Children with Bipolar Disorder Focus on Different Facial Features

Children with bipolar disorder (BD) or severe mood dysregulation (SMD) may look at faces in a way that impairs their ability to determine emotional expressions, according to new research. The study shows children with BD or SMD spend less time looking at the eyes compared with healthy children when trying to identify facial expressions.  The new research was presented at Neuroscience 2011, the annual meeting of the Society for Neuroscience and the world’s largest source of emerging news about brain science and health.

Studies have shown children with psychiatric disorders including autism make more errors than other children when labeling emotional facial expressions (happy, sad, fearful, and angry) at least, in part, because they pay less attention to the eyes. Children with BD and SMD have similar deficits in identifying expressions, and the current study sought to find out why.

Researchers led by Pilyoung Kim, PhD, of the National Institute of Mental Health, tracked eye movements in children viewing emotional faces.  Across all emotional expressions, all children spent more time looking at the eyes, the component of expression that conveys the most information about emotion, relative to other facial features. However,  BD and SMD children paid less attention to the eyes and more attention to the noses and mouths when compared with healthy children.

“In combination with other studies, our findings indicate the potential value of treatment programs that teach children how to identify emotions by looking at others’ eyes,” said Kim. “If such training helps children to process the emotional information in their world more accurately, that may in turn increase their ability to regulate their emotional reactions to social situations.”

Research was supported by the Intramural Research Program of the National Institute of Mental Health. 

Severe Mood Dysregulation (SMD)

Not that any of us confused parents need another addition to the alphabet soup of potential diagnoses for our “combo platter” kids…but, the National Institute of Mental Health (NIMH) released a most interesting report last week of a study that may be the start of distinguishing pediatric Bipolar Disorder (BD) from another, similar disorder – Severe Mood Dysregulation (SMD).

Researchers at NIMH compared the EEGs of children with BD and those believed to have SMD, and found that they have surprisingly different electrical patterns. This leads researchers to believe that these two disorders may need to be treated very differently.

If you’re like me, SMD is a new one. I searched and found little information out there, except that is was only recently defined and is often treated like BD. This caught my attention, because five years ago LuLu had her first QEEG. I took it, along with another done the following year, to our psychiatrist when we finally acquiesced and began to explore medication options. Our psychiatrist very clearly told me that LuLu had a severely dysregulated electrical pattern, BUT, that she did not have Bipolar Disorder. However, much of her medication regime is similar to that of people with BD.

Scientific Presentation: Sunday, Nov. 13, 2 – 3 p.m., Halls A – C  

 

TECHNICAL ABSTRACT: Introduction: Children with bipolar disorder (BD) or severe mood dysregulation (SMD) have deficits in face emotion labeling. Face emotion labeling deficit among BD children may be associated with abnormal eye-movement in response to facial stimuli. Adult BD patients and children with other psychiatric disorders such as autism or high psychopathic traits have deficits in face emotion labeling, and the deficits are further linked to reduced fixations on emotionally salient facial features such as eye regions. Thus, the current study examined whether decreased attentions to eye regions among children with BD or SMD may be associated with their face emotion labeling deficits. Methods: Participants included children with BD (N=17), or SMD (N=28), and healthy volunteer (HV) children (N=14). No between-group difference in age, IQ and gender was found. Eye movements were measured with an EyeLink II head- mounted eye-tracker (SR Research, Mississauga, ON, Canada), and sampled pupil centroid at 500 Hz. Before starting the task, eyes were calibrated and validated,  and a drift correction was performed every 5 trials during the task. During the task, participants saw photographs of four emotional faces (happy, sad, anger, and fear) and a neutral face. After a fixation cross (300 ms), and each picture (2s) are shown, participants labeled the emotion of each face. A fixation cross was shown during the inter-trial intervals (average 1s) between trials. Rectangular areas-of-interest (AOIs) were drawn for each face around eyes, nose, and mouth. Data is analyzed using a repeated-measures analysis of covariance (ANOVA) where group (BD, SMD and control) is the between-group factor and emotion and AOI were the within-group factors. Results: Behaviorally, SMD children had lower accuracy relative to BD and HV children across emotions, F(2,57)= 4.53, p<.05,  whereas BD children showed slower reaction time relative to SMD and HV children across emotion, F(2,57)= 2.78, p<.10. For fixation duration, the group X AOI interaction was found, F(4,2187)=12,33, p<.001. Across all emotions, in the eye regions, both BD and SMD children showed shorter fixation duration to HV children. In the nose regions, BD children showed longer fixation whereas in the mouth regions, SMD children showed longer duration compared to other groups.  No difference was found for fixation numbers. Discussion: Abnormal eye-movements such as decreased attentions to eye regions among BD and SMD children may be an underlying mechanism for their face emotion labeling deficits. 


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Lead author: Pilyoung Kim, PhD National Institute of Mental Health   Bethesda, Md.

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