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Suslow T, Günther V, Hensch T, Kersting A, Bodenschatz CM. Alexithymia Is Associated With Deficits in Visual Search for Emotional Faces in Clinical Depression. Front Psychiatry 2021; 12:668019. [PMID: 34267686 PMCID: PMC8275928 DOI: 10.3389/fpsyt.2021.668019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 06/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The concept of alexithymia is characterized by difficulties identifying and describing one's emotions. Alexithymic individuals are impaired in the recognition of others' emotional facial expressions. Alexithymia is quite common in patients suffering from major depressive disorder. The face-in-the-crowd task is a visual search paradigm that assesses processing of multiple facial emotions. In the present eye-tracking study, the relationship between alexithymia and visual processing of facial emotions was examined in clinical depression. Materials and Methods: Gaze behavior and manual response times of 20 alexithymic and 19 non-alexithymic depressed patients were compared in a face-in-the-crowd task. Alexithymia was empirically measured via the 20-item Toronto Alexithymia-Scale. Angry, happy, and neutral facial expressions of different individuals were shown as target and distractor stimuli. Our analyses of gaze behavior focused on latency to the target face, number of distractor faces fixated before fixating the target, number of target fixations, and number of distractor faces fixated after fixating the target. Results: Alexithymic patients exhibited in general slower decision latencies compared to non-alexithymic patients in the face-in-the-crowd task. Patient groups did not differ in latency to target, number of target fixations, and number of distractors fixated prior to target fixation. However, after having looked at the target, alexithymic patients fixated more distractors than non-alexithymic patients, regardless of expression condition. Discussion: According to our results, alexithymia goes along with impairments in visual processing of multiple facial emotions in clinical depression. Alexithymia appears to be associated with delayed manual reaction times and prolonged scanning after the first target fixation in depression, but it might have no impact on the early search phase. The observed deficits could indicate difficulties in target identification and/or decision-making when processing multiple emotional facial expressions. Impairments of alexithymic depressed patients in processing emotions in crowds of faces seem not limited to a specific affective valence. In group situations, alexithymic depressed patients might be slowed in processing interindividual differences in emotional expressions compared with non-alexithymic depressed patients. This could represent a disadvantage in understanding non-verbal communication in groups.
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Affiliation(s)
- Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Vivien Günther
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Tilman Hensch
- Department of Psychiatry and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
- Department of Psychology, IU International University of Applied Science, Erfurt, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Charlott Maria Bodenschatz
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
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Bodenschatz CM, Czepluch F, Kersting A, Suslow T. Efficient visual search for facial emotions in patients with major depression. BMC Psychiatry 2021; 21:92. [PMID: 33573637 PMCID: PMC7879523 DOI: 10.1186/s12888-021-03093-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depressive disorder has been associated with specific attentional biases in processing emotional facial expressions: heightened attention for negative and decreased attention for positive faces. However, using visual search paradigms, previous reaction-time-based research failed, in general, to find evidence for increased spatial attention toward negative facial expressions and reduced spatial attention toward positive facial expressions in depressed individuals. Eye-tracking analyses allow for a more detailed examination of visual search processes over time during the perception of multiple stimuli and can provide more specific insights into the attentional processing of multiple emotional stimuli. METHODS Gaze behavior of 38 clinically depressed individuals and 38 gender matched healthy controls was compared in a face-in-the-crowd task. Pictures of happy, angry, and neutral facial expressions were utilized as target and distractor stimuli. Four distinct measures of eye gaze served as dependent variables: (a) latency to the target face, (b) number of distractor faces fixated prior to fixating the target, (c) mean fixation time per distractor face before fixating the target and (d) mean fixation time on the target. RESULTS Depressed and healthy individuals did not differ in their manual response times. Our eye-tracking data revealed no differences between study groups in attention guidance to emotional target faces as well as in the duration of attention allocation to emotional distractor and target faces. However, depressed individuals fixated fewer distractor faces before fixating the target than controls, regardless of valence of expressions. CONCLUSIONS Depressed individuals seem to process angry and happy expressions in crowds of faces mainly in the same way as healthy individuals. Our data indicate no biased attention guidance to emotional targets and no biased processing of angry and happy distractors and targets in depression during visual search. Under conditions of clear task demand depressed individuals seem to be able to allocate and guide their attention in crowds of angry and happy faces as efficiently as healthy individuals.
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Affiliation(s)
- Charlott Maria Bodenschatz
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Felix Czepluch
- Department of Social Psychology, University of Leipzig, Neumarkt 9-19, 04109 Leipzig, Germany
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
| | - Thomas Suslow
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103 Leipzig, Germany
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Jenkins LM, Kassel MT, Gabriel LB, Gowins JR, Hymen EA, Vergés A, Calamia M, Crane NA, Jacobs RH, Ajilore O, Welsh RC, Drevets WC, Phillips ML, Zubieta JK, Langenecker SA. Amygdala and dorsomedial hyperactivity to emotional faces in youth with remitted Major Depression. Soc Cogn Affect Neurosci 2015; 11:736-45. [PMID: 26714574 DOI: 10.1093/scan/nsv152] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 12/15/2015] [Indexed: 01/25/2023] Open
Abstract
We present neuroimaging markers of the remitted state of major depressive disorder (rMDD) during facial emotion perception in 84 individuals during fMRI. Participants comprised 47 individuals (aged 18-23) diagnosed with rMDD and 37 healthy controls (HCs). Participants classified emotional faces or animals (control condition) in the Facial Emotion Perception Test (FEPT) during fMRI. Behavioural performance on the FEPT did not differ significantly between groups. During fMRI, both groups demonstrated significant blood oxygen level-dependent (BOLD) activity in bilateral inferior frontal gyri for the faces minus animals (F-A) contrast. The rMDD group additionally showed BOLD activity during F-A in numerous regions, including the bilateral paracingulate gyri, middle temporal gyri and right amygdala. The rMDD group exhibited significantly greater activity than the HC group in regions including the bilateral middle temporal gyri and left superior frontal gyrus. Although the rMDD group did not manifest the behavioural performance deficits on facial emotion recognition tasks that have been observed in actively depressed individuals, the rMDD group nevertheless showed increased BOLD activity compared with never-depressed controls during F-A in multiple posterior brain regions, suggesting that persistent effects of illness or possible trait vulnerabilities may distinguish individuals with rMDD from never-depressed controls.
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Affiliation(s)
- Lisanne M Jenkins
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Michelle T Kassel
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Laura B Gabriel
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Jennifer R Gowins
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Erica A Hymen
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Alvaro Vergés
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Matthew Calamia
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Natania A Crane
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Rachel H Jacobs
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Olusola Ajilore
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL
| | - Robert C Welsh
- Departments of Psychiatry and Radiology, The University of Michigan, Ann Arbor, MI
| | - Wayne C Drevets
- The University of Pittsburgh Medical Center, Pittsburgh, PA, and Janssen Research & Development, LLC, of Johnson & Johnson, Inc., Raritan, NJ, USA
| | - Mary L Phillips
- The University of Pittsburgh Medical Center, Pittsburgh, PA, and
| | - Jon-Kar Zubieta
- Departments of Psychiatry and Radiology, The University of Michigan, Ann Arbor, MI
| | - Scott A Langenecker
- Department of Psychiatry, The University of Illinois at Chicago, Chicago, IL, Departments of Psychiatry and Radiology, The University of Michigan, Ann Arbor, MI,
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