Impaired Facial Affect Perception in Unaffected Children at Familial Risk for Panic Disorder

Facial emotion recognition in panic disorder: a mini-review of behavioural studies

BACKGROUND

Panic Disorder (PD) is characterized by unexpected and repeated moments of intense fear or anxiety, which manifest themselves through strong cognitive and behavioural symptoms. However, a clear picture of how impairments in recognition and processing of facial emotions affect the everyday life of PD patients has yet to be delineated. This review attempts to provide an overview of behavioural studies of emotion detection from facial stimuli in PD patients.

METHODS

A bibliographic research on PubMed of all studies investigating the recognition and processing of facial emotion stimuli in patients with PD and in high-risk offspring was performed, and nine articles (yrs: 2000 to 2019) were discovered.

RESULTS

In several of the reviewed studies, PD patients showed significant deficits in detecting (particularly negative) emotions in facial stimuli. These impairments were also found in the offspring of parents with PD and high-risk individuals.

LIMITATIONS

Inferences are constrained by methodological heterogeneity, included but not limited to cross-study variability in the stimuli employed, and in the clinical characterization of PD patients.

CONCLUSIONS

In general, the results of this survey confirm that deficits in processing facially conveyed negative emotions should be considered a core impairment in PD. However, future larger and more homogenous studies are warranted to better highlight the connection between emotion recognition and PD.

Stress reactivity in healthy child offspring of parents with anxiety disorders

Several studies suggest that anxiety disorders (AD) involve dysregulation of the autonomic nervous system (ANS) and hypothalamic-pituitary (HPA) axis. However, it is unknown if alterations in these biological systems are premorbid markers of AD risk or a state-dependent feature of anxiety. This study examined ANS and HPA-axis response to a laboratory stressor in healthy child offspring of parents with (n = 55) and without (n = 98) a history of AD. High frequency heart rate variability (HF-HRV) was assessed during sitting and standing baseline conditions and during a speech task where participants remained standing. Salivary cortisol was measured at baseline and at 15, 30, 45 and 60 min post-speech. Subjective anxiety was assessed with a visual analogue scale. Children of parents with AD displayed reduced HRV and a blunted cortisol response to the speech task compared to children of non-anxious parents. No risk group effect was found for anxiety ratings. These preliminary data suggest that healthy children of anxious parents exhibit altered stress reactivity to an acute laboratory stressor. Further research is needed to confirm findings and identify mechanisms that may account for altered self-regulation processes to a stressor in children at familial risk for AD.