State-dependent alteration in face emotion recognition in depression

Spatio-temporal CNN-BiLSTM dynamic approach to emotion recognition based on EEG signal

In this paper, a hybrid CNN-BiLSTM model for EEG-based emotion detection system is presented. The proposed technique is developed by extracting features using Power Spectral Density (PSD) signal. The proposed approach is carried out by combining CNN and bidirectional LSTM models to increase the comprehension of context in sequential data. The proposed approach is tested on the widely-used SEED datasets for the accurate classification of milder emotions such as positive, negative and neutral. The proposed approach is designed with the effectiveness in extracting spatial features of CNN architecture and LSTM network are utilized for their capability in modeling temporal relationships in EEG signals. The proposed approach is robust because experimentally the proposed approach yields a rate of 97.5 % accuracy to categorize emotions, improving the performance of EEG-based emotion recognition systems, opening up new possibilities for developing advanced brain monitoring and real-time emotion-aware systems.

Transcutaneous vagus nerve stimulation improves emotional processing

BACKGROUND

Invasive vagus nerve stimulation (iVNS) is approved for the treatment of major depressive disorder (MDD). The limited understanding of its underlying mechanisms, however, hinders stratification and the prediction of treatment response. Given the strong projections of the afferent vagal nucleus to brain regions involved in emotional processing, we tested whether acute transauricular VNS (taVNS) can improve emotional processing that is a core deficit in MDD.

METHODS

We performed a randomized controlled trial. The facial emotion recognition task was performed by 52 participants with MDD and 44 controls during taVNS and sham stimulation. Linear mixed-effect models were used to evaluate the effect of taVNS.

RESULTS

At baseline, we found a negative bias across all participants with lower accuracy in detecting positive facial expressions (F(1, 173) = 17.39, p < 0.001) and more misclassification towards negative facial expressions (F(1, 173) = 13.73, p < 0.001). Acute taVNS improved the accuracy of detecting positive facial expressions across all participants (F(1, 90.26) = 6.49, p = 0.013), both at low and high intensity. Moreover, fewer negative emotional states as quantified by visual analogue scales were reported during taVNS (F(1, 85) = 5.34, p = 0.023). The effect of taVNS on ratings of positive emotional states was group-dependent (F(1, 86) = 4.20, p = 0.044), as only controls reported less positive emotions (t = 2.06, p = 0.042).

CONCLUSION

Independent of diagnosis acute taVNS has an impact on emotional processing. Future studies need to explore whether these acute effects can serve as a predictive marker for the long-term impact of taVNS.

Relationship between low mood and micro-expression processing: evidence of negative bias in interpreting fleeting facial expressions

Depression affects the recognition of emotion in facial expressions by reducing the detection accuracy and adding a bias towards negativity. However, no study has examined associations between depression and the recognition of microfacial expressions (fleeting facial cues of emotions in people's faces). Thus, we investigated associations between low mood and micro-expression processing using video stimuli of micro-expressions. We examined whether (i) individuals with low mood had trouble recognizing emotions, (ii) were more likely to perceive happy facial expressions as neutral and neutral facial expressions as sad, and (iii) recognized sad emotional expressions better than control subjects (n = 349). We found that participants with low mood showed poorer performance when judging emotions in faces (p = 0.03). Furthermore, there was a specific deficit among them in recognizing happiness. Lastly, participants with low moods were more likely to perceive neutral faces as sad (p = 0.042). However, no evidence was found that individuals with low moods confused happy faces as neutral or were better than the control group at recognizing sad faces. Our results show that mood affects the perception of emotions in facial expressions, which has the potential to negatively affect interpersonal interactions and ultimately quality of life.

The effect of emotion recognition and mindfulness on depression symptoms: A case-control study

Abnormalities in emotion recognition (ER) are frequently reported in depression, with lower recognition accuracy in patients with major depressive disorder (MDD) when compared to healthy individuals. Mindfulness was found to directly impact the severity of depressive symptoms, by recognizing negative cognitions and dysfunctional reactions. The aims of this study were to compare ER and mindfulness levels between MDD patients and healthy controls (HCs), as well as to examine whether ER and mindfulness are related to symptom severity in MDD patients. Sixty-eight patients with MDD and 93 HCs participated in the study. A sociodemographic form, reading the mind in the eyes test (RMET), five facet mindfulness questionnaire-short form (FFMQ-S) and the Montgomery-Asberg depression scale (MADRS) were administered. Group comparison in ER and mindfulness was performed using the multivariate analysis of covariance (MANCOVA). Bivariate correlations and hierarchical linear regression analyses were performed to assess the associations between depression severity, ER and mindfulness in the patient group. Higher level of mindfulness was found in HCs relative to MDD group, however, no ER difference was present between the groups. A positive association between depression severity and the non-reactivity facet of mindfulness was found. On the other hand, ER was not significantly associated with symptom severity among individuals with MDD. Non-reactivity, unlike other dimensions of mindfulness, seems to increase with the severity of depressive symptoms among MDD patients. A particular focus on this subdimension in mindfulness techniques may yield better outcomes in alleviation of depressive symptoms.

Transdiagnostic effects of therapist self-disclosure on diverse emotional experiences of clients with emotional disorders and schizophrenia

OBJECTIVE

Despite the clinical significance of emotional diversity, also known as emodiversity, there has been limited investigation into the therapeutic interventions that influence this construct. In the current study we examined the association between immediate therapist self-disclosure (TSD) and emodiversity among two diagnostic groups who tend to experience emotional difficulties: people with schizophrenia and people with emotional disorders (i.e., depression and/or anxiety).

METHOD

The sample comprised 74 clients (37 diagnosed with schizophrenia and 37 with emotional disorders) treated by 45 therapists in a university clinic setting. Following each session, clients self-reported their emotions, and therapists completed a measure of frequency and centrality of their immediate TSD during the session.

RESULTS

Longitudinal multilevel models indicated that immediate TSD was positively associated with clients' global emodiversity, both at the within- and the between-client levels, as well as with clients' negative emodiversity at the between-client level. Moreover, clients with emotional disorders and clients with schizophrenia did not differ in the association between immediate TSD and emodiversity. In addition, across groups, clients treated by therapists who used more immediate TSD on average showed greater increases in global emodiversity during treatment.

CONCLUSIONS

immediate TSD is associated with clients' ability to experience rich and diverse emotional experiences across different disorders. The theoretical and clinical implications of these findings are discussed.

Emotional Context Effects on the Rating of Ambiguous Facial Expressions in Depression and Schizophrenia Spectrum Disorders

ObjectiveTo investigate the influence of visual contextual information on emotion recognition of ambiguous facial expressions in depression and schizophrenia spectrum disorders. Method: Ambiguous facial expressions and emotional contexts representing anger, disgust, fear, joy, sadness and surprise were validated in a pre-test with healthy independent raters. Afterwards, 20 healthy participants (8 women, 12 men; mean age 24.35 ± 2.85 years), 20 participants with schizophrenia spectrum disorders (9 women, 11 men; mean age 40.25 ± 11.68 years) and 19 participants with depression (11 women, 8 men; mean age 43.74 ± 12.65 years) rated the emotional content of nine different faces in seven different emotion-suggesting contexts. The proportions of context-congruent answers and differences between emotion ratings in each context were analysed using non-parametric Kruskal-Wallis and explorative, paired Wilcoxon tests. Correlational analyses explored the influence of clinical symptoms assessed by clinician-administered scales. Results: The overall proportion of context-congruent answers did not differ between participants with depression and schizophrenia spectrum disorders compared to healthy participants. Participants with schizophrenia spectrum disorders were more susceptible to anger-suggesting contexts and participants with depression were more susceptible to fear-suggesting contexts. Differences in emotion recognition were associated with the severity of depressive, but not psychotic, symptoms. Conclusion: Despite increased susceptibility to anger-suggesting cues in schizophrenia and to fear-suggesting cues in depression, visual contextual influence remains largely consistent with healthy participants. Preserved emotional responsiveness suggests an efficacy of emotion training but emphasizes the need for additional research focusing on other factors contributing to social interaction deficits.

State-dependent alterations of implicit emotional dominance during binocular rivalry in subthreshold depression

Binocular rivalry, a visual perception phenomenon where two or more percepts alternate every few seconds when distinct stimuli are presented to the two eyes, has been reported as a biomarker in several psychiatric disorders. It is unclear whether abnormalities of binocular rivalry in depression could occur when emotional rivaling stimuli are used, and if so, whether an emotional binocular rivalry test could provide a trait-dependent or state-dependent biomarker. In the current study, 34 individuals with subthreshold depression and 31 non-depressed individuals performed a binocular rivalry task associated with implicit emotional processing. Participants were required to report their perceived orientations of the rival gratings in the foreground and to neglect emotional face stimuli in the background. The participants were retested after an approximately 4-month time interval. Compared to the non-depressed group, the subthreshold depression group showed significantly longer perceptual dominance durations of the grating with emotional faces as the background (i.e., implicit emotional dominance) at the initial assessment. However, the abnormality was not found at the follow-up assessment. More importantly, we found smaller changes in depressive severity at the follow-up assessment for individuals displaying longer emotional dominance at the initial assessment than for individuals with weaker emotional dominance. The current emotional binocular rivalry test may provide an objective, state-dependent biomarker for distinguishing individuals with subthreshold depression from non-depressed individuals.

Can you smell my stress? Influence of stress chemosignals on empathy and emotion recognition in depressed individuals and healthy controls

Human body odors contain chemical signals that play a key role in our non-verbal communication regarding health, genetic identity, immune system, fitness, and emotional state. Studies on human chemosignaling in individuals with psychiatric diseases are scarce but indicate altered smell perception and emotion recognition in depressed individuals. In the present project, we aimed to investigate the influence of chemosensory substances in social stress sweat on emotion recognition, perspective taking, affective responsiveness as well as stress level in healthy and depressed individuals. Therefore, chemosensory stimuli (sweat samples from Trier social stress test (TSST) and friendly-TSST (fTSST)) were obtained from 39 healthy participants (19 females). In a next step, chemosensory stimuli and an odor-free blank (cotton pad) were used to stimulate another group of 40 healthy participants (20 females) and 37 individuals with depression (24 females). Those stimuli were examined regarding their influence on subjective feelings of stress, emotion perception and empathic reactions using an empathy test. Furthermore, physiological data (breathing, heart rate, skin conductance response, stress hormones) of the participants were collected during chemosensory stimulation. Depressed individuals improved their ability of perspective taking and affective responsiveness for the emotion grief when presented with stress chemosignals compared to no chemosignals. Healthy individuals remained unaffected regarding perspective taking and affective responsiveness. Both depressed and healthy individuals showed no increased stress hormone cortisol and α-amylase values during the social stress chemosignals condition, but reduced values for fTSST condition compared to no chemosignals respectively. The results imply that stress chemosignals do not trigger a stress reaction, but for depressed individuals they lead to a better emotion assessment for grief. This research contributes to a deeper understanding of the effects of social stress chemosignals on healthy and depressed individuals. Knowing the impact of human chemosignals on emotional processing is crucial for a better understanding of non-verbal human interaction.

Emotion recognition in EEG signals using deep learning methods: A review

Emotions are a critical aspect of daily life and serve a crucial role in human decision-making, planning, reasoning, and other mental states. As a result, they are considered a significant factor in human interactions. Human emotions can be identified through various sources, such as facial expressions, speech, behavior (gesture/position), or physiological signals. The use of physiological signals can enhance the objectivity and reliability of emotion detection. Compared with peripheral physiological signals, electroencephalogram (EEG) recordings are directly generated by the central nervous system and are closely related to human emotions. EEG signals have the great spatial resolution that facilitates the evaluation of brain functions, making them a popular modality in emotion recognition studies. Emotion recognition using EEG signals presents several challenges, including signal variability due to electrode positioning, individual differences in signal morphology, and lack of a universal standard for EEG signal processing. Moreover, identifying the appropriate features for emotion recognition from EEG data requires further research. Finally, there is a need to develop more robust artificial intelligence (AI) including conventional machine learning (ML) and deep learning (DL) methods to handle the complex and diverse EEG signals associated with emotional states. This paper examines the application of DL techniques in emotion recognition from EEG signals and provides a detailed discussion of relevant articles. The paper explores the significant challenges in emotion recognition using EEG signals, highlights the potential of DL techniques in addressing these challenges, and suggests the scope for future research in emotion recognition using DL techniques. The paper concludes with a summary of its findings.

Valence in the eyes: An emotion decoding profile of adults with major depressive disorder and a history of childhood maltreatment

BACKGROUND

Individuals with major depressive disorder (MDD) and childhood maltreatment have been proposed to constitute a subgroup with worse illness course and outcomes. To elucidate a potential social cognitive vulnerability in this subgroup, this study compared the emotion decoding abilities of MDD patients with and without a history of childhood maltreatment.

METHODS

Participants with a diagnosis of MDD were recruited from nationwide mental health organizations. Emotion decoding abilities were assessed using the Reading the Mind in the Eyes Test, while childhood maltreatment was measured with the Adverse Childhood Experiences Questionnaire.

RESULTS

The MDD patients with a history of childhood maltreatment exhibited poorer emotion decoding abilities than MDD patients without such past. This difference applied specifically to the decoding of positive and negative emotions, while no group differences emerged for the decoding of neutral emotions. When specific maltreatment types were considered as predictors only emotional neglect was associated with lower emotion decoding abilities. These associations remained when adjusting for demographic and clinical covariates.

CONCLUSIONS

By indicating that emotion decoding difficulties characterize the MDD subgroup with childhood maltreatment, the findings highlight a potential vulnerability that merits further examination in terms of its developmental antecedents and prognostic relevance.

Face-specific negative bias of aesthetic perception in depression: Behavioral and EEG evidence

INTRODUCTION

Symptoms of depression are associated with the dysfunction of neural systems such as the emotion, reward system, and the default mode network. These systems were suggested by the model of neuroaesthetics as key contributions to aesthetic experience, leading to the prediction of atypical aesthetic orientation in depression. Here we investigated the aesthetic characteristics of depression and the corresponding neural underpinnings.

METHODS

Fifty-two (25 depression patients, 27 healthy controls) participants were asked to make aesthetic judgments on faces and landscapes in an electroencephalographic (EEG) experiment.

RESULTS

Our results indicate that relative to the controls, the depression tended to give ugly judgments and refrained from giving beautiful judgments, which was observed only for faces but not for landscapes. We also found that the face-induced component N170 was more negative in the depression group than the control group for ugly and neutral faces. Moreover, the aesthetic evaluation of ugly faces was associated with decreased N200 negativity in the depression group than in the control group, while the evaluation of beautiful faces was associated with decreased brain synchronization at the theta band.

DISCUSSION

These results suggested a face-specific negative aesthetic bias in depression which can help to design and develop aesthetics-oriented schemes in assisting the clinical diagnosis and therapy of depression.

A Single Session of Bifrontal tDCS Can Improve Facial Emotion Recognition in Major Depressive Disorder: An Exploratory Pilot Study

Emotional processing deficits are key features in major depressive disorder (MDD). Neuroimaging studies indicate that the dorsolateral prefrontal cortex (DLPFC) plays a pivotal role in both depressive symptoms and emotional processing. Recently, transcranial Direct Current Stimulations (tDCS) applied over the DLPFCs have held the promise to alleviate the symptoms in patients with MDD, but the effect on emotional processing in the patients is unclear. Here, we investigated the effect of a single session of tDCS over the DLPFCs on the emotional processing in patients with treatment-resistant MDD. In a randomized sham-controlled study, 35 patients received a single 30 min session of either active (2 mA, n = 18) or sham tDCS (n = 17). The anode was placed over the left and the cathode over the right DLPFC. Emotional processing accuracy was measured by a facial emotion recognition (FER) task. We observed an overall improvement in FER performance after the active tDCS, but not the sham tDCS. These exploratory results suggest that a single session of tDCS over the DLPFCs may improve FER in MDD, a crucial function of social cognition. Further studies are needed to investigate whether this acute improvement of FER in response to a single tDCS session could translate into clinical benefits or predict remission following repeated sessions of stimulation.

Variation in Thyroid-Stimulating Hormone and Cognitive Disorders in Unmedicated Middle-Aged Patients with Major Depressive Disorder: A Proton Magnetic Resonance Spectroscopy Study

Background

Middle-aged (45-59 years old) patients with major depressive disorder (MDD) have a predilection for dementia and cognitive disorders (CDs); however, the characteristics and mechanisms of CDs in these patients remain unclear. There are also known connections between thyroid-stimulating hormone (TSH), brain biochemical metabolism, and cognitive function (CF); however, there is scanty of information about these connections in middle-aged MDD patients.

Methods

Cognitive assessment was performed on 30 first-episode, untreated middle-aged patients with MDD and 30 well-matched healthy controls (HCs) using the MATRICS Consensus Cognitive Battery (MCCB). N-acetyl aspartate (NAA)/creatine (Cr) and choline (Cho)/Cr ratios in the prefrontal cortex (PFC) and cerebellum were also obtained via proton magnetic resonance spectroscopy (¹H-MRS), and the TSH level was measured by chemiluminescence analysis.

Results

MDD patients presented significantly lower processing speed, working memory, verbal learning, reasoning problem-solving, visual learning, and composite cognition scores than controls, with a statistically lower NAA/Cr ratio in the right cerebellum. Age was positively related to reasoning problem-solving in the MDD group (r = 0.6249, p = 0.0220). Education also showed a positive association with visual learning, social cognition, and composite cognition. The 24-item Hamilton Depression Rating Scale (HDRS-24) score was negatively related to all domains of CF. TSH levels were markedly decreased in the MDD group, and a positive connection was determined between the NAA/Cr ratio in the right PFC and the TSH level.

Conclusions

Middle-aged MDD patients have multidimensional CDs. There are changes in PFC and cerebellar biochemical metabolism in middle-aged patients with MDD, which may be related to CDs or altered TSH levels.

Impaired Facial Emotion Recognition and Gaze Direction Detection in Mild Alzheimer's Disease: Results from the PACO Study

BACKGROUND

Facial emotion recognition (FER) and gaze direction (GD) identification are core components of social cognition, possibly impaired in many psychiatric or neurological conditions. Regarding Alzheimer's disease (AD), current knowledge is controversial.

OBJECTIVE

The aim of this study was to explore FER and GD identification in mild AD compared to healthy controls.

METHODS

180 participants with mild AD drawn from the PACO study and 74 healthy elderly controls were enrolled. Participants were asked to complete three socio-cognitive tasks: face sex identification, recognition of facial emotions (fear, happiness, anger, disgust) expressed at different intensities, and GD discrimination. Multivariate analyses were conducted to compare AD participants and healthy controls.

RESULTS

Sex recognition was preserved. GD determination for subtle deviations was impaired in AD. Recognition of prototypically expressed facial emotions was preserved while recognition of degraded facial emotions was impacted in AD participants compared to controls. Use of multivariate analysis suggested significant alteration of low-expressed fear and disgust recognition in the AD group.

CONCLUSION

Our results showed emotion recognition and GD identification in patients with early-stage AD compared to elderly controls. These impairments could be the object of specific therapeutic interventions such as social cognition remediation or raising awareness of primary caregivers to improve the quality of life of patients with early AD.

Neural circuits underpinning face tuning in male depression

Reading bodies and faces is essential for efficient social interactions, though it may be thought-provoking for individuals with depression. Yet aberrations in the face sensitivity and underwriting neural circuits are not well understood, in particular, in male depression. Here, we use cutting-edge analyses of time course and dynamic topography of gamma oscillatory neuromagnetic cortical activity during administration of a task with Arcimboldo-like images. No difference in face tuning was found between individuals with depression and their neurotypical peers. Furthermore, this behavioral outcome nicely dovetails with magnetoencephalographic data: at early processing stages, the gamma oscillatory response to images resembling a face was rather similar in patients and controls. These bursts originated primarily from the right medioventral occipital cortex and lateral occipital cortex. At later processing stages, however, its topography altered remarkably in depression with profound engagement of the frontal circuits. Yet the primary difference in depressive individuals as compared with their neurotypical peers occurred over the left middle temporal cortices, a part of the social brain, engaged in feature integration and meaning retrieval. The outcome suggests compensatory recruitment of neural resources in male depression.

The effects of hypnotherapy compared to cognitive behavioral therapy in depression: a NIRS-study using an emotional gait paradigm

Hypnotherapy (HT) is a promising approach to treating depression, but so far, no data are available on the neuronal mechanisms of functional reorganization after HT for depressed patients. Here, 75 patients with mild to moderate depression, who received either HT or Cognitive Behavioral Therapy (CBT), were measured before and after therapy using functional near-infrared spectroscopy. We investigated the patients' cerebral activation during an emotional human gait paradigm. Further, rumination was included as predictor. Our results showed a decrease of functional connectivity (FC) between two regions that are crucial to emotional processing, the Extrastriate Body Area (EBA) and the Superior Temporal Sulcus (STS). This FC decrease was traced back to an activation change throughout therapy in the right STS, not the EBA and was only found in the HT group, depending on rumination: less ruminating HT patients showed a decrease in right STS activation, while highly ruminating patients showed an increase. We carefully propose that this activation change is due to the promotion of emotional experiences during HT, while in CBT a focus lay on activating behavior and changing negative cognitions. HT seemed to have had differential effects on the patients, depending on their rumination style: The increase of right STS activation in highly ruminating patients might mirror the improvement of impaired emotional processing, whilst the decrease of activation in low ruminating patients might reflect a dismissal of an over-compensation, associated with a hyperactivity before therapy. We conclude that HT affects emotional processing and this effect is moderated by rumination.

Emotional Word Processing in Patients With Juvenile Myoclonic Epilepsy

Objective

According to Panksepp's hierarchical emotion model, emotion processing relies on three functionally and neuroanatomically distinct levels. These levels comprise subcortical networks (primary level), the limbic system (secondary level), and the neocortex (tertiary level) and are suggested to serve differential emotional processing. We aimed to validate and extend previous evidence of discrete and dimensional emotion processing in patient with juvenile myoclonic epilepsy (JME).

Methods

We recorded brain activity of patients with JME and healthy controls in response to lexical decisions to words reflecting the discrete emotion fear and the affective dimension negativity previously suggested to rely on different brain regions and to reflect different levels of processing. In all study participants, we tested verbal cognitive functions, as well as the relationship of psychiatric conditions, seizure types and duration of epilepsy and emotional word processing.

Results

In support of the hierarchical emotion model, we found an interaction of discrete emotion and affective dimensional processing in the right amygdala likely to reflect secondary level processing. Brain activity related to affective dimensional processing was found in the right inferior frontal gyrus and is suggested to reflect tertiary level processing. Psychiatric conditions, type of seizure nor mono- vs. polytherapy and duration of epilepsy within patients did not have any effect on the processing of emotional words. In addition, no differences in brain activity or response times between patients and controls were observed, despite neuropsychological testing revealed slightly decreased verbal intelligence, verbal fluency and reading speed in patients with JME.

Significance

These results were interpreted to be in line with the hierarchical emotion model and to highlight the amygdala's role in processing biologically relevant stimuli, as well as to suggest a semantic foundation of affective dimensional processing in prefrontal cortex. A lack of differences in brain activity of patients with JME and healthy controls in response to the emotional content of words could point to unaffected implicit emotion processing in patients with JME.

Sleep quality and emotion recognition in individuals with and without internalizing psychopathologies

BACKGROUND AND OBJECTIVES

Separate lines of research indicate sleep quality may impact recognition of facial expressions in anxious or depressed individuals. This study examined facial emotion recognition ability in the context of self-perceived sleep quality and anxiety and depression symptom levels in individuals with and without internalizing psychopathologies.

METHODS

Seventy anxious and/or depressed patients and 24 demographically matched healthy controls completed the Pittsburgh Sleep Quality Index (PSQI), standard measures of anxiety and depression, and an Emotion Recognition Task comprising negative and positive facial expressions.

RESULTS

Analyses of variance results revealed patients reported worse sleep quality than controls. Linear mixed-effects models indicated that all participants demonstrated better emotion recognition abilities in identifying positive versus negative emotions. For reaction time, but not accuracy, regression results revealed significant individual differences, with worse sleep quality predicting slower reaction times for positive faces, specifically for happiness.

LIMITATIONS

The use of a subjective measure of sleep quality and a specific behavioral paradigm for emotion recognition may impact the generalizability of the findings.

CONCLUSIONS

Associations between task performance and emotional valence of facial expression implies that poor sleep quality, beyond internalizing symptom severity, may disrupt emotion processing.

Depressive affect moderates the effects of biological sex on the recognition of facial emotion

Females show a small processing advantage relative to males in the ability to identify facial expressions of emotion. In laboratory studies, this is expressed as a sex difference in the accuracy of discrimination or in recognition latencies (the time required to identify an expression). Reasons for the sex difference are not well-understood. In the current pilot study, young adults (N = 62) with and without mild to moderate symptoms of depression were asked to discriminate facial images of infants and toddlers expressing six cardinal emotions. Results showed that elevated depressive affect was associated with more rapid recognition of negative emotions by females, and with potentiation of the typically observed sex difference, compared with non-depressed observers. Differences in endogenous affective status might be one proximate factor contributing to a female advantage in emotion recognition.

Signal Detection Theory as a Novel Tool to Understand Cognitive Fatigue in Individuals With Multiple Sclerosis

Multiple Sclerosis (MS) affects 2.8 million persons worldwide. One of the most persistent, pervasive, and debilitating symptoms of MS is cognitive fatigue. While this has been known for over a century, cognitive fatigue has been difficult to study because patients' subjective (self-reported) cognitive fatigue has consistently failed to correlate with more objective measures, such as reaction time (RT) and accuracy. Here, we investigated whether more nuanced metrics of performance, specifically the metrics of Signal Detection Theory (SDT), would show a relationship to cognitive fatigue even if RT and accuracy did not. We also measured brain activation to see whether SDT metrics were related to activation in brain areas that have been shown to be sensitive to cognitive fatigue. Fifty participants (30 MS, 20 controls) took part in this study and cognitive fatigue was induced using four blocks of a demanding working memory paradigm. Participants reported their fatigue before and after each block, and their performance was used to calculate SDT metrics (Perceptual Certainty and Criterion) and RT and accuracy. The results showed that the SDT metric of Criterion (i.e., response bias) was positively correlated with subjective cognitive fatigue. Moreover, the activation in brain areas previously shown to be related to cognitive fatigue, such as the striatum, was also related to Criterion. These results suggest that the metrics of SDT may represent a novel tool with which to study cognitive fatigue in MS and other neurological populations. These results hold promise for characterizing cognitive fatigue in MS and developing effective interventions in the future.

Inducing Affective Learning Biases with Cognitive Training and Prefrontal tDCS: A Proof-of-Concept Study

Background

Cognitive models of mood disorders emphasize a causal role of negative affective biases in depression. Computational work suggests that these biases may stem from a belief that negative events have a higher information content than positive events, resulting in preferential processing of and learning from negative outcomes. Learning biases therefore represent a promising target for therapeutic interventions. In this proof-of-concept study in healthy volunteers, we assessed the malleability of biased reinforcement learning using a novel cognitive training paradigm and concurrent transcranial direct current stimulation (tDCS).

Methods

In two studies, young healthy adults completed two sessions of negative (n = 20) or positive (n = 20) training designed to selectively increase learning from loss or win outcomes, respectively. During training active or sham tDCS was applied bilaterally to dorsolateral prefrontal cortex. Analyses tested for changes both in learning rates and win- and loss-driven behaviour. Potential positive/negative emotional transfer of win/loss learning was assessed by a facial emotion recognition task and mood questionnaires.

Results

Negative and positive training increased learning rates for losses and wins, respectively. With negative training, there was also a trend for win (but not loss) learning rates to decrease over successive task blocks. After negative training, there was evidence for near transfer in the form of an increase in loss-driven choices when participants performed a similar (untrained) task. There was no change in far transfer measures of emotional face processing or mood. tDCS had no effect on any aspect of behaviour.

Discussion and Conclusions

Negative training induced a mild negative bias in healthy adults as reflected in loss-driven choice behaviour. Prefrontal tDCS had no effect. Further research is needed to assess if this training procedure can be adapted to enhance learning from positive outcomes and whether effects translate to affective disorders.

Electronic supplementary material

The online version of this article (10.1007/s10608-020-10146-9) contains supplementary material, which is available to authorized users.

Dynamic face processing impairments are associated with cognitive and positive psychotic symptoms across psychiatric disorders

Impairments in social cognition-including recognition of facial expressions-are increasingly recognised as a core deficit in schizophrenia. It remains unclear whether other aspects of face processing (such as identity recognition) are also impaired, and whether such deficits can be attributed to more general cognitive difficulties. Moreover, while the majority of past studies have used picture-based tasks to assess face recognition, literature suggests that video-based tasks elicit different neural activations and have greater ecological validity. This study aimed to characterise face processing using video-based stimuli in psychiatric inpatients with and without psychosis. Symptom correlates of face processing impairments were also examined. Eighty-six psychiatric inpatients and twenty healthy controls completed a series of tasks using video-based stimuli. These included two emotion recognition tasks, two non-emotional facial identity recognition tasks, and a non-face control task. Symptoms were assessed using the Positive and Negative Syndrome Scale. Schizophrenia and bipolar disorder groups were significantly impaired on the emotion-processing tasks and the non-face task compared to healthy controls and patients without psychosis. Patients with other forms of psychosis performed intermediately. Groups did not differ in non-emotional face processing. Positive symptoms of psychosis correlated directly with both emotion-processing performance and non-face discrimination across patients. We found that identity processing performance was inversely associated with cognition-related symptoms only. Findings suggest that deficits in emotion-processing reflect symptom pathology independent of diagnosis. Emotion-processing deficits in schizophrenia may be better accounted for by task-relevant factors-such as attention-that are not specific to emotion processing.

Examining the roles of cognitive flexibility, emotion recognition, and metacognitions in adult Attention Deficit and Hyperactivity Disorder with predominantly inattentive presentation

The evaluation of cognitive functions in Attention Deficit and Hyperactivity Disorder (ADHD) is fundamental to improve the efficacy of therapeutic interventions. However, the role of specific higher-order cognitive functions in adult ADHD, including cognitive flexibility, emotion recognition, and metacognitions, remains unclear. Therefore, in the current study, we aimed to examine these three distinct higher-order cognitive functions among adult ADHD individuals. Forty patients with ADHD with predominantly inattentive presentation and 42 healthy controls participated in the study. The Adult Attention Deficit and Hyperactivity Disorder Scale (AADHDS), the Wisconsin Card Sorting Test (WCST), the Reading the Mind in the Eyes Test (RMET), and the Metacognitions Questionnaire-30 (MCQ-30) were administered. Results indicated that patients with ADHD had worse metacognitions scores, in specific subdimensions, relative to healthy controls. However, cognitive flexibility and emotion recognition did not differ between the groups. Moreover, the cognitive confidence subdimension of the MCQ-30 was found to be sole significant predictor in the attention deficit subdimension of the AADHDS. Our findings suggest that lack of cognitive confidence may contribute to ADHD symptomatology despite regularly functioning cognitive flexibility and emotion recognition. Therefore, metacognitions could be a suitable target to alleviate the severity of ADHD symptoms.

Multi-Modal Adaptive Fusion Transformer Network for the Estimation of Depression Level

Depression is a severe psychological condition that affects millions of people worldwide. As depression has received more attention in recent years, it has become imperative to develop automatic methods for detecting depression. Although numerous machine learning methods have been proposed for estimating the levels of depression via audio, visual, and audiovisual emotion sensing, several challenges still exist. For example, it is difficult to extract long-term temporal context information from long sequences of audio and visual data, and it is also difficult to select and fuse useful multi-modal information or features effectively. In addition, how to include other information or tasks to enhance the estimation accuracy is also one of the challenges. In this study, we propose a multi-modal adaptive fusion transformer network for estimating the levels of depression. Transformer-based models have achieved state-of-the-art performance in language understanding and sequence modeling. Thus, the proposed transformer-based network is utilized to extract long-term temporal context information from uni-modal audio and visual data in our work. This is the first transformer-based approach for depression detection. We also propose an adaptive fusion method for adaptively fusing useful multi-modal features. Furthermore, inspired by current multi-task learning work, we also incorporate an auxiliary task (depression classification) to enhance the main task of depression level regression (estimation). The effectiveness of the proposed method has been validated on a public dataset (AVEC 2019 Detecting Depression with AI Sub-challenge) in terms of the PHQ-8 scores. Experimental results indicate that the proposed method achieves better performance compared with currently state-of-the-art methods. Our proposed method achieves a concordance correlation coefficient (CCC) of 0.733 on AVEC 2019 which is 6.2% higher than the accuracy (CCC = 0.696) of the state-of-the-art method.

Cognitive function after electroconvulsive therapy for depression: relationship to clinical response

BACKGROUND

As uncertainty remains about whether clinical response influences cognitive function after electroconvulsive therapy (ECT) for depression, we examined the effect of remission status on cognitive function in depressed patients 4 months after a course of ECT.

METHOD

A secondary analysis was undertaken on participants completing a randomised controlled trial of ketamine augmentation of ECT for depression who were categorised by remission status (MADRS ⩽10 v. >10) 4 months after ECT. Cognition was assessed with self-rated memory and neuropsychological tests of anterograde verbal and visual memory, autobiographical memory, verbal fluency and working memory. Patients were assessed through the study, healthy controls on a single occasion, and compared using analysis of variance.

RESULTS

At 4-month follow-up, remitted patients (N = 18) had a mean MADRS depression score of 3.8 (95% CI 2.2-5.4) compared with 27.2 (23.0-31.5) in non-remitted patients (N = 19), with no significant baseline differences between the two groups. Patients were impaired on all cognitive measures at baseline. There was no deterioration, with some measures improving, 4-months after ECT, at which time remitted patients had significantly improved self-rated memory, anterograde verbal memory and category verbal fluency compared with those remaining depressed. Self-rated memory correlated with category fluency and autobiographical memory at follow-up.

CONCLUSIONS

We found no evidence of persistent impairment of cognition after ECT. Achieving remission improved subjective memory and verbal memory recall, but other aspects of cognitive function were not influenced by remission status. Self-rated memory may be useful to monitor the effects of ECT on longer-term memory.

Anodal Transcranial Direct Current Stimulation over the Cerebellum Enhances Sadness Recognition in Parkinson's Disease Patients: a Pilot Study

Emotional processing impairments, resulting in a difficulty to decode emotions from faces especially for negative emotions, are characteristic non-motor features of Parkinson’s disease (PD). There is limited evidence about the specific contribution of the cerebellum to the recognition of emotional contents in facial expressions even though patients with cerebellar dysfunction often lose this ability. In this study, we aimed to evaluate whether the recognition of facial expressions can be modulated by cerebellar transcranial direct current stimulation (tDCS) in PD patients. Nine PD patients were enrolled and received anodal and sham tDCS (2 mA, 20 min), for 5 consecutive days, in two separate cycles at intervals of at least 1 month. The facial emotion recognition task was administered at baseline (T0) and after cerebellar tDCS on day 5 (T1). Our preliminary study showed that anodal cerebellar tDCS significantly enhanced emotional recognition in response to sad facial expressions by about 16%, but left recognition of anger, happiness, and neutral facial expressions unchanged. Despite the small sample size, our preliminary results show that anodal tDCS applied for five consecutive days over the cerebellum modulates the way PD patients recognize specific facial expressions, thus suggesting that the cerebellum plays a crucial role in recognition of negative emotions and corroborating previous knowledge on the link between social cognition and the cerebellum.

Using Signal Detection Theory to Better Understand Cognitive Fatigue

When we are fatigued, we feel that our performance is worse than when we are fresh. Yet, for over 100 years, researchers have been unable to identify an objective, behavioral measure that covaries with the subjective experience of fatigue. Previous work suggests that the metrics of signal detection theory (SDT)-response bias (criterion) and perceptual certainty (d')-may change as a function of fatigue, but no work has yet been done to examine whether these metrics covary with fatigue. Here, we investigated cognitive fatigue using SDT. We induced fatigue through repetitive performance of the n-back working memory task, while functional magnetic resonance imaging (fMRI) data was acquired. We also assessed cognitive fatigue at intervals throughout. This enabled us to assess not only whether criterion and d' covary with cognitive fatigue but also whether similar patterns of brain activation underlie cognitive fatigue and SDT measures. Our results show that both criterion and d' were correlated with changes in cognitive fatigue: as fatigue increased, subjects became more conservative in their response bias and their perceptual certainty declined. Furthermore, activation in the striatum of the basal ganglia was also related to cognitive fatigue, criterion, and d'. These results suggest that SDT measures represent an objective measure of cognitive fatigue. Additionally, the overlap and difference in the fMRI results between cognitive fatigue and SDT measures indicate that these measures are related while also separate. In sum, we show the relevance of SDT measures in the understanding of fatigue, thus providing researchers with a new set of tools with which to better understand the nature and consequences of cognitive fatigue.

Maternal Depression and Mother-Child Oxytocin Synchrony in Youth with Anxiety Disorders

The neuropeptide oxytocin (OT) plays a central role in the regulation of affiliative bonds and anxiety. However, the degree to which its levels are synchronized between interaction partners has not yet been assessed. Physiological synchrony assessed using other peripheral measures (e.g., heart rate, etc.) has been tied to positive outcomes for the individual and the dyad. The present study examined OT synchrony in the context of child anxiety and maternal depression by examining mother-child dyads. Mothers and their children with anxiety disorders participated in a behavioral interaction task. Changes in OT levels and mother-child OT synchrony before and after the interaction, as well as their moderation by maternal depression, were assessed. Ninety-eight youth with anxiety disorders (ages 10 to 17) and their mothers underwent psychiatric evaluation, and mothers rated their own depressive symptoms and their children's behavior problems. Salivary OT was assayed from mother and child before and after the task. Behavioral coding showed that interactions were characterized by high behavioral synchrony between mothers and their children, and both individuals displayed higher levels of positive vs. negative affect during the interactions. Mothers and their children also showed decreases in OT levels after the interaction. As hypothesized, OT synchrony increased following the task, but only dyads in which mothers showed high levels of depressive symptoms showed this increase. As hypothesized, lower levels of OT-synchrony were associated with higher levels of child internalizing symptoms. The findings suggest that positive interactions may be beneficial for youth with anxiety disorders with mothers with depression.

Assessing Pragmatic Language Skills in Adults with Major Depressive Disorder: An Exploratory Study

INTRODUCTION

There is increasing evidence that major depressive disorder (MDD) is associated with significant pragmatic language impairments. However, there is a lack of studies that use standardized tools and simultaneously investigate all pragmatic language skills among MDD patients. The aim of this study was to propose a more thorough investigation of all pragmatic language skills in patients with MDD.

METHODS

Twenty adults (aged 22-65) with a DSM-5 diagnosis of MDD were assessed using BLED Santa Lucia (Batteria sul Linguaggio dell'Emisfero Destro Santa Lucia), a battery designed to evaluate pragmatic language skills (comprehension of inferences, of picture and written metaphors, of indirect requests, of humoristic expressions, and of prosody). The performance of the MDD participants on all BLED Santa Lucia subscales was compared to 20 healthy control subjects (aged 20-60) matched for gender, age, years of education, and employment status.

RESULTS

MDD patients performed poorer than controls in comprehension of inferences (p < 0.01), picture metaphors (p < 0.001), written metaphors (p < 0.001), indirect requests (p < 0.01), humoristic expression (p < 0.05), and prosody (p < 0.05).

CONCLUSIONS

All pragmatic language skills can be significantly impaired in MDD patients. A valid assessment of all pragmatic language skills can allow, for each patient, the definition of a specific profile of risk and protective factors before and during psychotherapy.

Social Inferences as Mediators of Wellbeing in Depression

BACKGROUND

Depression is an increasingly prevalent chronic mental health condition that involves a range of potentially negative implications, in the long term. Theory of Mind (ToM) serves to form and maintain social relationships, by accurately identifying thoughts and emotions in others. Defective ToM abilities have been noted in people with a history of clinical depression.

PURPOSE

To identify whether impairments of emotion recognition are correlated with a lower subjective feeling of wellbeing in people diagnosed with a chronic depressive illness.

PATIENTS AND METHODS

In a cross-sectional analysis of a recurrent depressive disorder (RDD, as per WHO ICD-10 nosology) cohort (n=57), the BECK depression scale and the "Reading the mind in the eyes" test were employed for the diagnosis of clinical symptoms, and for the evaluation of individual ToM skills, respectively. Wellbeing was quantified using the FANLCT scale.

RESULTS

The wellbeing of service-users decreased significantly, in correlation with their defective emotion recognition abilities. Additionally, a low capacity for the correct perception of emotions in other people appears to significantly influence the social relationships status, with scores of 14.00 (10.00-18.50) at low capacity vs 23.00 (17.58-24.75) at normal capacity (Mann-Whitney U-test, p < 0.001). Our study findings indicate that a normal ability for a correct recognition of emotions in others is significantly and strongly correlated with adequate social relationships (Spearman r = 0.757, p < 0.05).

CONCLUSION

Wellbeing is significantly correlated with the individual ability for a correct recognition of emotions in others.

An Exploratory Study on Cross-Cultural Differences in Facial Emotion Recognition Between Adults From Malaysia and Australia

While culture and depression influence the way in which humans process emotion, these two areas of investigation are rarely combined. Therefore, the aim of this study was to investigate the difference in facial emotion recognition among Malaysian Malays and Australians with a European heritage with and without depression. A total of 88 participants took part in this study (Malays n = 47, Australians n = 41). All participants were screened using The Structured Clinical Interview for DSM-5 Clinician Version (SCID-5-CV) to assess the Major Depressive Disorder (MDD) diagnosis and they also completed the Beck Depression Inventory (BDI). This study consisted of the facial emotion recognition (FER) task whereby the participants were asked to look at facial images and determine the emotion depicted by each of the facial expressions. It was found that depression status and cultural group did not significantly influence overall FER accuracy. Malaysian participants without MDD and Australian participants with MDD performed quicker as compared to Australian participants without MDD on the FER task. Also, Malaysian participants more accurately recognized fear as compared to Australian participants. Future studies can focus on the extent of the influence and other aspects of culture and participant condition on facial emotion recognition.

Lower recognition thresholds for sad facial expressions in subthreshold depression: a longitudinal study

Subthreshold depression (StD) is more prevalent than major depressive disorder (MDD) all over the world. Previous studies have indicated that depression is associated with impaired perception of facial expressions. However, for individuals with StD, whether perceptual sensitivity toward facial expressions could be altered and whether these alterations could stabilize over time remain largely unknown. Using the QUEST psychometric procedure, here we assessed recognition thresholds of five facial expressions (angry, fear, happy, sad and neutral) for individuals with StD and non-depressed controls. These subjects were retested after approximately 2-month time intervals. At the initial assessment, individuals with StD demonstrated lower recognition thresholds (i.e., stronger sensitivity) for only sadness compared to non-depressed controls. At the follow-up assessment, we classified the StD group as two subgroups: the non-remitted and the remitted group. For the former, lower recognition thresholds for only sadness were again found; for the latter, there was no significant difference. More importantly, individuals displaying lower recognition thresholds for sadness at the initial assessment were less likely to improve in depressive symptoms at the follow-up assessment. These results indicate that the alteration of perceptual sensitivity toward the sad expression for individuals with StD is associated with the current clinical state.

Increases in loneliness during medical school are associated with increases in individuals' likelihood of mislabeling emotions as negative

Expressions of emotion represent an important and unique source of information about the states of others. Being able to effectively understand expressions of emotions to make inferences about others' internal mental states and use these inferences to guide decision-making and behavior is critical to navigating social relationships. Loneliness, the perception that one lacks social connection, has important functional consequences for how individuals attend to signals of emotions in others. However, it is less clear whether loneliness changes how individuals recognize emotions in others. In medical practitioners, being able to accurately recognize emotional cues from patients is critical to effectively diagnosing and reacting with care to those patients. The current study examines the relationship between changes in loneliness during medical school and students' recognition of emotion in others. Measures of loneliness and emotion recognition were collected from 122 medical students during their first 3 years of medical school at the beginning and end of each academic year. Changes in loneliness were related to changes in emotion detection, with increases in loneliness being associated with decreases in the probability of accurately discriminating sad and angry faces from other expressions, decreases in the probability of mislabeling emotion expressions as happy, and increases in the probability of mislabeling other emotional expressions as pained and angry. This study suggests that changes in loneliness during medical school are associated with increases in students' labeling emotional expressions as negative, possibly by shifting attention to cues of negative emotion and away from cues of positive emotion. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

EEG cross-frequency correlations as a marker of predisposition to affective disorders

EEG cross-frequency amplitude-amplitude correlation (CF-AAC) has been considered as a potential marker of social anxiety and other affective disturbances. Functional significance of this phenomenon remains unclear, partly because the majority of studies used channel-level analysis, which precluded the spatial localization of observed effects. It is not also clear whether CF-AAC may serve as a marker of specific pathological conditions and specific states, or a more general predisposition to affective disturbances. We used source-level analysis of EEG data obtained in resting conditions in a nonclinical sample and patients with major depressive disorder (MDD) and investigated associations of CF-AAC measures with a broad range of known risk factors for affective disorders, including age, gender, genotype, stress exposure, personality, and self-reported ‘neurotic’ symptomatology. A consistent pattern of associations showed that all investigated risk factors were associated with an enhancement of CF-AAC in cortical regions associated with emotional and self-referential processing. It could be concluded that CF-AAC is a promising candidate marker of a general predisposition to affective disorders at preclinical stages.

Impaired Recognition of Basic Emotions from Facial Expressions in Young People with Autism Spectrum Disorder: Assessing the Importance of Expression Intensity

It has been proposed that impairments in emotion recognition in ASD are greater for more subtle expressions of emotion. We measured recognition of 6 basic facial expressions at 8 intensity levels in young people (6-16 years) with ASD (N = 63) and controls (N = 64) via an Internet platform. Participants with ASD were less accurate than controls at labelling expressions across intensity levels, although differences at very low levels were not detected due to floor effects. Recognition accuracy did not correlate with parent-reported social functioning in either group. These findings provide further evidence for an impairment in recognition of basic emotion in ASD and do not support the idea that this impairment is limited solely to low intensity expressions.

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.

A systematic review of the impact of social cognitive deficits on psychosocial functioning in major depressive disorder and opportunities for therapeutic intervention

Social cognition is the ability to identify, perceive and interpret socially relevant information from the external world. It is an important adaptive trait, but is frequently affected in major depressive disorder by a mood-congruent interpretive bias. The present review examined the existing body of literature to determine (i) the impact social cognitive deficits in depression have on psychosocial functioning; and (ii) the utility of psychotropic, psychological and procedural interventions employed to target these deficits. A total of 107 studies met inclusion criteria for review. Social cognitive performance was found to adversely impact depressed patients' psychosocial functioning across the key domains of general cognitive functioning and quality of life. Secondly, many current therapies were found to have a normalising effect on the social cognitive abilities of subjects with major depressive disorder, both at a neural and functional level. In particular, certain anti-depressant medications corrected facial affect recognition deficits, while several psychotherapeutic approaches improved impairments in theory of mind and negative interpretive bias.

Facial Sadness Recognition is Modulated by Estrogen Receptor Gene Polymorphisms in Healthy Females

Polymorphisms of the estrogen receptor ESR1 and ESR2 genes have been linked with cognitive deficits and affective disorders. The effects of these genetic variants on emotional processing in females with low estrogen levels are not well known. The aim was to explore the impact of the ESR1 and ESR2 genes on the responses to the facial emotion recognition task in females. Postmenopausal healthy female volunteers were genotyped for the polymorphisms Xbal and PvuII of ESR1 and the polymorphism rs1256030 of ESR2. The effect of these polymorphisms on the response to the facial emotion recognition of the emotions happiness, sadness, disgust, anger, surprise, and fear was analyzed. Females carrying the P allele of the PvuII polymorphism or the X allele of the Xbal polymorphism of ESR1 easily recognized facial expressions of sadness that were more difficult for the women carrying the p allele or the x allele. They displayed higher accuracy, fast response time, more correct responses, and fewer omissions to complete the task, with a large effect size. Women carrying the ESR2 C allele of ESR2 showed a faster response time for recognizing facial expressions of anger. These findings link ESR1 and ESR2 polymorphisms in facial emotion recognition of negative emotions.

Social cognition and interaction training for major depression: A preliminary study

The present work investigated the efficacy of social cognition and interaction training (SCIT) for patients with major depression. Thirty first-episode patients with major depression who received the SCIT plus the treatment-as-usual (i.e., SCIT + TAU group) were compared with twenty-nine patients who only received treatment-as-usual (i.e., TAU group). Patients received SCIT showed a significantly greater improvement on emotion perception, theory of mind, and attributional styles from baseline to follow-up assessments, with a significant reduction of severity of depressive symptoms, compared to those in TAU group. The preliminary findings indicate that SCIT is a feasible and promising method to improve social cognition for patients with major depression.

Impaired facial expression recognition in patients with social anxiety disorder: a case-control study

INTRODUCTION

The aim of this study was to investigate whether social anxiety disorder (SAD) patients have low emotion recognition accuracy, take longer for emotion recognition and tended to interpret a stimulus more negatively than controls.

METHODS

Fifty-six SAD patients and 56 healthy controls were participated in this study. We evaluated facial emotion recognition using a computer program in which participants chose one of seven emotions as displayed in each of 55 photographs of faces. We compared the accuracy and reaction times of the patients and controls. We further analysed which emotions were selected in the incorrect answers.

RESULTS

SAD patients showed delayed reaction times for all emotions except anger and lower accuracy for fear, surprise, neutrality and happiness compared to controls. After applying Bonferroni correction, only delayed reaction time for surprise and happiness were remain significant. Neutrality was not mistaken for a negative emotion at a higher rate by SAD patients than by controls.

CONCLUSION

This result suggests that the alterations of reaction time and accuracy of emotion recognition of SAD patients, especially in emotions with positive valence, play a more important role than negative bias in the cognitive aspects of SAD.

Clinical pilot study of transcranial direct current stimulation combined with Cognitive Emotional Training for medication resistant depression

BACKGROUND

While the clinical results from transcranial direct current stimulation (tDCS) for the treatment of depression have been promising, antidepressant effects in patients with medication resistance have been suboptimal. There is therefore a need to further optimise tDCS for medication resistant patients. In this clinical pilot study we examined the feasibility, safety, and clinical efficacy of combining tDCS with a psychological intervention which targets dysfunctional circuitry related to emotion regulation in depression, Cognitive Emotional Training (CET).

METHODS

tDCS was administered during CET three times a week for a total of 18 sessions over 6 weeks. Mood, cognition and emotion processing outcomes were examined at baseline and after 3 and 6 weeks of treatment.

RESULTS

Twenty patients with medication resistant depression participated, of whom 17 were study completers. tDCS combined with CET was found to be feasible, safe, and associated with significant antidepressant efficacy at 6 weeks, with 41% of study completers showing treatment response (≥ 50% improvement in depression score). There were no significant cognitive enhancing effects with the exception of improved emotion recognition. Responders demonstrated superior recognition for the emotions fear and surprise at pre-treatment compared to non-responders, suggesting that better pre-treatment emotion recognition may be associated with antidepressant efficacy.

LIMITATIONS

This was an open label study.

CONCLUSIONS

tDCS combined with CET has potential as a novel method for optimising the antidepressant efficacy of tDCS in medication resistant patients. Future controlled studies are required to determine whether tDCS combined with CET has greater antidepressant efficacy compared to either intervention alone.

Multimodal Emotion Recognition Is Resilient to Insufficient Sleep: Results From Cross-Sectional and Experimental Studies

Objectives

Insufficient sleep has been associated with impaired recognition of facial emotions. However, previous studies have found inconsistent results, potentially stemming from the type of static picture task used. We therefore examined whether insufficient sleep was associated with decreased emotion recognition ability in two separate studies using a dynamic multimodal task.

Methods

Study 1 used a cross-sectional design consisting of 291 participants with questionnaire measures assessing sleep duration and self-reported sleep quality for the previous night. Study 2 used an experimental design involving 181 participants where individuals were quasi-randomized into either a sleep-deprivation (N = 90) or a sleep-control (N = 91) condition. All participants from both studies were tested on the same forced-choice multimodal test of emotion recognition to assess the accuracy of emotion categorization.

Results

Sleep duration, self-reported sleep quality (study 1), and sleep deprivation (study 2) did not predict overall emotion recognition accuracy or speed. Similarly, the responses to each of the twelve emotions tested showed no evidence of impaired recognition ability, apart from one positive association suggesting that greater self-reported sleep quality could predict more accurate recognition of disgust (study 1).

Conclusions

The studies presented here involve considerably larger samples than previous studies and the results support the null hypotheses. Therefore, we suggest that the ability to accurately categorize the emotions of others is not associated with short-term sleep duration or sleep quality and is resilient to acute periods of insufficient sleep.

Psilocybin with psychological support improves emotional face recognition in treatment-resistant depression

RATIONALE

Depressed patients robustly exhibit affective biases in emotional processing which are altered by SSRIs and predict clinical outcome.

OBJECTIVES

The objective of this study is to investigate whether psilocybin, recently shown to rapidly improve mood in treatment-resistant depression (TRD), alters patients' emotional processing biases.

METHODS

Seventeen patients with treatment-resistant depression completed a dynamic emotional face recognition task at baseline and 1 month later after two doses of psilocybin with psychological support. Sixteen controls completed the emotional recognition task over the same time frame but did not receive psilocybin.

RESULTS

We found evidence for a group × time interaction on speed of emotion recognition (p = .035). At baseline, patients were slower at recognising facial emotions compared with controls (p < .001). After psilocybin, this difference was remediated (p = .208). Emotion recognition was faster at follow-up compared with baseline in patients (p = .004, d = .876) but not controls (p = .263, d = .302). In patients, this change was significantly correlated with a reduction in anhedonia over the same time period (r = .640, p = .010).

CONCLUSIONS

Psilocybin with psychological support appears to improve processing of emotional faces in treatment-resistant depression, and this correlates with reduced anhedonia. Placebo-controlled studies are warranted to follow up these preliminary findings.

Late chronotype is associated with enhanced amygdala reactivity and reduced fronto-limbic functional connectivity to fearful versus happy facial expressions

Increasing evidence suggests late chronotype individuals are at increased risk of developing depression. However, the underlying neural mechanisms that confer risk are not fully understood. Here, fifty healthy, right-handed individuals without a current or previous diagnosis of depression, family history of depression or sleep disorder underwent functional magnetic resonance imaging (FMRI). Participants completed an implicit emotion processing task (gender discrimination) including happy and fearful facial expressions. Linear effects of chronotype on BOLD response in bilateral amygdala were tested for significance using nonparametric permutation tests. Functional connectivity between amygdala and prefrontal cortex was also investigated using psychophysiological interaction (PPI) analysis. A significant negative correlation between BOLD response and chronotype was observed in bilateral amygdala where later chronotype was associated with an enhanced amygdala response to fearful vs. happy faces. This response remained significant after sleep quality, age, gender, mood, and time of scan were included as covariates in the regression model. Later chronotype was also significantly associated with reduced functional connectivity between amygdala and dorsal anterior cingulate cortex (dACC). The current results appear consistent with theories of impaired emotion regulation of the limbic system (particularly the amygdala) associated with depression and may, in part, explain the increased vulnerability for depression in late chronotype individuals.

Negative bias in expression-related mismatch negativity(MMN) in remitted late-life depression: An event-related potential study

Negative bias in cognition is closely associated with susceptibility to recurrent episodes of depression. Given the high recurrence rate of depression, previous studies have focused on the attentive level in late-life depression (LLD), but depression relapse is difficult to detect as a lower chief complaint in elderly people. Facial expression mismatch negativity (EMMN) is a tool that can measure cognitive bias in pre-attentive processing. In this study, we sought to explore the cognitive bias in pre-attentive emotional information processing in LLD. Thirty patients with remitted LLD and 30 non-depressed, age- and gender-matched normal controls (NC) were enrolled in this study. Automatic emotional processing was elicited by using an expression-related oddball paradigm in all participants. There were no significant differences in N170 amplitude and latency between remitted LLD and NC. Compared with NC subjects, patients with remitted LLD demonstrated an attenuated mean amplitude of positive and negative EMMN, whereas the mean amplitude of negative EMMN in remitted LLD was much larger than that of positive EMMN. Our findings suggest that although basic processing of facial expressions is intact in remitted LLD, automatic processing of facial expressions in remitted LLD is impaired with a negative bias in cognition. Further investigation of the contributions of negative bias in EMMN to susceptibility to recurrence of LLD is warranted.

Cognitive bias modification for facial interpretation: a randomized controlled trial of transfer to self-report and cognitive measures in a healthy sample

Cognitive bias modification is a potential low-intensity intervention for mood disorders, but previous studies have shown mixed success. This study explored whether facial interpretation bias modification (FIBM), a similar paradigm designed to shift emotional interpretation (and/or perception) of faces would transfer to: (i) self-reported symptoms and (ii) a battery of cognitive tasks. In a preregistered, double-blind randomized controlled trial, healthy participants received eight online sessions of FIBM (N = 52) or eight sham sessions (N = 52). While we replicate that FIBM successfully shifts ambiguous facial expression interpretation in the intervention group, this failed to transfer to the majority of self-report or cognitive measures. There was, however, weak, inconclusive evidence of transfer to a self-report measure of stress, a cognitive measure of anhedonia, and evidence that results were moderated by trait anxiety (whereby transference was greatest in those with higher baseline symptoms). We discuss the need for work in both larger and clinical samples, while urging caution that these FIBM training effects may not transfer to clinically relevant domains.

A Transdiagnostic Review of Negative Symptom Phenomenology and Etiology

In the DSM5, negative symptoms are 1 of the 5 core dimensions of psychopathology evaluated for schizophrenia. However, negative symptoms are not pathognomonic-they are also part of the diagnostic criteria for other schizophrenia-spectrum disorders, disorders that sometimes have comorbid psychosis, diagnoses not in the schizophrenia-spectrum, and the general "nonclinical" population. Although etiological models of negative symptoms have been developed for chronic schizophrenia, there has been little attention given to whether these models have transdiagnostic applicability. In the current review, we examine areas of commonality and divergence in the clinical presentation and etiology of negative symptoms across diagnostic categories. It was concluded that negative symptoms are relatively frequent across diagnostic categories, but individual disorders may differ in whether their negative symptoms are persistent/transient or primary/secondary. Evidence for separate dimensions of volitional and expressive symptoms exists, and there may be multiple mechanistic pathways to the same symptom phenomenon among DSM-5 disorders within and outside the schizophrenia-spectrum (ie, equifinality). Evidence for a novel transdiagnostic etiological model is presented based on the Research Domain Criteria (RDoC) constructs, which proposes the existence of 2 such pathways-a hedonic pathway and a cognitive pathway-that can both lead to expressive or volitional symptoms. To facilitate treatment breakthroughs, future transdiagnostic studies on negative symptoms are warranted that explore mechanisms underlying volitional and expressive pathology.