Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder.
Tackling heterogeneity: Individual variability of emotion decoding deficits in severe alcohol use disorder.
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DOI：
10.1016/j.jad.2020.10.022
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发表时间：
2021-01-15
影响因子：
6.6
通讯作者：
Peyroux E
中科院分区：
文献类型：
--
作者：
Maurage P;Pabst A;Lannoy S;D'Hondt F;de Timary P;Gaudelus B;Peyroux E
严重酒精使用障碍（SAUD）与社会认知缺陷有关。SAUD患者对情绪面部表情的识别能力受损，特别是在禁欲的早期阶段。这些缺陷损害人际关系，增加复发风险。然而，不确定性仍然充斥着他们的情绪变化和患者之间的情绪障碍的异质性。我们通过探索缺陷如何根据情绪的类型/强度和患者的异质性而变化来解决这些问题。65名最近戒毒的SAUD患者和65名匹配的健康对照者进行了面部情绪识别测试，评估识别六种情绪（愤怒，蔑视，厌恶，恐惧，快乐，悲伤）的能力，这些情绪由不同强度的变形面孔显示。收集每种情绪的准确性分数和检测阈值。除了组间比较，多个单一病例分析确定了每种情绪解码缺陷患者的百分比。当当前的抑郁和焦虑症状得到控制时，患者并没有表现出一般的情绪解码缺陷，而是表现为厌恶/蔑视准确性和厌恶检测阈值分数的特定缺陷。单例分析显示，只有三分之一的患者表现出临床显著的情绪缺陷。当亚临床精神病理状态得到控制时，SAUD患者仅对特定的人际情感（厌恶/蔑视）表现出情感解码缺陷，并且没有表现出一般的情感障碍。这与该人群普遍存在社会认知缺陷的提议背道而驰。此外，这种群体效应掩盖了患者之间的巨大异质性，这在实验和临床水平上都有影响。
Severe alcohol use disorder (SAUD) is associated with social cognition deficits. Patients with SAUD are impaired for the recognition of emotional facial expressions, particularly at early stages of abstinence. These deficits damage interpersonal relations and increase relapse risk. However, uncertainties still abound on their variation across emotions and on the heterogeneity of emotional impairments across patients. We addressed these questions by exploring how the deficit varies according to emotions’ type/intensity and patients’ heterogeneity. Sixty-five recently detoxified patients with SAUD and 65 matched healthy controls performed the Facial Emotion Recognition Test, assessing the ability to identify six emotions (anger, contempt, disgust, fear, happiness, sadness) displayed by morphed faces with various intensities. Accuracy scores and detection thresholds were collected for each emotion. Beyond group comparisons, multiple single-case analyses determined the percentage of patients presenting decoding deficits for each emotion. When current depression and anxiety symptoms were controlled for, patients did not present a general emotion decoding deficit, but were rather characterized by specific deficits for disgust/contempt in accuracy, and for disgust in detection threshold scores. Single-case analyses showed that only a third of patients presented a clinically significant emotional deficit. Patients with SAUD only present emotional decoding deficits for specific interpersonal emotions (disgust/contempt) when subclinical psychopathological states are controlled for, and show no general emotional impairment. This goes against the proposal of a generalized social cognition deficit in this population. This group effect moreover masks a massive heterogeneity across patients, which has implications at experimental and clinical levels.
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