title: Facial expression to emotional stimuli in non-psychotic disorders: A systematic review and meta-analysis.
abstract: Facial expression of emotion is crucial to social interaction and emotion regulation; therefore, altered facial expressivity can be a contributing factor in social isolation, difficulties with emotion regulation and a target for therapy. This article provides a systematic review and meta-analysis of the literature on automatic emotional facial expression in people with non-psychotic disorders compared to healthy comparison groups. Studies in the review used an emotionally salient visual induction method, and reported on automatic facial expression in response to congruent stimuli. A total of 39 studies show alterations in emotional facial expression across all included disorders, except anxiety disorders. In depression, decreases in facial expression are mainly evident for positive affect. In eating disorders, a meta-analysis showed decreased facial expressivity in response to positive and negative stimuli. Studies in autism partially support generally decreased facial expressivity in this group. The data included in this review point towards decreased facial emotional expressivity in individuals with different non-psychotic disorders. This is the first review to synthesise facial expression studies across clinical disorders.
authors.affiliation: King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, London SE5 8AF, UK.
authors.forename: H
authors.initials: H
authors.lastname: Davies
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Wolz
authors.affiliation: King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, London SE5 8AF, UK.
authors.forename: J
authors.initials: J
authors.lastname: Leppanen
authors.affiliation: Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain; CIBER Fisiopatologia Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Barcelona, Spain; Clinical Sciences Department, School of Medicine, University of Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Fernandez-Aranda
authors.affiliation: King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, London SE5 8AF, UK.
authors.forename: U
authors.initials: U
authors.lastname: Schmidt
authors.affiliation: King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neurosciences, London SE5 8AF, UK; Illia University, Department of Psychology, Tbilisi, Georgia. Electronic address: Kate.Tchanturia@kcl.ac.uk.
authors.forename: K
authors.initials: K
authors.lastname: Tchanturia
mesh_terms: D004644:Emotions; D005149:Facial Expression; D006801:Humans; D001523:Mental Disorders / Q000503:physiopathology / Q000523:psychology*
keywords: Anxiety; Autism; Borderline personality disorder; Depression; Eating disorders; Emotion regulation; Facial expression; Obsessive-compulsive