Evaluating the Efficacy of a Digital Therapeutic (CT-152) as an Adjunct to Antidepressant Treatment in Adults With Major Depressive Disorder: Protocol for the MIRAI Remote Study.

BACKGROUND: Major depressive disorder (MDD) is common worldwide and can be highly disabling. People with MDD face many barriers to treatment and may not experience full symptom relief even when treated. Therefore, new treatment modalities are needed for MDD. Digital therapeutics (DTx) may provide people with MDD an additional treatment option. OBJECTIVE: This study aimed to describe a phase 3 remote, multicenter, randomized, masked, sham-controlled trial evaluating the efficacy of a smartphone app-based DTx (CT-152) in adult participants diagnosed with MDD, used as an adjunct to antidepressant therapy (ADT). METHODS: Participants aged 22-64 years with a current primary diagnosis of MDD and an inadequate response to ADT were included. Participants were randomized 1:1 to CT-152 or a sham DTx. CT-152 is a smartphone app-based DTx that delivers a cognitive-emotional and behavioral therapeutic intervention. The core components of CT-152 are the Emotional Faces Memory Task exercises, brief lessons to learn and apply key therapeutic skills, and SMS text messaging to reinforce lessons and encourage engagement with the app. The sham DTx is a digital working memory exercise with emotionally neutral stimuli designed to match CT-152 for time and attention. Participants took part in the trial for up to 13 weeks. The trial included a screening period of up to 3 weeks, a treatment period of 6 weeks, and an extension period of 4 weeks to assess the durability of the effect. Sites and participants had the option of an in-person or remote screening visit; the remaining trial visits were remote. Efficacy was evaluated using the Montgomery-Åsberg Depression Rating Scale, the Generalized Anxiety Disorder-7, Clinical Global Impression-Severity scale, the Patient Health Questionnaire-9, and the World Health Organization Disability Assessment Schedule 2.0. The durability of the effect was evaluated with the Montgomery-Åsberg Depression Rating Scale and Generalized Anxiety Disorder-7 scale. Adverse events were also assessed. Satisfaction, measured by the Participant and Healthcare Professional Satisfaction Scales, and health status, measured by the EQ-5D-5L, were summarized using descriptive statistics. RESULTS: This study was initiated in February 2021 and had a primary completion date in October 2022. CONCLUSIONS: This represents the methodological design for the first evaluation of CT-152 as an adjunct to ADT. This study protocol is methodologically robust and incorporates many aspects of conventional pivotal pharmaceutical phase 3 trial design, such as randomization and safety end points. Novel considerations included the use of a sham comparator, masking considerations for visible app content, and outcome measures relevant to DTx. The rigor of this methodology will provide a more comprehensive understanding of the effectiveness of CT-152. TRIAL REGISTRATION: ClinicalTrials.gov NCT04770285; https://clinicaltrials.gov/study/NCT04770285. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/56960.

You're Beautiful When You Smile: Event-Related Brain Potential (ERP) Evidence of Early Opposite-Gender Bias in Happy Faces.

Studies of social cognition have shown gender differences regarding human face processing. One interesting finding is the enhanced processing of opposite-gender faces at different time stages, as revealed by event-related brain potentials. Crucially, from an evolutionary perspective, such a bias might interact with the emotional expression of the face. To investigate this, 100 participants (50 female, 50 male) completed an expression-detection task while their EEG was recorded. In three blocks, fearful, happy and neutral faces (female and male) were randomly presented, with participants instructed to respond to only one predefined target expression level in each block. Using linear mixed models, we observed both faster reaction times as well as larger P1 and late positive potential (LPP) amplitudes for women compared to men, supporting a generally greater female interest in faces. Highly interestingly, the analysis revealed an opposite-gender bias at P1 for happy target faces. This suggests that participants' attentional templates may include more opposite-gender facial features when selectively attending to happy faces. While N170 was influenced by neither the face nor the participant gender, LPP was modulated by the face gender and specific combinations of the target status, face gender and expression, which is interpreted in the context of gender-emotion stereotypes. Future research should further investigate this expression and attention dependency of early opposite-gender biases.

Neural responses to facial emotions and subsequent clinical outcomes in difficult-to-treat depression.

BACKGROUND: Amygdala and dorsal anterior cingulate cortex responses to facial emotions have shown promise in predicting treatment response in medication-free major depressive disorder (MDD). Here, we examined their role in the pathophysiology of clinical outcomes in more chronic, difficult-to-treat forms of MDD. METHODS: Forty-five people with current MDD who had not responded to ⩾2 serotonergic antidepressants (n = 42, meeting pre-defined fMRI minimum quality thresholds) were enrolled and followed up over four months of standard primary care. Prior to medication review, subliminal facial emotion fMRI was used to extract blood-oxygen level-dependent effects for sad v. happy faces from two pre-registered a priori defined regions: bilateral amygdala and dorsal/pregenual anterior cingulate cortex. Clinical outcome was the percentage change on the self-reported Quick Inventory of Depressive Symptomatology (16-item). RESULTS: We corroborated our pre-registered hypothesis (NCT04342299) that lower bilateral amygdala activation for sad v. happy faces predicted favorable clinical outcomes (rs[38] = 0.40, p = 0.01). In contrast, there was no effect for dorsal/pregenual anterior cingulate cortex activation (rs[38] = 0.18, p = 0.29), nor when using voxel-based whole-brain analyses (voxel-based Family-Wise Error-corrected p < 0.05). Predictive effects were mainly driven by the right amygdala whose response to happy faces was reduced in patients with higher anxiety levels. CONCLUSIONS: We confirmed the prediction that a lower amygdala response to negative v. positive facial expressions might be an adaptive neural signature, which predicts subsequent symptom improvement also in difficult-to-treat MDD. Anxiety reduced adaptive amygdala responses.

Superior facial emotion recognition in adolescents with anorexia nervosa - A replication study.

OBJECTIVE: Anorexia nervosa (AN) has been associated with alterations in the processing of socio-emotional information, including impairments in the recognition of emotions in other people's faces. However, adolescents with AN might not show the impairments found in adult patients. The present study investigated facial emotion recognition in adolescents with AN, aiming to replicate our previous results of superior emotion recognition abilities in adolescents with AN compared to adolescents without mental disorders. METHOD: Adolescent girls (12-18 years) with AN (n = 33) were compared to girls without mental disorders (n = 41). Participants completed one task requiring identification of emotions (happy, sad, afraid, angry, neutral) in faces and one control task. RESULTS: As expected, adolescents with AN showed superior emotion recognition, with higher accuracy rates specifically for afraid faces. CONCLUSION: This is the first study replicating previous results on basic emotion recognition in adolescents with AN using (almost) the same methodology. The results suggest that, in contrast to adults, adolescents with AN do not show impairments in facial emotion recognition. The impairments may arise in the longer course of the illness, however, longitudinal studies are necessary to confirm this assumption.

Altered Lateral Prefrontal Cortex Functioning During Emotional Interference Resistance Is Associated With Affect Lability in Adults With Persisting Symptoms of Attention-Deficit/Hyperactivity Disorder From Childhood.

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder characterized by inattention and/or impulsivity/hyperactivity. ADHD, especially when persisting into adulthood, often includes emotional dysregulation, such as affect lability; however, the neural correlates of emotionality in adults with heterogeneous ADHD symptom persistence remain unclear. METHODS: The present study sought to determine shared and distinct functional neuroanatomical profiles of neural circuitry during emotional interference resistance using the emotional face n-back task in adult participants with persisting (n = 47), desisting (n = 93), or no (n = 42) childhood ADHD symptoms while undergoing functional magnetic resonance imaging. RESULTS: Participants without any lifetime ADHD diagnosis performed significantly better (faster and more accurately) than participants with ADHD diagnoses on trials with high cognitive loads (2-back) that included task-irrelevant emotional distractors, tapping into executive functioning and emotion regulatory processes. In participants with persisting ADHD symptoms, more severe emotional symptoms were related to worse task performance. Heightened dorsolateral and ventrolateral prefrontal cortex activation was associated with more accurate and faster performance on 2-back emotional faces trials, respectively. Reduced activation was associated with greater affect lability in adults with persisting ADHD, and dorsolateral prefrontal cortex activation mediated the relationship between affect lability and task accuracy. CONCLUSIONS: These findings suggest that alterations in dorsolateral prefrontal cortex function associated with greater interference in cognitive processes from emotion could represent a marker of risk for problems with emotional dysregulation in individuals with persisting ADHD and thus represent a potential therapeutic target for those with greater emotional symptoms of ADHD.

Mimicking Facial Expressions Facilitates Working Memory for Stimuli in Emotion-Congruent Colours.

It is one thing for everyday phrases like "seeing red" to link some emotions with certain colours (e.g., anger with red), but can such links measurably bias information processing? We investigated whether emotional face information (angry/happy/neutral) held in visual working memory (VWM) enhances memory for shapes presented in a conceptually consistent colour (red or green) (Experiment 1). Although emotional information held in VWM appeared not to bias memory for coloured shapes in Experiment 1, exploratory analyses suggested that participants who physically mimicked the face stimuli were better at remembering congruently coloured shapes. Experiment 2 confirmed this finding by asking participants to hold the faces in mind while either mimicking or labelling the emotional expressions of face stimuli. Once again, those who mimicked the expressions were better at remembering shapes with emotion-congruent colours, whereas those who simply labelled them were not. Thus, emotion-colour associations appear powerful enough to guide attention, but-consistent with proposed impacts of "embodied emotion" on cognition-such effects emerged when emotion processing was facilitated through facial mimicry.

Emotional Face Processing in Autism Spectrum Condition: A Study of Attentional Orienting and Inhibitory Control.

A core feature of Autistic Spectrum Condition (ASC) is the presence of difficulties in social interactions. This can be explained by an atypical attentional processing of social information: individuals with ASC may show problems with orienting attention to socially relevant stimuli and/or inhibiting their attentional responses to irrelevant ones. To shed light on this issue, we examined attentional orienting and inhibitory control to emotional stimuli (angry, happy, and neutral faces). An antisaccade task (with both prosaccade and antisacade blocks) was applied to a final sample of 29 children with ASC and 27 children with typical development (TD). Whereas children with ASC committed more antisaccade errors when seeing angry faces than happy or neutral ones, TD children committed more antisaccade errors when encountering happy faces than neutral faces. Furthermore, latencies in the prosaccade and antisaccade blocks were longer in children with ASC and they were associated with the severity of ASC symptoms. Thus, children with ASC showed an impaired inhibitory control when angry faces were presented. This bias to negative high-arousal information is congruent with affective information-processing theories on ASC, suggesting that threatening stimuli induce an overwhelming response in ASC. Therapeutic strategies where train the shift attention to emotional stimuli (i.e. faces) may improve ASC symptomatology and their socials functioning.

Look me in the eyes! A preliminary study on eye-contact in adolescents with anorexia nervosa.

OBJECTIVE: Anorexia nervosa (AN) is often associated with impairments in the socio-emotional domain. Avoidance of eye-contact may underlie some of these difficulties and has been found in adults with AN in several studies. This study aimed to clarify whether adolescents with AN also show reduced eye-contact when viewing social stimuli, that is, faces. METHODS: In this cross-sectional study, girls aged 12-18 years with AN (n = 38) were compared with a clinical (girls with depression and/or anxiety disorders; n = 30) and a healthy (n = 36) control group. Eye-contact was operationalised as maintenance of visual attention to the eye-area of faces showing different emotional expressions (happy, angry, afraid, sad, neutral), recorded via eye-tracking. RESULTS: Contrary to our expectations, we did not find adolescents with AN to dwell less on the eye-area than control groups; instead, we found preliminary evidence for increased attention to the eye-area in the AN group compared to the healthy control group. CONCLUSIONS: The results suggest that reduced eye-contact found in adult AN samples is not (yet) present in adolescents with AN but may develop with the prolonged duration of the disorder. However, replication and longitudinal studies are needed to confirm this assumption.

Relationship between types of anxiety and the ability to recognize facial expressions.

This study examined whether three subtypes of anxiety (trait anxiety, state anxiety, and social anxiety) have different effects on recognition of facial expressions. One hundred and thirty-eight participants matched facial expressions of three intensity levels (20 %, 40 %, 100 %) with one of the six emotion labels ("happy", "sad", "fear", "angry", "disgust", and "surprise"). While using a conventional method of analysis we were able to replicate some significant correlations between each anxiety type and recognition performance found in the literature. However, when we used partial correlation to isolate the effect of each anxiety type, most of these correlations were no longer significant, apart from the negative correlations between Beck Anxiety Inventory and reaction time to fearful faces displayed at 40 % intensity level, and the correlations between anxiety and categorisation errors. Specifically, social anxiety was positively correlated with misidentifying a happy face as a disgust face at 40 % intensity level, and state anxiety negatively correlated with misidentifying a happy face as a sad face at 20 % intensity level. However, these partial correlation analyses became non-significant after p value adjustment for multiple comparisons. Our eye tracking data also showed that state anxiety may be associated with reduced fixations on the eye regions of low-intensity sad or fearful faces. These analyses cast doubts on some effects reported in the previous studies because they are likely to reflect a mixture of influences from highly correlated anxiety subtypes.

Trust in the police and affective evaluation of police faces: a preliminary study.

Introduction: A study was conducted to investigate if an individual's trust in law enforcement affects their perception of the emotional facial expressions displayed by police officers. Methods: The study invited 77 participants to rate the valence of 360 face images. Images featured individuals without headgear (condition 1), or with a baseball cap (condition 2) or police hat (condition 3) digitally added to the original photograph. The images were balanced across sex, race/ethnicity (Asian, African American, Latine, and Caucasian), and facial expression (Happy, Neutral, and Angry). After rating the facial expressions, respondents completed a survey about their attitudes toward the police. Results: The results showed that, on average, valence ratings for "Angry" faces were similar across all experimental conditions. However, a closer examination revealed that faces with police hats were perceived as angrier compared to the control conditions (those with no hat and those with a baseball cap) by individuals who held negative views of the police. Conversely, participants with positive attitudes toward the police perceived faces with police hats as less angry compared to the control condition. This correlation was highly significant for angry faces (p < 0.01), and stronger in response to male faces compared to female faces but was not significant for neutral or happy faces. Discussion: The study emphasizes the substantial role of attitudes in shaping social perception, particularly within the context of law enforcement.

Mindfulness training modifies attentional bias to facial emotion and emotional symptoms.

BACKGROUND: Mindfulness training has been shown to improve emotional symptoms such as anxiety and depressive symptoms. However, its cognitive-behavioral mechanism is still unclear. The present study aimed to investigate the effect of mindfulness training on attention to emotional faces and its role in the improvement in emotional symptoms. METHODS: Eighty participants were recruited and randomly divided into a training group (n = 40) that received eight weeks of mindfulness training and a control group (n = 40) that attended a mindfulness lecture. Before training (T1), immediately after training (T2), and three months after training (T3), all participants were asked to complete the Self-Rating Depression Scale (SDS) and the Self-Rating Anxiety Scale (SAS) to assess their emotional symptoms and a modified dot-probe task to measure their attention to emotional faces. RESULTS: Mindfulness training significantly reduced anxiety and depressive symptoms at both T2 and T3. After training, the attentional bias toward happy faces increased, while the attentional bias toward sad faces decreased in the training group compared with the control group. Mediation analysis showed that the improvement in attentional bias toward sad faces partially mediated the effect of mindfulness training on depression at T2. LIMITATIONS: Our participants were not a clinical sample (i.e., were not diagnosed with emotional disorders), and the time course of attention components was difficult to examine in the present study. CONCLUSIONS: Mindfulness training can stably reduce anxious and depressive symptoms. However, it may have a temporary effect on attentional bias toward facial emotions, which plays a limited role in improving emotional symptoms.

Acute effects of mifepristone on emotional processing related brain activity: A functional MRI study.

The Hypothalamic-pituitary-adrenal (HPA) axis plays an important role in the pathophysiology of mood disorders, and preliminary data suggests that glucocorticoid receptor (GR) antagonism may be an important therapeutic mechanism. The effects of modulating HPA axis function on emotional processing related brain activity, which may be abnormal in depressed mood, is poorly understood. This study used a pharmacological functional magnetic resonance imaging (fMRI) design to determine the effects of the GR and progesterone receptor antagonist mifepristone on emotional faces processing task related brain activations in 19 right-handed healthy male participants. Each participant received 600 mg mifepristone or placebo on two separate imaging days and then performed an emotional processing fMRI task four hours later. The effect of mifepristone on task related brain activations was determined using Region-of-Interest (ROI) analyses and an exploratory whole brain voxel-wise analyses. No significant changes were observed in the defined ROIs (amygdala, anterior cingulate cortex, insula) or in the exploratory whole brain analyses that was associated with mifepristone administration in either the angry vs happy faces or angry and happy faces vs implicit baseline contrasts. Task reaction times and accuracy were similar in both mifepristone and placebo conditions (all p > 0.05). Our study failed to show significant evidence of modulation of emotional processing related brain activity associated with acute mifepristone administration. Future research should use fMRI to investigate the longer-term administration effects of mifepristone on mood in healthy participants and people with mood disorders to provide a deeper understanding of the potential effects on depressive symptoms.

The development of the relationship between auditory and visual neural sensitivity and autonomic arousal from 6 m to 12 m.

The differential sensitivity hypothesis argues that environmental sensitivity has the bivalent effect of predisposing individuals to both the risk-inducing and development-enhancing influences of early social environments. However, the hypothesis requires that this variation in environmental sensitivity be general across domains. In this study, we focused on neural sensitivity and autonomic arousal to test domain generality. Neural sensitivity can be assessed by correlating measures of perceptual sensitivity, as indexed by event-related potentials (ERP) in electrophysiology. The sensitivity of autonomic arousal can be tested via heart rate changes. Domain generality was tested by comparing associations in perceptual sensitivity across auditory and visual domains, and associations between sensitivity in sensory domains and heart rate. We contrasted ERP components in auditory (P3) and visual (P1, N290 and P4) detection-of-difference tasks for N = 68 infants longitudinally at 6 and 12 months of age. Domain generality should produce correlated individual differences in sensitivity across the two modalities, with higher levels of autonomic arousal associating with increased perceptual sensitivity. Having controlled for multiple comparisons, at 6 months of age, the difference in amplitude of the P3 component evoked in response to standard and deviant tones correlated with the difference in amplitude of the P1 N290 and P4 face-sensitive components evoked in response to fearful and neutral faces. However, this correlation was not found at 12 months of age. Similarly, autonomic arousal correlated with neural sensitivity at 6 months but not at 12 months. The results suggest bottom-up neural perceptual sensitivity is domain-general across auditory and visual domains and is related to autonomic arousal at 6 months but not at 12 months of age. We interpret the development of the association of these markers of ES within a neuroconstructivist framework and with respect to the concept of interactive specialisation. By 12 months of age, more experience of visual processing may have led to top-down endogenous attention mechanisms that process visual information in a way that no longer associates with automatic auditory perceptual sensitivity.

Chronic stress in peer relationships moderates the association between pubertal development and neural response to emotional faces in adolescence.

Adolescence is a period of heightened risk for multiple forms of psychopathology, partly due to greater exposure to interpersonal stress. One way that interpersonal stress may increase risk for psychopathology is by altering the normative development of neural systems that support socio-affective processing. The late positive potential (LPP) is an event-related potential component that reflects sustained attention to motivationally-salient information and is a promising marker of risk for stress-related psychopathology. However, it is not clear how the LPP to socio-affective information changes across adolescence, nor whether exposure to stress with peers interferes with normative developmental differences in the LPP to socio-affective content during this period. In 92 adolescent girls (10-19 years old), we assessed the LPP to task-irrelevant emotional and neutral faces, as well as behavioural measures of interference following the presentation of these faces. Adolescents at more advanced stages of puberty showed a smaller LPP to emotional faces, but adolescents exposed to greater peer stress exhibited a larger LPP to these stimuli. Additionally, for girls exposed to lower levels of peer stress, more advanced pubertal development was associated with a smaller LPP to emotional faces, whereas for girls exposed to higher levels of peer stress, the association between pubertal development and the LPP to emotional faces was not significant. Neither stress nor pubertal stage was significantly associated with behavioural measures. Combined, these data suggest that one pathway through which stress exposure increases risk for psychopathology during adolescence is by interfering with the normative development of socio-affective processing.

Affective evaluation of consciously perceived emotional faces reveals a "correct attribution effect".

The strength of the affective priming effect is influenced by various factors, including the duration of the prime. Surprisingly, short-duration primes that are around the threshold for conscious awareness typically result in stronger effects compared to long-duration primes. The misattribution effect theory suggest that subliminal primes do not provide sufficient cognitive processing time for the affective feeling to be attributed to the prime. Instead, the neutral target being evaluated is credited for the affective experience. In everyday social interactions, we shift our gaze from one face to another, typically contemplating each face for only a few seconds. It is reasonable to assume that no affective priming takes place during such interactions. To investigate whether this is indeed the case, participants were asked to rate the valence of faces displayed one by one. Each face image simultaneously served as both a target (primed by the previous trial) and a prime (for the next trial). Depending on the participant's response time, images were typically displayed for about 1-2 s. As predicted by the misattribution effect theory, neutral targets were not affected by positive affective priming. However, non-neutral targets showed a robust priming effect, with emotional faces being perceived as even more negative or positive when the previously seen face was emotionally congruent. These results suggest that a "correct attribution effect" modulates how we perceive faces, continuously impacting our social interactions. Given the importance of faces in social communication, these findings have wide-ranging implications.

The influence of selective attention to specific emotions on the processing of faces as revealed by event-related brain potentials.

Event-related potential studies using affective words have indicated that selective attention to valence can increase affective discrimination at early perceptual stages. This effect most likely relies on neural associations between perceptual features of a stimulus and its affective value. Similar to words, emotional expressions in human faces are linked to specific visual elements. Therefore, selectively attending to a given emotion should allow for the preactivation of neural networks coding for the emotion and associated first-order visual elements, leading to enhanced early processing of faces expressing the attended emotion. To investigate this, we employed an expression detection task (N = 65). Fearful, happy, and neutral faces were randomly presented in three blocks while participants were instructed to respond only to one predefined target level of expression in each block. Reaction times were the fastest for happy target faces, which was accompanied by an increased occipital P1 for happy compared with fearful faces. The N170 yielded an arousal effect (emotional > neutral) while both components were not modulated by target status. In contrast, the early posterior negativity (EPN) arousal effect tended to be larger for target compared with nontarget faces. The late positive potential (LPP) revealed large effects of status and expression as well as an interaction driven by an increased LPP specifically for nontarget fearful faces. These findings tentatively indicate that selective attention to facial affect may enhance early emotional processing (EPN) even though further research is needed. Moreover, late controlled processing of facial emotions appears to involve a negativity bias.

The emotional facial recognition performance of Chinese patients with schizophrenia: An event-related potentials study.

Background: Patients with schizophrenia have deficits in identifying and recognizing emotional facial expressions. Aim: This study aimed to explore the event-related potential (ERP) responses of patients with schizophrenia (SZ) and healthy controls (HC) using the Chinese Facial Affective Picture System (CFAPS). Methods: This study included 30 SZs and 31 HCs. We asked them to complete the task based on the oddball paradigm, in which three emotional faces (happy, fearful, and neutral) were used as target stimuli. Additionally, the amplitude and latency of the N170 component and the P300 component were recorded synchronously. Results: Compared with HCs, SZs had significantly smaller amplitudes of N170 and P300 to all facial expressions. The pairwise comparison revealed that fearful faces could trigger a significantly larger P300 amplitude in HCs than neutral faces, while the such a difference was not found in SZs. Conclusion: These findings indicated that SZs had a noticeable deficiency in the structural coding of face recognition and available attentional resources.

Perinatal nicotine exposure relates to stimulus-locked event-related potentials in early adolescence during an emotional go/no-go task.

Nicotine exposure is associated with negative consequences on the developing brain, both in utero and after birth. We investigated the relationship between perinatal nicotine exposure and electroencephalographic brain activity recorded during an emotional faces Go/No-Go task among adolescents. Seventy-one adolescents aged 12-15 years completed a Go/No-Go task using fearful and happy faces. Parents completed questionnaire measures of their child's temperament and self-regulation and retrospectively reported on nicotine exposure during the perinatal period. Perinatally exposed children (n = 20) showed increased and prolonged frontal event-related potential (ERP) differentiation in stimulus-locked analyses; that is, greater emotion and condition differentiation in comparison with their non-exposed peers (n = 51). However, non-exposed children showed greater late emotion differentiation recorded over posterior sites. Response-locked ERP differences were not found. ERP effects were not related to temperamental, self-regulatory, or parental education and income-related factors. This study is the first to demonstrate a relationship between perinatal nicotine exposure and ERPs in an emotional Go/No-Go task among adolescents. Findings suggest that while conflict detection remains intact for adolescents with perinatal nicotine exposure, their attentional allocation to behaviourally relevant stimuli may be magnified to beyond optimal levels, particularly when emotion is salient in information processing. Future studies can extend these findings by isolating prenatal nicotine exposure and comparing its effects to isolated postnatal exposure and clarifying the implications of the face and performance processing differences in adolescence.

Face processing in young adults with autism and ADHD: An event related potentials study.

Background: Atypicalities in perception and interpretation of faces and emotional facial expressions have been reported in both autism and attention-deficit/hyperactivity disorder (ADHD) during childhood and adulthood. Investigation of face processing during young adulthood (18 to 25 years), a transition period to full-fledged adulthood, could provide important information on the adult outcomes of autism and ADHD. Methods: In this study, we investigated event-related potentials (ERPs) related to visual face processing in autism, ADHD, and co-occurring autism and ADHD in a large sample of young adults (N = 566). The groups were based on the Diagnostic Interview for ADHD in Adults 2.0 (DIVA-2) and the Autism Diagnostic Observation Schedule-2 (ADOS-2). We analyzed ERPs from two passive viewing tasks previously used in childhood investigations: (1) upright and inverted faces with direct or averted gaze; (2) faces expressing different emotions. Results: Across both tasks, we consistently found lower amplitude and longer latency of N170 in participants with autism compared to those without. Longer P1 latencies and smaller P3 amplitudes in response to emotional expressions and longer P3 latencies for upright faces were also characteristic to the autistic group. Those with ADHD had longer N170 latencies, specific to the face-gaze task. Individuals with both autism and ADHD showed additional alterations in gaze modulation and a lack of the face inversion effect indexed by a delayed N170. Conclusion: Alterations in N170 for autistic young adults is largely consistent with studies on autistic adults, and some studies in autistic children. These findings suggest that there are identifiable and measurable socio-functional atypicalities in young adults with autism.

Neural correlates of conscious processing of emotional faces: Evidence from event-related potentials.

There is a theoretical debate between the early and late neural correlates of consciousness (NCCs). Previous studies using neutral face stimuli supported an early NCC and suggested that visual awareness negativity (VAN) is associated with consciousness, while late positivity (LP) reflects post-perceptual activity. However, emotional faces may help to examine the relationship between LP and consciousness due to the differences in late processing between emotional and neutral faces. To explore the effects of facial emotional information on NCCs, the present study manipulated consciousness with the inattentional blindness paradigm and used happy, fearful, and neutral faces as visual stimuli. The results showed that the conscious processing of emotional faces was correlated with VAN and LP, while the conscious processing of neutral faces was associated with VAN. First, the results suggest that VAN is an NCC, and the relationship between LP and consciousness is affected by facial emotional information. Second, VAN reflects the early perceptual experience of emotional faces, whereas LP may reflect the late conscious processing of emotional faces. Furthermore, source localization analysis showed that the LPs of emotional faces were mainly located in the frontal and parietal lobes, whereas those of neutral faces showed no significant activation. This suggests that facial emotional information may affect the brain regions associated with conscious processing. Time-frequency analysis showed that conscious processing is related to the enhancement of alpha and theta oscillation, indicating that conscious processing may be associated with the suppression of irrelevant stimuli. Overall, the present study suggests that the integration of the theories that support early and late NCCs helps explain the conscious processing of emotional faces.