Emotional Priming With Facial Exposures in Euthymic Patients With Bipolar Disorder
Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea.The Journal of nervous and mental disease (Impact Factor: 1.69). 12/2011; 199(12):971-7. DOI: 10.1097/NMD.0b013e3182392903
People with bipolar disorder have abnormal emotional processing. We investigated the automatic and controlled emotional processing via a priming paradigm with subliminal and supraliminal facial exposure. We compared 20 euthymic bipolar patients and 20 healthy subjects on their performance in subliminal and supraliminal tasks. Priming tasks consisted of three different primes according to facial emotions (happy, sad, and neutral) followed by a neutral face as a target stimulus. The prime stimuli were presented subliminally (17 msec) or supraliminally (1000 msec). In subliminal tasks, both patients and controls judged the neutral target face as significantly more unpleasant (negative judgment shift) when presented with negative emotion primes compared with positive primes. In supraliminal tasks, bipolar subjects showed significant negative judgment shift, whereas healthy subjects did not. There was a significant group × emotion interaction for the judgment rate in supraliminal tasks. Our finding of persistent affective priming even at conscious awareness may suggest that bipolar patients have impaired cognitive control on emotional processing rather than automatically spreading activation of emotion.
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ABSTRACT: Pediatric bipolar disorder (PBD) often presents differently than adult onset bipolar disorder with mixed manic and depressive symptoms, higher incidence of comorbid attention deficit hyperactivity disorder, rapid cycling, and irritability. Biological factors include underactivity of the ventrolateral prefrontal cortex (VLPFC) activity and overactivity of the amygdala during emotion processing. The VLPFC underactivity and striatal overactivity is noted during response inhibition. Concordant findings are also noted with diffusion tensor imaging studies reporting compromised integrity of white matter tracts involving the fronto-striatal and fronto-limbic regions. These functional and structural findings underscore the combined affective and cognitive circuitry disturbances. Neurocognitive difficulties are common in the domains of executive function, attention, working memory, and verbal memory. There is increased fourfold genetic risk in inheriting PBD. Systematic pharmacotherapy algorithm exercises problem-solving strategies in mood stabilization and treatment of comorbidity. Family-focused and individual interventions incorporate cognitive behavioral and interpersonal psychotherapeutic techniques. These complementary multimodal treatment modules that foster resilience and avoid any perceived punitive approaches target the emotion dysregulation and reactivity that underlie the brain circuitry disturbances.
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ABSTRACT: Background: Borderline Personality Disorder (BPD) is characterized by severe deficits in social interactions, which might be linked to deficits in emotion recognition. Research on emotion recognition abilities in BPD revealed heterogeneous results, ranging from deficits to heightened sensitivity. The most stable findings point to an impairment in the evaluation of neutral facial expressions as neutral, as well as to a negative bias in emotion recognition; that is the tendency to attribute negative emotions to neutral expressions, or in a broader sense to report a more negative emotion category than depicted. However, it remains unclear which contextual factors influence the occurrence of this negative bias. Previous studies suggest that priming by preceding emotional information and also constrained processing time might augment the emotion recognition deficit in BPD. Methods: To test these assumptions, 32 female BPD patients and 31 healthy females, matched for age and education, participated in an emotion recognition study, in which every facial expression was preceded by either a positive, neutral or negative scene. Furthermore, time constraints for processing were varied by presenting the facial expressions with short (100 ms) or long duration (up to 3000 ms) in two separate blocks. Results: BPD patients showed a significant deficit in emotion recognition for neutral and positive facial expression, associated with a significant negative bias. In BPD patients, this emotion recognition deficit was differentially affected by preceding emotional information and time constraints, with a greater influence of emotional information during long face presentations and a greater influence of neutral information during short face presentations. Conclusions: Our results are in line with previous findings supporting the existence of a negative bias in emotion recognition in BPD patients, and provide further insights into biased social perceptions in BPD patients.
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