Facial expression recognition in depressed subjects: the impact of intensity level and arousal dimension

The goal was to investigate whether patients with depression perform more poorly in overall emotion perception tasks compared with controls and whether this difference varies as a function of emotional intensity and arousal, with a perceptual bias toward high arousal emotions. Data were collected from 23 depressed and 23 control subjects, matched for gender, age, and education. Basic emotions were presented at 5 intensity levels ranging from 20% to 100%. Results showed that, relative to controls, patients with depression showed a significant impairment in the ability to recognize facial expressions, and that the impairment was most pronounced at subtle, but clearly recognizable emotional facial stimuli representing low arousal. Furthermore, depressed patients were found to make more misattribution errors of neutral and low arousal facial expressions in the direction of high arousal emotions. We conclude that the inability to accurately recognize nonemotional and emotional facial expressions along with the tendency for more attributions to the high arousal emotions can represent 2 basic contributing factors to the well-documented social problems of patients with depression.