Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-23T03:53:30.604Z Has data issue: false hasContentIssue false
  • English
  • Français

Combined Processing of Facial and Vocal Emotion in Remitted Patients With Bipolar I Disorder

Published online by Cambridge University Press:  07 February 2019

Christine M. Hoertnagl Open the ORCID record for Christine M. Hoertnagl [Opens in a new window] ,
Falko Biedermann ,
Nursen Yalcin-Siedentopf ,
Anna-Sophia Welte ,
Beatrice Frajo-Apor Open the ORCID record for Beatrice Frajo-Apor [Opens in a new window] ,
Eberhard A. Deisenhammer ,
Armand Hausmann ,
Georg Kemmler ,
Moritz Muehlbacher  and
Alex Hofer
Christine M. Hoertnagl*
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Falko Biedermann
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Nursen Yalcin-Siedentopf
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Anna-Sophia Welte
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Beatrice Frajo-Apor
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Eberhard A. Deisenhammer
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Armand Hausmann
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Georg Kemmler
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
Moritz Muehlbacher
Affiliation:
Private Medical University Salzburg, Department of Psychiatry and Psychotherapy, Salzburg, Austria
Alex Hofer
Affiliation:
Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Innsbruck, Austria
*
Correspondence and reprint requests to: Christine Hoertnagl, Medical University Innsbruck, Department of Psychiatry, Psychotherapy and Psychosomatics, Division of Psychiatry I, Anichstrasse 35, A-6020 Innsbruck, Austria. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: Bipolar disorder (BD) is associated with impairments in facial emotion and emotional prosody perception during both mood episodes and periods of remission. To expand on previous research, the current study investigated cross-modal emotion perception, that is, matching of facial emotion and emotional prosody in remitted BD patients. Methods: Fifty-nine outpatients with BD and 45 healthy volunteers were included into a cross-sectional study. Cross-modal emotion perception was investigated by using two subtests out of the Comprehensive Affective Testing System (CATS). Results: Compared to control subjects patients were impaired in matching sad (p < .001) and angry emotional prosody (p = .034) to one of five emotional faces exhibiting the corresponding emotion and significantly more frequently matched sad emotional prosody to happy faces (p < .001) and angry emotional prosody to neutral faces (p = .017). In addition, patients were impaired in matching neutral emotional faces to the emotional prosody of one of three sentences (p = .006) and significantly more often matched neutral faces to sad emotional prosody (p = .014). Conclusions: These findings demonstrate that, even during periods of symptomatic remission, patients suffering from BD are impaired in matching facial emotion and emotional prosody. As this type of emotion processing is relevant in everyday life, our results point to the necessity to provide specific training programs to improve psychosocial outcomes. (JINS, 2019, 25, 336–342)

Keywords

Cross-modal emotion perceptionFacial expressionLinguistic expressionBipolar disorder
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 25 , Issue 3 , March 2019 , pp. 275 - 284
Copyright
Copyright © The International Neuropsychological Society 2019 

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

REFERENCES

Altshuler, L.L., Post, R.M., Black, D.O., Keck, P.E. Jr., Nolen, W.A., Frye, M.A., … Mintz, J. (2006). Sub-syndromal depressive symptoms are associated with functional impairment in patients with bipolar disorder: Results of a large, multisite study. Journal of Clinical Psychiatry, 67, 1551–1560.Google Scholar
American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders. (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Anderson, A.K., & Phelps, E.A. (2001). Lesions of human amygdala impair enhanced perception of emotionally salient events. Nature, 411, 305–309.Google Scholar
Bilderbeck, A.C., Atkinson, L.Z., Geddes, J.R., Goodwin, G.M., & Harmer, C.J. (2017). The effects of medication and current mood upon facial emotion recognition: Findings from a large bipolar disorder cohort study. Journal of Psychopharmacology, 31, 320–326.Google Scholar
Bora, E., Yücel, M., & Pantelis, C. (2010). Cognitive impairment in affective psychoses: A meta-analysis. Schizophrenia Bulletin, 36, 112–125.Google Scholar
Bozikas, V.P., Kosmidis, M.H., Tonia, T., Andreou, C., Focas, K., & Karavatos, A. (2007). Impaired perception of affective prosody in remitted patients with bipolar disorder. The Journal of Neuropsychiatry & Clinical Neurosciences, 19, 436–440.Google Scholar
Burdick, K.E., Russo, M., Frangou, S., Mahon, K., Braga, R.J., Shanahan, M., & Malhotra, A.K. (2014). Empirical evidence for discrete neurocognitive subgroups in bipolar disorder: Clinical implications. Psychological Medicine, 44, 3083–3096.Google Scholar
Calder, J., Keane, T., Manly, R., Sprengelmeyer, R., Scott, S., Nimmo-Smith, I., & Young, A.W. (2003). Facial expression recognition across the adult life span. Neuropsychologia, 41, 195–202.Google Scholar
Coryell, W., Scheftner, W., Keller, M., Endicott, J., Maser, J., & Klermann, G.L. (1993). The enduring psychosocial consequences of mania and depression. American Journal of Psychiatry, 150, 720–727.Google Scholar
DeGelder, B., & Vroomen, J., (2000). The perception of emotion by ear and by eye. Cognition and Emotion, 14, 289–311.Google Scholar
Derntl, B., Seidel, E.M., Kryspin-Exner, I., Hasmann, A., & Dobmeier, M. (2009). Facial emotion recognition in patients with bipolar I and bipolar II disorder. British Journal of Clinical Psychology, 48, 363–375.Google Scholar
Drevets, W.C., Price, J.L., Bardgett, M.E., Reich, T., Todd, R.D., & Raichle, M.E. (2002). Glucose metabolism in the amygdala in depression: Relationship to diagnostic subtype and plasma cortisol levels. Pharmacology Biochemistry, & Behavior, 71, 431–447.Google Scholar
Fazel, S., Zetterqvist, L., Larsson, H., Langström, N., & Lichtenstein, P. (2014). Antipsychotics, mood stabilisers, and risk of violent crime. Lancet, 384, 1206–1214.Google Scholar
Frajo-Apor, B., Kemmler, G., Pardeller, S., Plass, T., Mühlbacher, M., Welte, A.S., … Hofer, A. (2017). Emotional intelligence and non-social cognition in schizophrenia and bipolar I disorder. Psychological Medicine, 47, 35–42.Google Scholar
Franke, G.H. (2000). BSI - Brief Symptom Inventory. von L. R. Derogatis (Kurzform der SCL-90-R) - Deutsche Version - Manual. Göttingen: Beltz Test GmbH.Google Scholar
Froming, K.B., Gregory, A., Levy, C.M., & Ekman, P. (2003). The Comprehensive Affective Testing System. User’s Manual. Gainesville, FL: Psychology Software Tools, Inc.Google Scholar
Gutierrez-Rojas, L., Gurpegui, M., Ayuso-Mateos, J.L., Gutierrez-Ariza, J.A., Ruiz-Veguilla, M., & Jurado, D. (2008). Quality of life in bipolar disorder patients: A comparison with a general population sample. Bipolar Disorder, 10, 625–634.Google Scholar
Goghari, V.M., & Sponheim, S.R. (2012). More pronounced deficits in facial emotion recognition for schizophrenia that bipolar disorder. Comprehensive Psychiatry, 4, 388–397.Google Scholar
Hafeman, D.M., Chang, K.D., Garrett, A.S., Sanders, E.M., & Phillips, M.L. (2012). Effects of medication on neuroimaging findings in bipolar disorder: An updated review. Bipolar Disorders, 14, 375–410.Google Scholar
Hall, J.A. (1984). Nonverbal sex differences, communication accuracy and expressive style. Baltimore, MD: John Hopkins University Press.Google Scholar
Harmer, C.J., Grayson, L., & Goodwin, G.M. (2002). Enhanced recognition of disgust in bipolar illness. Biological Psychiatry, 51, 298–304.Google Scholar
Hoertnagl, C.M., Muehlbacher, M., Biedermann, F., Yalcin, N., Baumgartner, S., Schwitzer, G., … Hofer, A. (2011). Facial emotion recognition and its relationship to subjective and functional outcomes in remitted patients with bipolar I disorder. Bipolar Disorders, 13, 537–544.Google Scholar
Hoertnagl, C.M., Yalcin-Siedentopf, N., Baumgartner, S., Biedermann, F., Deisenhammer, E.A., Hausmann, A., … Hofer, A. (2014). Affective prosody perception in symptomatically remitted patients with schizophrenia and bipolar disorder. Schizophrenia Research, 158, 100–104.Google Scholar
Hoertnagl, C.M., Biedermann, F., Yalcin-Siedentopf, N., Muehlbacher, M., Rauch, A.S., Baumgartner, S., … Hofer, A. (2015). Prosodic and semantic affect perception in remitted patients with bipolar I disorder. Journal of Clinical Psychiatry, 76, e779–786. doi:10.4088/JCP.14m08990.Google Scholar
Hofer, A., Biedermann, F., Yalcin, N., & Fleischhacker, W.W. (2014). Neurocognition and social cognition in patients with schizophrenia or mood disorder [article in German]. Neuropsychiatry, 24, 161–169.Google Scholar
Ketter, T.A., Kimbrell, T.A., George, M.S., Dunn, R.T., Speer, A.M., Benson, B.E., … Post, R.M. (2001). Effect of mood and subtype on cerebral glucose metabolism in treatment-resistant bipolar disorder. Biological Psychiatry, 49, 97–109.Google Scholar
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, 303–309.Google Scholar
Kreifelts, B., Ethofer, T., Grodd, W., Erb, M., & Wildgruber, D. (2007). Audiovisual integration of emotional signals in voice and face: An event-related fMRI study. Neuroimage, 37, 1445–1456.Google Scholar
Lawrence, A.D., Calder, A.J., McGowan, S.W., & Grasby, P.M. (2002). Selective disruption of the recognition of facial expressions of anger. NeuroReport, 13, 881–884.Google Scholar
Lawrence, A.D., Evans, A.H., & Lees, A.J. (2003). Compulsive use of dopamine replacement therapy in Parkinson’s disease: Reward systems gone awry? Lancet Neurology, 2, 596–604.Google Scholar
Lawrence, N.S., Williams, A.M., Surguladze, S., Giampietro, V., Brammer, M.J., Andrew, C., … Phillips, M.L. (2004). Subcortical and ventral prefrontal cortical neural responses in facial expressions distinguish patients with bipolar disorder and major depression. Biological Psychiatry, 55, 578–587.Google Scholar
Lembke, A., & Ketter, T.A., 2002. Impaired recognition of facial emotion in mania. American Journal of Psychiatry, 159, 302–304.Google Scholar
Montagne, B., Kessels, R.P., Frigerio, E., de Haan, E.H., & Perrett, D.I. (2005). Sex differences in the perception of affective facial expressions: Do men really lack emotional sensitivity? Cognitive Processing, 6, 136–141.Google Scholar
Montgomery, S.A., & Åsberg, M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134, 382–389.Google Scholar
Robinson, L.J., & Ferrier, I.N. (2006). Evolution of cognitive impairment in bipolar disorder: A systematic review of cross-sectional evidence. Bipolar Disorders, 8, 103–116.Google Scholar
Paulmann, S., & Pell, M.D. (2011). Is there an advantage for recognizing multi-modal emotional stimuli? Motivation and Emotion, 35, 192–201.Google Scholar
Robinson, L.J., Gray, J.M., Burt, M., Ferrier, N., & Gallagher, P. (2015). Processing of facial emotion in bipolar depression and euthymia. Journal of the International Neuropsychological Society, 21, 709–721.Google Scholar
Rich, B.A., Vinton, D.T., Roberson-Nay, R., Hommer, R.E., Berghorst, L.H., McClure, E.B., … Leibenluft, E. (2006). Limbic hyperactivation during processing of neutral facial expressions in children with bipolar disorder. Proceedings of the National Academy of Sciences of the United States of America, 103, 8900–8905.Google Scholar
Rossell, S.L., Van Rheenen, T.E., Groot, C., Gogos, A., O’Regan, A., & Joshua, N.R. (2013). Investigating affective prosody in psychosis: A study using the Comprehensive Affective Testing System. Psychiatry Research, 210, 896–900.Google Scholar
Rossell, S.L., Van Rheenen, T.E., Joshua, N.R., O’Regan, A., & Gogos, A. (2013). Investigating facial affect perception in psychosis. A study using the Comprehensive Affective Testing System. Schizophrenia Research, 157, 55–59.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.Google Scholar
Simon, G.E., Bauer, M.S., Ludman, E.J., Operskalski, B.H., & Unutzer, J. (2007). Mood symptoms, functional impairment, and disability in people with bipolar disorder: Specific effects of mania and depression. Journal of Clinical Psychiatry, 68, 1237–1245.Google Scholar
Tohen, M., Hennen, J., Zarate, C.M. Jr., Baldessarini, R.J., Strakowski, S.M., Stoll, A. L., … Cohen, B.M. (2000). Two-year syndromal and functional recovery in 219 cases of first-episode major affective disorder with psychotic features. American Journal of Psychiatry, 157, 220–228.Google 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, 163–178.Google Scholar
Van Rheenen, T.E., & Rossell, S.L. (2014). Let’s face it: Facial emotion processing is impaired in bipolar disorder. Journal of the International Neuropsychological Society, 20, 200–208.Google Scholar
Vaskinn, A., Sundet, K., Friis, S., Simonsen, C., Birkenaes, A.B., Engh, J.A., … Andreassen, O.A., 2007. The effect of gender on emotion perception in schizophrenia and bipolar disorder. Acta Psychiatrica Scandinavica, 116, 263–270.Google Scholar
Vedermann, A.C., Weisenbach, S.L., Rapport, L.J., Leon, H.M., Hase, 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, 1027–1034.Google Scholar
Venn, H.R., Gray, J.M., Montagne, B., Murray, L.K., Burt, D.M., Frigerio, E., … Young, A.H. (2004). Perception of facial expression of emotion in bipolar disorder. Bipolar Disorders, 6, 286–293.Google Scholar
Wessa, M., & Linke, J. (2009). Emotional processing in bipolar disorder: Behavioural and neuroimaging findings. International Review of Psychiatry (Abingdon, England), 21, 357–367.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, 440–445.Google Scholar
Young, R.C., Biggs, J.T., Ziegler, V.E., & Meyer, D.A. (1978). A rating scale for mania: Reliability, validity and sensitivity. The British Journal of Psychiatry, 133, 429–435.Google Scholar