Facial emotion recognition in children with externalising behaviours: A systematic review

Difficulties in facial emotion recognition (FER) are associated with a range of mental health and antisocial presentations in adolescents and adults. Externalising behaviours in children are often one of the earliest signs of risk for the development of such difficulties. This article systematically reviews the evidence (from both group and correlational studies) for whether there is a relationship between FER and externalising behaviours in pre-adolescent children (aged 12 and under), both across and within externalising behaviour domains (hyperactivity, conduct problems, callous-unemotional traits, and aggression). Four electronic databases were searched producing 1,296 articles. Articles were included if they used validated measures of FER and externalising behaviours. Sixteen articles met criteria for inclusion in the review. Overall, the results suggested FER problems are present in ADHD, CP and callous-unemotional presentations, and in samples of children with higher levels of externalising problems rather than in community samples. However, there was no consistent evidence for specific emotions being implicated in the studies reviewed. Clinically, the findings suggest that FER difficulties are commonly associated with externalising behaviours, and hence this review offers some support that FER deficits could be a relevant target of intervention for externalising behaviours. However, more longitudinal studies are required, that control for other variables that might underlie FER difficulties (e.g. IQ or basic Theory of Mind abilities), to inform our knowledge of whether FER difficulties are a causal factor in externalising behaviours.