Processing of Facial Emotion in Bipolar Depression and Euthymia

Abstract

Previous studies of facial emotion processing in bipolar disorder (BD) have reported conflicting findings. In independently conducted studies, we investigate facial emotion labeling in euthymic and depressed BD patients using tasks with static and dynamically morphed images of different emotions displayed at different intensities. Study 1 included 38 euthymic BD patients and 28 controls. Participants completed two tasks: labeling of static images of basic facial emotions (anger, disgust, fear, happy, sad) shown at different expression intensities; the Eyes Test (Baron-Cohen, Wheelwright, Hill, Raste, & Plumb, 2001), which involves recognition of complex emotions using only the eye region of the face. Study 2 included 53 depressed BD patients and 47 controls. Participants completed two tasks: labeling of “dynamic” facial expressions of the same five basic emotions; the Emotional Hexagon test (Young, Perret, Calder, Sprengelmeyer, & Ekman, 2002). There were no significant group differences on any measures of emotion perception/labeling, compared to controls. A significant group by intensity interaction was observed in both emotion labeling tasks (euthymia and depression), although this effect did not survive the addition of measures of executive function/psychomotor speed as covariates. Only 2.6–15.8% of euthymic patients and 7.8–13.7% of depressed patients scored below the 10th percentile of the controls for total emotion recognition accuracy. There was no evidence of specific deficits in facial emotion labeling in euthymic or depressed BD patients. Methodological variations—including mood state, sample size, and the cognitive demands of the tasks—may contribute significantly to the variability in findings between studies. (JINS, 2015, 21, 709–721)

Emotion processing and psychosocial functioning in euthymic bipolar disorder

“…As in our study, the effect size was large for most measures. In accordance with other results, several studies , but not all , have found emotion recognition deficits in EBP. Three recent meta‐analysis have confirmed a small but significant effect size (Cohen′s d < 0.5) for facial emotion recognition, similar to that observed in our study for the perceiving emotions branch.…”

“…Several studies have shown that patients with BD have emotion processing deficits not only during acute exacerbations of their illness, but also during periods of euthymia although not all studies could replicate those findings . In a recent meta‐analysis, no significant differences were observed between patients with BD and controls for facial affect recognition.…”

Neurocognitive performance as an endophenotype for mood disorder subgroups

“…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).…”

Facial Emotion Recognition Impairments in Bipolar Disorder. A Cognitive Problem?

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In their recent study investigating emotion recognition impairments in bipolar disorder (BD), Robinson et al (2015) report that two well-characterized groups of BD individuals failed to show performance deficits on a series of facial emotion processing tasks when compared to controls. This is in contrast to our findings of BD patient impairments on a similar set of facial emotion recognition measures in a group of stable outpatients in mixed mood states but with relatively minimal mean symptom severity .

Robinson et al state that methodological issues related to neurocognitive ability may account for some inconsistencies in the literature.

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