological measures were available. To determine eligibility, participants completed paper–pencil questionnaires addressing demographics and substance use histories including chronicity, quantity, and frequency of alcohol use (Quantity–Frequency Index; QFI, Cahalan et al., ).…”

“…Finally, as an exploratory analysis and to supplement our recent report (Lewis et al., ), we examined correlations between domains of interpersonal problems using the IIP‐64 (Horowitz et al, ) and EFE performance. In our prior report, we considered alcohol‐related effects on IIP‐64 total scores.…”