Are you angry at me? Negative interpretations of neutral facial expressions are linked to child maltreatment but not to posttraumatic stress disorder

• Published in: European journal of psychotraumatology 2019-01, Vol.10 (1), p.1682929
• Main Authors: Pfaltz, Monique C., Passardi, Sandra, Auschra, Bianca, Fares-Otero, Natalia E., Schnyder, Ulrich, Peyk, Peter
• Format: Article
• Language: English
• Subjects: Alexithymia; ambiguous social stimuli; Anger; Bias; Borderline personality disorder; Child abuse & neglect; Child sexual abuse; Childhood; childhood trauma; Children; Clinical; Emotion recognition; Emotional abuse; Emotions; estimulo social ambiguo; expresiones faciales neutras; Mental depression; negative perceptual bias; neutral facial expressions; Patients; Personality disorders; Post traumatic stress disorder; posttraumatic stress disorder; reconocimiento de las emociones; sesgo perceptivo negativo; Sex crimes; Therapists; Trastorno de Estrés Postraumático; Trauma; trauma infantil; Verbal communication; 中性面部表情; 创伤后应激障碍; 模糊社会刺激; 童年创伤; 表情识别; 负性认知偏差
• ISSN: 2000-8066; 2000-8198; 2000-8066
• DOI: 10.1080/20008198.2019.1682929

Background: Individuals with a high prevalence of child maltreatment, e.g. those with borderline personality disorder, tend to see neutral facial expressions as negative. Objective: Our aim was to assess whether this bias is present in individuals with posttraumatic stress disorder (PTSD) and whether it is linked to child maltreatment. Methods: Thirty-nine PTSD participants, 44 traumatized and 35 non-traumatized healthy controls watched 300 one-second movies showing 30 neutral and 270 emotional facial expressions, and indicated whether they interpreted each as a neutral or as one of nine emotional expressions. Results: PTSD individuals did not perform differently than the two control groups in the recognition and interpretation of neutral facial expressions (p's < .300). Higher levels of childhood sexual and emotional abuse, and physical neglect were linked to more interpretations of neutral facial expressions as contempt (p's < .043), and (for sexual abuse and physical neglect) to more interpretations of neutral facial expressions as anger (p's < .014). Comparisons of statistical model fits suggested that childhood sexual abuse was the most relevant predictor of recognition accuracy in our sample. Alexithymia, state dissociation, interpersonal trauma, and number of experienced trauma types were not associated with deficits in the interpretation of neutral expressions. Conclusions: Child maltreatment, especially sexual abuse, may shape the interpretation of neutral facial expressions. Future research should explore whether the observed biases extend to real-life situations. If so, therapists might improve the therapeutic relationship with patients with a history of child maltreatment by paying more attention to their own non-verbal communication and their patients' responses to it. Furthermore, similarly to individuals with high depressive and high social anxiety symptoms, facial expression recognition training might counteract negativity bias in individuals with a history of childhood (sexual and emotional) abuse, and (physical) neglect. * Individuals with posttraumatic stress disorder (PTSD) do not show abnormalities in the recognition and interpretation of neutral facial expressions. * Childhood sexual and emotional abuse, and physical neglect are linked to more interpretations of neutral facial expressions as contempt and anger. * Childhood sexual abuse seems to be the most relevant predictor of recognition accuracy for neutral expressions.