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Many studies have explored associations between depression and facial emotion recognition (ER). However, these studies have used various paradigms and multiple stimulus sets, rendering comparisons difficult. Few studies have attempted to determine the magnitude of any effect and whether studies are properly powered to detect it. We conducted a meta-analysis to synthesize the findings across studies on ER in depressed individuals compared to controls.
Studies of ER that included depressed and control samples and published before June 2013 were identified in PubMed and Web of Science. Studies using schematic faces, neuroimaging studies and drug treatment studies were excluded.
Meta-analysis of k = 22 independent samples indicated impaired recognition of emotion [k = 22, g = −0.16, 95% confidence interval (CI) −0.25 to −0.07, p < 0.001]. Critically, this was observed for anger, disgust, fear, happiness and surprise (k's = 7–22, g's = −0.42 to −0.17, p's < 0.08), but not sadness (k = 21, g = −0.09, 95% CI −0.23 to +0.06, p = 0.23). Study-level characteristics did not appear to be associated with the observed effect. Power analysis indicated that a sample of approximately 615 cases and 615 controls would be required to detect this association with 80% power at an alpha level of 0.05.
These findings suggest that the ER impairment reported in the depression literature exists across all basic emotions except sadness. The effect size, however, is small, and previous studies have been underpowered.
Growing evidence suggests that perinatal depression is associated with disrupted mother–infant interactions and poor infant outcomes. Antenatal depression may play a key role in this cycle by disrupting the development of a maternal response to infant stimuli. The current study therefore investigated the impact of depressive symptoms on the basic cognitive processing of infant stimuli at the beginning of pregnancy.
A total of 101 women were recruited by community midwives and tested at an average gestation of 11 weeks. An established computerized paradigm measured women's ability to disengage attention from infant and adult faces displaying negative positive and neutral emotions. Depressive symptoms were measured using a computerized interview (the Clinical Interview Schedule).
The effect of infant emotion on women's ability to disengage from infant faces was found to be influenced by depressive symptoms. Non-depressed pregnant women took longer to disengage attention from distressed compared with non-distressed infant faces. This bias was not, however, seen in women experiencing depressive symptoms. There was a difference of −53 (s.d.=0.7) ms (95% confidence interval −90 to −14, p=0.007) between those with and without depressive symptoms in this measure of attentional bias towards distressed infant faces.
Our results suggest that depressive symptoms are already associated with differential attentional processing of infant emotion at the very beginning of childbearing. The findings have potential implications for our understanding of the impact of depressive symptoms during pregnancy on the developing mother–infant relationship.
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