Anxiety disorders in adolescence are associated with impaired facial expression recognition to negative valence

Abstract Objective The aim of the present study was to test the ability of adolescents with a current anxiety diagnosis to recognize facial affective expressions, compared to those without an anxiety disorder. Methods Forty cases and 27 controls were selected from a larger cross sectional community sample of adolescents, aged from 10 to 17 years old. Adolescent’s facial recognition of six human emotions (sadness, anger, disgust, happy, surprise and fear) and neutral faces was assessed through a facial labeling test using Ekman’s Pictures of Facial Affect (POFA). Results Adolescents with anxiety disorders had a higher mean number of errors in angry faces as compared to controls: 3.1 (SD = 1.13) vs. 2.5 (SD = 2.5), OR = 1.72 (CI95% 1.02 to 2.89; p  = 0.040). However, they named neutral faces more accurately than adolescents without anxiety diagnosis: 15% of cases vs. 37.1% of controls presented at least one error in neutral faces, OR = 3.46 (CI95% 1.02 to 11.7; p  = 0.047). No differences were found considering other human emotions or on the distribution of errors in each emotional face between the groups. Conclusion Our findings support an anxiety-mediated influence on the recognition of facial expressions in adolescence. These difficulty in recognizing angry faces and more accuracy in naming neutral faces may lead to misinterpretation of social clues and can explain some aspects of the impairment in social interactions in adolescents with anxiety disorders.