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10-09-2012 | Mental health | Article

Emotion recognition problematic for BD youth


Free abstract

medwireNews: Children with bipolar disorder (BD) are less able to identify certain facial expressions of emotion than other children, research shows.

Stewart Shankman and colleagues from the University of Illinois in Chicago, USA, found that pediatric patients with BD misidentified sad, fearful, and neutral faces significantly more often than children without BD.

They also found that irritability was a significant mediator of the relationship between diagnosis and performance on facial emotion recognition tasks.

"One interpretation of this effect is that youths with pediatric BD may be too focused on their own feelings of irritability to correctly recognize the facial expressions of others," says the team.

"As recognition of emotional faces is closely related to the ability to empathize with others' emotional state, these results suggest that irritability may be a proximal factor in this critical interpersonal skill and potentially the overall interpersonal deficits observed in pediatric BD."

The researchers studied 98 medication-naïve children, aged 8-17 years, with BD and 104 mentally healthy children (controls). There were no significant differences between the groups regarding age or ethnicity.

Affect recognition was assessed using the Emotion Recognition Task (ER-40) and a variant of the Pediatric Emotional Acuity Task (Chicago-PEAT).

For the ER-40, participants viewed 40 adult faces and indicated whether they thought the face was happy, sad, angry, fearful, or neutral. And for the Chicago-PEAT, participants viewed 40 faces of adults, adolescents, and children and were asked to decide whether the face was very happy, moderately happy, slightly happy, neutral, slightly angry, moderately angry, or very angry.

In the ER-40, both groups performed best at correctly identifying happy faces and worst at identifying angry faces, and there were no significant differences between the groups at identifying these two facial expressions of emotion. However, pediatric BD patients correctly identified significantly fewer sad, fearful, and neutral faces than controls.

In the Chicago-PEAT, the two groups did not differ significantly at identifying the intensity of happy faces. However, pediatric BD patients were less accurate at identifying the intensity of angry faces compared with controls. This was mainly driven by girls with BD performing significantly worse than control girls at identifying very angry faces.

Irritability mediated the relationship between diagnosis and accuracy score for sad and fearful faces on the ER-40, and the relationship between diagnosis and correct valence score for very angry faces on the Chicago-PEAT.

Shankman et al conclude: "The results suggest that individuals with pediatric BD have deficits in identifying sad, fearful and very intense angry faces and that irritability may be an important mediator of these deficits."

They add: "As correctly identifying the emotions of others is a key component of adaptive interpersonal functioning, one clinical implication of these results is that psychosocial interventions should address this deficit, perhaps by targeting the irritability observed in pediatric BD."

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Mark Cowen, Senior medwireNews Reporter

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