Depression Impairs Judgment of Facial Expression

Mood Disorders Affect Accurate Interpretation of Emotional Cues

Feb 26, 2009

Depressed people are more likely to exhibit a negative bias and misjudge neutral facial cues. Perception errors can trigger negative feelings and depression

Most people are aware that non-verbal communication cues such as body language and facial expressions affect how people respond to each other. Several studies indicate that a person's mood or state of mind can influence if they interpret someone's facial expressions accurately.

Depression Leads to Negative Facial Expression Bias

Researchers have long observed how people with mood disorders process emotional stimuli (facial expressions, etc.). In a review article of past studies entitled, "Emotional information processing in mood disorders: a review of behavioral and neuroimaging findings," (Current Opinion in Psychiatry, January 2006), Jukka M Leppanen summarized that "major depressive disorders involve specific abnormalities in the cognitive and neural processing of emotional information and that these abnormalities may potentially contribute to the vulnerability for negative emotion and onset of depressive episodes."

People diagnosed with a depressive disorder are more likely to misinterpret and misjudge facial cues. These individuals exhibit a bias towards negative expressions (seeing faces sadder than they are) rather than positive (happy). In addition, depressed people have an enhanced recall of "negative emotional material;" they're more likely to remember the unpleasant memories.

While researchers are not entirely clear why some individuals have this cognitive and neural processing abnormality, they believe misinterpreting facial cues can trigger negative emotions and potentially a depressive episode. Facial cue errors literally become a self-fulfilling prophecy.

Leppanen notes that patients' in remission, (not experiencing mood symptoms at the time), as well as healthy individuals at high risk for developing a mood disorder, still exhibit some facial cue processing errors.

PMDD (Premenstrual Dysphoric Disorder) Leads to Mistakes Identifying Emotions

In a study published in the Journal of Affective Disorders, (December 2007, Rubinow DR, Smith MJ, Schenkel LA, Schmidt PJ, Dancer K) researchers administered a Facial Discrimination Task to 28 women with pre-menstrual dysphoric disorder (luteal phase impairment during menstrual cycle as indicated by dramatic changes in mood), and 27 women without symptoms. The women with PMDD were more likely to make mistakes identifying emotions in facial expressions.

Mistakes included recognition errors and negative bias as well as impaired "specificity" of judgments (an inability to discriminate neutral from negative stimuli). Results and conclusions were similar to findings with depressed patients.

Bipolar Disorder with Mania Increases Recognition Errors and Positive Bias

In a study by Anna Lembke and Terence A. Ketter entitled, “Impaired Recognition of Facial Emotion," (American Journal of Psychiatry, Feb 2002), patients in the manic (euphoria) phase of bipolar disorder had worse overall recognition of facial emotion than all other groups. More notably, these subjects showed worse recognition of fear and disgust than the healthy subjects. Mania phase positive bias supports the negative bias research results found in depressed patients.

Depression and Facial Expression Research: Practical Implications

As neuropsychologists continue to study mood disorders, facial expression error studies provide researchers with additional insight to help understand and treat the underlying causes. Common links among patients with depression, anxiety, PMDD, or healthy people at high risk for a mood disorder helps researchers pinpoint areas of the brain that may be involved, as well as how cognitive and processing distortions, (formed from mental reactions to adverse events), contribute to the disorder.

In addition, Rubinow et al note that "measurement of facial expression perception may prove to be a useful experiment tool for assessing efficacy of antidepressant treatments," due to the current "lack of valid and sensitive markers of mood state."

As millions of people continue to struggle with mood disorders, it might be useful for practitioners to discuss facial expression perception errors with their patients. Interpreting emotional cues as negative when they're neutral or positive can stimulate a negative mental state and potentially trigger a depressive episode in people already at risk.

Jonathan P Roiser, Judy S Rubinsztein and Barbara J Sahakian. "The Neuropsychology of Mood Disorders." Psychiatry. May 2006.

The copyright of the article Depression Impairs Judgment of Facial Expression in Clinical Psychology is owned by Laura Owens. Permission to republish Depression Impairs Judgment of Facial Expression in print or online must be granted by the author in writing.