This article was downloaded by: ["University at Buffalo Libraries"] On: 01 February 2015, At: 17:29 Publisher: Routledge Informa Ltd Registered in England and Wales Registered Number: 1072954 Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK
Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uear20
Emotion Recognition Ability and Mild Depressive Symptoms in Late Adulthood Vasiliki Orgeta
a
a
Click for updates
Mental Health Sciences Unit , University College London , London , UK Published online: 27 Jan 2014.
To cite this article: Vasiliki Orgeta (2014) Emotion Recognition Ability and Mild Depressive Symptoms in Late Adulthood, Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process, 40:1, 1-12, DOI: 10.1080/0361073X.2014.857535 To link to this article: http://dx.doi.org/10.1080/0361073X.2014.857535
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any
losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
Experimental Aging Research, 40: 1–12, 2014 Copyright # Taylor & Francis Group, LLC ISSN: 0361-073X print=1096-4657 online DOI: 10.1080/0361073X.2014.857535
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
EMOTION RECOGNITION ABILITY AND MILD DEPRESSIVE SYMPTOMS IN LATE ADULTHOOD
Vasiliki Orgeta Mental Health Sciences Unit, University College London, London, UK Background=Study Context: Current evidence suggests that dysphoric mood affects the ability to recognize facial emotion. Methods: In the present study, older adults with and without mild depressive symptoms were asked to complete a task measuring their ability to identify facial affect representative of six different emotions (happiness, surprise, disgust, fear, anger, and sadness). Results: Consistent with previous findings, results showed that older adults experiencing mild depressive symptoms were less accurate in their ability to recognize facial expressions of fear and anger. No group differences were observed in the recognition of happiness, surprise, disgust, and sadness. Conclusion: The present study has contributed to previous research by demonstrating that mild depressive symptoms affect the ability to recognize facial emotion in a sample of older adults.
Decoding of emotional facial expressions constitutes an important facet of social skills, with most individuals able to identify facial affective cues with a high degree of accuracy (Ekman, 2003; Ekman, Sorenson, & Friesen, 1969; Leppanen, Milders, Bell, Terriere, & Hietanen, 2004; Persad & Polivy, 1993). Relatively recently a number of studies have been conducted investigating the extent to which biased affective information processes are modified by affective symptoms (Asthana, Mandal, Khurana, & Haque-Nizamie, 1998; Mendlewicz, Linkowski, Bazelmans, & Philippot, 2005). Prior work, for example, has shown that individuals experiencing moderate to Received 30 April 2009; accepted 15 December 2012. Address correspondence to Vasiliki Orgeta, Mental Health Sciences Unit, 67–73 Riding House Street, 2nd Floor, Charles Bell House, London, W1W 7EJ, UK. E-mail: v.orgeta@ ucl.ac.uk
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
2
V. Orgeta
severe symptoms of depression experience difficulty with emotional perception of facial expressions (Langenecker et al., 2005). Most studies demonstrate that patients with depression exhibit a global deficit in facial judgment accuracy (Asthana et al., 1998; Gollan, Pane, McCloskey, & Coccaro, 2008; Langenecker et al., 2005; Persad & Polivy, 1993), although contradictory findings have also been reported, with some studies reporting no such deficit (Kan, Mimura, Kamijima, & Kawamura, 2004). Although much attention has been given in investigating emotion recognition accuracy in major depression (Gur et al., 1992; Mikhailova, Vladimirova, Iznak, Tsusulkovskaya, & Sushko, 1996; Weniger, Lange, Ruther, & Irle, 2004), less research has been conducted examining the relationship between psychiatric symptom distress observed in healthy populations and the ability to judge emotional facial expressions. Several studies have demonstrated that individuals with an increased familial risk of depression who have not yet experienced a depressive episode are less accurate in recognizing emotional facial expressions (Le Masurier, Cowen, & Harmer, 2007). This line of research is consistent with cognitive models of depression proposing that biased processing of emotional material is a stable vulnerability factor that affects the onset, maintenance, and recurrence of depressive episodes (Beck, 1976). Despite the above findings, it appears that little research has investigated whether depressive symptoms that fail to meet criteria for a clinical diagnosis might be associated with deficits in emotion recognition ability. In addition, it appears that most studies have focused on adult populations, with currently no studies examining the influence of depressive symptoms on older adults’ ability to discriminate facial affect, despite well-replicated evidence of age effects on emotion recognition ability (Calder et al., 2003; Isaacowitz et al., 2007; Keightley, Winocur, Burianova, Hongwanishkul, & Grady, 2006). The idea, for example, that the ability to recognize facial affect may decline with age has attracted considerable attention by researchers (Sullivan & Ruffman, 2004; Suzuki, Hoshino, Shigemasu, & Kawamura, 2007), with most studies demonstrating an age-related decline in the ability to identify fear, anger, and sadness (Orgeta & Phillips, 2008; Sullivan, Ruffman, & Hutton, 2007). The purpose of the present study, therefore, was to examine whether self-reported mild depressive symptoms affect the ability to recognize emotion in a sample of community-dwelling older adults. Based on previous research, the first hypothesis of this study was that older adults experiencing mild depressive symptoms would have poorer performance in affective facial recognition in comparison with
Emotion Recognition Ability in Late Adulthood
3
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
nondepressed older adults. Because poor overall recognition rate of facial expressions has been found to be associated with poor performance on cognitive tests in both psychiatric populations (Asthana et al., 1998; Johnston, Katsikitis, & Carr, 2001) and normal aging (Orgeta & Phillips, 2008; Sullivan & Ruffman, 2004), cognitive tasks were also included in the present study, to ensure that any deficits observed were not attributed to a generalized performance deficit. METHODS Participants Seventy older community residents ranging in age from 60 to 82 years (43 females and 27 males) were recruited from a university panel of volunteers and were invited to participate. All participants were screened for possible cognitive impairment with the Mini-Mental State Examination (Folstein, Folstein, & McHugh, 1975), with a cutoff score of >25 (Chayer, 2002). Three participants were excluded from the study on the basis of this criterion. Given previous studies suggesting that when assessing mood in late adulthood, the Geriatric Depression Scale (GDS; Yesavage et al., 1982) should be preferred to the Beck Depression Inventory—II (BDI-II) (Jefferson, Powers, & Pope, 2000; Montorio & Izal, 1996), participants were divided into two groups based on their total score on the GDS (Cronbach’s a ¼ .86). In the GDS, cutoff scores of 11 or greater are considered to represent significant mild depression, whereas scores of 21 and higher indicate severe depression (Yesavage et al., 1982). Thirty-two participants obtained scores consistent with mild depressive symptoms (MDS) (GDS 10–19; M ¼ 13.73, SD ¼ 3.48) and 35 normal control (NC) participants obtained scores in the normal range (GDS < 10; M ¼ 3.96, SD ¼ 2.61). This approach has been successfully used by previous studies demonstrating the effects of mild depressive symptoms in letter and semantic fluency tasks in older adults (Ravdin, Katzen, Agrawal, & Relkin, 2003). Participants also completed the Beck Depression Inventory—II (Beck, Steer, & Brown, 1996) (BDI–II), where the MDS group scored significantly higher compared with the NCs, t(65) ¼ 12.31, p < .001, d ¼ 1.66. The two groups did not differ in terms of age, t(65) ¼ .13, p > .05, d ¼ .44, or years of education, t(65) ¼ .59, p > .05, d ¼ .14. Older adults in the MDS group reported lower levels of overall health, t(65) ¼ 3.74, p < .001, d ¼ .87. Participants were tested on the
V. Orgeta
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
4
National Adult Reading Test (NART) in order to estimate premorbid verbal IQ (Nelson, 1982), and on the Culture Fair Intelligence Test (CFIT; Cattell & Cattell, 1959) as an estimate of current cognitive function. Group differences were found on the NART, t(65) ¼ 2.34, p < .01, d ¼ .75, where the NCs made fewer errors. There were no group differences on the CFIT, t(65) ¼ 1.22, p > .05, d ¼ .13 (see Table 1). The Benton Facial Recognition Test (BFRT) (Benton, Hamsher, Varney, & Spreen, 1983) was included in order to assess nonemotional aspects of facial recognition. All participants performed within the normal range according to norms established for older adults on this measure (Christensen, Riley, Heffernan, Love, & McLaughlin Sta Maria, 2002). The Pelli-Robson Contrast Sensitivity Test (PRCST) (Pelli, Robson, & Wilkins, 1988) assessed visual acuity. NCs scored higher in the BFRT, indicating better visuoperceptual ability, t(65) ¼ 2.19, p < .05, d ¼ .53, whereas the two groups were comparable in their performance in the PRCST, t(65) ¼ 1.43, p > .05, d ¼ .33. Materials and Procedure The Emotion Recognition Task The facial images presented in the Emotion Recognition Task (ERT) were taken from the Facial Expressions of Emotion: Stimuli and Tests (Young, Perrett, Calder, Sprengelmeyer, & Ekman, 2002). A total of 108 trials were presented depicting the six fundamental emotions. Each trial consisted of the simultaneous presentation of the Table 1. Mean and standard deviations of demographic characteristics for both groups Normal controls Variable Chronological age Years of education Subjective physical health NART (errors) CFIT BFRT PRCST
Mild depressive symptoms
M
SD
M
SD
69.11 13.09 7.11 12.40 22.19 21.57 1.76
3.79 3.06 1.32 4.68 3.78 2.13 .14
70.66 13.53 5.88 16.06 21.66 19.47 1.71
3.19 3.12 1.49 5.13 4.17 5.23 .16
Note. NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959); BFRT ¼ Benton Facial Recognition Test (Benton et al., 1983); PRCST ¼ Pelli-Robson Contrast Sensitivity Test (Pelli, Robson, & Wilkins, 1988).
Emotion Recognition Ability in Late Adulthood
5
emotional expression (target) and six emotional labels from which participants had to choose the label that best described the presented emotion. Facial expressions of 50% and 75% emotional intensity were presented in order to avoid ceiling effects (see Young et al., 2002). The presentation of emotional expressions and the presentation of labels were random in every trial.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
RESULTS Mild Depressive Symptoms and Emotion Recognition Accuracy of emotion recognition (percentage correct) was analyzed by conducting a 2 6 analysis of variance (ANOVA) with group as a between-subjects factor, and type of emotion as the within-subjects factor. Means and standard deviations for each emotion and group are presented in Table 2. There was a main effect of emotion, F(3.66, 237.95) ¼ 29.94, p < .001, g2p ¼ :32, a main effect of group, F(1, 65) ¼ 3.56, p < .05, g2p ¼ :05, qualified by a significant interaction between type of emotion and group, F(5, 237.95) ¼ 3.57, p < .01, g2p ¼ :05. Follow-up analyses showed that older adults experiencing MDS were worse in their ability to identify fear, t(65) ¼ 4.44, p < .001, d ¼ 1.08, and anger, t(65) ¼ 2.07, p < .05, d ¼ .50. There were no group differences in the identification of happiness, t(65) ¼ 1.64, p > .05, d ¼ .05, surprise, t(65) ¼ .02, p > .05, d ¼ .01, disgust, t(65) ¼ .64, p > .05, d ¼ .16, and sadness, t(65) ¼ .17, p > .05, d ¼ .04. Table 3 shows correlations between the number of correct identifications of the five emotions in the ERT and the remaining variables. Happiness was excluded from the correlational analyses because of ceiling effects and poor variance. The NART and the CFIT had the most consistent relationship with performance in the ERT across Table 2. Mean and standard errors of the mean of correct responses on the Emotion Recognition Task for the six emotions tested for each group Normal controls Emotion category Happiness Surprise Disgust Fear Anger Sadness
Mild depressive symptoms
M
SE
M
SE
96.27 72.38 70.24 76.90 77.38 61.42
1.29 4.51 3.53 3.15 1.93 4.79
95.44 72.52 66.69 54.19 64.99 60.15
2.90 4.47 4.29 4.09 4.23 5.60
V. Orgeta
6
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Table 3. Correlations between the Emotion Recognition Task and fluid, verbal, and visuoperceptual abilities Emotion category
NART
CFIT
BFRT
PRCST
Surprise Disgust Fear Anger Sadness
.15 .33 .45 .36 .42
.14 .23 .22 .35 .05
.16 .04 .05 .14 .05
.11 .10 .12 .19 .26
Note. NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959); BFRT ¼ Benton Facial Recognition Test (Benton et al., 1983); PRCST ¼ Pelli-Robson Contrast Sensitivity Test (Pelli et al., 1988). p < .05; p < .01.
emotion. Specifically, the NART was negatively associated with emotion recognition of fear, sadness, and disgust and recognition of angry faces. The CFIT was positively related to recognition of fear, anger, and disgust. Recognizing sad facial cues was significantly correlated with PRCST. Additional Analyses To determine the relative and unique contribution of depression in predicting emotion recognition ability, two multiple regression analyses were conducted. Tolerance for multicollinearity in the independent variable was within the acceptable range. Fear and anger recognition scores were entered in the regression model as the Table 4. Summary of the regression analyses on the number of correct identifications of fear and anger Parameter
Fear b
Anger b
Age GDS NART CFIT R2 (%)
.05 .29 .33 .10 28
.19 .26 .28 .04 24
Note. GDS ¼ Geriatric Depression Scale (Yesavage et al., 1982); NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959) b is the average increase in the dependent variable associated with an increase of 1 unit in the independent variable. p < .05; p < .01.
7
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
Figure 1. Scatter plots of performance on facial affect recognition of fear (top panel) and anger (bottom panel) by depression scores with the fitted line from the adjusted model, at mean values of the covariates (age, premorbid IQ, and fluid intelligence).
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
8
V. Orgeta
dependent variables. A simultaneous solution entered predictor variables as a block, with each predictor assessed as if it had entered the equation last. GDS scores, NART, age, and CFIT scores were entered as the independent variables. The results of the regression analyses are presented in Table 4. Multiple R for the regression with fear recognition as the dependent variable was significantly different from zero, F(4, 66) ¼ 9.96, p < .001. Multiple R was .53; thus, together the variables accounted for 28% of the variance in fear recognition, where GDS scores and performance on the NART made unique contributions in predicting recognition of fear. A second regression analysis examined the incremental contributions of the independent variables relative to anger recognition. Multiple R for the regression of anger recognition as the dependent variable was significantly different from zero, F(4, 66) ¼ 4.95, p < .001, Multiple R ¼ .49; thus, together all the variables accounted for 24% of the variance in anger recognition scores. For this analysis, GDS and NART made unique contributions in predicting recognition of anger. These relationships are depicted graphically as scatter plots in Figure 1, with regression lines included. DISCUSSION The purpose of the present study was to examine the influence of self-reported mild depressive symptoms on the ability to recognize facial affect in community-dwelling older adults. The main hypothesis of the present study was that participants with mild depressive symptomatology would perform more poorly than nondepressed older adults on the emotion recognition task. Overall, the current study supports the idea that depressed mood is associated with deficits in the identification of facial expressions (Surguladze et al., 2004). As hypothesized, the main effect of group was qualified by an interaction between type of group and emotion, where the pattern of group differences varied across specific emotions. Consistent with previous studies, older adults reporting mild depressive symptoms were impaired in their ability to identify fear and anger (Asthana et al., 1998; Gollan et al., 2008; Langenecker et al., 2005; Persad & Polivy, 1993). Current findings mirror those reported by Shanon (1970), where depressed psychiatric patients were less accurate than normal controls in identifying facial representations of fear and anger. The results of the present study are consistent with the notion that older adults reporting mild depressive symptoms do not have a general deficit affecting all facial emotions but a disproportionate
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
9
impairment in the recognition of facial expressions of fear and anger. Current results are consistent with theoretical cognitive models of depression, which argue that biased processing of emotional material is a stable vulnerability factor that affects the onset, maintenance, and recurrence of depressive episodes (Beck, 1976). Overall, current findings raise the possibility that difficulties in emotion processing, and specifically recognition of emotional expressions, appear to coexist with depressive symptoms, an effect that has not been replicated in a sample of older adults. The influence of mild depressive symptoms in the ability to identify angry facial expressions is consistent with the hypothesis that depression is related to an inhibition of the emotion of anger (Riley, Treiber, & Woods, 1989). The findings that have been reported are consistent with recent studies demonstrating deficits in emotion recognition in healthy populations experiencing nonclinical psychological distress (Leppanen et al., 2004). Interestingly, in line with previous studies, the sample experiencing mild depressive symptoms was also impaired in visual processing of facial stimuli (Asthana et al., 1998); however, correlational analyses showed that visuoperceptual ability made the least contribution in explaining emotion identification performance. On the other hand, premorbid functioning as measured by the NART had the most consistent relationship across emotion and group, indicating that this variable appears to be the most significant predictor. In line with previous studies, fluid intelligence, as measured by the CFIT, also contributed towards explaining recognition of facial expressions of affect (Sullivan & Ruffman, 2004; Suzuki et al., 2007). In conclusion, the current study was designed to examine whether participants who are reporting experiencing mild depressive symptoms differ from healthy control participants in their identification of subtle expressions of emotion. Present findings have demonstrated that older adults experiencing mild depressive affect are impaired in their ability to identify facial expressions of fear and anger. It is significant at this point to acknowledge the limitations of the present study. The primary limitation relates to generalizability. The current sample consisted of older adults who were generally healthy, community dwelling (of university panel volunteers), further limiting the generalizability of the results in the wider aging population, since the current sample may differ from older adults in general and since mild depressive symptoms were assessed only via self-report. A further limitation of the present study is that despite the importance of depressive episodes, data on the frequency of occurrence of depressive episodes were not collected. Other mechanisms that might be associated with emotion perception deficits are eye-gaze patterns
10
V. Orgeta
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
(Wong, Cronin-Golomb, & Neargarder, 2005), future research should therefore include measures of eye tracking in order to fully investigate the mechanisms underlying depression-related biases in the processing of emotional facial expressions. Future studies could also examine whether deficits in emotion recognition ability may be related to impairments in interpersonal interactions that may contribute in vulnerability to depressive episodes (Joiner & Timmons, 2008). ACKNOWLEDGMENT The author thanks those who kindly volunteered to participate in the study. FUNDING This research was funded by the College of Life Sciences and Medicine of University of Aberdeen. REFERENCES Asthana, H. S., Mandal, M. K., Khurana, H., & Haque-Nizamie, S. (1998). Visuospatial and affect recognition deficit in depression. Journal of Affective Disorders, 48, 57–62. Beck, A. T. (Ed.). (1976). Cognitive therapy and the emotional disorders. New York, NY: New American Library. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the BDI-II. San Antonio, TX: The Psychological Corporation. Benton, A. L., Hamsher, K., Varney, N. R., & Spreen, O. (1983). Contributions to neuropsychological assessment. New York, NY: Oxford University Press. Calder, J. A., Keane, J., Manly, T., Sprengelmeyer, R., Scott, S., Nimmo-Smith, I., & Young, A. W. (2003). Facial expression recognition across the adult life span. Neuropsychologia, 41, 195–202. Cattell, R., & Cattell, A. K. (1959). The Culture Fair Intelligence Test. Savoy, IL: The Institute for Personality and Ability Testing. Chayer, C. (2002). The neurologic examination: Brief mental status. Journal of Geriatric Care, 1, 265–267. Christensen, K. J., Riley, B. E., Heffernan, K. A., Love, S. B., & McLaughlin Sta Maria, M. E. (2002). Facial recognition test in the elderly: Norms, reliability and premorbid estimation. The Clinical Neuropsychologist, 16, 51–56. Ekman, P. (2003). Emotions revealed: Recognizing faces and feelings to improve communication and emotional life. New York, NY: Henry Holt & Company. Ekman, P., Sorenson, E. R., & Friesen, W. V. (1969). Pan-cultural elements in facial displays of emotion. Science, 164, 86–88.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
11
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). ‘‘Mini-mental state": A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. Gollan, J. K., Pane, H. T., McCloskey, M. S., & Coccaro, E. F. (2008). Identifying differences in biased affective information processing in major depression. Psychiatry Research, 159, 18–24. Gur, R. C., Erwin, R. J., Gur, R. E., Zwil, A. S., Heimberg, C., & Kraemer, H. C. (1992). Facial emotion discrimination: II. Behavioural findings in depression. Psychiatry Research, 42, 241–251. Isaacowitz, D. M., Lockenhoff, C. E., Lane, R. D., Wright, R., Sechrest, L., Riedel, R., & Costa, P. T. (2007). Age differences in recognition of emotion in lexical stimuli and facial expressions. Psychology and Aging, 22, 147–159. Jefferson, A. L., Powers, D. P., & Pope, M. (2000). Beck depression inventory-II (BDI-II) and the geriatric depression scale (GDS) in older women. Clinical Gerontologist, 22, 3–12. Johnston, P. J., Katsikitis, M., & Carr, V. J. (2001). A generalised deficit can account for problems in facial emotion recognition in schizophrenia. Biological Psychology, 58, 203–227. Joiner, T. E., & Timmons, K. A. (2008). Depression in its interpersonal context. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 322– 339). New York, NY: Guildford Press. Kan, Y., Mimura, M., Kamijima, K., & Kawamura, M. (2004). Recognition of emotion from moving facial and prosodic stimuli in depressed patients. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 1667–1671. Keightley, M. L., Winocur, G., Burianova, H., Hongwanishkul, D., & Grady, C. L. (2006). Age effects on social cognition: Faces tell a different story. Psychology and Aging, 21, 558–572. Langenecker, S. A., Bieliauskas, L. A., Rapport, L. J., Zubieta, J. K., Wilde, E. A., & Berent, S. (2005). Face emotion perception and executive functioning deficits in depression. Journal of Clinical and Experimental Neuropsychology, 27, 320–333. Le Masurier, M., Cowen, P. J., & Harmer, C. J. (2007). Emotional bias and waking salivary cortisol in relatives of patients with major depression. Psychological Medicine, 37, 403–410. Leppanen, J. M., Milders, M., Bell, J. S., Terriere, E., & Hietanen, J. K. (2004). Depression biases the recognition of emotionally neutral faces. Psychiatry Research, 128, 123–133. Mendlewicz, L., Linkowski, P., Bazelmans, C., & Philippot, P. (2005). Decoding emotional facial expressions in depressed and anorexic patients. Journal of Affective Disorders, 89, 195–199. Mikhailova, E. S., Vladimirova, T. V., Iznak, A. F., Tsusulkovskaya, E. J., & Sushko, N. V. (1996). Abnormal recognition of facial expression of emotions in depressed patients with major depression disorder and schizotypal personality disorder. Biological Psychiatry, 40, 697–705. Montorio, I., & Izal, M. (1996). The geriatric depression scale: A review of its development and utility. International Psychogeriatrics, 8, 103–112.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
12
V. Orgeta
Nelson, H. E. (1982). National Adult Reading Test (NART): Test manual. Windsor, UK: National Foundation for Educational Research. Orgeta, V., & Phillips, L. H. (2008). Effects of age and emotional intensity on the recognition of facial emotion. Experimental Aging Research, 34, 63–79. Pelli, D. G., Robson, J. G., & Wilkins, A. J. (1988). The design of a new letter chart for measuring contrast sensitivity. Clinical Vision Sciences, 2, 187–199. Persad, S. M., & Polivy, J. (1993). Differences between depressed and nondepressed individuals in the recognition of and response to facial emotional cues. Journal of Abnormal Psychology, 102, 358–368. Ravdin, L. D., Katzen, H. L., Agrawal, P., & Relkin, N. R. (2003). Letter and semantic fluency in older adults: Effects of mild depressive symptoms and agestratified normative data. The Clinical Neuropsychologist, 17, 195–202. Riley, W. T., Treiber, F. A., & Woods, M. G. (1989). Anger and hostility in depression. Journal of Nervous and Mental Disease, 11, 668–674. Shanon, A. M. (1970). Differences between depressives and schizophrenics in the recognition of facial expression of emotion (Unpublished doctoral dissertation). University of California, San Francisco, CA. Sullivan, S., & Ruffman, T. (2004). Emotion recognition deficits in the elderly. International Journal of Neuroscience, 114, 403–432. Sullivan, S., Ruffman, T., & Hutton, S. B. (2007). Age differences in emotion recognition skills and the visual scanning of emotion faces. The Journals of Gerontology: Psychological Sciences and Social Sciences, 62, P53–P60. Surguladze, S. A., Young, A. W., Senior, C., Brebion, G., Travis, M. J., & Phillips, M. L. (2004). Recognition accuracy and response bias to happy and sad facial expressions in patients with major depression. Neuropsychology, 18, 212–218. Suzuki, A., Hoshino, T., Shigemasu, K., & Kawamura, M. (2007). Decline or improvement? Age-related differences in facial expression recognition. Biological Psychology, 74, 75–84. Weniger, G., Lange, C., Ruther, E., & Irle, E. (2004). Differential impairments of facial affect recognition in schizophrenia subtypes and major depression. Psychiatry Research, 128, 135–146. Wong, B., Cronin-Golomb, A., & Neargarder, S. (2005). Patterns of visual scanning as predictors of emotion identification in normal aging. Neuropsychology, 19, 739–749. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. Young, A. W., Perrett, D. I., Calder, A. J., Sprengelmeyer, R., & Ekman, P. (2002). Facial expression of emotion: Stimuli and tests (FEEST). Bury St. Edmunds, England: Thames Valley Test Company.
Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process Publication details, including instructions for authors and subscription information: http://www.tandfonline.com/loi/uear20
Emotion Recognition Ability and Mild Depressive Symptoms in Late Adulthood Vasiliki Orgeta
a
a
Click for updates
Mental Health Sciences Unit , University College London , London , UK Published online: 27 Jan 2014.
To cite this article: Vasiliki Orgeta (2014) Emotion Recognition Ability and Mild Depressive Symptoms in Late Adulthood, Experimental Aging Research: An International Journal Devoted to the Scientific Study of the Aging Process, 40:1, 1-12, DOI: 10.1080/0361073X.2014.857535 To link to this article: http://dx.doi.org/10.1080/0361073X.2014.857535
PLEASE SCROLL DOWN FOR ARTICLE Taylor & Francis makes every effort to ensure the accuracy of all the information (the “Content”) contained in the publications on our platform. However, Taylor & Francis, our agents, and our licensors make no representations or warranties whatsoever as to the accuracy, completeness, or suitability for any purpose of the Content. Any opinions and views expressed in this publication are the opinions and views of the authors, and are not the views of or endorsed by Taylor & Francis. The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any
losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at http://www.tandfonline.com/page/terms-and-conditions
Experimental Aging Research, 40: 1–12, 2014 Copyright # Taylor & Francis Group, LLC ISSN: 0361-073X print=1096-4657 online DOI: 10.1080/0361073X.2014.857535
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
EMOTION RECOGNITION ABILITY AND MILD DEPRESSIVE SYMPTOMS IN LATE ADULTHOOD
Vasiliki Orgeta Mental Health Sciences Unit, University College London, London, UK Background=Study Context: Current evidence suggests that dysphoric mood affects the ability to recognize facial emotion. Methods: In the present study, older adults with and without mild depressive symptoms were asked to complete a task measuring their ability to identify facial affect representative of six different emotions (happiness, surprise, disgust, fear, anger, and sadness). Results: Consistent with previous findings, results showed that older adults experiencing mild depressive symptoms were less accurate in their ability to recognize facial expressions of fear and anger. No group differences were observed in the recognition of happiness, surprise, disgust, and sadness. Conclusion: The present study has contributed to previous research by demonstrating that mild depressive symptoms affect the ability to recognize facial emotion in a sample of older adults.
Decoding of emotional facial expressions constitutes an important facet of social skills, with most individuals able to identify facial affective cues with a high degree of accuracy (Ekman, 2003; Ekman, Sorenson, & Friesen, 1969; Leppanen, Milders, Bell, Terriere, & Hietanen, 2004; Persad & Polivy, 1993). Relatively recently a number of studies have been conducted investigating the extent to which biased affective information processes are modified by affective symptoms (Asthana, Mandal, Khurana, & Haque-Nizamie, 1998; Mendlewicz, Linkowski, Bazelmans, & Philippot, 2005). Prior work, for example, has shown that individuals experiencing moderate to Received 30 April 2009; accepted 15 December 2012. Address correspondence to Vasiliki Orgeta, Mental Health Sciences Unit, 67–73 Riding House Street, 2nd Floor, Charles Bell House, London, W1W 7EJ, UK. E-mail: v.orgeta@ ucl.ac.uk
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
2
V. Orgeta
severe symptoms of depression experience difficulty with emotional perception of facial expressions (Langenecker et al., 2005). Most studies demonstrate that patients with depression exhibit a global deficit in facial judgment accuracy (Asthana et al., 1998; Gollan, Pane, McCloskey, & Coccaro, 2008; Langenecker et al., 2005; Persad & Polivy, 1993), although contradictory findings have also been reported, with some studies reporting no such deficit (Kan, Mimura, Kamijima, & Kawamura, 2004). Although much attention has been given in investigating emotion recognition accuracy in major depression (Gur et al., 1992; Mikhailova, Vladimirova, Iznak, Tsusulkovskaya, & Sushko, 1996; Weniger, Lange, Ruther, & Irle, 2004), less research has been conducted examining the relationship between psychiatric symptom distress observed in healthy populations and the ability to judge emotional facial expressions. Several studies have demonstrated that individuals with an increased familial risk of depression who have not yet experienced a depressive episode are less accurate in recognizing emotional facial expressions (Le Masurier, Cowen, & Harmer, 2007). This line of research is consistent with cognitive models of depression proposing that biased processing of emotional material is a stable vulnerability factor that affects the onset, maintenance, and recurrence of depressive episodes (Beck, 1976). Despite the above findings, it appears that little research has investigated whether depressive symptoms that fail to meet criteria for a clinical diagnosis might be associated with deficits in emotion recognition ability. In addition, it appears that most studies have focused on adult populations, with currently no studies examining the influence of depressive symptoms on older adults’ ability to discriminate facial affect, despite well-replicated evidence of age effects on emotion recognition ability (Calder et al., 2003; Isaacowitz et al., 2007; Keightley, Winocur, Burianova, Hongwanishkul, & Grady, 2006). The idea, for example, that the ability to recognize facial affect may decline with age has attracted considerable attention by researchers (Sullivan & Ruffman, 2004; Suzuki, Hoshino, Shigemasu, & Kawamura, 2007), with most studies demonstrating an age-related decline in the ability to identify fear, anger, and sadness (Orgeta & Phillips, 2008; Sullivan, Ruffman, & Hutton, 2007). The purpose of the present study, therefore, was to examine whether self-reported mild depressive symptoms affect the ability to recognize emotion in a sample of community-dwelling older adults. Based on previous research, the first hypothesis of this study was that older adults experiencing mild depressive symptoms would have poorer performance in affective facial recognition in comparison with
Emotion Recognition Ability in Late Adulthood
3
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
nondepressed older adults. Because poor overall recognition rate of facial expressions has been found to be associated with poor performance on cognitive tests in both psychiatric populations (Asthana et al., 1998; Johnston, Katsikitis, & Carr, 2001) and normal aging (Orgeta & Phillips, 2008; Sullivan & Ruffman, 2004), cognitive tasks were also included in the present study, to ensure that any deficits observed were not attributed to a generalized performance deficit. METHODS Participants Seventy older community residents ranging in age from 60 to 82 years (43 females and 27 males) were recruited from a university panel of volunteers and were invited to participate. All participants were screened for possible cognitive impairment with the Mini-Mental State Examination (Folstein, Folstein, & McHugh, 1975), with a cutoff score of >25 (Chayer, 2002). Three participants were excluded from the study on the basis of this criterion. Given previous studies suggesting that when assessing mood in late adulthood, the Geriatric Depression Scale (GDS; Yesavage et al., 1982) should be preferred to the Beck Depression Inventory—II (BDI-II) (Jefferson, Powers, & Pope, 2000; Montorio & Izal, 1996), participants were divided into two groups based on their total score on the GDS (Cronbach’s a ¼ .86). In the GDS, cutoff scores of 11 or greater are considered to represent significant mild depression, whereas scores of 21 and higher indicate severe depression (Yesavage et al., 1982). Thirty-two participants obtained scores consistent with mild depressive symptoms (MDS) (GDS 10–19; M ¼ 13.73, SD ¼ 3.48) and 35 normal control (NC) participants obtained scores in the normal range (GDS < 10; M ¼ 3.96, SD ¼ 2.61). This approach has been successfully used by previous studies demonstrating the effects of mild depressive symptoms in letter and semantic fluency tasks in older adults (Ravdin, Katzen, Agrawal, & Relkin, 2003). Participants also completed the Beck Depression Inventory—II (Beck, Steer, & Brown, 1996) (BDI–II), where the MDS group scored significantly higher compared with the NCs, t(65) ¼ 12.31, p < .001, d ¼ 1.66. The two groups did not differ in terms of age, t(65) ¼ .13, p > .05, d ¼ .44, or years of education, t(65) ¼ .59, p > .05, d ¼ .14. Older adults in the MDS group reported lower levels of overall health, t(65) ¼ 3.74, p < .001, d ¼ .87. Participants were tested on the
V. Orgeta
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
4
National Adult Reading Test (NART) in order to estimate premorbid verbal IQ (Nelson, 1982), and on the Culture Fair Intelligence Test (CFIT; Cattell & Cattell, 1959) as an estimate of current cognitive function. Group differences were found on the NART, t(65) ¼ 2.34, p < .01, d ¼ .75, where the NCs made fewer errors. There were no group differences on the CFIT, t(65) ¼ 1.22, p > .05, d ¼ .13 (see Table 1). The Benton Facial Recognition Test (BFRT) (Benton, Hamsher, Varney, & Spreen, 1983) was included in order to assess nonemotional aspects of facial recognition. All participants performed within the normal range according to norms established for older adults on this measure (Christensen, Riley, Heffernan, Love, & McLaughlin Sta Maria, 2002). The Pelli-Robson Contrast Sensitivity Test (PRCST) (Pelli, Robson, & Wilkins, 1988) assessed visual acuity. NCs scored higher in the BFRT, indicating better visuoperceptual ability, t(65) ¼ 2.19, p < .05, d ¼ .53, whereas the two groups were comparable in their performance in the PRCST, t(65) ¼ 1.43, p > .05, d ¼ .33. Materials and Procedure The Emotion Recognition Task The facial images presented in the Emotion Recognition Task (ERT) were taken from the Facial Expressions of Emotion: Stimuli and Tests (Young, Perrett, Calder, Sprengelmeyer, & Ekman, 2002). A total of 108 trials were presented depicting the six fundamental emotions. Each trial consisted of the simultaneous presentation of the Table 1. Mean and standard deviations of demographic characteristics for both groups Normal controls Variable Chronological age Years of education Subjective physical health NART (errors) CFIT BFRT PRCST
Mild depressive symptoms
M
SD
M
SD
69.11 13.09 7.11 12.40 22.19 21.57 1.76
3.79 3.06 1.32 4.68 3.78 2.13 .14
70.66 13.53 5.88 16.06 21.66 19.47 1.71
3.19 3.12 1.49 5.13 4.17 5.23 .16
Note. NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959); BFRT ¼ Benton Facial Recognition Test (Benton et al., 1983); PRCST ¼ Pelli-Robson Contrast Sensitivity Test (Pelli, Robson, & Wilkins, 1988).
Emotion Recognition Ability in Late Adulthood
5
emotional expression (target) and six emotional labels from which participants had to choose the label that best described the presented emotion. Facial expressions of 50% and 75% emotional intensity were presented in order to avoid ceiling effects (see Young et al., 2002). The presentation of emotional expressions and the presentation of labels were random in every trial.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
RESULTS Mild Depressive Symptoms and Emotion Recognition Accuracy of emotion recognition (percentage correct) was analyzed by conducting a 2 6 analysis of variance (ANOVA) with group as a between-subjects factor, and type of emotion as the within-subjects factor. Means and standard deviations for each emotion and group are presented in Table 2. There was a main effect of emotion, F(3.66, 237.95) ¼ 29.94, p < .001, g2p ¼ :32, a main effect of group, F(1, 65) ¼ 3.56, p < .05, g2p ¼ :05, qualified by a significant interaction between type of emotion and group, F(5, 237.95) ¼ 3.57, p < .01, g2p ¼ :05. Follow-up analyses showed that older adults experiencing MDS were worse in their ability to identify fear, t(65) ¼ 4.44, p < .001, d ¼ 1.08, and anger, t(65) ¼ 2.07, p < .05, d ¼ .50. There were no group differences in the identification of happiness, t(65) ¼ 1.64, p > .05, d ¼ .05, surprise, t(65) ¼ .02, p > .05, d ¼ .01, disgust, t(65) ¼ .64, p > .05, d ¼ .16, and sadness, t(65) ¼ .17, p > .05, d ¼ .04. Table 3 shows correlations between the number of correct identifications of the five emotions in the ERT and the remaining variables. Happiness was excluded from the correlational analyses because of ceiling effects and poor variance. The NART and the CFIT had the most consistent relationship with performance in the ERT across Table 2. Mean and standard errors of the mean of correct responses on the Emotion Recognition Task for the six emotions tested for each group Normal controls Emotion category Happiness Surprise Disgust Fear Anger Sadness
Mild depressive symptoms
M
SE
M
SE
96.27 72.38 70.24 76.90 77.38 61.42
1.29 4.51 3.53 3.15 1.93 4.79
95.44 72.52 66.69 54.19 64.99 60.15
2.90 4.47 4.29 4.09 4.23 5.60
V. Orgeta
6
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Table 3. Correlations between the Emotion Recognition Task and fluid, verbal, and visuoperceptual abilities Emotion category
NART
CFIT
BFRT
PRCST
Surprise Disgust Fear Anger Sadness
.15 .33 .45 .36 .42
.14 .23 .22 .35 .05
.16 .04 .05 .14 .05
.11 .10 .12 .19 .26
Note. NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959); BFRT ¼ Benton Facial Recognition Test (Benton et al., 1983); PRCST ¼ Pelli-Robson Contrast Sensitivity Test (Pelli et al., 1988). p < .05; p < .01.
emotion. Specifically, the NART was negatively associated with emotion recognition of fear, sadness, and disgust and recognition of angry faces. The CFIT was positively related to recognition of fear, anger, and disgust. Recognizing sad facial cues was significantly correlated with PRCST. Additional Analyses To determine the relative and unique contribution of depression in predicting emotion recognition ability, two multiple regression analyses were conducted. Tolerance for multicollinearity in the independent variable was within the acceptable range. Fear and anger recognition scores were entered in the regression model as the Table 4. Summary of the regression analyses on the number of correct identifications of fear and anger Parameter
Fear b
Anger b
Age GDS NART CFIT R2 (%)
.05 .29 .33 .10 28
.19 .26 .28 .04 24
Note. GDS ¼ Geriatric Depression Scale (Yesavage et al., 1982); NART ¼ National Adult Reading Test (Nelson, 1982); CFIT ¼ Culture Fair Intelligence Test (Cattell & Cattell, 1959) b is the average increase in the dependent variable associated with an increase of 1 unit in the independent variable. p < .05; p < .01.
7
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
Figure 1. Scatter plots of performance on facial affect recognition of fear (top panel) and anger (bottom panel) by depression scores with the fitted line from the adjusted model, at mean values of the covariates (age, premorbid IQ, and fluid intelligence).
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
8
V. Orgeta
dependent variables. A simultaneous solution entered predictor variables as a block, with each predictor assessed as if it had entered the equation last. GDS scores, NART, age, and CFIT scores were entered as the independent variables. The results of the regression analyses are presented in Table 4. Multiple R for the regression with fear recognition as the dependent variable was significantly different from zero, F(4, 66) ¼ 9.96, p < .001. Multiple R was .53; thus, together the variables accounted for 28% of the variance in fear recognition, where GDS scores and performance on the NART made unique contributions in predicting recognition of fear. A second regression analysis examined the incremental contributions of the independent variables relative to anger recognition. Multiple R for the regression of anger recognition as the dependent variable was significantly different from zero, F(4, 66) ¼ 4.95, p < .001, Multiple R ¼ .49; thus, together all the variables accounted for 24% of the variance in anger recognition scores. For this analysis, GDS and NART made unique contributions in predicting recognition of anger. These relationships are depicted graphically as scatter plots in Figure 1, with regression lines included. DISCUSSION The purpose of the present study was to examine the influence of self-reported mild depressive symptoms on the ability to recognize facial affect in community-dwelling older adults. The main hypothesis of the present study was that participants with mild depressive symptomatology would perform more poorly than nondepressed older adults on the emotion recognition task. Overall, the current study supports the idea that depressed mood is associated with deficits in the identification of facial expressions (Surguladze et al., 2004). As hypothesized, the main effect of group was qualified by an interaction between type of group and emotion, where the pattern of group differences varied across specific emotions. Consistent with previous studies, older adults reporting mild depressive symptoms were impaired in their ability to identify fear and anger (Asthana et al., 1998; Gollan et al., 2008; Langenecker et al., 2005; Persad & Polivy, 1993). Current findings mirror those reported by Shanon (1970), where depressed psychiatric patients were less accurate than normal controls in identifying facial representations of fear and anger. The results of the present study are consistent with the notion that older adults reporting mild depressive symptoms do not have a general deficit affecting all facial emotions but a disproportionate
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
9
impairment in the recognition of facial expressions of fear and anger. Current results are consistent with theoretical cognitive models of depression, which argue that biased processing of emotional material is a stable vulnerability factor that affects the onset, maintenance, and recurrence of depressive episodes (Beck, 1976). Overall, current findings raise the possibility that difficulties in emotion processing, and specifically recognition of emotional expressions, appear to coexist with depressive symptoms, an effect that has not been replicated in a sample of older adults. The influence of mild depressive symptoms in the ability to identify angry facial expressions is consistent with the hypothesis that depression is related to an inhibition of the emotion of anger (Riley, Treiber, & Woods, 1989). The findings that have been reported are consistent with recent studies demonstrating deficits in emotion recognition in healthy populations experiencing nonclinical psychological distress (Leppanen et al., 2004). Interestingly, in line with previous studies, the sample experiencing mild depressive symptoms was also impaired in visual processing of facial stimuli (Asthana et al., 1998); however, correlational analyses showed that visuoperceptual ability made the least contribution in explaining emotion identification performance. On the other hand, premorbid functioning as measured by the NART had the most consistent relationship across emotion and group, indicating that this variable appears to be the most significant predictor. In line with previous studies, fluid intelligence, as measured by the CFIT, also contributed towards explaining recognition of facial expressions of affect (Sullivan & Ruffman, 2004; Suzuki et al., 2007). In conclusion, the current study was designed to examine whether participants who are reporting experiencing mild depressive symptoms differ from healthy control participants in their identification of subtle expressions of emotion. Present findings have demonstrated that older adults experiencing mild depressive affect are impaired in their ability to identify facial expressions of fear and anger. It is significant at this point to acknowledge the limitations of the present study. The primary limitation relates to generalizability. The current sample consisted of older adults who were generally healthy, community dwelling (of university panel volunteers), further limiting the generalizability of the results in the wider aging population, since the current sample may differ from older adults in general and since mild depressive symptoms were assessed only via self-report. A further limitation of the present study is that despite the importance of depressive episodes, data on the frequency of occurrence of depressive episodes were not collected. Other mechanisms that might be associated with emotion perception deficits are eye-gaze patterns
10
V. Orgeta
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
(Wong, Cronin-Golomb, & Neargarder, 2005), future research should therefore include measures of eye tracking in order to fully investigate the mechanisms underlying depression-related biases in the processing of emotional facial expressions. Future studies could also examine whether deficits in emotion recognition ability may be related to impairments in interpersonal interactions that may contribute in vulnerability to depressive episodes (Joiner & Timmons, 2008). ACKNOWLEDGMENT The author thanks those who kindly volunteered to participate in the study. FUNDING This research was funded by the College of Life Sciences and Medicine of University of Aberdeen. REFERENCES Asthana, H. S., Mandal, M. K., Khurana, H., & Haque-Nizamie, S. (1998). Visuospatial and affect recognition deficit in depression. Journal of Affective Disorders, 48, 57–62. Beck, A. T. (Ed.). (1976). Cognitive therapy and the emotional disorders. New York, NY: New American Library. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the BDI-II. San Antonio, TX: The Psychological Corporation. Benton, A. L., Hamsher, K., Varney, N. R., & Spreen, O. (1983). Contributions to neuropsychological assessment. New York, NY: Oxford University Press. Calder, J. A., Keane, J., Manly, T., Sprengelmeyer, R., Scott, S., Nimmo-Smith, I., & Young, A. W. (2003). Facial expression recognition across the adult life span. Neuropsychologia, 41, 195–202. Cattell, R., & Cattell, A. K. (1959). The Culture Fair Intelligence Test. Savoy, IL: The Institute for Personality and Ability Testing. Chayer, C. (2002). The neurologic examination: Brief mental status. Journal of Geriatric Care, 1, 265–267. Christensen, K. J., Riley, B. E., Heffernan, K. A., Love, S. B., & McLaughlin Sta Maria, M. E. (2002). Facial recognition test in the elderly: Norms, reliability and premorbid estimation. The Clinical Neuropsychologist, 16, 51–56. Ekman, P. (2003). Emotions revealed: Recognizing faces and feelings to improve communication and emotional life. New York, NY: Henry Holt & Company. Ekman, P., Sorenson, E. R., & Friesen, W. V. (1969). Pan-cultural elements in facial displays of emotion. Science, 164, 86–88.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
Emotion Recognition Ability in Late Adulthood
11
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). ‘‘Mini-mental state": A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. Gollan, J. K., Pane, H. T., McCloskey, M. S., & Coccaro, E. F. (2008). Identifying differences in biased affective information processing in major depression. Psychiatry Research, 159, 18–24. Gur, R. C., Erwin, R. J., Gur, R. E., Zwil, A. S., Heimberg, C., & Kraemer, H. C. (1992). Facial emotion discrimination: II. Behavioural findings in depression. Psychiatry Research, 42, 241–251. Isaacowitz, D. M., Lockenhoff, C. E., Lane, R. D., Wright, R., Sechrest, L., Riedel, R., & Costa, P. T. (2007). Age differences in recognition of emotion in lexical stimuli and facial expressions. Psychology and Aging, 22, 147–159. Jefferson, A. L., Powers, D. P., & Pope, M. (2000). Beck depression inventory-II (BDI-II) and the geriatric depression scale (GDS) in older women. Clinical Gerontologist, 22, 3–12. Johnston, P. J., Katsikitis, M., & Carr, V. J. (2001). A generalised deficit can account for problems in facial emotion recognition in schizophrenia. Biological Psychology, 58, 203–227. Joiner, T. E., & Timmons, K. A. (2008). Depression in its interpersonal context. In I. H. Gotlib & C. L. Hammen (Eds.), Handbook of depression (pp. 322– 339). New York, NY: Guildford Press. Kan, Y., Mimura, M., Kamijima, K., & Kawamura, M. (2004). Recognition of emotion from moving facial and prosodic stimuli in depressed patients. Journal of Neurology, Neurosurgery, and Psychiatry, 75, 1667–1671. Keightley, M. L., Winocur, G., Burianova, H., Hongwanishkul, D., & Grady, C. L. (2006). Age effects on social cognition: Faces tell a different story. Psychology and Aging, 21, 558–572. Langenecker, S. A., Bieliauskas, L. A., Rapport, L. J., Zubieta, J. K., Wilde, E. A., & Berent, S. (2005). Face emotion perception and executive functioning deficits in depression. Journal of Clinical and Experimental Neuropsychology, 27, 320–333. Le Masurier, M., Cowen, P. J., & Harmer, C. J. (2007). Emotional bias and waking salivary cortisol in relatives of patients with major depression. Psychological Medicine, 37, 403–410. Leppanen, J. M., Milders, M., Bell, J. S., Terriere, E., & Hietanen, J. K. (2004). Depression biases the recognition of emotionally neutral faces. Psychiatry Research, 128, 123–133. Mendlewicz, L., Linkowski, P., Bazelmans, C., & Philippot, P. (2005). Decoding emotional facial expressions in depressed and anorexic patients. Journal of Affective Disorders, 89, 195–199. Mikhailova, E. S., Vladimirova, T. V., Iznak, A. F., Tsusulkovskaya, E. J., & Sushko, N. V. (1996). Abnormal recognition of facial expression of emotions in depressed patients with major depression disorder and schizotypal personality disorder. Biological Psychiatry, 40, 697–705. Montorio, I., & Izal, M. (1996). The geriatric depression scale: A review of its development and utility. International Psychogeriatrics, 8, 103–112.
Downloaded by ["University at Buffalo Libraries"] at 17:29 01 February 2015
12
V. Orgeta
Nelson, H. E. (1982). National Adult Reading Test (NART): Test manual. Windsor, UK: National Foundation for Educational Research. Orgeta, V., & Phillips, L. H. (2008). Effects of age and emotional intensity on the recognition of facial emotion. Experimental Aging Research, 34, 63–79. Pelli, D. G., Robson, J. G., & Wilkins, A. J. (1988). The design of a new letter chart for measuring contrast sensitivity. Clinical Vision Sciences, 2, 187–199. Persad, S. M., & Polivy, J. (1993). Differences between depressed and nondepressed individuals in the recognition of and response to facial emotional cues. Journal of Abnormal Psychology, 102, 358–368. Ravdin, L. D., Katzen, H. L., Agrawal, P., & Relkin, N. R. (2003). Letter and semantic fluency in older adults: Effects of mild depressive symptoms and agestratified normative data. The Clinical Neuropsychologist, 17, 195–202. Riley, W. T., Treiber, F. A., & Woods, M. G. (1989). Anger and hostility in depression. Journal of Nervous and Mental Disease, 11, 668–674. Shanon, A. M. (1970). Differences between depressives and schizophrenics in the recognition of facial expression of emotion (Unpublished doctoral dissertation). University of California, San Francisco, CA. Sullivan, S., & Ruffman, T. (2004). Emotion recognition deficits in the elderly. International Journal of Neuroscience, 114, 403–432. Sullivan, S., Ruffman, T., & Hutton, S. B. (2007). Age differences in emotion recognition skills and the visual scanning of emotion faces. The Journals of Gerontology: Psychological Sciences and Social Sciences, 62, P53–P60. Surguladze, S. A., Young, A. W., Senior, C., Brebion, G., Travis, M. J., & Phillips, M. L. (2004). Recognition accuracy and response bias to happy and sad facial expressions in patients with major depression. Neuropsychology, 18, 212–218. Suzuki, A., Hoshino, T., Shigemasu, K., & Kawamura, M. (2007). Decline or improvement? Age-related differences in facial expression recognition. Biological Psychology, 74, 75–84. Weniger, G., Lange, C., Ruther, E., & Irle, E. (2004). Differential impairments of facial affect recognition in schizophrenia subtypes and major depression. Psychiatry Research, 128, 135–146. Wong, B., Cronin-Golomb, A., & Neargarder, S. (2005). Patterns of visual scanning as predictors of emotion identification in normal aging. Neuropsychology, 19, 739–749. Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. Young, A. W., Perrett, D. I., Calder, A. J., Sprengelmeyer, R., & Ekman, P. (2002). Facial expression of emotion: Stimuli and tests (FEEST). Bury St. Edmunds, England: Thames Valley Test Company.
