Relationships between retinal structure and function and vision-related quality of life measures in advanced age-related macular degeneration.

PURPOSE: To evaluate the association between ophthalmic structure/function measures and five standardized quality of life (QoL) instruments, in patients with advanced age-related macular degeneration (AMD). METHODS: We examined 20 AMD patients (ages 66-93 years) recruited from the Canberra Hospital Ophthalmology Department. Visual function measures included low and high contrast visual acuity (LCVA and HCVA) and measures from 10-2 Matrix visual fields (VF). Optical coherence tomography (OCT) quantified central retinal thickness (CRT), average macular thickness (AT), and retinal nerve fibre layer thickness (RNFL). The QoL instruments were the macular degeneration-related quality of life (MacDQoL), the National Eye Institute Visual Functioning Questionnaire (VFQ), its two face-recognition questions (A6 and 11), and the Geriatric Depression Scale (GDS). Pearson correlations, Canonical Correlation Analysis (CCA), and cross-validated stepwise-regression were used to examine the relationships between structure/function measures and the QoL instruments. RESULTS: The selected models for the five instruments had R2 ranging from 0.65 ± 0.12 to 0.90 ± 0.05 (mean ± SD) and median F-statistics > 188. HCVA was strongly associated with all QoL except the GDS, for which CRT, AT and RNFL figured highly. RNFL was most important for MacDQoL, and 2nd for VFQ question-A6. Centrally weighted VF measures were rarely selected but global VF measures were common, especially for the overall NEI-VFQ questionnaire. CCA revealed that the structure/function measures and QoL instruments contained 2 statistically independent mechanisms. CONCLUSIONS: In patients with advanced AMD, CRT and HCVA were strong determinants of QoL instruments in AMD patients.

Caricaturing can improve facial expression recognition in low-resolution images and age-related macular degeneration.

Previous studies of age-related macular degeneration (AMD) report impaired facial expression recognition even with enlarged face images. Here, we test potential benefits of caricaturing (exaggerating how the expression's shape differs from neutral) as an image enhancement procedure targeted at mid- to high-level cortical vision. Experiment 1 provides proof-of-concept using normal vision observers shown blurred images as a partial simulation of AMD. Caricaturing significantly improved expression recognition (happy, sad, anger, disgust, fear, surprise) by ∼4%-5% across young adults and older adults (mean age 73 years); two different severities of blur; high, medium, and low intensity of the original expression; and all intermediate accuracy levels (impaired but still above chance). Experiment 2 tested AMD patients, running 19 eyes monocularly (from 12 patients, 67-94 years) covering a wide range of vision loss (acuities 6/7.5 to poorer than 6/360). With faces pre-enlarged, recognition approached ceiling and was only slightly worse than matched controls for high- and medium-intensity expressions. For low-intensity expressions, recognition of veridical expressions remained impaired and was significantly improved with caricaturing across all levels of vision loss by 5.8%. Overall, caricaturing benefits emerged when improvement was most needed, that is, when initial recognition of uncaricatured expressions was impaired.

Reduced willingness to approach genuine smilers in social anxiety explained by potential for social evaluation, not misperception of smile authenticity.

We investigate perception of, and responses to, facial expression authenticity for the first time in social anxiety, testing genuine and polite smiles. Experiment 1 (N = 141) found perception of smile authenticity was unaffected, but that approach ratings, which are known to be reduced in social anxiety for happy faces, are more strongly reduced for genuine than polite smiles. Moreover, we found an independent contribution of social anxiety to approach ratings, over and above general negative affect (state/trait anxiety, depression), only for genuine smiles, and not for polite ones. We argue this pattern of results can be explained by genuine smilers signalling greater potential for interaction - and thus greater potential for the scrutiny that is feared in social anxiety - than polite smiles. Experiment 2 established that, relative to polite smilers, genuine smilers are indeed perceived as friendlier and likely to want to talk for longer if approached. Critically, the degree to which individual face items were perceived as wanting to interact correlated strongly with the amount that social anxiety reduced willingness to approach in Experiment 1. We conclude it is the potential for social evaluation and scrutiny signalled by happy expressions, rather than their positive valence, that is important in social anxiety.

Diagnosing prosopagnosia in East Asian individuals: Norms for the Cambridge Face Memory Test-Chinese.

The Cambridge Face Memory Test (CFMT) is widely accepted as providing a valid and reliable tool in diagnosing prosopagnosia (inability to recognize people's faces). Previously, large-sample norms have been available only for Caucasian-face versions, suitable for diagnosis in Caucasian observers. These are invalid for observers of different races due to potentially severe other-race effects. Here, we provide large-sample norms (N = 306) for East Asian observers on an Asian-face version (CFMT-Chinese). We also demonstrate methodological suitability of the CFMT-Chinese for prosopagnosia diagnosis (high internal reliability, approximately normal distribution, norm-score range sufficiently far above chance). Additional findings were a female advantage on mean performance, plus a difference between participants living in the East (China) or the West (international students, second-generation children of immigrants), which we suggest might reflect personality differences associated with willingness to emigrate. Finally, we demonstrate suitability of the CFMT-Chinese for individual differences studies that use correlations within the normal range.

Perceived emotion genuineness: normative ratings for popular facial expression stimuli and the development of perceived-as-genuine and perceived-as-fake sets.

In everyday social interactions, people's facial expressions sometimes reflect genuine emotion (e.g., anger in response to a misbehaving child) and sometimes do not (e.g., smiling for a school photo). There is increasing theoretical interest in this distinction, but little is known about perceived emotion genuineness for existing facial expression databases. We present a new method for rating perceived genuineness using a neutral-midpoint scale (-7 = completely fake; 0 = don't know; +7 = completely genuine) that, unlike previous methods, provides data on both relative and absolute perceptions. Normative ratings from typically developing adults for five emotions (anger, disgust, fear, sadness, and happiness) provide three key contributions. First, the widely used Pictures of Facial Affect (PoFA; i.e., "the Ekman faces") and the Radboud Faces Database (RaFD) are typically perceived as not showing genuine emotion. Also, in the only published set for which the actual emotional states of the displayers are known (via self-report; the McLellan faces), percepts of emotion genuineness often do not match actual emotion genuineness. Second, we provide genuine/fake norms for 558 faces from several sources (PoFA, RaFD, KDEF, Gur, FacePlace, McLellan, News media), including a list of 143 stimuli that are event-elicited (rather than posed) and, congruently, perceived as reflecting genuine emotion. Third, using the norms we develop sets of perceived-as-genuine (from event-elicited sources) and perceived-as-fake (from posed sources) stimuli, matched on sex, viewpoint, eye-gaze direction, and rated intensity. We also outline the many types of research questions that these norms and stimulus sets could be used to answer.

Fearful faces drive gaze-cueing and threat bias effects in children on the lookout for danger.

Most developmental studies of face emotion processing show faces in isolation, in the absence of any broader context. Here we investigate two types of interactions between expression and threat contexts. First, in adults, following of another person's direction of social attention is increased when that person shows fear and the context requires vigilance for danger. We investigate whether this also occurs in children. Using a Posner-style eye-gaze cueing paradigm, we tested whether children would show greater gaze-cueing from fearful than happy expressions when the task was to be vigilant for possible dangerous animals. Testing across the 8-12-year-old age range, we found this fear priority effect was absent in the youngest children but developed to reach adult levels in the oldest children. However, even the oldest children were unable to sustain fear-prioritization when the onset of the target was delayed. Second, we addressed the development of 'threat bias' - namely faster identification of dangerous animals than safe animals - in the social context provided by expressive faces. In our non-anxious samples (i.e. with typical-population levels of anxiety), adults showed a threat bias regardless of the expression or looking direction of the just-seen cue face whereas 8-12-year-olds only showed a threat bias when the just-seen cue face displayed fear. Overall, the results argue that some, but not all, aspects of expression-context interactions are mature by 12 years of age.

Domain-specific development of face memory but not face perception.

How does the remarkable human ability for face recognition arise over development? Competing theories have proposed either late maturity (beyond 10 years) or early maturity (before 5 years), but have not distinguished between perceptual and memory aspects of face recognition. Here, we demonstrate a perception-memory dissociation. We compare rate of development for (adult, human) faces versus other social stimuli (bodies), other discrete objects (cars), and other categories processed in discrete brain regions (scenes, bodies), from 5 years to adulthood. For perceptual discrimination, performance improved with age at the same rate for faces and all other categories, indicating no domain-specific development. In contrast, face memory increased more strongly than non-face memory, indicating domain-specific development. The results imply that each theory is partly true: the late maturity theory holds for face memory, and the early maturity theory for face perception.

A new theoretical approach to improving face recognition in disorders of central vision: face caricaturing.

Damage to central vision, of which age-related macular degeneration (AMD) is the most common cause, leaves patients with only blurred peripheral vision. Previous approaches to improving face recognition in AMD have employed image manipulations designed to enhance early-stage visual processing (e.g., magnification, increased HSF contrast). Here, we argue that further improvement may be possible by targeting known properties of mid- and/or high-level face processing. We enhance identity-related shape information in the face by caricaturing each individual away from an average face. We simulate early- through late-stage AMD-blur by filtering spatial frequencies to mimic the amount of blurring perceived at approximately 10° through 30° into the periphery (assuming a face seen premagnified on a tablet computer). We report caricature advantages for all blur levels, for face viewpoints from front view to semiprofile, and in tasks involving perceiving differences in facial identity between pairs of people, remembering previously learned faces, and rejecting new faces as unknown. Results provide a proof of concept that caricaturing may assist in improving face recognition in AMD and other disorders of central vision.

Aftereffects support opponent coding of face gender.

Many aspects of faces derived from structural information appear to be neurally represented using norm-based opponent coding. Recently, however, Zhao, Seriès, Hancock, and Bednar (2011) have argued that another aspect with a strong structural component, namely face gender, is instead multichannel coded. Their conclusion was based on finding that face gender aftereffects initially increased but then decreased for adaptors with increasing levels of gender caricaturing. Critically, this interpretation rests on the untested assumption that caricaturing the differences between male and female composite faces increases perceived sexual dimorphism (masculinity/femininity) of faces. We tested this assumption in Study 1 and found that it held for male, but not female faces. A multichannel account cannot, therefore, be ruled out, although a decrease in realism of adaptors was observed that could have contributed to the decrease in aftereffects. However, their aftereffects likely reflect low-level retinotopic adaptation, which was not minimized for most of their participants. In Study 2 we minimized low-level adaptation and found that face gender aftereffects were strongly positively related to the perceived sexual dimorphism of adaptors. We found no decrease for extreme adaptors, despite testing adaptors with higher perceived sexual dimorphism levels than those used by Zhao et al. These results are consistent with opponent coding of higher-level dimensions related to the perception of face gender.

The composite effect reveals that human (but not other primate) faces are special to humans.

Recognising faces is widely believed to be achieved using "special" neural and cognitive mechanisms that depend on "holistic" processing, which are not used when recognising other kinds of objects. An important, but largely unaddressed, question is how much like a Human face a stimulus needs to be to engage this "special" mechanism(s). In the current study, we attempted to answer this question in 3 ways. In Experiments 1 and 2 we examined the extent to which the disproportionate inversion effect for human faces extends to the faces of other species (including a range of other primates). Results suggested that the faces of other primates engage the mechanism responsible for the inversion effect approximately as well as that mechanism is engaged by Human faces, but that non-primate faces engage the mechanism less well. And so primate faces, in general, seem to produce a disproportionate inversion effect. In Experiment 3 we examined the extent to which the Composite effect extends to the faces of a range of other primates, and found no compelling evidence of a composite effect for the faces of any other primate. The composite effect was exclusive to Human faces. Because these data differ so dramatically from a previously reported study asking similar questions Taubert (2009), we also (in Experiment 4) ran an exact replication of Taubert's Experiment 2, which reported on both Inversion and Composite effects in a range of species. We were unable to reproduce the pattern of data reported by Taubert. Overall, the results suggest that the disproportionate inversion effect extends to all of the faces of the non-human primates tested, but that the composite effect is exclusive to Human faces.

Why the other-race effect matters: Poor recognition of other-race faces impacts everyday social interactions.

What happens to everyday social interactions when other-race recognition fails? Here, we provide the first formal investigation of this question. We gave East Asian international students (N = 89) a questionnaire concerning their experiences of the other-race effect (ORE) in Australia, and a laboratory test of their objective other-race face recognition deficit using the Cambridge Face Memory Test (CFMT). As a 'perpetrator' of the ORE, participants reported that their problems telling apart Caucasian people contributed significantly to difficulties socializing with them. Moreover, the severity of this problem correlated with their ORE on the CFMT. As a 'victim' of the ORE, participants reported that Caucasians' problems telling them apart also contributed to difficulties socializing. Further, 81% of participants had been confused with other Asians by a Caucasian authority figure (e.g., university tutor, workplace boss), resulting in varying levels of upset/difficulty. When compared to previously established contributors to international students' high rates of social isolation, ORE-related problems were perceived as equally important as the language barrier and only moderately less important than cultural differences. We conclude that the real-world impact of the ORE extends beyond previously identified specialized settings (eyewitness testimony, security), to common everyday situations experienced by all humans.

Face aftereffects predict individual differences in face recognition ability.

Face aftereffects are widely studied on the assumption that they provide a useful tool for investigating face-space coding of identity. However, a long-standing issue concerns the extent to which face aftereffects originate in face-level processes as opposed to earlier stages of visual processing. For example, some recent studies failed to find atypical face aftereffects in individuals with clinically poor face recognition. We show that in individuals within the normal range of face recognition abilities, there is an association between face memory ability and a figural face aftereffect that is argued to reflect the steepness of broadband-opponent neural response functions in underlying face-space. We further show that this correlation arises from face-level processing, by reporting results of tests of nonface memory and nonface aftereffects. We conclude that face aftereffects can tap high-level face-space, and that face-space coding differs in quality between individuals and contributes to face recognition ability.

A critical review of the development of face recognition: experience is less important than previously believed.

Historically, it has been argued that face individuation develops very slowly, not reaching adult levels until adolescence, with experience being the driving force behind this protracted improvement. Here, we challenge this view based on extensive review of behavioural and neural findings. Results demonstrate qualitative presence of all key phenomena related to face individuation (encoding of novel faces, holistic processing effects, face-space effects, face-selective responses in neuroimaging) at the earliest ages tested, typically 3-5 years of age and in many cases even infancy. Results further argue for quantitative maturity by early childhood, based on an increasing number of behavioural studies that have avoided the common methodological problem of restriction of range, as well as event-related potential (ERP), but not functional magnetic resonance imaging (fMRI) studies. We raise a new possibility that could account for the discrepant fMRI findings-namely, the use of adult-sized head coils on child-sized heads. We review genetic and innate contributions to face individuation (twin studies, neonates, visually deprived monkeys, critical periods, perceptual narrowing). We conclude that the role of experience in the development of the mechanisms of face identification has been overestimated. The emerging picture is that the mechanisms supporting face individuation are mature early, consistent with the social needs of children for reliable person identification in everyday life, and are also driven to an important extent by our evolutionary history.

Global face distortion aftereffects tap face-specific and shape-generic processes.

Face aftereffects are commonly used to investigate the mechanisms underlying face processing, based on the assumption that they tap processes involved specifically with face-level coding (e.g., face space). However, face aftereffects could potentially arise from many levels of the visual system, and recent research has shown that one figural aftereffect (eye height) has both face-level and shape-generic components. Another very widely used figural manipulation is global face distortion. Here we investigate whether a global face distortion aftereffect (vertical compression) transfers to nonface stimuli, and if so, to what extent. Arguing for a mid- or high-level shape-generic component to our face aftereffect, we found significant face-to-object transfer even after minimizing retinotopic components. Arguing for an additional face-specific component, we found, first, that face-to-face aftereffects were significantly larger than face-to-object aftereffects and second, that this occurred only when the adaptor face was whole and intact rather than scrambled. Our results argue that global face distortion aftereffects are a useful tool for investigating face-space but that, to do so unambiguously, requires developing methods to minimize or account for the shape-generic contribution.

The Cambridge Car Memory Test: a task matched in format to the Cambridge Face Memory Test, with norms, reliability, sex differences, dissociations from face memory, and expertise effects.

Many research questions require a within-class object recognition task matched for general cognitive requirements with a face recognition task. If the object task also has high internal reliability, it can improve accuracy and power in group analyses (e.g., mean inversion effects for faces vs. objects), individual-difference studies (e.g., correlations between certain perceptual abilities and face/object recognition), and case studies in neuropsychology (e.g., whether a prosopagnosic shows a face-specific or object-general deficit). Here, we present such a task. Our Cambridge Car Memory Test (CCMT) was matched in format to the established Cambridge Face Memory Test, requiring recognition of exemplars across view and lighting change. We tested 153 young adults (93 female). Results showed high reliability (Cronbach's alpha = .84) and a range of scores suitable both for normal-range individual-difference studies and, potentially, for diagnosis of impairment. The mean for males was much higher than the mean for females. We demonstrate independence between face memory and car memory (dissociation based on sex, plus a modest correlation between the two), including where participants have high relative expertise with cars. We also show that expertise with real car makes and models of the era used in the test significantly predicts CCMT performance. Surprisingly, however, regression analyses imply that there is an effect of sex per se on the CCMT that is not attributable to a stereotypical male advantage in car expertise.

Face ethnicity and measurement reliability affect face recognition performance in developmental prosopagnosia: evidence from the Cambridge Face Memory Test-Australian.

The Cambridge Face Memory Test (CFMT, Duchaine & Nakayama, 2006) provides a validated format for testing novel face learning and has been a crucial instrument in the diagnosis of developmental prosopagnosia. Yet, some individuals who report everyday face recognition symptoms consistent with prosopagnosia, and are impaired on famous face tasks, perform normally on the CFMT. Possible reasons include measurement error, CFMT assessment of memory only at short delays, and a face set whose ethnicity is matched to only some Caucasian groups. We develop the "CFMT-Australian" (CFMT-Aus), which complements the CFMT-original by using ethnicity better matched to a different European subpopulation. Results confirm reliability (.88) and validity (convergent, divergent using cars, inversion effects). We show that face ethnicity within a race has subtle but clear effects on face processing even in normal participants (includes cross-over interaction for face ethnicity by perceiver country of origin in distinctiveness ratings). We show that CFMT-Aus clarifies diagnosis of prosopagnosia in 6 previously ambiguous cases. In 3 cases, this appears due to the better ethnic match to prosopagnosics. We also show that face memory at short (<3-min), 20-min, and 24-hr delays taps overlapping processes in normal participants. There is some suggestion that a form of prosopagnosia may exist that is long delay only and/or reflects failure to benefit from face repetition.

Correlation of Central Versus Peripheral Macular Structure-Function With Acuity in Age-Related Macular Degeneration.

Purpose: Patients with advanced age-related macular degeneration (AMD) may have preserved visual function despite significant retinal structural changes. We aimed to evaluate the relationships among retinal thickness, macular sensitivity, and visual acuity (VA) in advanced AMD. Methods: We examined 43 eyes of 22 patients with advanced AMD (ages 66-93 years), prospectively recruited from the Canberra Hospital Ophthalmology Department. Visual function was measured on participants with low and high contrast visual acuity (LCVA and HCVA) and 10-2 Matrix visual fields. Retinal structure was determined with spectral domain optical coherence tomography (OCT), and customized software mapped the 64 OCT macular thickness regions onto the 44 regions of the 10-2 test. Results: Median retinal thickness at each 10-2 region was near normal. Just 7 of 88 regions from the OCT analysis that were thicker than the median had sensitivity that declined significantly with increasing thickness (r = -0.698 ± 0.082, mean ± SD), whereas 17 of 88 thinner regions showed significantly decreasing sensitivity with decreasing thickness (r = 0.723 ± 0.078). The absolute value of deviations from median optical coherence tomography thickness (aOCT) outside the central eight degrees was significantly correlated with HCVA (r = -0.34, P = 0.047). Thickness in the central eight degrees was not. Similarly, matrix sensitivities inside the central eight degrees were significantly correlated with outer aOCT (r = -0.49, P = 0.002). Conclusions: Retinal thickness outside eight degrees were significantly associated with HCVA and macular sensitivity. These results suggest that outer macular thickness may be a useful prognostic indicator in AMD. Translational Relevance: Retinal structure at the borders of the macula may be a surrogate marker of vision and retinal thickness near fixation.

Face recognition impairments despite normal holistic processing and face space coding: evidence from a case of developmental prosopagnosia.

Holistic processing and face space coding are widely considered primary perceptual mechanisms behind good face recognition. Here, however, we present the case of S.P., a developmental prosopagnosic who demonstrated severe impairments in face memory and face perception, yet showed normal holistic processing and face space coding. Across three composite experiments, S.P. showed normal-strength holistic processing for upright faces and no composite effect for inverted faces. Across five aftereffect experiments, S.P. showed normal-sized face aftereffects, which derived normally from face space rather than shape-generic mechanisms. The case of S.P. implies: (a) normal holistic processing and face space coding can be insufficient for good face recognition even when present in combination; and (b) the focus of recent literature on holistic processing and face space should be expanded to include other potential face processing mechanisms (e.g., part-based processing). Our article also highlights the importance of internal task reliability in drawing inferences from single-case studies.

Solving the upside-down puzzle: Why do upright and inverted face aftereffects look alike?

Face aftereffects for upright faces have been widely assumed to derive from face space and to provide useful information about its properties. Yet remarkably similar aftereffects have consistently been reported for inverted faces, a problematic finding because other paradigms argue that inverted faces are processed by different mechanisms from upright faces. Here, we identify a qualitative difference between upright and inverted face aftereffects. Using eye-height aftereffects, we tested for opponent versus multichannel coding of face dimensions by manipulating distance of the adaptor from the average, and face-specific versus shape-generic contributions via transfer of aftereffects between faces and simple T-shapes. Our results argue that (i) inverted face aftereffects derive entirely from shape-generic mechanisms, (ii) upright face aftereffects derive partly from shape-generic mechanisms but also have a substantial face space component, and (iii) both face-specific and shape-generic multidimensional spaces use opponent coding.

Four-to-six-year-old children use norm-based coding in face-space.

Children's performance on face perception tests does not reach adult levels until adolescence, a result which, a priori, could be due to qualitative change in face mechanisms with age, quantitative change in these mechanisms, or improvements in general cognitive abilities that are not face-specific (e.g., memory, attention). In adults, the major functional mechanisms of face recognition include holistic/configural processing and face-space coding. Previous research has established that holistic/configural processing is present by 4-6 years of age. Very little, however, is known about face-space coding in children. Here, we demonstrate that 4-6-year-old children show adaptation aftereffects for figural distortions (expanded/contracted, eyes up/down), providing the first evidence of aftereffects for identity-relevant information in children younger than 8 years. We also show that in 4-5 year-olds, as in adults, face aftereffects are stronger for adaptors far from the average (extreme distortions) than for adaptors closer to the average (mild distortions). This result provides the first compelling evidence that face-space coding is norm-based in children younger than 8 years of age, and rules out a qualitative shift from exemplar-based to norm-based coding as the source of developmental improvement in face identification performance beyond preschool age.