“Facial Emotion Labeling Deficits in Children and Adolescents at Risk for Bipolar Disorder,”

National Institute of Mental Health (NIMH), 베서스다, Maryland, United States
American Journal of Psychiatry (Impact Factor: 12.3). 04/2008; 165(3):385-9. DOI: 10.1176/appi.ajp.2007.06122050
Source: PubMed


Research has revealed facial emotion labeling deficits in children and adolescents with bipolar disorder. To assess whether such impairments may be an endophenotype for bipolar disorder, the authors examined facial emotion identification proficiency in children who were at risk for bipolar disorder because they had a first-degree relative with the illness.
The facial expressions subtests of the Diagnostic Analysis of Nonverbal Accuracy scale were administered to 52 patients with bipolar disorder, 24 at-risk youths, and 78 control subjects, all 4-18 years of age.
Compared with the control group, both the bipolar and at-risk groups made more errors identifying facial emotions. The number of errors did not differ significantly between the bipolar and at-risk groups.
Deficits in facial emotion labeling may be a risk marker for bipolar disorder. Further study is needed to determine the neural mechanisms involved, as well as to explore other emotional processing impairments in youths at risk for bipolar disorder and to identify genetic associations.

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Available from: Brendan A Rich
    • "In addition to neuropsychological functioning, emotion processing and higher-order social cognitive impairments (such as face processing and theory of mind deficits) have been identified in BD irrespective of mood state (Olley et al. 2005; Montag et al. 2010; Schenkel et al. 2014) and in a few studies of unaffected relatives of bipolar-I disorder (BD-I) patients (McClure et al. 2005; Brotman et al. 2008). There is also some evidence that social cognitive performance may be worse in BD-I relative to bipolar-II disorder (BD-II) (Schenkel et al. 2014). "
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    ABSTRACT: Impairments in key neuropsychological domains (e.g. working memory, attention) and social cognitive deficits have been implicated as intermediate (endo) phenotypes for bipolar disorder (BD), and should therefore be evident in unaffected relatives. Method Neurocognitive and social cognitive ability was examined in 99 young people (age range 16–30 years) with a biological parent or sibling diagnosed with the disorder [thus deemed to be at risk (AR) of developing BD], compared with 78 healthy control (HC) subjects, and 52 people with a confirmed diagnosis of BD. Results Only verbal intelligence and affective response inhibition were significantly impaired in AR relative to HC participants; the BD participants showed significant deficits in attention tasks compared with HCs. Neither AR nor BD patients showed impairments in general intellectual ability, working memory, visuospatial or language ability, relative to HC participants. Analysis of BD-I and BD-II cases separately revealed deficits in attention and immediate memory in BD-I patients (only), relative to HCs. Only the BD (but not AR) participants showed impaired emotion recognition, relative to HCs. Conclusions Selective cognitive deficits in the capacity to inhibit negative affective information, and general verbal ability may be intermediate markers of risk for BD; however, the extent and severity of impairment in this sample was less pronounced than has been reported in previous studies of older family members and BD cases. These findings highlight distinctions in the cognitive profiles of AR and BD participants, and provide limited support for progressive cognitive decline in association with illness development in BD.
    No preview · Article · Dec 2015 · Psychological Medicine
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    • "Indeed, schizophrenia (Strauss et al., 2010), bipolar disorder (McClure et al., 2005; Brotman et al., 2008b), and depression (Schepman et al., 2012) all typically manifest first in adolescence and are associated with deficits in face emotion identification. Moreover, face emotion labeling deficits are present in adolescents at risk for developing these disorders (Brotman et al., 2008a; Lopez-Duran et al., 2013), suggesting that face emotion labeling deficits may develop in tandem with socio-emotional symptoms. Facial emotion labeling deficits in adolescents with or at risk for depression are particularly apparent with more subtle faces compared to full-intensity faces (Schepman et al., 2012; Lopez-Duran et al., 2013). "
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    ABSTRACT: Adolescence is a time of increased risk for the onset of psychological disorders associated with deficits in face emotion labeling. We used fMRI to examine age-related differences in brain activation while adolescents and adults labeled the emotion on fearful, happy, and angry faces of varying intensities (0% (i.e., neutral), 50%, 75%, 100%). Adolescents and adults did not differ on accuracy to label emotions. In the superior temporal sulcus, ventrolateral prefrontal cortex, and middle temporal gyrus, adults show an inverted-U-shaped response to increasing intensities of fearful faces and a U-shaped response to increasing intensities of happy faces, whereas adolescents show the opposite patterns. In addition, adults, but not adolescents, show greater inferior occipital gyrus activation to negative (angry, fearful) versus positive (happy) emotions. In sum, when subjects classify subtly varying facial emotions, developmental differences manifest in several "ventral stream" brain regions. Charting the typical developmental course of the brain mechanisms of socio-emotional processes, such as facial emotion labeling, is an important focus for developmental psychopathology research. Published by Oxford University Press 2015. This work is written by US Government employees and is in the public domain in the US.
    Full-text · Article · Aug 2015 · Social Cognitive and Affective Neuroscience
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    • "Cognitive deficits likely underlie these observed social skills impairments. Youth with PBD have difficulty recognizing emotional prosody in spoken language (Deveney et al. 2012) and identifying emotional facial expressions (Brotman et al. 2008; Schenkel et al. 2007), particularly in peers' faces (McClure et al. 2005). Such deficits would likely impair an adolescent's ability to form close friendships, as other work shows that mutual empathy and understanding is contingent upon accurately reading others' social cues and responding appropriately (Keenan-Miller et al. 2012). "
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    ABSTRACT: Background Pediatric bipolar disorder (PBD) is associated with psychosocial impairment, but few studies have examined peer relationship functioning and PBD. Adolescence is a crucial developmental period when peers become increasingly salient. Objective This study compared perceived friendship quality and peer victimization in adolescents with PBD to external community benchmarks and to adolescents with other psychopathology. We also measured the association between peer difficulties and current mood symptoms across diagnoses. Methods Participants were 189 adolescents, ages 10–17 years (46 % female; 58 % African American, 32 % Caucasian, 10 % Other), recruited from a community mental health center (n = 73) and an academic medical center (n = 116). Diagnoses were made via semi-structured diagnostic interviews. Adolescents completed questionnaires to assess peer relationship functioning and mood symptoms. Caregivers completed a questionnaire to assess adolescents’ mood symptoms. Results Adolescents with PBD reported significantly fewer positive and negative qualities in a close friendship and more relational victimization than external community controls. There were no significant differences between adolescents with PBD and those with other psychopathology. Depression and (hypo)mania were both associated with more negative friendship quality and peer victimization. Conclusions Adolescents with psychiatric disorders reported more peer difficulties than an external community sample, but difficulties were not specific to PBD. Mood symptoms were problematic for perceived close friendship quality and peer victimization in youth with a variety of psychiatric diagnoses. Results suggest that treatments targeting mood symptoms may improve peer relationships and those with an interpersonal focus may be particularly helpful to address mood symptoms.
    Full-text · Article · Jun 2015 · Child and Youth Care Forum
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