Explicit facial emotion processing in patients with dissociative seizures

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Objective: There have, as yet, been few experimental studies of explicit facial affect recognition in patients with dissociative seizures (DS). The aim of the study was to examine explicit recognition and physiological responses to facial expressions in this group, relative to healthy controls.
Methods: Forty patients with DS and 43 controls completed a computerised test of facial affect recognition, including five basic expressions (happiness, anger, disgust, fear, neutral). Recognition accuracy, emotional intensity judgements, skin conductance levels (SCLs) and responses (SCRs) were dependent measures. Analyses controlled for a range of potentially confounding variables, including anxiety, depression and medication effects.
Results: The DS group were less accurate at identifying facial expressions than controls (p = .005, η2p = .10). No group difference emerged for intensity judgements (p = .72, η2p = .002). Mean SCLs were higher in the DS group relative to controls (p = .046, η2p = .053). However, a subgroup of DS patients showed attenuated SCRs to the facial stimuli, compared to controls (p = .015, η2p = .18). These differences could not be accounted for by possible confounding variables. Recognition accuracy for neutral faces correlated negatively with trauma scores (r = -.486, p = .002) and abandonment concerns (r = -.493, p = .002) in the DS group.
Conclusions: Patients with DS showed reduced recognition accuracy for facial affect, despite accurately perceiving its intensity. Elevated autonomic arousal may characterise patients with DS in general, alongside reduced phasic autonomic responses to facial expressions in some patients with the disorder.
Original languageEnglish
Pages (from-to)874-885
JournalPsychosomatic Medicine
Issue number7
Publication statusPublished - 1 Sept 2016


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