Objective Research has shown that individuals with Dissociative Seizures (DS) disproportionately allocate attention to angry faces. Behavioural avoidance of such stimuli has also been reported. Previous studies have included emotional faces that are processed implicitly, or at a preconscious level. However, as yet there have been no specific experimental studies of subjective/explicit responses to consciously perceived facial emotion. The aim of this study was to examine subjective responses to consciously perceived emotional facial expressions in patients with DS, using experimental methods.
Method The study employed a cross-sectional between-groups design. The performance of 40 patients with DS was compared to that of a non-clinical control group (n=43). Participants completed a computerised test of facial expression recognition, in which standardised pictures of facial emotion (happiness, anger, disgust, fear, neutral) were presented individually and participants were required to select the matching emotion label (from those listed above). Each face was also rated for the intensity of the emotion displayed on a Likert scale (0–7).
Results After controlling for possible confounding variables (e.g. education, anxiety, depression), there was an overall effect of group on accuracy, with the DS group performing significantly worse than the control group. However, a lack of group by expression interaction suggested that the deficit was not specific to any single emotion in the DS group. No group effect was observed for ratings of intensity. The observed deficit in recognition accuracy could not be accounted for by group differences in IQ, general facial processing abilities or short-term visual memory.
Conclusion The findings indicate that individuals who experience DS find facial emotional cues difficult to interpret and categorise, despite perceiving the intensity of the emotion accurately. This could lead to instances in which the emotional states of others could be misinterpreted. Such a difficulty may be linked to problems in interpersonal relationships, and therefore, could play an important aetiological role in triggering individual seizures and/or perpetuating the disorder.
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