Accuracy in non-verbal emotional processing in children of parents diagnosed with bipolar disorder – preliminary results

Abstract

Background: Children of parents diagnosed with bipolar disorder are at greater risk of developing bipolar disorder as well other axis I conditions. This increased risk is associated with deficits in frontal top-down regulatory pathways, involved with emotional processing and regulation. Previous research has also shown that depressive and anxiety-related symptoms in children at-risk have been linked to greater likelihood of developing bipolar disorder later on. Better understanding the deficits involved in this pathway during the progression of the disorder will help further our understanding of risk and the core psychopathology underlying bipolar disorder. The goal of our study is to compare performance during a nonverbal emotional labeling task between symptomatic high-risk bipolar offspring and children of healthy control parents. Methods: We plan to compare a total of 45 high-risk bipolar offspring with 15 healthy control participants during the well-validated Diagnostic Analysis of Nonverbal Accuracy (DANVA) task. To date, 14 high-risk partially-affected offspring (average age = 13.7(2.9) years, 6 females) and 12 healthy control offspring (average age = 13.2(2.7) years, 8 females) have participated. Overall accuracy and type of error, including intensity and emotion, have been compared between groups using Mann-Whitney U tests. Similarly, we performed a secondary analysis using diagnosis of depression and anxiety-related disorders in high-risk offspring to compare performance on this task using Kruskal-Wallis rank sum test. Results: High-risk offspring were shown to have significant increase in total number of errors on both child and adult face subsections of the DANVA (p b 0.0001 for both). High-risk offspring performed worse when the emotional intensity of the face shown was low for both child and adult faces and interestingly, for high intensity faces in adults. High-risk offspring were also more likely to inaccurately label angry faces as well as fearful adult faces. During a secondary analysis, we compared high-risk offspring with depression (n = 7), anxiety-related disorders (n = 6) and healthy controls (n = 12) and found the labeling accuracy difference between the three groups during the identification of low intensity emotion in adult faces (p = 0.04) as well as when adults faces were expressing anger (p = 0.008). Conclusions: Our results provide further evidence that the DANVA can be used to examine the emotional labeling deficits in offspring at high risk to develop bipolar disorder. Such deficits may be part of the core psychopathology in bipolar disorder.