Lack of emotional gaze preferences using eye-tracking in remitted bipolar I disorder

Eye-tracking metrics during image viewing as possible biomarkers of cognitive alterations: A systematic review and meta-analysis in people with bipolar disorder

Eye-tracking metrics, such as fixation latency, fixation count, saccade amplitude, and gaze duration, are emerging digital biomarkers that can enhance our understanding of cognitive and emotional alterations in mental disorders. For bipolar disorder (BD), eye-tracking offers a promising approach to investigate the mechanisms underlying the deficits in attention, inhibitory control, and emotion processing. This meta-analysis examined the differences in eye-tracking metrics in individuals with BD compared to healthy controls (HCs) or individuals with other psychiatric conditions, while observing images with emotional or non-emotional content. A comprehensive search of the PubMed/MEDLINE, Scopus, and PsycINFO databases was conducted from inception to August 20, 2024. Studies investigating differences in eye-tracking metrics using an image viewing paradigm were reviewed, and meta-analyses were performed. Ten studies met the inclusion criteria: BD (n = 337) was compared to HCs (n = 352) in all ten studies, to major depressive disorder (n = 60) in two studies, and to schizophrenia (n = 22) in one study. Meta-analyses were only feasible for comparisons between BD and HCs. Individuals with BD exhibited higher latency for the first fixation, a reduced number of fixations, shorter gaze duration, and lower saccadic peak velocity and amplitude. Additionally, they showed shorter fixation durations only when viewing images with negative content. This report provides valuable insights into the cognitive and emotional difficulties faced by individuals with BD, which can guide the development of more targeted and effective assessments and interventions for this population.

Impaired emotional response inhibition among adolescents with bipolar depression: evidence from event-related potentials and behavioral performance

BACKGROUND

Impaired inhibition of inappropriate responses in the emotional context is a core feature in patients with bipolar disorder. However, there has been little research exploring the underlying mechanism of impaired response inhibition for emotional stimuli in adolescents with bipolar depression. To explore this issue, we employed event-related potentials (ERPs) to investigate the underlying neuroelectrophysiological mechanisms of inhibition of inappropriate emotional stimuli in adolescents with bipolar depression.

METHODS

Twenty-five adolescents with bipolar depression and nineteen healthy controls completed an emotional Go/No-Go task during electroencephalography recording. Reaction time (RT), reaction time variability (RTV), discriminability, and response bias were measured as behavioral performance indicators. ERP components, theta-band oscillation and inter-trial coherence (ITC) were compared between the two groups.

RESULTS

Behavioral performance analysis found that adolescents with bipolar depression showed smaller d' values, and larger RT and RTV, than healthy controls. Nogo-P3 amplitude was decreased in adolescents with bipolar depression in comparison with healthy controls. Theta-band oscillation and ITC for emotional stimuli were also reduced in adolescents with bipolar depression. Pearson correlation analysis showed there was a negative correlation between the Nogo-P3 amplitude induced by negative trials and RTV in adolescents with bipolar depression.

CONCLUSION

Our findings suggest that adolescents with bipolar depression exhibit abnormal response inhibition in the emotional context. Impaired attentional function and discrimination of emotional information are related to the failure of behavioral inhibition in negative emotional contexts, and attenuated P3 amplitude and theta-band oscillation could be an electrophysiological indicator for this impairment.

The Role of Eye Gaze in Regulating Turn Taking in Conversations: A Systematized Review of Methods and Findings

Eye gaze plays an important role in communication but understanding of its actual function or functions and the methods used to elucidate this have varied considerably. This systematized review was undertaken to summarize both the proposed functions of eye gaze in conversations of healthy adults and the methodological approaches employed. The eligibility criteria were restricted to a healthy adult population and excluded studies that manipulated eye gaze behavior. A total of 29 articles—quantitative, qualitative and mixed methods were returned, with a wide range of methodological designs. The main areas of variability related to number of conversants, their familiarity and status, conversation topic, data collection tools—video and eye tracking—and definitions of eye gaze. The findings confirm that eye gaze facilitates turn yielding, plays a role in speech monitoring, prevents and repairs conversation breakdowns and facilitates intentional and unintentional speech interruptions. These findings were remarkably consistent given the variability in methods across the 29 articles. However, in relation to turn initiation, the results were less consistent, requiring further investigation. This review provides a starting point for future studies to make informed decisions about study methods for examining eye gaze and selecting variables of interest.

Associations between hypomania proneness and attentional bias to happy, but not angry or fearful, faces in emerging adults

Mania, the core feature of bipolar disorder, is associated with heightened and positive emotion responding. Yet, little is known about the underlying cognitive processes that may contribute to heightened positive emotionality observed. Additionally, while previous research has investigated positive emotion biases in non-clinical samples, few if any, account for subthreshold clinical symptoms or traits, which have reliably assessed psychopathological risk. The present study compared continuous scores on a widely used self-report measure of hypomania proneness (HPS-48) with a dot-probe task to investigate attentional biases for happy, angry, fearful, and neutral faces among 66 college student participants. Results suggested that hypomania proneness was positively associated with attentional bias towards happy, but not angry or fearful faces. Results remained robust when controlling for positive affect and did not appear to be affected by negative affect or current symptoms of depression, anxiety, and stress. Findings provide insight into potential behavioural markers that co-occur with heightened positive emotional responding and hypomania in emerging adults.

Eye gaze and facial displays of emotion during emotional film clips in remitted patients with bipolar disorder

Background.

Aberrant emotional reactivity is a putative endophenotype for bipolar disorder (BD), but the findings of behavioral studies are often negative due to suboptimal sensitivity of the employed paradigms. This study aimed to investigate whether visual gaze patterns and facial displays of emotion during emotional film clips can reveal subtle behavioral abnormalities in remitted BD patients.

Methods.

Thirty-eight BD patients in full or partial remission and 40 healthy controls viewed 7 emotional film clips. These included happy, sad, and neutral scenarios and scenarios involving winning, risk-taking, and thrill-seeking behavior of relevance to the BD phenotype. Eye gaze and facial expressions were recorded during the film clips, and participants rated their emotional reactions after each clip.

Results.

BD patients showed a negative bias in both facial displays of emotion and self-rated emotional responses. Specifically, patients exhibited more fearful facial expressions during all film clips. This was accompanied by less positive self-rated emotions during the winning and happy film clips, and more negative emotions during the risk-taking/thrill-related film clips.

Conclusions.

These findings suggest that BD is associated with trait-related abnormalities in subtle behavioral displays of emotion processing. Future studies comparing patients with BD and unipolar depression are warranted to clarify whether these differences are specific to BD. If so, assessments of visual gaze and facial displays of emotion during emotional film clips may have the potential to be implemented in clinical assessments to aid diagnostic accuracy.

Affective cognition in bipolar disorder: A systematic review by the ISBD targeting cognition task force

BACKGROUND

Impairments in affective cognition are part of the neurocognitive profile and possible treatment targets in bipolar disorder (BD), but the findings are heterogeneous. The International Society of Bipolar Disorder (ISBD) Targeting Cognition Task Force conducted a systematic review to (i) identify the most consistent findings in affective cognition in BD, and (ii) provide suggestions for affective cognitive domains for future study and meta-analyses.

METHODS

The review included original studies reporting behavioral measures of affective cognition in BD patients vs controls following the procedures of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) statement. Searches were conducted on PubMed/MEDLINE, EMBASE, and PsychInfo from inception until November 2018.

RESULTS

A total of 106 articles were included (of which nine included data for several affective domains); 41 studies assessed emotional face processing; 23 studies investigated reactivity to emotional words and images; 3 investigated explicit emotion regulation; 17 assessed implicit emotion regulation; 31 assessed reward processing and affective decision making. In general, findings were inconsistent. The most consistent findings were trait-related difficulties in facial emotion recognition and implicit emotion regulation, and impairments in reward processing and affective decision making during mood episodes. Studies using eye-tracking and facial emotion analysis revealed subtle trait-related abnormalities in emotional reactivity.

CONCLUSION

The ISBD Task Force recommends facial expression recognition, implicit emotion regulation, and reward processing as domains for future research and meta-analyses. An important step to aid comparability between studies in the field would be to reach consensus on an affective cognition test battery for BD.

Looking on the bright side and seeing it vividly: interpretation bias and involuntary mental imagery are related to risk for bipolar disorder

BACKGROUND

Involuntary mental imagery is elevated among people with bipolar disorder, and has been shown to shape biases in interpretation of ambiguous information. However, it is not clear whether biases in interpretation of ambiguous scenarios can be observed in those at risk for bipolar disorder, or whether involuntary imagery is related to such a bias.

AIMS

In the present study, we extended a prominent model of bipolar cognition to an at-risk sample. We specifically tested whether positive interpretation bias and involuntary mental imagery are linked to a greater risk of bipolar disorder.

METHOD

Young adults (N = 169) completed measures of risk for bipolar disorder (the Hypomanic Personality Scale [HPS]), interpretation bias, and involuntary mental imagery.

RESULTS

Higher scores on the HPS were significantly correlated with more positive interpretations of ambiguous scenarios (β = 0.29, p <. 01) and more frequent involuntary mental imagery (β = 0.22, p < .01). There was no evidence of an interaction between interpretation bias and mental imagery in predicting HPS score, β = .04, p = .62.

CONCLUSIONS

Further research is warranted to determine if intrusive imagery or interpretation bias influence the development of bipolar disorder over time in those at risk.