Facial Emotion Recognition Abilities in Women Experiencing Eating Disorders

OBJECTIVE Impairments in facial emotion recognition are an underlying factor of deficits in emotion regulation and interpersonal difficulties in mental disorders, and are evident in eating disorders (EDs). METHODS We used a computerized psychophysical paradigm to manipulate parametrically the quantity of signal in facial expressions of emotion (QUEST threshold seeking algorithm). This was used to measure emotion recognition in 311 adult women (anorexia nervosa (AN,n=61), bulimia nervosa (BN,n=58), healthy controls (HC,n=130) and mixed mental disorders (mixed,n=59)). The mean age was 22.84 years (SD=3.90). The aim was to establish recognition thresholds defining how much information a person needs to recognize a facial emotion expression and to identify deficits in EDs compared to healthy and clinical controls. The stimuli included six basic emotion expressions (fear, anger, disgust, happiness, sadness, surprise) plus a neutral expression. RESULTS Happiness was discriminated at the lowest, fear at the highest threshold by all groups. There were no differences regarding thresholds between groups, except for the mixed and the BN group with respect to the expression of disgust (F(3,302)=5.97, p=.001, eta=.056). Emotional clarity, ED pathology and depressive symptoms did not predict performance (RChange≤.010, F(1,305)≤5.74, p≥.079). The confusion matrix did not reveal specific biases in either group. CONCLUSIONS Overall, within-subject effects were as expected, whereas between-subject effects were marginal and psychopathology did not influence emotion recognition. Facial emotion recognition abilities in women suffering from EDs compared to women suffering from mixed mental disorders and HCs were similar. While basic facial emotion recognition processes seems to be intact, dysfunctional aspects such as misinterpretation might be important in emotion regulation problems. CLINICAL TRIAL REGISTRATION NUMBER DRKS-ID: DRKS00005709.