Impairment in emotion perception from body movements in individuals with bipolar I and bipolar II disorder is associated with functional capacity

Anja Vaskinn,Thomas D Bjella,Kjetil Sundet,Carmen Simonsen,Torill Ueland,Trine Vik Lagerberg,Ole A Andreassen

doi:10.1186/s40345-017-0083-7

Anja Vaskinn, Thomas D Bjella + Show 5 more

Open Access

https://doi.org/10.1186/s40345-017-0083-7

Copy DOI

Abstract

BackgroundIndividuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state. The impairment extends to theory of mind and to the perception of emotion in faces and voices, but it is unclear if emotion perception from body movements is affected. The main aim of this study was to examine if participants with bipolar disorder perform worse than healthy control participants on a task using point-light displays of human full figures moving in a manner indicative of a basic emotion (angry, happy, sad, fearful, neutral/no emotion). A secondary research question was whether diagnostic subtypes (bipolar I, bipolar II) and history of psychosis impacted on this type of emotion perception. Finally, symptomatic, neurocognitive, and functional correlates of emotion perception from body movements were investigated.MethodsFifty-three individuals with bipolar I (n = 29) or bipolar II (n = 24) disorder, and 84 healthy control participants were assessed for emotion perception from body movements. The bipolar group also underwent clinical, cognitive, and functional assessment. Research questions were analyzed using analyses of variance and bivariate correlations.ResultsThe bipolar disorder group differed significantly from healthy control participants for emotion perception from body movements (Cohen’s d = 0.40). Analyses of variance yielded no effects of sex, diagnostic subtype (bipolar I, bipolar II), or history of psychosis. There was an effect of emotion, indicating that some emotions are easier to recognize. The lack of a significant group × emotion interaction effect points, however, to this being so regardless of the presence of bipolar disorder. Performance was unrelated to manic and depressive symptom load but showed significant associations with neurocognition and functional capacity.ConclusionsIndividuals with bipolar disorder had a small but significant impairment in the ability to perceive emotions from body movement. The impairment was global, i.e., affecting all emotions and equally present for males and females. The impairment was associated with neurocognition and functional capacity, but not symptom load. Our findings identify pathopsychological factors underlying the functional impairment in bipolar disorder and suggest the consideration of social cognition training as part of the treatment for bipolar disorder.

Highlights

Individuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state
Reviews and metaanalyses show that individuals with bipolar disorder (BD) perform better than persons diagnosed with schizophrenia for both facial emotion perception and ToM (Bora and Pantelis 2016), especially for complex ToM tasks of a more ecological valid nature, where individuals with schizophrenia evidence large deficits (Mitchell and Young 2014)
In our second research aim, we investigate if there are differences between participants with BD I and BD II, and if history of psychosis is associated with body language reading performance

Summary

Introduction

Individuals with bipolar disorder present with moderate impairments in social cognition during the euthymic state. Social cognition encompasses different domains (Pinkham 2014) of which emotion perception and theory of mind (ToM, i.e., the ability to infer the intentions, dispositions, or beliefs of others) have been the most commonly investigated in BD. Individuals with BD present with deficits for both domains, across illness phase, i.e., in manic, depressed, or euthymic states (Samamé 2013). According to a systematic review, deficits are more pronounced for ToM (d = 0.5–0.8) than for emotion perception (d < 0.5), albeit significantly for both domains (Samamé et al 2012), in the euthymic phase. A meta-analysis (Bora et al 2016) found ToM deficits to be significantly more pronounced (d = 1.23) in acute phases (manic or depressed mood). Reviews and metaanalyses show that individuals with BD perform better than persons diagnosed with schizophrenia for both facial emotion perception and ToM (Bora and Pantelis 2016), especially for complex ToM tasks of a more ecological valid nature, where individuals with schizophrenia evidence large deficits (Mitchell and Young 2014)

Objectives

Methods

Results

Discussion

Conclusion