Impaired fixation to eyes during facial emotion labelling in children with bipolar disorder or severe mood dysregulation

• Published in: Journal of psychiatry & neuroscience 2013-11, Vol.38 (6), p.407-416
• Main Authors: Kim, Pilyoung, PhD, Rosen, Brooke H., BA, Razdan, Varun, BS, Haring, Catherine T., BA, Jenkins, Sarah E., BA, Deveney, Christen M., PhD, Brotman, Melissa A., PhD, Blair, R. James R., PhD, Pine, Daniel S., MD, Leibenluft, Ellen, MD, Baker, Chris I., PhD, Arizpe, Joseph, BS
• Format: Article
• Language: English
• Subjects: Adolescent; Adult and adolescent clinical studies; Biological and medical sciences; Bipolar disorder; Bipolar Disorder - physiopathology; Bipolar disorders; Case-Control Studies; Child; Child psychology; Emotional disorders; Eye; Face; Facial Expression; Female; Fixation, Ocular - physiology; Fundamental and applied biological sciences. Psychology; Humans; Indexing in process; Male; Medical Education; Medical sciences; Mood disorders; Mood Disorders - physiopathology; Movements; Neuropsychology; Pediatrics; Photic Stimulation; Physiological aspects; Psychiatry; Psychoanalysis; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Psychopathology. Psychiatry; Research Papers; Social Perception
• ISSN: 1180-4882; 1488-2434
• DOI: 10.1503/jpn.120232

Background Children with bipolar disorder (BD) or severe mood dysregulation (SMD) show behavioural and neural deficits during facial emotion processing. In those with other psychiatric disorders, such deficits have been associated with reduced attention to eye regions while looking at faces. Methods We examined gaze fixation patterns during a facial emotion labelling task among children with pediatric BD and SMD and among healthy controls. Participants viewed facial expressions with varying emotions (anger, fear, sadness, happiness, neutral) and emotional levels (60%, 80%, 100%) and labelled emotional expressions. Results Our study included 22 children with BD, 28 with SMD and 22 controls. Across all facial emotions, children with BD and SMD made more labelling errors than controls. Compared with controls, children with BD spent less time looking at eyes and made fewer eye fixations across emotional expressions. Gaze patterns in children with SMD tended to fall between those of children with BD and controls, although they did not differ significantly from either of these groups on most measures. Decreased fixations to eyes correlated with lower labelling accuracy in children with BD, but not in those with SMD or in controls. Limitations Most children with BD were medicated, which precluded our ability to evaluate medication effects on gaze patterns. Conclusion Facial emotion labelling deficits in children with BD are associated with impaired attention to eyes. Future research should examine whether impaired attention to eyes is associated with neural dysfunction. Eye gaze deficits in children with BD during facial emotion labelling may also have treatment implications. Finally, children with SMD exhibited decreased attention to eyes to a lesser extent than those with BD, and these equivocal findings are worthy of further study.