Facial Expression Recognition Test Research Articles

Mentalizing can be Impaired in Patients with Meningiomas Originating in the Anterior Skull Base

Mentalizing is an essential function of our social lives. Impairment of mentalizing due to meningiomas has not received attention since most patients return to their social lives after surgical treatment. We investigated the influence of meningiomas and their surgical resection on mentalizing. Low- and high-level mentalizing were retrospectively examined in 61 patients with meningiomas and 14 healthy volunteers. Mentalizing was assessed using the facial expression recognition test and picture arrangement test of the Wechsler Adult Intelligence Scale, third edition, before and after surgery. We examined the influence of tumor localization on mentalizing and recovery from mentalizing disorders after tumor resection. Voxel-based lesion-symptom mapping (VLSM) was performed to investigate the relationship between impairments in mentalizing and tumor location. Before surgery, mentalizing was impaired significantly in patients with meningiomas compared to those in the control group (low-level: p=0.015, high-level: p=0.011). This impairment was associated with contact between the tumor and frontal lobe (low-level: p=0.036, high-level: p=0.047) and was severe in patients with tumors arising in the anterior skull base (low-level: p=0.0045, high-level: p=0.043). VLSM revealed that when the basal cortex of the frontal lobe was compressed by the tumor, the risk of impaired mentalizing was high. The region responsible for high-level mentalizing was located deeper than that responsible for low-level mentalizing. After the surgical removal of the tumor, the test scores significantly improved (low-level: p=0.035, high-level: p=0.045). Mentalizing was impaired by meningiomas arising from the anterior skull base, but it can improve after surgical resection of the tumors.

Validation of the P1vital® Faces Set for Use as Stimuli in Tests of Facial Emotion Recognition.

BackgroundNegative bias in facial emotion recognition is a well-established concept in mental disorders such as depression. However, existing face sets of emotion recognition tests may be of limited use in international research, which could benefit from more contemporary and diverse alternatives. Here, we developed and provide initial validation for the P1vital® Affective Faces set (PAFs) as a contemporary alternative to the widely-used Pictures of Facial Affect (PoFA).MethodsThe PAFs was constructed of 133 color photographs of facial expressions of ethnically-diverse trained actors and compared with the PoFA, comprised of 110 black and white photographs of facial expressions of generally Caucasian actors. Sixty-one recruits were asked to classify faces from both sets over six emotions (happy, sad, fear, anger, disgust, surprise) varying in intensity in 10% increments from 0 to 100%.ResultsParticipants were significantly more accurate in identifying correct emotions viewing faces from the PAFs. In both sets, participants identified happy faces more accurately than fearful faces, were least likely to misclassify facial expressions as happy and most likely to misclassify all emotions at low intensity as neutral. Accuracy in identifying facial expressions improved with increasing emotion intensity for both sets, reaching peaks at 60 and 80% intensity for the PAFs and PoFA, respectively. The study was limited by small sizes and age-range of participants and ethnic diversity of actors.ConclusionsThe PAFs successfully depicted a range of emotional expressions with improved performance over the PoFA and may be used as a contemporary set in facial expression recognition tests.

TREFACE: A New Computerized Test of Emotional Stroop with Facial Expressions

Using the conflict principle of the Stroop task, “effect of interference in color naming”, the present study proposes to create a computational version of the emotional Stroop task, called TREFACE, for its acronyms in Portuguese “Teste de Reconhecimento de Expressões Faciais com Conflito Emocional” (Facial Expression Recognition Test with Emotional Conflict). In this protocol, four fixed styles of presentation were generated according to the condition: Congruent Word Reading, Incongruent Word Reading, Congruent Recognition of Face Expression and Incongruent Recognition of Face Expression, counterbalanced in terms of each facial expression, word and gender of the photo character. Forty-two healthy volunteers completed the task. Results revealed that a task associated with word reading allows better performance than a task associated with face recognition. It was also identified that in the congruent condition, there is an advantage in terms of the correct responses. Additionally, the data regarding recognition of face expression showed greater difficulty when the image was not congruent with the word. In general, the results suggest that the emotional attribute can compromise the ability to recognize the faces, reaching the functioning of mechanisms such as cognitive control and regulation of emotions. Thus, the TREFACE paradigm can be considered a good assessment tool for monitoring emotional conflict, in addition to presenting itself as a new instrument in Portuguese language for assessing emotional working memory in healthy individuals and, eventually, in different pathologies that affect the functioning of cortical areas related to executive functions.

Posterior-prefrontal and medial orbitofrontal regions play crucial roles in happiness and sadness recognition

The core brain regions responsible for basic human emotions are not yet fully understood. We investigated the key areas responsible for emotion recognition of facial expressions of happiness and sadness using data obtained from patients who underwent local brain resection. A total of 44 patients with right cerebral hemispheric brain tumors and 33 healthy volunteers were enrolled and subjected to a facial expression recognition test. Voxel-based lesion-symptom mapping was performed to investigate the relationship between the accuracy of emotion recognition and the resected regions. Consequently, trade-off relationships were discovered: the posterior-prefrontal region was related to a low score of happiness recognition and a high score of sadness recognition (disorder-of-happiness group), whereas the medial orbitofrontal region was related to a low score of sadness recognition and a high score of happiness recognition (disorder-of-sadness group). The emotion recognition score in both the happiness and sadness disorder groups was significantly lower than that in the control group (p = 0.0009 and p = 0.021, respectively). Interestingly, the deficit in happiness recognition was temporary, whereas the deficit in sadness recognition persisted during the chronic phase. Using graph theoretical analysis, we identified structural connectivity between the posterior-prefrontal and medial orbitofrontal regions. When either of these regions was damaged, the tract volume connecting them was significantly reduced (p = 0.013). These results indicate that the posterior-prefrontal and medial orbitofrontal regions may be crucial for maintaining a balance between happiness and sadness recognition in humans. Investigating the clinical impact of certain area resections using lesion studies combined with connectivity analysis is a useful neuroimaging method for understanding neural networks.

Emotional cognition subgroups in unaffected first-degree relatives of patients with mood disorders.

Patients with major depressive disorder (MDD) or bipolar disorder (BD) exhibit difficulties with emotional cognition even during remission. There is evidence for aberrant emotional cognition in unaffected relatives of patients with these mood disorders, but studies are conflicting. We aimed to investigate whether emotional cognition in unaffected first-degree relatives of patients with mood disorders is characterised by heterogeneity using a data-driven approach. Data from 94 unaffected relatives (33 of MDD patients; 61 of BD patients) and 203 healthy controls were pooled from two cohort studies. Emotional cognition was assessed with the Social Scenarios Test, Facial Expression Recognition Test and Faces Dot-Probe Test. Hierarchical cluster analysis was conducted using emotional cognition data from the 94 unaffected relatives. The resulting emotional cognition clusters and controls were compared for emotional and non-emotional cognition, demographic characteristics and functioning. Two distinct clusters of unaffected relatives were identified: a relatively 'emotionally preserved' cluster (55%; 40% relatives of MDD probands) and an 'emotionally blunted' cluster (45%; 29% relatives of MDD probands). 'Emotionally blunted' relatives presented with poorer neurocognitive performance (global cognition p = 0.010), heightened subsyndromal mania symptoms (p = 0.004), lower years of education (p = 0.004) and difficulties with interpersonal functioning (p = 0.005) than controls, whereas 'emotionally preserved' relatives were comparable to controls on these measures. Our findings show discrete emotional cognition profiles that occur across healthy first-degree relatives of patients with MDD and BD. These emotional cognition clusters may provide insight into emotional cognitive markers of genetically distinct subgroups of individuals at familial risk of mood disorders.

The Relationship Between Facial Expression and Cognitive Function in Patients With Depression.

Objective: Considerable evidence has shown that facial expression recognition ability and cognitive function are impaired in patients with depression. We aimed to investigate the relationship between facial expression recognition and cognitive function in patients with depression.Methods: A total of 51 participants (i.e., 31 patients with depression and 20 healthy control subjects) underwent facial expression recognition tests, measuring anger, fear, disgust, sadness, happiness, and surprise. The Chinese version of the MATRICS Consensus Cognitive Battery (MCCB), which assesses seven cognitive domains, was used.Results: When compared with a control group, there were differences in the recognition of the expressions of sadness (p = 0.036), happiness (p = 0.041), and disgust (p = 0.030) in a depression group. In terms of cognitive function, the scores of patients with depression in the Trail Making Test (TMT; p < 0.001), symbol coding (p < 0.001), spatial span (p < 0.001), mazes (p = 0.007), the Brief Visuospatial Memory Test (BVMT; p = 0.001), category fluency (p = 0.029), and continuous performance test (p = 0.001) were lower than those of the control group, and the difference was statistically significant. The accuracy of sadness and disgust expression recognition in patients with depression was significantly positively correlated with cognitive function scores. The deficits in sadness expression recognition were significantly correlated with the TMT (p = 0.001, r = 0.561), symbol coding (p = 0.001, r = 0.596), maze (p = 0.015, r = 0.439), and the BVMT (p = 0.044, r = 0.370). The deficits in disgust expression recognition were significantly correlated with impairments in the TMT (p = 0.005, r = 0.501) and symbol coding (p = 0.001, r = 0.560).Conclusion: Since cognitive function is impaired in patients with depression, the ability to recognize negative facial expressions declines, which is mainly reflected in processing speed, reasoning, problem-solving, and memory.

Facial expression recognition in mild cognitive impairment and dementia: is the preservation of happiness recognition hypothesis true?

Social cognition encompasses facial expression recognition (FER), theory of mind, and empathy. Although studies examining FER in large numbers of patients with mild cognitive impairment (MCI) or dementia are rare, relative preservation of happiness recognition in dementia was reported in some studies. In this study, we examined performance on FER tests and its relationship to clinical demographics and other cognitive function test scores in patients with cognitive decline. The present study administered an FER test and several cognitive tests to outpatients at a memory clinic. The FER test presents four facial expressions (happiness, surprise, anger, and sadness). A total of 187 patients were placed in one of the three groups based on their cognitive status: dementia group (n = 63), MCI group (n = 92), and normal cognition group (n = 32). The total scores on the FER test significantly differed among the three groups (normal > MCI > dementia). In the recognition of happiness and surprise, the dementia group had significantly lower scores than the normal cognition group. There were no significant differences in the recognition of anger and sadness scores among the three groups. The FER scores for happiness and surprise were primarily related to executive function scores, but the FER scores for anger and sadness were primarily related to age. We note the difference in recognition of causative factors among the four emotions (happiness, surprise, anger, sadness). Our study raises serious doubts about the preservation of happiness recognition hypothesis in dementia based on FER tests.

Effects of Self-Control Training on Emotional Wellbeing and Opioid Craving Among Men with Opioid Use Disorder

Background: Today, opioid use is recognized as a global concern, threatening people’s physical and mental health. Objectives: This study was conducted to investigate the effects of self-control training on emotional wellbeing and opioid craving among men with opioid use disorder. Methods: In this quasi experimental study, the sample included all men with opioid use disorder, who were admitted to drug treatment centers of district 6, Tehran, Iran during year 2015. Fifty subjects were initially selected, matched, and randomly assigned to experimental and control groups (25 cases per group). After a diagnostic interview, the subjects were asked to complete the pretests, including the cognitive emotion regulation questionnaire (CERQ), facial expression recognition test (FERT), emotional processing scale (EPS), toronto alexithymia scale (TAS), and craving beliefs questionnaire (CBQ). The experimental group participated in 10 weekly sessions of self-control training. A week after the intervention, both groups were tested using the same instruments. For data analysis, multiple analysis of variance (MANOVA) test was applied in SPSS version 18. Results: Self-control training caused a significant increase in positive emotion regulation (P < 0.001), emotion recognition (P = 0.002), and emotion processing (P < 0.001), while reducing negative emotion regulation (P = 0.002), alexithymia (P < 0.001), and opioid craving in men with opioid use disorder (P < 0.001). Conclusions: Self-control training exerts a significant effect on the improvement of emotional wellbeing in men with opioid use disorder and reduces their opioid craving.

Development and validation of the Facial Expression Recognition Test (FERT).

Detecting the emotional state of others from facial expressions is a key ability in emotional competence and several instruments have been developed to assess it. Typical emotion recognition tests are assumed to be unidimensional, use pictures or videos of emotional portrayals as stimuli, and ask the participant which emotion is depicted in each stimulus. However, using actor portrayals adds a layer of difficulty in developing such a test: the portrayals may fail to be convincing and may convey a different emotion than intended. For this reason, evaluating and selecting stimuli is of crucial importance. Existing tests typically base item evaluation on consensus or expert judgment, but these methods could favor items with high agreement over items that better differentiate ability levels and they could not formally test the item pool for unidimensionality. To address these issues, the authors propose a new test, named Facial Expression Recognition Test (FERT), developed using an item response theory two-parameter logistic model. Data from 1,002 online participants were analyzed using both a unidimensional and a bifactor model, and showed that the item pool could be considered unidimensional. The selection was based on the items' discrimination parameters, retaining only the most informative items to investigate the latent ability. The resulting 36-item test was reliable and quick to administer. The authors found both a gender difference in the ability to recognize emotions and a decline of such ability with age. The PsychoPy implementation of the test and the scoring script are available on a Github repository. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Different levels of facial expression recognition in patients with first-episode schizophrenia: A functional MRI study

BackgroundThe impairment of facial expression recognition has become a biomarker for early identification of first-episode schizophrenia, and this kind of research is increasing.AimsTo explore the differences in brain area activation...

Characteristics of facial expression recognition ability in patients with Lewy body disease

BackgroundThe facial expression of medical staff has been known to greatly affect the psychological state of patients, making them feel uneasy or conversely, cheering them up. By clarifying the characteristics of facial expression recognition ability in patients with Lewy body disease, the aim of this study is to examine points to facilitate smooth communication between caregivers and patients with the disease whose cognitive function has deteriorated.MethodsDuring the period from March 2016 to July 2017, we examined the characteristics of recognition of the six facial expressions of “happiness,” “sadness,” “fear,” “anger,” “surprise,” and “disgust” for 107 people aged 60 years or more, both outpatient and inpatient, who hospital specialists had diagnosed with Lewy body diseases of Parkinson’s disease, Parkinson’s disease with dementia, and dementia with Lewy bodies. Based on facial expression recognition test results, we classified them by cluster analysis and clarified features of each type.ResultsIn patients with Lewy body disease, happiness was kept unaffected by aging, age of onset, duration of the disease, cognitive function, and apathy; however, recognizing the facial expression of fear was difficult. In addition, due to aging, cognitive decline, and apathy, the facial expression recognition ability for sadness and anger decreased. In particular, cognitive decline reduced recognition of all of the facial expressions except for happiness. The test accuracy rates were classified into three types using the cluster analysis: “stable type,” “mixed type,” and “reduced type”. In the “reduced type”, the overall facial recognition ability declined except happiness, and in the mixed type, recognition ability of anger particularly declined.ConclusionThere were several facial expressions that the Lewy body disease patients were unable to accurately identify. Caregivers are recommended to make an effort to compensate for such situations with language or body contact, etc., as a way to convey correct feeling to the patients of each type.

Supplemental Material for Development and Validation of the Facial Expression Recognition Test (FERT)

Supplemental Material for Development and Validation of the Facial Expression Recognition Test (FERT)

Insular cognitive impairment at the early stage of dementia with Lewy bodies: a preliminary study.

The anterior part of the insula appears atrophied in the early stage of dementia with Lewy bodies (DLB) whereas it is not the case in early Alzheimer's disease (AD). The objective of this study was to develop neuropsychological markers supposed to reflect insular dysfunction, which would facilitate early diagnosis of DLB, namely in comparison to AD. Twelve patients with DLB, 12 patients with AD, all at the stage of Mild cognitive impairment (MCI) or mild dementia, as well as 10 Controls subjects (CS) participated in the study. Cognitive functions supposedly related to the insula were evaluated with a battery of tests: a facial expression recognition test, a test assessing the feeling of disgust with images, a test evaluating idioms' comprehension, an empathy questionnaire and a questionnaire screening for disgusting behaviors. Compared to AD patients and CS, DLB patients experienced less disgust when they were shown disgusting images, whereas their ability to recognize emotional expression of disgust appeared to be preserved. Furthermore, DLB patients seemed less empathetic than AD patients. Finally, compared to CS, DLB patients were less effective to provide an intuitive decision about idioms' signification since they needed significantly more time to answer. This preliminary study suggests the existence of a potential «insular cognitive impairment» profile in DLB at the early stage. These results provide interesting leads to develop tools facilitating the differential diagnosis of DLB and AD.

Interaction Between Val158Met Catechol-O-Methyltransferase Polymorphism and Social Cognitive Functioning in Schizophrenia: Pilot Study.

The Val158Met catechol-O-methyltransferase (COMT) functional polymorphism may influence social cognitive functioning in patients with schizophrenia. Aspects of social cognition were evaluated with the Facial Expression Recognition Test, the Voice Emotion Recognition Test, and the Reading the Mind in the Eyes Test. The Short Recognition Memory Test for Faces was used as a control measure. The Schedule for the Assessment of Negative Symptoms, Schedule for the Assessment of Positive Symptoms, and Beck Depression Inventory were used to rate of patient symptoms. There were 100 patients with the following genotypes: Val/Val (21), Met/Met (30), and Val/Met (49). The genotype distribution of polymorphism of Val158Met COMT did not differ between the patient and control groups. Schizophrenia carriers of the Val/Val genotype performed worse in social cognitive measures, in comparison with the other groups. No statistically significant correlations were recorded between age at schizophrenia onset and polymorphism of Val158Met COMT. There was an influence of genotype in the control group: the Met homozygotes performing better. Schizophrenia patients homozygous for the Val allele showed significant disadvantages over patients homozygous or heterozygous for the Met allele in social cognitive processes. The COMT genotype may not, however, contribute to the age of onset of schizophrenia.

Intact social cognitive processes in outpatients with anorexia nervosa: a pilot study.

ObjectiveThe aim of the study was to assess social cognition in community patients suffering from anorexia nervosa (AN) compared to healthy controls.Methods25 women diagnosed with AN and 25 women matched for education level and age were involved in the study. Both subject groups were assessed using a set of validated experimental tasks, such as the facial expression recognition test, short recognition memory test for faces, ‘Reading the mind in the eyes’ test. Patients were assessed for symptoms of: eating disorder (the eating attitudes test—EAT-26), OCD (the Yale–Brown obsessive compulsive scale—Y-BOCS) and depression (Beck depression inventory—BDI). The research hypothesis indicated that patients suffering from anorexia represent no significant difference in social cognitive functioning in comparison to the healthy controls. These assessment scales were used to identify whether there are any problems according to social cognitive functioning especially emotion recognition and theory of mind (ToM). The primary outcome assessment was to identify social cognitive deficits in anorexic outpatients and secondary outcome was to verify whether these problems in emotional functioning found in women in acute phase of AN are state or trait effects.ResultsAnorexic patients showed significantly higher scores on EAT-26, BDI and Y-BOCS. No significant differences were found in performance of social cognitive tests and facial perception test.DiscussionNo marked alterations were found in social cognitive functioning in community patients with average body mass index (BMI) of 17.6. This may indicate that social cognition is a very complex construct to be reliably measured in anorexia nervosa considering relatively limited psychometric data for many social cognitive tasks. Further longitudinal studies are needed to untangle ongoing controversy whether social cognitive deficits in AN could be state or trait related.

The recognition of facial emotions in bipolar disorder

Introduction Bipolar disorder is a common chronic psychiatric disorder, marked by the severity and frequency of mood episodes and their impact on the psychosocial functioning of these patients. Even during inter-critical periods, these patients' cognitive functions are altered. Patients diagnosed with bipolar disorder, by definition, have problems with emotional regulation. However, it remains uncertain whether these patients also have a deficit in processing emotions of others. The main objective was to assess social cognition (recognition of facial emotions) in euthymic bipolar subjects by comparing them to a control group. Methodology This is a transversal case-witness study, conducted in consultation with the post-treatment, of 30 euthymic bipolar patients and 30 healthy volunteers matched for age, sex and educational level, with the help of a questionnaire targeting socio-demographic and clinical data, as well as a facial expression recognition test to measure social cognition. Results Our study showed that bipolar patients had deficits in social cognition compared to the volunteers' group. Bipolar patients have more difficulties than healthy subjects to recognize facial emotions of fear, anger and disgust, and assign intentions to others from images. These deficits are even more accentuated in the early onset forms. Conclusion This study shows a disturbance of perception of emotions in bipolar patients. These cognitive deficits could participate in behavioral and social disorders present in bipolar disorder.

Amygdala volume predicts inter-individual differences in fearful face recognition.

The present study investigates the relationship between inter-individual differences in fearful face recognition and amygdala volume. Thirty normal adults were recruited and each completed two identical facial expression recognition tests offline and two magnetic resonance imaging (MRI) scans. Linear regression indicated that the left amygdala volume negatively correlated with the accuracy of recognizing fearful facial expressions and positively correlated with the probability of misrecognizing fear as surprise. Further exploratory analyses revealed that this relationship did not exist for any other subcortical or cortical regions. Nor did such a relationship exist between the left amygdala volume and performance recognizing the other five facial expressions. These mind-brain associations highlight the importance of the amygdala in recognizing fearful faces and provide insights regarding inter-individual differences in sensitivity toward fear-relevant stimuli.

주의력결핍 과잉행동장애의 이환 여부에 따른 얼굴표정 정서 인식의 차이

Objectives : It is known that children with attention-deficit hyperactivity disorder (ADHD) experience significant difficulty in recognizing facial emotion, which involves processing of emotional facial expressions rather than speech, compared to children without ADHD. This objective of this study is to investigate the differences in facial emotion recognition between children with ADHD and normal children used as control. Methods : The children for our study were recruited from the Suwon Project, a cohort comprising a non-random convenience sample of 117 nine-year-old ethnic Koreans. The parents of the study participants completed study questionnaires such as the Korean version of Child Behavior Checklist, ADHD Rating Scale, Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version. Facial Expression Recognition Test of the Emotion Recognition Test was used for the evaluation of facial emotion recognition and ADHD Rating Scale was used for the assessment of ADHD. Results : ADHD children (N=10) were found to have impaired recognition when it comes to Emotional Differentiation and Contextual Understanding compared with normal controls (N=24). We found no statistically significant difference in the recognition of positive facial emotions (happy and surprise) and negative facial emotions (anger, sadness, disgust and fear) between the children with ADHD and normal children. Conclusion : The results of our study suggested that facial emotion recognition may be closely associated with ADHD, after controlling for covariates, although more research is needed.

Social Cognition and Visual Perception in Schizophrenia Inpatients Treated with First-and Second-Generation Antipsychotic Drugs

Social cognition captures affect recognition, social cue perception, "theory of mind," empathy, and attributional style. The aim of our study was to assess social cognition in schizophrenia inpatients being treated with first-generation antipsychotic drugs (FGAs), n=28 (perphenazine and haloperidol, FGAs) or with second-generation antipsychotic drugs (SGAs), n=56 (olanzapine and clozapine, SGAs). Eighty-four patients completed the Facial Expression Recognition Test, the Voice Emotion Recognition Test, the Short Recognition Memory Test for Faces, and the Reading the Mind in the Eyes Test. Patients also completed the Visual Object and Space Perception Test (VOSP) as a control task, which would not engage social cognition. The patients were compared with fifty healthy controls matched for age and gender. There were no significant differences on social cognitive performance between the FGA- and SGA-treatment groups. Nor was olanzapine superior to clozapine, FGAs or both. However, patients treated with FGAs performed significantly worse on VOSP compared to both groups treated with SGAs, a 10% difference. We cannot conclude that SGAs were associated with better social cognition than FGAs. However, there were small but significant advantages for SGAs in non-social visual processing function, as evaluated with the VOSP.