Abstract
Aberrant emotional reactivity is a putative endophenotype for bipolar disorder (BD), but the findings of behavioral studies are often negative due to suboptimal sensitivity of the employed paradigms. This study aimed to investigate whether visual gaze patterns and facial displays of emotion during emotional film clips can reveal subtle behavioral abnormalities in remitted BD patients. Thirty-eight BD patients in full or partial remission and 40 healthy controls viewed 7 emotional film clips. These included happy, sad, and neutral scenarios and scenarios involving winning, risk-taking, and thrill-seeking behavior of relevance to the BD phenotype. Eye gaze and facial expressions were recorded during the film clips, and participants rated their emotional reactions after each clip. BD patients showed a negative bias in both facial displays of emotion and self-rated emotional responses. Specifically, patients exhibited more fearful facial expressions during all film clips. This was accompanied by less positive self-rated emotions during the winning and happy film clips, and more negative emotions during the risk-taking/thrill-related film clips. These findings suggest that BD is associated with trait-related abnormalities in subtle behavioral displays of emotion processing. Future studies comparing patients with BD and unipolar depression are warranted to clarify whether these differences are specific to BD. If so, assessments of visual gaze and facial displays of emotion during emotional film clips may have the potential to be implemented in clinical assessments to aid diagnostic accuracy.
Highlights
Bipolar disorder (BD) is a chronic psychiatric disorder with recurrences [1], leading to a lower quality of life and an elevated risk of suicide [2,3]
We found that remitted patients with bipolar disorder (BD) exhibited subtle abnormalities in visual gaze patterns and facial displays of emotion when viewing aversive images [16]
The present study investigated for the first time eye movements, facial displays of emotion, and self-reported emotional reactivity in response to highly emotional film clips in remitted newly diagnosed BD patients compared with healthy controls (HCs)
Summary
Bipolar disorder (BD) is a chronic psychiatric disorder with recurrences [1], leading to a lower quality of life and an elevated risk of suicide [2,3]. It is plausible that these behavioral measures of emotion processing fail to detect differences between patients with BD and healthy controls (HCs) because of insufficient sensitivity of subjective ratings to detect abnormal brain function. This study aimed to investigate whether visual gaze patterns and facial displays of emotion during emotional film clips can reveal subtle behavioral abnormalities in remitted BD patients. Thirty-eight BD patients in full or partial remission and 40 healthy controls viewed 7 emotional film clips These included happy, sad, and neutral scenarios and scenarios involving winning, risk-taking, and thrill-seeking behavior of relevance to the BD phenotype. Patients exhibited more fearful facial expressions during all film clips This was accompanied by less positive self-rated emotions during the winning and happy film clips, and more negative emotions during the risk-taking/thrill-related film clips. Assessments of visual gaze and facial displays of emotion during emotional film clips may have the potential to be implemented in clinical assessments to aid diagnostic accuracy
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