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Errors in identifying emotion in body postures and facial expressions among pediatric patients with bipolar disorder

ABSTRACT Introduction Facial emotion processing impairments have been consistently demonstrated among patients with pediatric bipolar disorder (PBD). However, less is known about other domains of nonverbal emotion recognition in this group. Therefore, the aim of the current study was to investigate emotion identification for body postures in addition to facial expressions among PBD patients and matched healthy comparison (HC) subjects. Method Youth with PBD (n = 25) and HC subjects (n = 25), equal on intellectual and demographic variables, completed the body postures and faces subtests of the Diagnostic Analysis of Nonverbal Accuracy-2 scale (DANVA-2) along with diagnostic and clinical assessments. Results Compared to HC, PBD patients made significantly more errors identifying emotion in both body postures and faces. Poorer performance on the faces subtest was associated with more problematic peer functioning. Greater manic symptoms were associated with poorer performance on negative emotional stimuli but not positive. Conclusions In addition to impairments in facial emotion processing, youth with PBD also show impairments in the ability to correctly identify emotion from body postures. In this group, greater manic symptomatology appears to impair processing for negative facial expressions and body postures, but not positive ones. Interestingly, facial emotion processing impairments appear to be a better indicator of real-world psychosocial difficulties among PBD patients compared to body postures. Psychosocial treatments for youth with PBD should focus on improving the ability to accurately identify and respond to various facial and body postural cues, as well as symptom management and emotion regulation strategies.