شناخت احساسات از زبان بدن در میان بیماران مبتلا به افسردگی تک قطبی

Major depression may be associated with abnormal perception of emotions and impairment in social adaptation. Emotion recognition from body language and its possible implications to social adjustment have not been examined in patients with depression. Three groups of participants (51 with depression; 68 with history of depression in remission; and 69 never depressed healthy volunteers) were compared on static and dynamic tasks of emotion recognition from body language. Psychosocial adjustment was assessed using the Social Adjustment Scale Self-Report (SAS-SR). Participants with current depression showed reduced recognition accuracy for happy stimuli across tasks relative to remission and comparison participants. Participants with depression tended to show poorer psychosocial adaptation relative to remission and comparison groups. Correlations between perception accuracy of happiness and scores on the SAS-SR were largely not significant. These results indicate that depression is associated with reduced ability to appraise positive stimuli of emotional body language but emotion recognition performance is not tied to social adjustment. These alterations do not appear to be present in participants in remission suggesting state-like qualities.

Major depressive disorder represents a significant and common cause of disability and social impairment (Kessler et al., 2003 and Richards, 2011). Its frequency and burden are expected to increase in years to come (Monroe and Harkness, 2011). Individuals affected by unipolar depression continue to exhibit diminished psychosocial adjustment in multiple domains of functioning during the remission phase of the illness (Wells et al., 1989, Coryell et al., 1993, Hays et al., 1995 and Shapira et al., 1999). Psychosocial adaptation reflects an individual's functioning and satisfaction in multiple social roles (e.g., family, work environment, friends) and is the result of a complex interplay of personal needs/wants and social demands (for further insights see Figueira and Brissos (2011)). The reasons behind psychosocial impairment in depression are not well understood (Hammen et al., 2009). One hypothesis suggests that a significant underpinning is abnormal emotion recognition from socially relevant stimuli (Ridout et al., 2007, Bourke et al., 2010 and Bistricky et al., 2011). As a whole, results of emotion recognition in depression have not been entirely consistent. Some investigators have shown that persons with depression exhibit impaired recognition of happy stimuli (Walker, 1981; Mandal and Bhattacharya, 1985 and Surguladze et al., 2004; Csulkly et al., 2009) while others have not (Cooley and Nowicki, 1989 and Gur et al., 1992; Rubinow and Post, 1992, Persad and Polivy, 1993 and Leppanen and Hietanen, 2004; Kan et al., 2004; Csulkly et al., 2009). Adding further complexity to the issue, in some studies, depression was associated with impaired recognition of negative emotions (e.g., angry, fearful and sad stimuli) ( Feinberg et al., 1986, Rubinow and Post, 1992, Persad and Polivy, 1993 and Asthana et al., 1998). Whereas impairment in recognition of happiness is mood congruent, reduced recognition of negative emotions is arguably a less mood congruent feature. The studies discussed above were based on emotions portrayed by facial expressions, and in fact, emotion perception research in depression has primarily used human face stimuli neglecting the universe of emotional body language (Coulson, 2004). Findings attained using facial expressions are often extrapolated as indicators of the category of socially relevant stimuli as a whole. Novel and complementary insights may emerge when expanding the study of emotion perception to emotional body language (EBL, de Gelder, 2006 and Hinzman and Kelly, 2012). In addition, the study of perception of EBL in depression fills a critical niche because the brain circuits processing EBL stimuli are only partially overlapping with the brain circuits processing facial expressions (de Gelder, 2006) and may be differentially affected by the depressive illness. Body language may be defined as the collection of signs (e.g., posture, speed of movement, meaningful coordination of actions) expressed by the human body (Watzlawick et al., 1967, de Gelder, 2006 and Schindler et al., 2008). Body language conveys a significant amount of emotionally and socially relevant information (Adolphs and Tranel, 2003, Heberlein et al., 2004, Bigelow et al., 2006 and Atkinson et al., 2007). Perception of body language has been estimated to constitute up to 60–70% of human social communication (Burgoon, 1985). People who are able to correctly perceive body language signals tend to experience more meaningful relationships, greater social approval (Hodgins and Zuckerman, 1990) and competence (Seay and Altekruse, 1979; Noller, 1980 and Trower, 1980). This is not surprising considering that facial expressions and body postures signal relevant information about emotional behaviors and intentions (Ekman, 1993 and de Gelder, 2006) and that they are continuously appraised during social interactions (Bouhuys et al., 1999). Whereas EBL has been the subject of several studies in healthy participants (Coulson, 2004), schizophrenia (Bigelow et al., 2006), alcohol use disorder (Maurage et al., 2009), and focal brain damage (Heberlein and Saxe, 2005 and Atkinson et al., 2007), to date, EBL has never been studied in depression (Coulson, 2004, Meeren et al., 2005, Calvo-Merino et al., 2008 and Van den Stock et al., 2009). Emotion perception in general and perception of EBL in particular may relate to social adaptation, a critical outcome measure in depression studies (Paradiso et al., 2011). A relationship between change in perception of socially relevant stimuli and poorer social adaptation in depression has been often posited but not empirically tested (Hodgins and Zuckerman, 1990, Ridout et al., 2003, Yoon et al., 2009 and Gollan et al., 2010). One partial exception is a study that examined the association between emotion perception and psychological aggression towards sentimental partners as a function of depressive tendencies (Marshall et al., 2011). This study did not include individuals diagnosed with major depression (Marshall et al., 2011). The present study examined perception of emotions across different body language stimuli in patients with unipolar major depression. Stimuli were included to examine perceptual responses to distinct facets of EBL including single body stimuli, stimuli depicting social interaction and socially relevant stimuli in motion. This approach was planned with the intent to capture the complexity of emotion perception and allowed assessment of consistency and differences of responses for differing types of stimuli. Dynamic stimuli were chosen based on the evidence that static and dynamic stimuli are processed by partially differing brain structures (Downing et al., 2001 and Adolphs et al., 2003). Dynamic stimuli were added also because emotions in real-life are often conveyed by stimuli in motion (Kan et al., 2004 and Hoffmann et al., 2006). Analyses were planned to study the effects of static and dynamic tasks as a function of diagnosis. Considering the dearth of studies on EBL in depression and the inconsistencies in the literature on depression and emotion perception from face stimuli, specific predictions on valence and direction of potential abnormalities were not made. Examination of perception of EBL during remission was also a focus of the present report. This aspect of the present research was planned based on studies suggesting that alterations in the processing of social stimuli may continue into remission (Leppanen and Hietanen, 2004 and LeMoult et al., 2009) but also on views that some alterations of brain activity in depression may revert to normalcy following remission (Drevets, 1998, Mayberg et al., 1999, Sheline et al., 2001 and Drevets et al., 2002). Finally, analyses were planned to examine the association between variables showing a significant group effect on perception of EBL and psychosocial adaptation. It was expected that depression would be characterized by alterations in emotion perception and these would correlate with poorer social adaptation.