title: Explicit Facial Emotion Processing in Patients With Dissociative Seizures.
abstract: 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.
  
  
  
  Forty patients with DS and 43 controls completed a computerized test of facial affect recognition, including five basic expressions (happiness, anger, disgust, fear, neutral). Recognition accuracy, emotional intensity judgements, and skin conductance levels and responses were dependent measures. Analyses controlled for a range of potentially confounding variables, including anxiety, depression, and medication effects.
  
  
  
  The DS group was less accurate at identifying facial expressions than controls (p = .005, ηp = 0.10). No group difference emerged for intensity judgements (p = .72, ηp = 0.002). Mean skin conductance levels were higher in the DS group relative to controls (p = .046, ηp = 0.053). However, a subgroup of DS patients showed attenuated skin conductance responses to the facial stimuli, compared with controls (p = .015, ηp = 0.18). These differences could not be accounted for by possible confounding variables. Recognition accuracy for neutral faces correlated negatively with trauma scores (r = -0.486, p = .002) and abandonment concerns (r = -0.493, p = .002) in the DS group.
  
  
  
  Patients with DS showed reduced recognition accuracy for facial affect, despite accurately perceiving its intensity. Elevated autonomic arousal may characterize patients with DS in general, alongside reduced phasic autonomic responses to facial expressions in some patients with the disorder.
authors.affiliation: From the Department of Psychology, Institute of Psychiatry, Psychology, & Neuroscience (Pick, Goldstein), King's College London, London, UK; and Neuropsychiatry Department, Maudsley Hospital (Mellers), South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Susannah
authors.initials: S
authors.lastname: Pick
authors.forename: John D C
authors.initials: JD
authors.lastname: Mellers
authors.forename: Laura H
authors.initials: LH
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000502:physiology*; D004569:Electroencephalography; D005149:Facial Expression; D000066499:Facial Recognition / Q000502:physiology*; D005260:Female; D005712:Galvanic Skin Response; D006801:Humans; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000503:physiopathology*; D055815:Young Adult