A study on attentional bias and response inhibition of facial expressions in manic patients: evidence from eye movement

Abstract

Introduction: In recent years, evidence has accumulated to suggest that patients with bipolar disorder show altered processing of emotionally relevant information. However, only a few studies have examined manic patients’ eye movements when processing facial expressions. Method: A free viewing task and anti-saccade task were used separately to investigate attentional bias and response inhibition while processing emotional stimuli. Data were drawn from matched samples of manic patients (n = 25) and healthy controls (n = 20). Results: The analyses of eye-movement data revealed that there was a significant difference between manic patients and healthy controls in the total duration of fixations but not in the orientation or duration of the first fixation. However, no significant differences between manic patients and healthy controls in response inhibition were detected. Conclusion: These results demonstrate that compared to healthy controls, manic patients show a deficiency in processing speed. The patients showed no attentional vigilance to happy or sad expressions but did showed avoidance of the sad expression and focused more on the happy expression in later emotion processing. There were no impairments of response inhibition detected in manic patients.Key points Abnormal processing of emotional information and having aberrant inner-experiences of emotion is a feature of bipolar disorders. Processing speed is slow in manic patients versus healthy controls. Manic patients focused lesser on sad expression than healthy controls, which suggesting an avoidance of sad expressions. The findings show that psychotherapies like CBT may be applicable to manic patients.