title: Impaired fixation to eyes during facial emotion labelling in children with bipolar disorder or severe mood dysregulation.
abstract: BACKGROUND
  Children with bipolar disorder (BD) or severe mood dysregulation (SMD) show behavioural and neural deficits during facial emotion processing. In those with other psychiatric disorders, such deficits have been associated with reduced attention to eye regions while looking at faces.
  
  
  METHODS
  We examined gaze fixation patterns during a facial emotion labelling task among children with pediatric BD and SMD and among healthy controls. Participants viewed facial expressions with varying emotions (anger, fear, sadness, happiness, neutral) and emotional levels (60%, 80%, 100%) and labelled emotional expressions.
  
  
  RESULTS
  Our study included 22 children with BD, 28 with SMD and 22 controls. Across all facial emotions, children with BD and SMD made more labelling errors than controls. Compared with controls, children with BD spent less time looking at eyes and made fewer eye fixations across emotional expressions. Gaze patterns in children with SMD tended to fall between those of children with BD and controls, although they did not differ significantly from either of these groups on most measures. Decreased fixations to eyes correlated with lower labelling accuracy in children with BD, but not in those with SMD or in controls.
  
  
  CONCLUSIONS
  Most children with BD were medicated, which precluded our ability to evaluate medication effects on gaze patterns.
  
  
  CONCLUSIONS
  Facial emotion labelling deficits in children with BD are associated with impaired attention to eyes. Future research should examine whether impaired attention to eyes is associated with neural dysfunction. Eye gaze deficits in children with BD during facial emotion labelling may also have treatment implications. Finally, children with SMD exhibited decreased attention to eyes to a lesser extent than those with BD, and these equivocal findings are worthy of further study.
authors.affiliation: Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Md., and Department of Psychology, University of Denver, Denver, Colo., USA.
authors.forename: Pilyoung
authors.initials: P
authors.lastname: Kim
authors.forename: Joseph
authors.initials: J
authors.lastname: Arizpe
authors.forename: Brooke H
authors.initials: BH
authors.lastname: Rosen
authors.forename: Varun
authors.initials: V
authors.lastname: Razdan
authors.forename: Catherine T
authors.initials: CT
authors.lastname: Haring
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Jenkins
authors.forename: Christen M
authors.initials: CM
authors.lastname: Deveney
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Brotman
authors.forename: R James R
authors.initials: RJ
authors.lastname: Blair
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: Chris I
authors.initials: CI
authors.lastname: Baker
authors.forename: Ellen
authors.initials: E
authors.lastname: Leibenluft
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000503:physiopathology*; D016022:Case-Control Studies; D002648:Child; D005149:Facial Expression; D005260:Female; D005403:Fixation, Ocular / Q000502:physiology*; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000503:physiopathology*; D010775:Photic Stimulation; D012938:Social Perception
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