Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-25T15:10:50.890Z Has data issue: false hasContentIssue false

Processing of Facial Emotion in Bipolar Depression and Euthymia

Published online by Cambridge University Press:  19 October 2015

Lucy J. Robinson
Affiliation:
School of Psychology, Newcastle University, United Kingdom
John M. Gray
Affiliation:
Institute of Neuroscience (Academic Psychiatry), Newcastle University, United Kingdom
Mike Burt
Affiliation:
Department of Psychology, University of Durham, United Kingdom
I. Nicol Ferrier
Affiliation:
Institute of Neuroscience (Academic Psychiatry), Newcastle University, United Kingdom
Peter Gallagher*
Affiliation:
Institute of Neuroscience (Academic Psychiatry), Newcastle University, United Kingdom Newcastle University Institute for Ageing, Newcastle University, United Kingdom
*
Correspondence and reprint requests to: Peter Gallagher, Institute of Neuroscience & Newcastle University Institute for Ageing, Henry Wellcome Building, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK. E-mail: [email protected]

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)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Addington, J., & Addington, D. (1998). Facial affect recognition and information processing in schizophrenia and bipolar disorder. Schizophrenia Research, 32(3), 171181.Google Scholar
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the Mind in the Eyes” Test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42(2), 241251.CrossRefGoogle ScholarPubMed
Bellack, A.S., Blanchard, J.J., & Mueser, K.T. (1996). Cue availability and affect perception in schizophrenia. Schizophrenia Bulletin, 22(3), 535544. doi:10.1093/schbul/22.3.535 CrossRefGoogle ScholarPubMed
Benton, A., Sivan, A., Hamsher, K., Varney, N., & Spreen, O. (1983). Contribution to neuropsychological assessment. NY: Oxford University Press.Google Scholar
Bonnín, C.M., Martínez-Arán, A., Torrent, C., Pacchiarotti, I., Rosa, A.R., Franco, C., & Vieta, E. (2010). Clinical and neurocognitive predictors of functional outcome in bipolar euthymic patients: A long-term, follow-up study. Journal of Affective Disorders, 12, 156160.Google Scholar
Bozikas, V.P., Tonia, T., Fokas, K., Karavatos, A., & Kosmidis, M.H. (2006). Impaired emotion processing in remitted patients with bipolar disorder. Journal of Affective Disorders, 91(1), 5356.CrossRefGoogle ScholarPubMed
Chapman, L.J., & Chapman, J.P. (1973). Problems in the measurement of cognitive deficit. Psychological Bulletin, 79(6), 380385.Google Scholar
Edwards, J., Pattison, P.E., Jackson, H.J., & Wales, R.J. (2001). Facial affect and affective prosody recognition in first-episode schizophrenia. Schizophrenia Research, 48(2–3), 235253. doi:http://dx.doi.org/10.1016/S0920-9964(00)00099-2 Google Scholar
Ekman, P., & Friesen, W.V. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Fagiolini, A., Kupfer, D.J., Masalehdan, A., Scott, J.A., Houck, P.R., & Frank, E. (2005). Functional impairment in the remission phase of bipolar disorder. Bipolar Disorders, 7(3), 281285.Google Scholar
First, M.B., Spitzer, R.L., Williams, J.B.W., & Gibbon, M. (1995). Structured Clinical Interview for DSM-IV (SCID-IV). New York: Biometrics Research Department, New York State Psychiatric Institute.Google Scholar
Gallagher, P., Gray, J.M., Watson, S., Young, A.H., & Ferrier, I.N. (2014). Neurocognitive functioning in bipolar depression: A component structure analysis. Psychological Medicine, 44(5), 961974. doi:10.1017/s0033291713001487 CrossRefGoogle ScholarPubMed
Getz, G.E., Shear, P.K., & Strakowski, S.M. (2003). Facial affect recognition deficits in bipolar disorder. Journal of the International Neuropsychological Society, 9(4), 623632.CrossRefGoogle ScholarPubMed
Goetz, I., Tohen, M., Reed, C., Lorenzo, M., & Vieta, E. (2007). Functional impairment in patients with mania: Baseline results of the EMBLEM study. Bipolar Disorders, 9(1-2), 4552. doi:10.1111/j.1399-5618.2007.00325.x Google Scholar
Gold, J.M., Barker, J.D., Barr, S., Bittner, J.L., Bromfield, W.D., Chu, N., & Srinath, A. (2013). The efficiency of dynamic and static facial expression recognition. Journal of Vision, 13(5). doi:10.1167/13.5.23 Google Scholar
Gray, J., Venn, H., Montagne, B., Murray, L., Burt, M., Frigerio, E., & Young, A.H. (2006). Bipolar patients show mood-congruent biases in sensitivity to facial expressions of emotion when exhibiting depressed symptoms, but not when exhibiting manic symptoms. Cognitive Neuropsychiatry, 11(6), 505520. doi:10.1080/13546800544000028 Google Scholar
Green, M.J., Cahill, C.M., & Malhi, G.S. (2007). The cognitive and neurophysiological basis of emotion dysregulation in bipolar disorder. Journal of Affective Disorders, 103, 2942. doi:10.1016/jjad.2007.01.024 Google Scholar
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 5662.Google Scholar
Hariri, A.R., Bookheimer, S.Y., & Mazziotta, J.C. (2000). Modulating emotional responses: Effects of a neocortical network on the limbic system. Neuroreport, 11(1), 4348.Google Scholar
Harmer, C.J., Grayson, L., & Goodwin, G.M. (2002). Enhanced recognition of disgust in bipolar illness. Biological Psychiatry, 51(4), 298304.Google Scholar
Jongen, E.M.M., Smulders, F.T.Y., Ranson, S.M.G., Arts, B.M.G., & Krabbendam, L. (2007). Attentional bias and general orienting processes in bipolar disorder. Journal of Behavior Therapy and Experimental Psychiatry, 38(2), 168183.Google Scholar
Judd, L.L., Akiskal, H.S., Schettler, P.J., Endicott, J., Maser, J., Solomon, D.A., &Keller, M.B. (2002). The long-term natural history of the weekly symptomatic status of bipolar I disorder. Archives of General Psychiatry, 59(6), 530537.Google Scholar
Judd, L.L., Akiskal, H.S., Schettler, P.J., Coryell, W., Endicott, J., Maser, J.D., &Keller, M.B. (2003). A prospective investigation of the natural history of the long-term weekly symptomatic status of bipolar II disorder. Archives of General Psychiatry, 60(3), 261269.CrossRefGoogle ScholarPubMed
Kohler, C.G., Hoffman, L.J., Eastman, L.B., Healey, K., & Moberg, P.J. (2011). Facial emotion perception in depression and bipolar disorder: A quantitative review. Psychiatry Research, 188(3), 303309. doi:10.1016/j.psychres.2011.04.019 Google Scholar
Krumhuber, E.G., Kappas, A., & Manstead, A.S.R. (2013). Effects of dynamic aspects of facial expressions: A review. Emotion Review, 5(1), 4146.Google Scholar
Lee, J., Altshuler, L., Glahn, D.C., Miklowitz, D.J., Ochsner, K., & Green, M.F. (2013). Social and nonsocial cognition in bipolar disorder and schizophrenia: Relative levels of impairment. American Journal of Psychiatry, 170(3), 334341. doi:10.1176/appi.ajp.2012.12040490 Google Scholar
Lembke, A., & Ketter, T.A. (2002). Impaired recognition of facial emotion in mania. American Journal of Psychiatry, 159(2), 302304.Google Scholar
Leppanen, J.M. (2006). Emotional information processing in mood disorders: A review of behavioral and neuroimaging findings. Current Opinion in Psychiatry, 19(1), 3439.Google Scholar
MacQueen, G.M., Young, L.T., & Joffe, R.T. (2001). A review of psychosocial outcome in patients with bipolar disorder. Acta Psychiatrica Scandinavica, 103(3), 163170.Google Scholar
Martino, D.J., Strejilevich, S.A., Fassi, G., Marengo, E., & Igoa, A. (2011). Theory of mind and facial emotion recognition in euthymic bipolar I and bipolar II disorders. Psychiatry Research, 189(3), 379384. doi:http://dx.doi.org/10.1016/j.psychres.2011.04.033 Google Scholar
Miklowitz, D.J. (2011). Functional impairment, stress, and psychosocial intervention in bipolar disorder. Current Psychiatry Report, 13(6), 504512. doi:10.1007/s11920-011-0227-x CrossRefGoogle ScholarPubMed
Montagne, B., Kessels, R.P., de Haan, E.H., & Perrett, D.I. (2007). The Emotion Recognition Task: a paradigm to measure the perception of facial emotional expressions at different intensities. Perceptual and Motor Skills, 104(2), 589598.Google Scholar
Robinson, L.J. (2010). Neuropsychological performance, emotion processing and psychosocial function in bipolar disorder. PhD, Newcastle University, Newcastle upon Tyne.Google Scholar
Rowland, J.E., Hamilton, M.K., Vella, N., Lino, B.J., Mitchell, P.B., & Green, M.J. (2012). Adaptive associations between social cognition and emotion regulation are absent in schizophrenia and bipolar disorder. Frontiers in Psychology, 3, 607.Google ScholarPubMed
Rubinsztein, J.S., Michael, A., Underwood, B.R., Tempest, M., & Sahakian, B.J. (2006). Impaired cognition and decision-making in bipolar depression but no ‘affective bias’ evident. Psychological Medicine, 36(5), 629639.CrossRefGoogle ScholarPubMed
Samamé, C., Martino, D.J., & Strejilevich, S.A. (2015). An individual task meta-analysis of social cognition in euthymic bipolar disorders. Journal of Affective Disorders, 173, 146153.Google Scholar
Sanchez-Moreno, J., Martinez-Aran, A., Tabares-Seisdedos, R., Torrent, C., Vieta, E., & Ayuso-Mateos, J.L. (2009). Functioning and disability in bipolar disorder: An extensive review. Psychotherapy & Psychosomatics, 78(5), 285297. doi:10.1159/000228249 [doi].Google Scholar
Schaefer, K.L., Baumann, J., Rich, B.A., Luckenbaugh, D.A., & Zarate, C.A. Jr. (2010). Perception of facial emotion in adults with bipolar or unipolar depression and controls. Journal of Psychiatric Research, 44(16), 12291235. doi:10.1016/j.jpsychires.2010.04.024 Google Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., &Dunbar, G.C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33; 3457.Google Scholar
Summers, M., Papadopoulou, K., Bruno, S., Cipolotti, L., & Ron, M.A. (2006). Bipolar I and bipolar II disorder: Cognition and emotion processing. Psychological Medicine, 36(12), 17991809.CrossRefGoogle ScholarPubMed
Thaler, N.S., Strauss, G.P., Sutton, G.P., Vertinski, M., Ringdahl, E.N., Snyder, J.S., &Allen, D.N. (2013). Emotion perception abnormalities across sensory modalities in bipolar disorder with psychotic features and schizophrenia. Schizophrenia Research, 147(2–3), 287292. doi:http://dx.doi.org/10.1016/j.schres.2013.04.001 Google Scholar
Thompson, J.M., Gallagher, P., Hughes, J.H., Watson, S., Gray, J.M., Ferrier, I.N., &Young, A.H. (2005). Neurocognitive impairment in euthymic patients with bipolar affective disorder. British Journal of Psychiatry, 186, 3240.Google Scholar
Tiddeman, B., Burt, M., & Perrett, D. (2001). Prototyping and transforming facial textures for perception research. IEEE Computer Graphics and Applications, 21(5), 4250. doi:10.1109/38.946630 CrossRefGoogle Scholar
Van Rheenen, T.E., & Rossell, S.L. (2013). Is the non-verbal behavioural emotion-processing profile of bipolar disorder impaired? A critical review. Acta Psychiatrica Scandinavica, 128(3), 163178. doi:10.1111/acps.12125 Google Scholar
Van Rheenen, T.E., & Rossell, S.L. (2014a). Let’s face it: Facial emotion processing is impaired in bipolar disorder. Journal of the International Neuropsychological Society, 20(2), 200208. doi:10.1017/s1355617713001367 Google Scholar
Van Rheenen, T.E., & Rossell, S.L. (2014b). Objective and subjective psychosocial functioning in bipolar disorder: An investigation of the relative importance of neurocognition, social cognition and emotion regulation. Journal of Affective Disorders, 162(0), 134141. doi:http://dx.doi.org/10.1016/j.jad.2014.03.043 Google Scholar
Vaskinn, A., Sundet, K., Friis, S., Simonsen, C., Birkenaes, A.B., Engh, J.A., & Andreasse, O.A. (2007). The effect of gender on emotion perception in schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica, 116(4), 263270. doi:10.1111/j.1600-0447.2007.00991.x CrossRefGoogle ScholarPubMed
Vederman, A.C., Weisenbach, S.L., Rapport, L.J., Leon, H.M., Haase, B.D., Franti, L.M., & Mcinnis, M.G. (2012). Modality-specific alterations in the perception of emotional stimuli in bipolar disorder compared to healthy controls and major depressive disorder. Cortex, 48(8), 10271034. doi:http://dx.doi.org/10.1016/j.cortex.2011.03.017 Google Scholar
Venn, H.R., Gray, J.M., Montagne, B., Murray, L.K., Michael Burt, D., Frigerio, E., &Young, A.H. (2004). Perception of facial expressions of emotion in bipolar disorder. Bipolar Disorders, 6(4), 286293.Google Scholar
Wechsler, D. (1981). WAIS-R manual, Wechsler Adult Intelligence Scale-Revised. Cleveland, OH: Psychological Corporation.Google Scholar
Wessa, M., & Linke, J. (2009). Emotional processing in bipolar disorder: Behavioural and neuroimaging findings. International Review of Psychiatry, 21(4), 357367. doi:10.1080/09540260902962156 Google Scholar
Yalcin-Siedentopf, N., Hoertnagl, C.M., Biedermann, F., Baumgartner, S., Deisenhammer, E.A., Hausmann, A., &Hofer, A. (2014). Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder. Schizophrenia Research, 152(2–3), 440445. doi:http://dx.doi.org/10.1016/j.schres.2013.11.024 Google Scholar
Young, A., Perret, D., Calder, A., Sprengelmeyer, R., & Ekman, P. (2002). Facial expressions of emotion: Stimuli and tests (FEEST). Bury, St. Edmunds: Thames Valley Test Company.Google Scholar
Young, R., Biggs, J., Ziegler, V., & Meyer, D. (1978). A rating scale for mania: Eeliability, validity and sensitivity. British Journal of Psychiatry, 133(5), 429435.Google Scholar