Diminished sensitivity and specificity at recognising facial emotional expressions of varying intensity underlie emotion-specific recognition deficits in autism spectrum disorders

BackgroundA plethora of research on facial emotion recognition in autism spectrum disorders (ASD) exists and reported deficits in ASD compared to controls, particularly for negative basic emotions. However, these studies have largely used static high intensity stimuli. The current study investigated facial emotion recognition across three levels of expression intensity from videos, looking at accuracy rates to investigate impairments in facial emotion recognition and error patterns (’confusions’) to explore potential underlying factors.MethodTwelve individuals with ASD (9 M/3F; M(age) = 17.3) and 12 matched controls (9 M/3F; M(age) = 16.9) completed a facial emotion recognition task including 9 emotion categories (anger, disgust, fear, sadness, surprise, happiness, contempt, embarrassment, pride) and neutral, each expressed by 12 encoders at low, intermediate, and high intensity.ResultsA facial emotion recognition deficit was found overall for the ASD group compared to controls, as well as deficits in recognising individual negative emotions at varying expression intensities. Compared to controls, the ASD group showed significantly more, albeit typical, confusions between emotion categories (at high intensity), and significantly more confusions of emotions as ‘neutral’ (at low intensity).ConclusionsThe facial emotion recognition deficits identified in ASD, particularly for negative emotions, are in line with previous studies using other types of stimuli. Error analysis showed that individuals with ASD had difficulties detecting emotional information in the face (sensitivity) at low intensity, and correctly identifying emotional information (specificity) at high intensity. These results suggest different underlying mechanisms for the facial emotion recognition deficits at low vs high expression intensity.     

Selective Impairment of Basic Emotion Recognition in People with Autism: Discrimination Thresholds for Recognition of Facial Expressions of Varying Intensities

Autism spectrum disorders (ASD) are characterized by early onset qualitative impairments in reciprocal social development. However, whether individuals with ASD exhibit impaired recognition of facial expressions corresponding to basic emotions is debatable. To investigate subtle deficits in facial emotion recognition, we asked 14 children diagnosed with high-functioning autism (HFA)/AS and 17 typically developing peers to complete a new highly sensitive test of facial emotion recognition. The test stimuli comprised faces expressing increasing degrees of emotional intensity that slowly changed from a neutral to a full-intensity happiness, sadness, surprise, anger, disgust, or fear expression. We assessed individual differences in the intensity of stimuli required to make accurate judgments about emotional expressions. We found that, different emotions had different identification thresholds and the two groups were generally similar in terms of the sequence of discrimination threshold of six basic expressions. It was easier for individuals in both groups to identify emotions that were relatively fully expressed (e.g., intensity >?50%). Compared with control participants, children with ASD generally required stimuli with significantly greater intensity for the correct identification of anger, disgust, and fear expressions. These results suggest that individuals with ASD do not have a general but rather a selective impairment in basic emotion recognition.     

Emotion Understanding in Children with ADHD

Several studies suggest that children with ADHD tend to perform worse than typically developing children on emotion recognition tasks. However, most of these studies have focused on the recognition of facial expression, while there is evidence that context plays a major role on emotion perception. This study aims at further investigating emotion processing in children with ADHD, by assessing not only facial emotion recognition (Experiment 1) but also emotion recognition on the basis of contextual cues (Experiment 2). Twenty-seven children and adolescents with ADHD were compared to age-matched typically developing controls. Importantly, findings of this study show that emotion-processing difficulties in children with ADHD extend beyond facial emotion and also affect the recognition of emotions on the basis of contextual information. Our data thus indicate that children with ADHD have an overall emotion-processing deficit.     

Beyond words: how do children with ADHD and/or conduct problems process nonverbal information about affect?

OBJECTIVE: To study nonverbal social cue perception in children with attention-deficit/hyperactivity disorder (ADHD; n = 86), conduct problems (CP; n = 24), or both disorders (ADHD + CP; n = 63), as well as normal controls (n = 27). METHOD: Using a standardized test of receptive nonverbal processing abilities, participants were required to interpret emotional cues from pictures of facial expressions and recordings of voices. RESULTS: As predicted, children with CP and ADHD were significantly less accurate at interpreting emotions than normal controls. However, children with CP and ADHD differed in the type of errors made: the ADHD group's errors were generally random in nature, whereas the CP group tended to misinterpret emotions as anger. Contrary to our hypothesis, the ADHD + CP group performed better than the ADHD and CP groups, was as accurate as the control group, and displayed a unique pattern of errors. CONCLUSIONS: These results support the idea that social deficiencies associated with CP arise from a biased perception of emotion, whereas social problems in ADHD originate from a failure to attend to the appropriate cues of affect. The findings also support the theory that comorbid ADHD + CP is a distinct disorder.     

The misclassification of facial expressions in generalised social phobia

The aim of this study was to investigate facial expression recognition (FER) accuracy in social phobia and in particular to explore how facial expressions of emotion were misclassified. We hypothesised that compared with healthy controls, subjects with social phobia would be no less accurate in their identification of facial emotions (as reported in previous studies) but that they would misclassify facial expressions as expressing threatening emotions (anger, fear or disgust). Thirty individuals with social phobia and twenty-seven healthy controls completed a FER task which featured six basic emotions morphed using computer techniques between 0 percent (neutral) and 100 percent intensity (full emotion). Supporting our hypotheses we found no differences between the groups on measures of the accuracy of emotion recognition but that compared with healthy controls the social phobia group were more likely both to misclassify facial expressions as angry and to interpret neutral facial expressions as angry. The healthy control group were more likely to misclassify neutral expressions as sad. The importance of the role of these biases in social phobia needs further replication but may help in understanding the disorder and provide an interesting area for future research and therapy.     

A multidimensional assessment of social cognition in psychometrically defined schizotypy

Individuals with schizophrenia exhibit impairments in multiple social cognitive domains. There is evidence that these impairments may be trait-related vulnerability markers for schizophrenia. However, the literature focusing on individuals vulnerable to developing schizophrenia-spectrum disorders, referred to as schizotypy, has produced inconsistent findings. This study's primary aim was to provide a more comprehensive understanding of social cognitive functioning within schizotypy than previous studies by employing a broad array of measures to assess multiple social cognitive domains, and examine how these domains relate to specific schizotypy traits (i.e., positive, negative, and disorganized) and Quality of Life (QOL). Facial emotion recognition, Theory of Mind (ToM), and aspects of emotional intelligence related to regulating one's own emotions (emotion management) and other's emotions (social management) were measured. Individuals with psychometrically defined schizotypy (n=36) and controls (n=26) were examined. The schizotypy group performed significantly worse than controls on facial emotion recognition, ToM, and emotion management, but not social management. Generally speaking, poorer social cognition performance was not a function of specific schizotypy traits. However, negative traits were associated with poorer facial emotion recognition, and disorganized traits were associated with better social management. Facial emotion recognition was associated with QOL in the schizotypy group.     

Selective difficulty in recognising facial expressions of emotion in boys with ADHD

Research on emotion understanding in ADHD shows inconsistent results. This study uses control methods to investigate two questions about recognition and understanding of emotional expressions in 36 five- to eleven-year-old boys with ADHD: [1] Do they find this task more difficult than judging non-emotional information from faces, thus suggesting a specific social-cognitive impairment? [2] Are their judgements about faces impaired by general limitations on task performance, such as impulsive responding? In Part 1, 19 boys with ADHD and 19 age-matched typically developing boys matched facial expressions of emotion to situations, and did a control non-emotional face-processing task. Boys with ADHD performed more poorly than age-matches on both tasks, but found the emotion task harder than the non-emotion task. In Part 2, 17 boys with ADHD and 13 five-to six-year-old typically developing boys performed the same tasks, but with an ‘inhibitory scaffolding’ procedure to prevent impulsive responding. Boys with ADHD performed as well as the younger controls on the non-emotional task, but still showed impairments in the emotion task. Boys with ADHD may show poorer task performance because of general cognitive factors, but also showed selective problems in matching facial emotions to situations.     

Altered right frontal cortical connectivity during facial emotion recognition in children with autism spectrum disorders

A growing body of evidence suggests that autism spectrum disorders (ASD) is associated with altered functional connectivity of the brain and with impairment in recognizing others’ emotions. To better understand the relationships among these neural and behavioral abnormalities, we examined cortical connectivity which was indicated by theta coherence during tasks of facial emotion recognition in 18 children with ASD and 18 typically developing (TD) children who were between 6 and 18 years of age. We found that the children with ASD had general impairment in recognizing facial emotions, after controlling for response bias. Additionally, we found that the TD children demonstrated significant modulation of right frontal theta coherence in response to emotional faces compared to neutral faces, whereas children with ASD did not exhibit any modulation of theta coherence. The extent of modulation of theta coherence to emotions was further found to be related to the severity of social impairments in ASD. Our findings of a general impairment in facial emotion recognition and the involvement of disordered cortical connectivity in social deficits in children with ASD have shed light for future exploration of interventions regarding emotional processing and social functioning in ASD.     

A Pilot Study Assessing the Feasibility of a Facial Emotion Training Paradigm for School-Age Children With Autism Spectrum Disorders

Many children with autism spectrum disorders (ASDs) demonstrate facial emotion recognition and expression impairments. These impairments may contribute to social disability and may put children with ASDs at risk for developing further mental health problems. In this pilot study, we examined the use of a coach- and computer-assisted facial emotion training program for children with ASDs. The intervention components focused on (a) increasing attention to relevant facial emotion cues, (b) increasing facial emotion recognition speed, and (c) using imitation to build skills of facial emotion expression. Three pilot participants demonstrated improved facial emotion recognition (accuracy and speed) of dynamic and static presentations of facial expressions and self-expression. Some improvements persisted 5 weeks after training. Results support the acceptability and feasibility of the training program. These preliminary findings are promising and suggest the need for replication with larger samples and further assessment of acceptability, feasibility, and efficacy.     

Facial emotion perception by intensity in children and adolescents with 22q11.2 deletion syndrome

Difficulties in the recognition of emotions in expressive faces have been reported in people with 22q11.2 deletion syndrome (22q11.2DS). However, while low-intensity expressive faces are frequent in everyday life, nothing is known about their ability to perceive facial emotions depending on the intensity of expression. Through a visual matching task, children and adolescents with 22q11.2DS as well as gender- and age-matched healthy participants were asked to categorise the emotion of a target face among six possible expressions. Static pictures of morphs between neutrality and expressions were used to parametrically manipulate the intensity of the target face. In comparison to healthy controls, results showed higher perception thresholds (i.e. a more intense expression is needed to perceive the emotion) and lower accuracy for the most expressive faces indicating reduced categorisation abilities in the 22q11.2DS group. The number of intrusions (i.e. each time an emotion is perceived as another one) and a more gradual perception performance indicated smooth boundaries between emotional categories. Correlational analyses with neuropsychological and clinical measures suggested that reduced visual skills may be associated with impaired categorisation of facial emotions. Overall, the present study indicates greater difficulties for children and adolescents with 22q11.2DS to perceive an emotion in low-intensity expressive faces. This disability is subtended by emotional categories that are not sharply organised. It also suggests that these difficulties may be associated with impaired visual cognition, a hallmark of the cognitive deficits observed in the syndrome. These data yield promising tracks for future experimental and clinical investigations.     

Facial emotion recognition in children with or without Attention Deficit/Hyperactivity Disorder: Impact of comorbidity

ObjectivesThis study sought to assess facial emotion recognition deficit in children with Attention Deficit/Hyperactivity Disorder (ADHD) and to test the hypothesis that it is increased by comorbid features.MethodForty children diagnosed with ADHD were compared with 40 typically developing children, all aged from 7 to 11 years old, on a computerized facial emotion recognition task (based on the Pictures of Facial Affect). Data from parents’ ratings of ADHD and comorbid symptoms (on the Conners’ Revised Parent Rating Scale) were also collected.ResultsChildren with ADHD had significantly fewer correct answer scores than typically developing controls on the emotional task while they performed similarly on the control task. Recognition of sadness was especially impaired in children with ADHD. While ADHD symptoms were slightly related to facial emotion recognition deficit, oppositional symptoms were related to a decrease in the number of correct answers on sadness and surprise recognition.ConclusionFacial emotion recognition deficit in children with ADHD might be related to an impaired emotional process during childhood. Moreover, Oppositional Defiant Disorder seems to be a risk factor for difficulties in emotion recognition especially in children with ADHD.     

Recognition of Facial Expressions and Prosodic Cues with Graded Emotional Intensities in Adults with Asperger Syndrome

This study investigated the ability of adults with Asperger syndrome to recognize emotional categories of facial expressions and emotional prosodies with graded emotional intensities. The individuals with Asperger syndrome showed poorer recognition performance for angry and sad expressions from both facial and vocal information. The group difference in facial expression recognition was prominent for stimuli with low or intermediate emotional intensities. In contrast to this, the individuals with Asperger syndrome exhibited lower recognition accuracy than typically-developed controls mainly for emotional prosody with high emotional intensity. In facial expression recognition, Asperger and control groups showed an inversion effect for all categories. The magnitude of this effect was less in the Asperger group for angry and sad expressions, presumably attributable to reduced recruitment of the configural mode of face processing. The individuals with Asperger syndrome outperformed the control participants in recognizing inverted sad expressions, indicating enhanced processing of local facial information representing sad emotion. These results suggest that the adults with Asperger syndrome rely on modality-specific strategies in emotion recognition from facial expression and prosodic information.     

From facial emotional recognition abilities to emotional attribution: A study in Down syndrome

Facial expression processing and the attribution of facial emotions to a context were investigated in adults with Down syndrome (DS) in two experiments. Their performances were compared with those of a child control group matched for receptive vocabulary. The ability to process faces without emotional content was controlled for, and no differences appeared between the two groups. Specific impairments were found in the DS group according to the task modalities and the type of facial emotional expressions. In the emotion matching condition, the DS adults showed overall difficulties whereas in the identification and recognition conditions they were particularly impaired when processing the neutral expression. In the emotion attribution task, they exhibited difficulties with the sad expression only and the analysis of their error pattern revealed that they rarely selected this expression throughout the task. The sad emotion was the only one that showed a significant relationship with the facial expression processing tasks.     

Differential amygdala response during facial recognition in patients with schizophrenia: an fMRI study

Human lesion or neuroimaging studies suggest that amygdala is involved in facial emotion recognition. Although impairments in recognition of facial and/or emotional expression have been reported in schizophrenia, there are few neuroimaging studies that have examined differential brain activation during facial recognition between patients with schizophrenia and normal controls. To investigate amygdala responses during facial recognition in schizophrenia, we conducted a functional magnetic resonance imaging (fMRI) study with 12 right-handed medicated patients with schizophrenia and 12 age- and sex-matched healthy controls. The experiment task was a type of emotional intensity judgment task. During the task period, subjects were asked to view happy (or angry/disgusting/sad) and neutral faces simultaneously presented every 3 s and to judge which face was more emotional (positive or negative face discrimination). Imaging data were investigated in voxel-by-voxel basis for single-group analysis and for between-group analysis according to the random effect model using Statistical Parametric Mapping (SPM). No significant difference in task accuracy was found between the schizophrenic and control groups. Positive face discrimination activated the bilateral amygdalae of both controls and schizophrenics, with more prominent activation of the right amygdala shown in the schizophrenic group. Negative face discrimination activated the bilateral amygdalae in the schizophrenic group whereas the right amygdala alone in the control group, although no significant group difference was found. Exaggerated amygdala activation during emotional intensity judgment found in the schizophrenic patients may reflect impaired gating of sensory input containing emotion.     

Recognition of emotional facial expressions in attention-deficit hyperactivity disorder

In ADHD, impaired interpersonal relationships have been documented. They have been hypothesized to be secondary to impairment of receptive nonverbal language. Recognition of emotional facial expressions is an important aspect of receptive nonverbal language, and it has been demonstrated to be central to organization of emotional and social behavior. This study investigated the identification of facial expression of four emotions (joy, anger, disgust, and sadness) in a group of 30 children aged 7-12 years who met the DSM-IV criteria for ADHD disorder of the predominantly hyperactive-impulsive type and have no comorbid mental retardation, specific learning difficulties, developmental coordination disorder, pervasive developmental disorders, conduct disorder, bipolar disorder, or substance abuse, and in 30 matched unimpaired control children. The test used includes 16 validated photographs depicting these emotions in varying intensities constructed by morphing. Children with ADHD exhibited a general deficit in decoding emotional facial expressions, with specific deficit in identifying anger and sadness. Self-rating of the task difficulty revealed lack of awareness of decoding errors in the ADHD group as compared with control subjects. Within the ADHD group, there was a significant correlation between interpersonal problems and emotional facial expression decoding impairment, which was more marked for anger expressions. These results suggest suboptimal nonverbal decoding abilities in ADHD that may have important implications for therapy.     

Reduced recognition of fear and sadness in post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is associated with impairments in emotional experience and expression. The current study examined the recognition of emotional facial expressions in PTSD patients and matched healthy controls, both in terms of accuracy and sensitivity. The task involved short video clips of a neutral face changing (morphing) into one of the six basic emotions (happiness, anger, fear, surprise, disgust and sadness). Clips differed in length, with short clips terminating at 20% of maximum emotional intensity, and the longest ones ending with a full-blown expression. We observed a specific impairment in the PTSD group for recognizing the emotions fear and sadness. This result was observed via a reduced accuracy and a decreased sensitivity for these emotions. We discuss the observed altered affective processing and its possible clinical implications.     

Perception of emotions from faces and voices following unilateral brain damage

The importance of the right hemisphere in emotion perception in general has been well documented but its precise role is disputed. We compared the performance of 30 right hemisphere damaged (RHD) patients, 30 left hemisphere damaged (LHD) patients, and 50 healthy controls on both facial and vocal affect perception tasks of specific emotions. Brain damaged subjects had a single episode cerebrovascular accident localised to one hemisphere. The results showed that right hemisphere patients were markedly impaired relative to left hemisphere and healthy controls on test performance: labelling and recognition of facial expressions and recognition of emotions conveyed by prosody. This pertained at the level of individual basic emotions, positive versus negative, and emotional expressions in general. The impairment remained highly significant despite covarying for the group's poorer accuracy on a neutral facial perception test and identification of neutral vocal expressions. The LHD group were only impaired relative to controls on facial emotion tasks when their performance was summed over all the emotion categories and before age and other cognitive factors were taken into account. However, on the prosody test the LHD patients showed significant impairment, performing mid-way between the right hemisphere patients and healthy comparison group. Recognition of positive emotional expressions was better than negative in all subjects, and was not relatively poorer in the LHD patients. Recognition of individual emotions in one modality correlated weakly with recognition in another, in all three groups. These data confirm the primacy of the right hemisphere in processing all emotional expressions across modalities--both positive and negative--but suggest that left hemisphere emotion processing is modality specific. It is possible that the left hemisphere has a particular role in the perception of emotion conveyed through meaningful speech.     

Emotional Understanding,Cooperation, and Social Behavior in High-Functioning Children with Autism

In contrast to typically developing children, children with autism rarely exhibit cooperative social behavior. To examine whether this problem reflects global developmental delays or autism-specific deficits, the present study compared cooperation, emotional understanding, personality characteristics, and social behavior of 10 children with autism who had average IQ to those of 16 children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD) and 10 typically developing children. In cooperative behavior, level of emotional understanding, and aloof behavior, the autism group outperformed the ADHD/ODD group and did not differ significantly from typically developing children. However, the autism group showed worse emotion recognition and more active-but-odd behavior than the other groups. The results indicate that high-functioning children with autism can develop cooperative social behavior and advanced theory of mind abilities, but continue to show deficits in identifying emotions and displaying socially appropriate behavior.     

Emotion recognition and experience in Huntington's disease: is there a differential impairment?

Findings on affective processing deficits in Huntington's disease (HD) have been inconsistent. It is still not clear whether HD patients are afflicted by specific deficits in emotion recognition and experience. We tested 28 symptomatic HD patients and presented them with pictures depicting facial expressions of emotions (Karolinska-Set) and with affective scenes (International Affective Picture System; IAPS). The faces were judged according to the displayed intensity of six basic emotions, whereas the scenes received intensity ratings for the elicited emotions in the viewer. Patients' responses were compared with those of 28 healthy controls. HD patients gave lower intensity ratings for facial expressions of anger, disgust and surprise than controls. Patients' recognition deficits were associated with reduced functional capacity, such as problems with social interactions. Moreover, their classification accuracy was reduced for angry, disgusted, sad and surprised faces. When judging affective scenes for the elicitation of happiness, disgust and fear, HD patients had a tendency to estimate them as more intense than controls. This finding points to a differential impairment in emotion recognition and emotion experience in HD. We found no significant correlations between emotion experience/recognition ratings and CAG repeats, symptom duration and UHDRS Motor Assessment in the patient group.     

Effects of diazepam on facial emotion recognition

OBJECTIVE: There have been few studies of the pharmacologic modulation of facial emotion recognition. The present study aimed to replicate and extend the finding that recognition of facial anger was selectively impaired by diazepam. The hypothesis was that, in comparison with placebo, diazepam would impair the recognition of facial anger in healthy volunteers, but not the recognition of 5 other basic emotions: happiness, surprise, fear, sadness and disgust. DESIGN: A randomized, counterbalanced, double-blind, placebo-controlled, within-subjects comparison of diazepam with placebo. SETTING: A university psychopharmacology research unit. PARTICIPANTS: Healthy male (n = 6) and female (n = 22) volunteers, aged 18-45 years. PROCEDURES: Subjects were tested on 2 tasks following the administration of diazepam, 15 mg, and placebo on separate occasions. In the first "multimorph" task, images of facial expressions were morphed to produce continua between the neutral and full expressions of 6 basic emotions. Accuracy and identification thresholds were assessed for stimuli in which the intensity of expression gradually increased. In the second "emotional hexagon" task, facial expressions were morphed between pairs of emotions. Single images were presented, and accuracy and speed of response were assessed. RESULTS: Diazepam produced broad impairments in response accuracy, recognition thresholds and response speed on the facial emotion tasks that were not limited to angry expressions. CONCLUSIONS: The present study found that diazepam, 15 mg, impaired facial emotion recognition, but not selectively. In the emotional hexagon task, a reaction-time analysis suggested that the identification of facial anger might be differentially sensitive to variations in stimulus duration, complicating the interpretation of this paradigm.