title: Risk for bipolar disorder is associated with face-processing deficits across emotions.
abstract: OBJECTIVE
  Youths with euthymic bipolar disorder (BD) have a deficit in face-emotion labeling that is present across multiple emotions. Recent research indicates that youths at familial risk for BD, but without a history of mood disorder, also have a deficit in face-emotion labeling, suggesting that such impairments may be an endophenotype for BD. It is unclear whether this deficit in at-risk youths is present across all emotions or if the impairment presents initially as an emotion-specific dysfunction that then generalizes to other emotions as the symptoms of BD become manifest.
  
  
  METHODS
  Thirty-seven patients with pediatric BD, 25 unaffected children with a first-degree relative with BD, and 36 typically developing youths were administered the Emotional Expression Multimorph Task, a computerized behavioral task, which presents gradations of facial emotions from 100% neutrality to 100% emotional expression (happiness, surprise, fear, sadness, anger, and disgust).
  
  
  RESULTS
  Repeated-measures analysis of covariance revealed that, compared with the control youths, the patients and the at-risk youths required significantly more intense emotional information to identify and correctly label face emotions. The patients with BD and the at-risk youths did not differ from each other. Group-by-emotion interactions were not significant, indicating that the group effects did not differ based on the facial emotion.
  
  
  CONCLUSIONS
  The youths at risk for BD demonstrate nonspecific deficits in face-emotion recognition, similar to patients with the illness. Further research is needed to determine whether such deficits meet all the criteria for an endophenotype.
authors.affiliation: National Institute of Mental Health, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA. brotmanm@mail.nih.gov
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Brotman
authors.forename: Martha
authors.initials: M
authors.lastname: Skup
authors.forename: Brendan A
authors.initials: BA
authors.lastname: Rich
authors.forename: Karina S
authors.initials: KS
authors.lastname: Blair
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: James R
authors.initials: JR
authors.lastname: Blair
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000235:genetics* / Q000523:psychology; D002648:Child; D004193:Discrimination Learning; D004644:Emotions; D005149:Facial Expression; D005260:Female; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D007360:Intelligence / Q000235:genetics; D008297:Male; D010364:Pattern Recognition, Visual; D010641:Phenotype; D012016:Reference Values; D012307:Risk Factors