Depression severity is associated with impaired facial emotion processing in a large international sample.

backgroundDepression is associated with biases in facial emotion processing, which have an impact on the course and treatment of depression. While decades of research have established a negativity bias in processing in depression, there is still a gap in our understanding of how depression severity impacts sensitivity to detecting differences in emotional faces.

methodsWe examined emotion sensitivity (ES), or the ability to to detect subtle differences in emotional faces, in a large, geographically and culturally diverse, web-based sample (N = 6598, age range = 18-96, 56.50% female, 66% Caucasian). Participants completed ES tasks (fear, anger, or happiness) and a Beck Depression Inventory-II, to determine depression severity.

resultsDepression severity was correlated with overall ES performance as well as ES performance for individual emotions. Higher depression scores were associated with poorer performance in detecting happiness, fear, and anger (ps < .001). Examining performance by region, Eastern countries showed significantly poorer ES performance compared to Western countries, and were significantly more depressed. LIMITATIONS: Our sample is non-clinical and self-selected.

conclusionsThis study is an extension of existing research on emotional facial processing, with an approach that takes into consideration the heterogeneity of depression symptoms and corrects psychometric confounds of traditional emotion face processing paradigms. Overall, factors related to severity, task reliability, and facial stimuli should be considered in determining the potential mechanism of facial emotion processing in the onset and course of depression.