Effects of intelligence level and place of residence on the ability of individuals with mental retardation to identify facial expressions

This study was designed to investigate the abilities of individuals with mental retardation to recognize and match emotional facial expressions from a series of photographs depicting various facial expressions. There were four groups of participants according to their place of residence (community or institution) and their intelligence level (mild or moderate). Each individual participated in two tasks: (1) recognizing a facial expression from an array of three pictures presented, and (2) matching a facial expression from one picture with a picture depicting a similar emotion from an array of three pictures. All information was presented to the participants in the native language, Hebrew. The six facial expressions used for the study included happiness, sadness, fear, anger, surprise, and disgust. The ability to recognize and match facial expressions was significantly higher for individuals with mild than moderate mental retardation. There was no significant difference for place of residence. Happiness was the easiest feeling to recognize and match for all groups. Fear and anger were the most difficult to recognize, while sadness and anger were most difficult to match.     

Enhancing the ability of adults with mental retardation to recognize facial expressions of emotion.

The ability to recognize accurately and respond appropriately to facial expressions of emotion is essential for interpersonal interaction. Individuals with mental retardation typically are deficient in these skills. The ability of 7 adults, 1 with severe and 6 with moderate mental retardation, to recognize facial expressions of emotion correctly was assessed. Then, they were taught this skill using a combination of a discrimination training procedure for differentiating facial movements, directed rehearsal, and Ekman and Friesen's "flashing photograph" technique. Their average increase in accuracy over baseline was at least 30% during the course of the training and over 50% during the last 5 days of the training phase. Further, these individuals were able to generalize their skills from posed photographs to videotaped role plays and were able to maintain their enhanced skills during the 8 to 9 months following the termination of training. This is the first study to show that individuals with mental retardation can be taught skills that enhance their ability to recognize facial expressions of emotion.     

Facial expressions of mentally retarded and nonretarded children: II. Recognition by nonretarded adults with varying experience with mental retardation

The influence of experience with mental retardation on nonretarded adults' ability to recognize facial expressions of emotion by young retarded children was examined. Four emotions were studied: happiness, anger, sadness, and neutrality (absence of affect). Slides of retarded and nonretarded children were presented to three groups: adults without experience in mental retardation, parents of retarded children, and teachers of the retarded stimulus children. Inexperienced adults identified fewer expressions of retarded children than did parents who, in turn, identified fewer expressions than did teachers. Teachers recognized expressions of retarded children best, inexperienced adults recognized expressions of nonretarded children best, and parents recognized expressions equally well in both retarded and nonretarded children. Happiness was recognized best in all children by all participants.     

Impaired facial expression recognition in children with temporal lobe epilepsy: impact of early seizure onset on fear recognition

The amygdala has been implicated in the recognition of facial emotions, especially fearful expressions, in adults with early-onset right temporal lobe epilepsy (TLE). The present study investigates the recognition of facial emotions in children and adolescents, 8–16 years old, with epilepsy. Twenty-nine subjects had TLE (13 right, 16 left) and eight had fronto-central epilepsy (FCE). Each was matched on age and gender with a control subject. Subjects were asked to label the emotions expressed in pictures of children's faces miming five basic emotions (happiness, sadness, fear, disgust and anger) or neutrality (no emotion). All groups of children with epilepsy performed less well than controls. Patterns of impairment differed according to the topography of the epilepsy: the left-TLE (LTLE) group was impaired in recognizing fear and neutrality, the right-TLE (RTLE) group was impaired in recognizing disgust and, the FCE group was impaired in recognizing happiness. We clearly demonstrated that early seizure onset is associated with poor recognition of facial expression of emotion in TLE group, particularly for fear. Although right-TLE and left-TLE subjects were both impaired in the recognition of facial emotion, their psychosocial adjustment, as measured by the CBCL questionnaire [Achenbach, T. M. (1991). Manual for the Child Behavior Checklist and Youth Self-report. Burlington, VT: University of Vermont Department of Psychiatry], showed that poor recognition of fearful expressions was related to behavioral disorders only in children with right-TLE. Our study demonstrates for the first time that early-onset TLE can compromise the development of recognizing facial expressions of emotion in children and adolescents and suggests a link between impaired fear recognition and behavioral disorders.     

Detecting subtle facial emotion recognition deficits in high-functioning Autism using dynamic stimuli of varying intensities

Autism Spectrum Disorders (ASD) are characterised by social and communication impairment, yet evidence for deficits in the ability to recognise facial expressions of basic emotions is conflicting. Many studies reporting no deficits have used stimuli that may be too simple (with associated ceiling effects), for example, 100% ‘full-blown’ expressions. In order to investigate subtle deficits in facial emotion recognition, 21 adolescent males with high-functioning Austism Spectrum Disorders (ASD) and 16 age and IQ matched typically developing control males completed a new sensitive test of facial emotion recognition which uses dynamic stimuli of varying intensities of expressions of the six basic emotions (Emotion Recognition Test; Montagne et al., 2007). Participants with ASD were found to be less accurate at processing the basic emotional expressions of disgust, anger and surprise; disgust recognition was most impaired - at 100% intensity and lower levels, whereas recognition of surprise and anger were intact at 100% but impaired at lower levels of intensity.     

Perception of emotional facial expressions at different intensities in early-symptomatic Huntington's disease

BACKGROUND: While there is abundant evidence that patients with Huntington's disease (HD) have an impairment in the recognition of the emotional facial expression of disgust, previous studies have only examined emotion perception using full-blown facial expressions. OBJECTIVE: The current study examines the perception of facial emotional expressions in HD at different levels of intensity to investigate whether more subtle deficits can be detected, possible also in other emotions. METHOD: We compared early symptomatic HD patients with healthy matched controls on emotion perception, presenting short video clips of a neutral face changing into one of the six basic emotions (happiness, anger, fear, surprise, disgust and sadness) with increasing intensity. Overall face perception ability as well as depressive symptoms were taken into account. RESULTS: A specific impairment in recognizing the emotions disgust and anger was found, which was present even at low emotion intensities. CONCLUSION: These results extend previous findings and support the use of more sensitive emotion perception paradigms, which enable the detection of subtle neurobehavioral deficits even in the pre- and early symptomatic stages of the disease.     

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.     

Impairment of recognition of disgust in Chinese with Huntington's or Wilson's disease

The selective involvement of the basal ganglia in recognition of the facial expression of disgust was investigated by examining a group of six symptomatic Huntington's disease patients and 32 Wilson's disease patients in China. Morphed photographs of facial expressions covering happiness-surprise-fear-sadness-disgust-anger were used and the patients were asked to label each photo. Other measures assessed basic cognitive functions and perception of non-emotion facial information, such as perception of gender, age, gaze direction, and recognition of unfamiliar as well as famous people. There was dissociation between the perception of emotions and other facial information, and between impairment of recognition of disgust and other emotions. The basal ganglia are the overlapping substrate involved in both Huntington's and Wilson's disease, although each has its own other lesions. The differentially severe impairment of recognition of disgust in the Chinese Huntington's disease and Wilson's disease patients strengthens the view that basal ganglia are selectively involved in processing the emotion of disgust.     

Disgust and happiness recognition correlate with anteroventral insula and amygdala volume respectively in preclinical Huntington's disease

Patients with Huntington's disease (HD) can show disproportionate impairments in recognizing facial signals of disgust, but the neural basis of this deficit remains unclear. Functional imaging studies have implicated the anterior insula in the ability to recognize disgust, but have identified other structures as well, including the basal ganglia. In view of variable insula and basal ganglia volume changes in HD, we used voxel-based morphometry to map regional variations in gray matter (GM) volume in participants carrying the mutation for HD, and correlated this with their performance on a test of facial emotion recognition for six basic emotions (disgust, fear, anger, happiness, sadness, surprise). The volume of the anteroventral insula was strongly correlated with performance on the disgust recognition task. The amygdala volume (bilaterally) correlated with the ability to recognize happy facial expressions. There was marked specificity of the regional correlations for the emotion involved. Recognition of other emotion expressions, or more general cognitive or motor performance as measured by a standardized rating scale, did not correlate with regional brain volume in this group. Control participants showed no effect for any measure. The strong linear correlations for disgust and happiness recognition imply direct involvement of the anterior insula in disgust appreciation, and a similar role for the amygdala in recognizing happy facial expressions. The absence of a significant correlation with the basal ganglia suggests a less critical role for these structures in disgust recognition than has previously been suggested. The findings also highlight the role of neurodegenerative diseases combined with statistical imaging techniques in elucidating the brain basis of behavior and cognition.     

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.     

Seeing happy emotion in fearful and angry faces: qualitative analysis of facial expression recognition in a bilateral amygdala-damaged patient

Neuropsychological studies reported that bilateral amygdala-damaged patients had impaired recognition of facial expressions of fear. However, the specificity of this impairment remains unclear. To address this issue, we carried out two experiments concerning the recognition of facial expression in a patient with bilateral amygdala damage (HY). In Experiment 1, subjects matched the emotion of facial expressions with appropriate verbal labels, using standardized photographs of facial expressions illustrating six basic emotions. The performance of HY was compared with age-matched normal controls (n = 13) and brain-damaged controls (n = 9). HY was less able to recognize facial expressions showing fear than normal controls. In addition, the error pattern exhibited by HY for facial expressions of fear and anger were distinct from those exhibited by both control groups, and suggested that HY confused these emotions with happiness. In Experiment 2, subjects were presented with morphed facial expressions that blended happiness and fear, happiness and anger, or happiness and sadness. Subjects were requested to categorize these expressions by two-way forced-choice selection. The performance of HY was compared with age-matched normal controls (n = 8). HY categorized the morphed fearful and angry expressions blended with some happy content as happy facial expressions more frequently than normal controls. These findings support the idea that amygdala-damaged patients have impaired processing of facial expressions relating to certain negative emotions, particularly fear and anger. More specifically, amygdala-damaged patients seem to give positively biased evaluations for these negative facial expressions.     

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.     

Can children with autistic spectrum disorders extract emotions out of contextual cues?

The aim of the present study was to determine whether children with autism spectrum disorders (ASD) are able to recognize facial expressions of emotion and objects missing on the basis of contextual cues. While most of these studies focused on facial emotion recognition, here we examined the ability to extract emotional information on the basis contextual cues. Nineteen children and adolescents with ASD were asked to recognize emotions and objects (control condition) masked within visual scenes and their performance was compared to that of 19 typically developing controls matched on chronological age and gender. Results revealed that children with ASD were able to use contextual cues to recognize objects but not emotions. Findings of this study are discussed within the framework of specific emotional processing deficits in ASD.     

Impaired facial emotion recognition and reduced amygdalar volume in schizophrenia

Structural abnormalities of the amygdala and impaired facial emotion recognition have been reported in schizophrenia. Most studies demonstrated reduced amygdalar volumes in schizophrenia patients, and difficulty in recognizing negative facial emotions has also been reported. However, findings on the deficit in facial emotion recognition have been inconsistent, and the relationships between this impairment and amygdalar volume reduction remain unclear. In this study, we investigated these relationships by performing volumetric analysis of the amygdala and evaluation of facial emotion recognition performance in the same subjects with schizophrenia. The sample group comprised 20 schizophrenia patients and 20 matched healthy controls. We measured the volumes of the amygdalae with high-resolution magnetic resonance imaging (MRI) at 3.0 Tesla. Additionally, we included a task that evaluated the subjects' ability to recognize the intensity of basic facial emotions. We found that impaired facial emotion recognition in schizophrenia patients is emotion-specific (sadness, surprise, disgust, and anger). Moreover, the volume of each amygdala on either side of the brain was reduced. Finally, we found a correlation between left amygdalar volume and the recognition of sadness in facial expressions. This study demonstrated that amygdala dysfunction may contribute to impaired facial emotion recognition in schizophrenia.     

Enhanced recognition of disgust in bipolar illness.

BACKGROUND: Bipolar disorder is associated with functional and structural abnormalities in the brain circuits involved in processing emotional stimuli. Although impairments of cognitive function have been found to persist in bipolar patients during periods of euthymic mood, it is not known whether abnormalities in emotional processing also occur during these periods of recovery. METHODS: The present investigation assessed the ability of euthymic patients with bipolar disorder to recognize different facial expressions of emotion, compared with matched controls. A nonemotional facial categorization task was used to control for possible nonspecific differences in perception or attention. RESULTS: In contrast to the small impairments seen in the nonemotional categorization task, patients with bipolar disorder showed a robust facilitation in the discrimination of disgusted facial expressions. The recognition of other basic negative and positive emotions was unchanged. CONCLUSIONS: The present results suggest a selective facilitation of the processes involved in recognizing facial expressions of disgust in patients with bipolar disorder. This difference in perception may be relevant to the decreased self-esteem and social functioning that have been associated with the euthymic phase of this disorder.     

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.     

Recognition of emotion from moving facial and prosodic stimuli in depressed patients

BACKGROUND: It has been suggested that depressed patients have a "negative bias" in recognising other people's emotions; however, the detailed structure of this negative bias is not fully understood. OBJECTIVES: To examine the ability of depressed patients to recognise emotion, using moving facial and prosodic expressions of emotion. METHODS: 16 depressed patients and 20 matched (non-depressed) controls selected one basic emotion (happiness, sadness, anger, fear, surprise, or disgust) that best described the emotional state represented by moving face and prosody. RESULTS: There was no significant difference between depressed patients and controls in their recognition of facial expressions of emotion. However, the depressed patients were impaired relative to controls in their recognition of surprise from prosodic emotions, judging it to be more negative. CONCLUSIONS: We suggest that depressed patients tend to interpret neutral emotions, such as surprise, as negative. Considering that the deficit was seen only for prosodic emotive stimuli, it would appear that stimulus clarity influences the recognition of emotion. These findings provide valuable information on how depressed patients behave in complicated emotional and social situations.     

Facial emotion recognition in 4- to 8-year-olds with autism spectrum disorder: A developmental trajectory approach

The investigation of emotion recognition in autism spectrum disorder (ASD) has both theoretical and practical implications. However, although many studies have examined facial emotion recognition in ASD, some points remain unclear. We therefore studied facial emotion recognition in young children with ASD across a small age range, in order to determine (1) their ability to recognize emotion and (2) the developmental trajectory of this ability. Twenty-two children with ASD aged 4–8 years were compared with typically developing children matched on either chronological age or verbal mental age. We administered three facial emotion tasks: matching, identification, and labeling. Results showed that children with ASD and typically developing children had difficulty with labeling emotions, but not with matching or identifying them. Happiness was the easiest to recognize, and surprise the hardest. The children with ASD did not exhibit delayed onset in the development of facial emotion recognition. To conclude, emotion recognition difficulties in children with ASD primarily concern the recognition of negative emotions and the identification of surprise, as they do in TD groups. This should be taken into account in future research, as well as in the design of future intervention programs.     

Disgust and Huntington's disease

The disproportionate impairment for the recognition of facial expressions of disgust in patients with Huntington's disease (HD) forms a double dissociation with the impaired recognition of fear that has been reported in amygdala patients. The dissociation has generated discussion regarding the potential existence of neural substrates dedicated to the recognition of facial signals of specific emotions. The aim of this study was to establish whether the impairment for disgust in HD was restricted solely to the domain of facial perception, or whether HD patients also demonstrate impairment in other kinds of disgust. Fourteen HD patients and fourteen age and education matched healthy controls participated in seven disparate emotion processing tasks. (1) A measure of knowledge for the situational determinants of distinct emotions; (2) recognition of emotion expressed in nonverbal vocalisations; (3) recognition of the emotional content of explicit lexical stimuli; (4) recognition of emotional content in pictures of emotion scenes; (5) a disgust experience questionnaire; (6) a measure of olfactory hedonic responsiveness; (7) a measure of gustatory perception. While verbal aspects of disgust processing were preserved, parallel impairments were revealed for olfactory disgust, vocal disgust expressions, the classification of disgusting pictures, and declarative knowledge of disgust elicitors. The finding of impaired perception of disgust signalled through different input domains suggests that the inability to recognise the facial expression in this population reflects a fundamental problem with disgust processing.     

Facial emotion recognition in Chinese with schizophrenia at early and chronic stages of illness

Deficits in facial emotion recognition have been recognised in Chinese patients diagnosed with schizophrenia. This study examined the relationship between chronicity of illness and performance of facial emotion recognition in Chinese with schizophrenia. There were altogether four groups of subjects matched for age and gender composition. The first and second groups comprised medically stable outpatients with first-episode schizophrenia (n=50) and their healthy controls (n=26). The third and fourth groups were patients with chronic schizophrenic illness (n=51) and their controls (n=28). The ability to recognise the six prototypical facial emotions was examined using locally validated coloured photographs from the Japanese and Caucasian Facial Expressions of Emotion. Chinese patients with schizophrenia, in both the first-episode and chronic stages, performed significantly worse than their control counterparts on overall facial emotion recognition, (P<0.001), with specific impairment in identifying surprise, fear and disgust. The level of deficit was similar at the two stages of illness. Findings suggest that impaired recognition of facial emotion did not appear to have worsened over the course of disease progression, suggesting that recognition of facial emotion is a rather stable trait of the illness. The emotion-specific deficit may have implications for understanding the social difficulties in schizophrenia.