Background. Emotion recognition is one of the abilities of Social Cognition. Many psychiatric disorders present this ability impaired, including eating disorders (ED), particularly in patients with anorexia nervosa (AN). Aim of the study. The primary aim of the study is to investigate the effect of diagnostic, clinical and neuropsychological factors on emotion recognition by the use of the ”Reading the Mind in the Eyes” Test. Due to the similarity between the test task and faces covered by masks during the Sars-Cov2 pandemic, the secondary aim of the study is to investigate the impact of the pandemic on emotion recognition. Materials and methods. 400 patients with Eating Disorders (ED) and 265 healthy subjects participated in the study. In addition to the Mindreading test, the two samples underwent clinical (SCL-90, EDI-2) and cognitive (WCST, ROCF) evaluation tests. The "Reading the Mind in the Eyes Test" consists of 36 eyes photographs to which the subject (without time limits, but as soon as possible) must associate one of the four emotions proposed. The case sample was divided by age, BMI and phenotype for comparison with controls. A division of eyes by sex, age and emotions was made to investigate the performance of the subjects in the Mindreading Test. "Bias" models were built in order to characterize the types of errors made by patients. To investigate the second purpose, the two samples were divided by age and by before and after Covid (March 2020) test performance. In the statistical analyses independent sample t-tests, Spearman correlations and regression analysis were used. Results. Emotions recognition development trajectory was constructed by linear regression analyses, finding an improvement in total scores on the Mindreading Test with increasing age, both for controls and cases (with a slightly reduced slope in the latter). Comparisons between independent samples showed difficulties in emotions recognition in the samples of patients with ED and BMI<18 (as patients with AN) and, above all, of patients with ED and restrictive phenotype. Patients are less able to recognize the emotions of female, young, and happy eyes than controls. "Bias" models, made to characterize subjects mistakes, show a propensity of the patients of the previously mentioned samples to mistake the eyes for fearful eyes (vs fearful), "happy" eyes for "angry" eyes (happy vs angry) and "angry" eyes for "fearful" eyes. Parametric correlations show that age, duration of illness and school education positively correlate with multiple measures related to performance on the Mindreading test, and data proves a mild correlation of psychopathological and neuropsychological factors and visuospatial skills with the results of the Mindreading test. In regression analyses, age (in accordance with the development trajectory) and phenotype are observed as the main trend predictors of Mindreading Test.From the comparisons and correlations for the groups divided into adolescents and adults (cases and controls) before and after Covid, it is possible to appreciate that Sars-Cov2 pandemic has negatively impacted in emotion recognition ability in control subjects (tendency to a worse recognition of "happy" emotions over time; happy bias: rho=0.34; p=0.05) and in subjects with ED (worse recognition of emotions in female faces over time; Mind Female: rho=-0.28; p=0.026 and a tendency to bias towards fear emotions; bias vs fearful: rho=0.25; p=0.05). Conclusions. Our study confirms the presence of difficulties in Social Cognition, particularly in emotions recognition (measured by the “Reading the Mind in the Eyes” Test), in patients with eating disorders. This compromised ability has specific characteristics in patients with certain diagnostic, clinical and neuropsychological conditions. Finally, the study describes the negative impact of the pandemic on the emotions recognition ability due to the prolonged masks use
Background. Il riconoscimento delle emozioni è una delle capacità della cosiddetta “Cognizione Sociale”. Tale capacità risulta alterata in molteplici disturbi psichiatrici tra cui i disturbi dell’alimentazione (DA), in particolar modo in pazienti con anoressia nervosa (AN). Scopo dello studio. Scopo primario dello studio è indagare l’effetto di fattori diagnostici, clinici e neuropsicologici sul riconoscimento delle emozioni attraverso l’utilizzo del Mindreading Test. Data la somiglianza tra il task del test e i volti coperti dalle mascherine durante la pandemia di Sars-Cov2, scopo secondario dello studio è indagare l’impatto della pandemia sul riconoscimento delle emozioni. Materiali e metodi. Hanno partecipato allo studio 400 pazienti con diagnosi di DA e 265 soggetti sani. I due campioni sono stati sottoposti oltre che al Mindreading test a dei test di valutazione clinica e cognitiva. Il “Reading the Mind in the Eyes Test” consta di 36 fotografie di sguardi a cui il soggetto deve associare uno dei quattro stati d’animo proposti. Il campione dei casi è stato diviso per età, IMC e fenotipo per il confronto con i controlli. Per indagare al meglio l’andamento dei soggetti al Mindreading Test si è optato per una divisione degli sguardi per sesso, età e stato d’animo e sono stati costruiti dei modelli “bias” al fine di caratterizzare i tipi di errori commessi dai pazienti. Per indagare il secondo scopo i due campioni sono stati suddivisi per età e per test effettuati pre e post Covid (Marzo 2020). Risultati. Attraverso le analisi di regressione lineare è stata costruita una traiettoria di sviluppo della capacità di riconoscere le emozioni, riscontrando un miglioramento dei punteggi totali al Mindreading Test all’aumentare dell’età, sia per i controlli che per i casi (seppur con una pendenza lievemente ridotta in questi ultimi). Il confronto tra campioni indipendenti ha evidenziato delle difficoltà nel riconoscere le emozioni nei campioni dei pazienti con DA e IMC<18 (pazienti con AN) e, soprattutto, dei pazienti con DA e fenotipo restrittivo. I pazienti riconoscono con meno precisione le emozioni di sguardi femminili, giovani e felici (“happy”) rispetto ai controlli. Per quanto riguarda la caratterizzazione degli errori commessi dai soggetti sono stati costruiti dei modelli “Bias” che hanno evidenziato una propensione dei pazienti dei campioni precedentemente enunciati a scambiare gli sguardi per sguardi di paura, scambiare gli sguardi “happy” per sguardi “angry” e a scambiare gli sguardi “angry” per sguardi “fearful”. Dalle correlazioni parametriche emerge che età, durata di malattia e scolarità correlano positivamente con molteplici misure relative alla performance al Mindreading test e si riscontra una blanda correlazione dei fattori psicopatologici e neuropsicologici e delle abilità visuospaziali con i risultati al Mindreading test.Dalle analisi di regressione si osservano come principali fattori predittivi dell’andamento al Mindreading Test l’età e il fenotipo. Dai confronti e dalle correlazioni per i gruppi divisi in adolescenti e adulti (casi e controlli) pre e post Covid è possibile notare come la pandemia di Sars-Cov2 abbia impattato negativamente sulla capacità di riconoscere le emozioni nei soggetti di controllo e nei soggetti con DA . Conclusioni. Il nostro studio conferma la presenza di difficoltà nella Social Cognition, in particolare nel riconoscimento delle emozioni (misurato con il Mindreading Test), nei pazienti con disturbi dell’alimentazione (DA). L’alterazione di tale capacità si presenta con peculiari caratteristiche in pazienti con determinate condizioni diagnostiche, cliniche e neuropsicologiche. Lo studio, infine, descrive, con i dovuti limiti, l’impatto negativo della pandemia sulla capacità di riconoscere le emozioni a causa del protratto utilizzo delle mascherine
Reading the Mind in the Eyes Test nell’anoressia nervosa: uno studio controllato sulla capacità di riconoscere le emozioni attraverso gli sguardi
BROMBIN, MIMMO
2022/2023
Abstract
Background. Emotion recognition is one of the abilities of Social Cognition. Many psychiatric disorders present this ability impaired, including eating disorders (ED), particularly in patients with anorexia nervosa (AN). Aim of the study. The primary aim of the study is to investigate the effect of diagnostic, clinical and neuropsychological factors on emotion recognition by the use of the ”Reading the Mind in the Eyes” Test. Due to the similarity between the test task and faces covered by masks during the Sars-Cov2 pandemic, the secondary aim of the study is to investigate the impact of the pandemic on emotion recognition. Materials and methods. 400 patients with Eating Disorders (ED) and 265 healthy subjects participated in the study. In addition to the Mindreading test, the two samples underwent clinical (SCL-90, EDI-2) and cognitive (WCST, ROCF) evaluation tests. The "Reading the Mind in the Eyes Test" consists of 36 eyes photographs to which the subject (without time limits, but as soon as possible) must associate one of the four emotions proposed. The case sample was divided by age, BMI and phenotype for comparison with controls. A division of eyes by sex, age and emotions was made to investigate the performance of the subjects in the Mindreading Test. "Bias" models were built in order to characterize the types of errors made by patients. To investigate the second purpose, the two samples were divided by age and by before and after Covid (March 2020) test performance. In the statistical analyses independent sample t-tests, Spearman correlations and regression analysis were used. Results. Emotions recognition development trajectory was constructed by linear regression analyses, finding an improvement in total scores on the Mindreading Test with increasing age, both for controls and cases (with a slightly reduced slope in the latter). Comparisons between independent samples showed difficulties in emotions recognition in the samples of patients with ED and BMI<18 (as patients with AN) and, above all, of patients with ED and restrictive phenotype. Patients are less able to recognize the emotions of female, young, and happy eyes than controls. "Bias" models, made to characterize subjects mistakes, show a propensity of the patients of the previously mentioned samples to mistake the eyes for fearful eyes (vs fearful), "happy" eyes for "angry" eyes (happy vs angry) and "angry" eyes for "fearful" eyes. Parametric correlations show that age, duration of illness and school education positively correlate with multiple measures related to performance on the Mindreading test, and data proves a mild correlation of psychopathological and neuropsychological factors and visuospatial skills with the results of the Mindreading test. In regression analyses, age (in accordance with the development trajectory) and phenotype are observed as the main trend predictors of Mindreading Test.From the comparisons and correlations for the groups divided into adolescents and adults (cases and controls) before and after Covid, it is possible to appreciate that Sars-Cov2 pandemic has negatively impacted in emotion recognition ability in control subjects (tendency to a worse recognition of "happy" emotions over time; happy bias: rho=0.34; p=0.05) and in subjects with ED (worse recognition of emotions in female faces over time; Mind Female: rho=-0.28; p=0.026 and a tendency to bias towards fear emotions; bias vs fearful: rho=0.25; p=0.05). Conclusions. Our study confirms the presence of difficulties in Social Cognition, particularly in emotions recognition (measured by the “Reading the Mind in the Eyes” Test), in patients with eating disorders. This compromised ability has specific characteristics in patients with certain diagnostic, clinical and neuropsychological conditions. Finally, the study describes the negative impact of the pandemic on the emotions recognition ability due to the prolonged masks useFile | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/60858