Unseen positive and negative affective information influences social perception in bipolar I disorder and healthy adults.

Bipolar disorder is fundamentally a disorder of emotion regulation, and associated with explicit processing biases for socially relevant emotional information in human faces. Less is known, however, about whether implicit processing of this type of emotional information directly influences social perception. We thus investigated group-related differences in the influence of unconscious emotional processing on conscious person perception judgments using a continuous flash suppression task among 22 individuals with remitted bipolar I disorder (BD; AgeM=30.82, AgeSD=7.04; 68.2% female) compared with 22 healthy adults (CTL; AgeM=20.86, AgeSD=9.91; 72.2% female). Across both groups, participants rated neutral faces as more trustworthy, warm, and competent when paired with unseen happy faces as compared to unseen angry and neutral faces; participants rated neutral faces as less trustworthy, warm, and competent when paired with unseen angry as compared to neutral faces. These findings suggest that emotion-related disturbances are not explained by early automatic processing stages, and that activity in the dorsal visual stream underlying implicit emotion processing is intact in bipolar disorder. Implications for understanding the etiology of emotion disturbance in BD are discussed.

In your eyes: does theory of mind predict impaired life functioning in bipolar disorder?

BACKGROUND: Deficits in emotion perception and social functioning are strongly implicated in bipolar disorder (BD). Examining theory of mind (ToM) may provide one potential mechanism to explain observed socio-emotional impairments in this disorder. The present study prospectively investigated the relationship between theory of mind performance and life functioning in individuals diagnosed with BD compared to unipolar depression and healthy control groups. METHODS: Theory of mind (ToM) performance was examined in 26 individuals with remitted bipolar I disorder (BD), 29 individuals with remitted unipolar depression (UD), and 28 healthy controls (CTL) using a well-validated advanced theory of mind task. Accuracy and response latency scores were calculated from the task. Life functioning was measured during a 12 month follow-up session. RESULTS: No group differences for ToM accuracy emerged. However, the BD group exhibited significantly shorter response times than the UD and CTL groups. Importantly, quicker response times in the BD group predicted greater life functioning impairment at a 12-month follow-up, even after controlling for baseline symptoms. LIMITATIONS: The stimuli were static representations of emotional states and do not allow for evaluating the appropriateness of context during emotional communication; due to sample size, neither specific comorbidities nor medication effects were analyzed for the BD and UD groups; preliminary status of theory of mind as a construct. CONCLUSIONS: Results suggest that quickened socio-emotional decision making may represent a risk factor for future functional impairment in BD.

Letting go of the bad: deficit in maintaining negative, but not positive, emotion in bipolar disorder.

Bipolar disorder is a disorder of emotion regulation. Less is known, however, about the specific processes that foster the maintenance of such prolonged and intense emotions-particularly positive-over time in this disorder. We investigated group-related differences in the ability to maintain positive and negative emotion representations over time using a previously validated emotion working memory task (Mikels et al., 2005, 2008) among individuals with bipolar I disorder (BD; n = 29) compared with both major depressive disorder (MDD; n = 29) and healthy control (n = 30) groups. Results revealed that the BD group exhibited a selective deficit in maintaining negative-but not positive-emotions compared to both the MDD and the control groups. The MDD and control groups did not differ significantly. These findings suggest that the heightened magnitude and duration of positive emotion observed in BD may, in part, be accounted for by difficulties maintaining negative emotions.