Altered Attentional Processing of Facial Expression Features in Severe Alcohol Use Disorder: An Eye-Tracking Study

• Published in: Journal of psychopathology and clinical science 2024-01, Vol.133 (1), p.103-114
• Main Authors: Pabst, Arthur, Bollen, Zoé, Masson, Nicolas, Gautier, Mado, Geus, Christophe, Maurage, Pierre
• Format: Article
• Language: English
• Subjects: Acknowledgment; Alcohol related disorders; Alcohol use; Alcohol Use Disorder; Alcoholism; Emotion recognition; Emotionality (Personality); Eye Fixation; Eye Movements; Eye tracking; Face; Facial expressions; Female; Fixation; Generalizability; Human; Male; Physical characteristics; Severity (Disorders); Social Cognition; Tracking
• ISSN: 2769-7541; 2769-755X
• DOI: 10.1037/abn0000868

Social cognition impairments, and notably emotional facial expression (EFE) recognition difficulties, as well as their functional and clinical correlates, are increasingly documented in severe alcohol use disorder (SAUD). However, insights into their underlying mechanisms are lacking. Here, we tested if SAUD was associated with alterations in the attentional processing of EFEs. In a preregistered study, 40 patients with SAUD and 40 healthy controls (HCs) had to identify the emotional expression conveyed by faces while having their gaze recorded by an eye-tracker. We assessed indices of initial (first fixation locations) and later (number of fixations and dwell-time) attention with reference to regions of interest corresponding to the eyes, mouth, and nose, which carry key information for EFE recognition. We centrally found that patients had less first fixations to key facial features in general, as well as less fixations and dwell time to the eyes specifically, relative to the rest of the face, compared to controls. These effects were invariant across emotional expressions. Additional exploratory analyses revealed that patients with SAUD had a less structured viewing pattern than controls. These results offer novel, direct, evidence that patients with SAUD's socioaffective difficulties already emerge at the facial attentional processing stage, along with precisions regarding the nature and generalizability of the effects. Potential implications for the mechanistic conceptualization and treatment of social cognition difficulties in SAUD are discussed. General Scientific Summary This study provides evidence that patients with severe alcohol use disorder (SAUD) differ, on average, from healthy individuals in the way they attend to facial expressions: they spend proportionally less time viewing informative areas, and mostly the eyes, and have a more disorganized viewing pattern. This is important as this may partly explain why patients with SAUD have more difficulties identifying others' emotions or states of mind, and consequently present more interpersonal problems, which are known markers of poor prognosis.