Division of Psychological Medicine, King's College London, Institute of Psychiatry, De Crespigny Park, PO59, London SE5 8AF, UK.
BMC Psychiatry. 2013 Nov 7;13:291. doi: 10.1186/1471-244X-13-291.
Recent models of anorexia nervosa (AN) have emphasised the importance of social and emotional difficulties as maintenance factors of the disorder, however, empirical data are limited. The aim of this study was to examine whether altered emotional facial expression, previously observed in people currently ill with anorexia nervosa, is limited to the ill state or present in people recovered from the illness.
The sample consisted of 123 participants [49 AN, 21 recovered AN (RecAN) and 53 healthy controls (HC)]. Participants watched three films clips (amusing, neutral, sad) whilst their facial expressions were recorded and completed the positive and negative affect scale (PANAS) to record subjective experience. Facial expressions were subsequently coded for frequency of positive and negative expression and frequency of looking away.
In response to the amusing clip, AN participants showed significantly less positive expression than both HC and RecAN groups and both AN and RecAN showed more negative expression than HC with no difference between groups in looking away.In response to the sad clip there was no difference between groups in positive expression, but current AN participants showed significantly less negative expression than HC and looked away from the stimuli more than RecAN or HC.In terms of their subjective emotional experience, patients with current AN reported less positive emotion in response to both the amusing and the sad film clip. There was no difference between groups in subjective negative experience.
Alterations in facial expression are present in people currently ill with AN contributing to the social difficulties found in AN and potentially exacerbating resistance to treatment. Some alterations in facial expression are found in women with a past history of AN but not to the same extent as those shown in the currently ill group. Future studies need to use a wider range of stimuli involving different emotions to corroborate findings.
最近的厌食症（AN）模型强调了社会和情感困难作为该障碍维持因素的重要性，但实证数据有限。本研究旨在探讨以前在患有厌食症的患者中观察到的情绪面部表情改变是否仅限于患病状态，或者是否存在于已从疾病中康复的患者中。
该样本由 123 名参与者组成[49 名 AN、21 名恢复的 AN（RecAN）和 53 名健康对照（HC）]。参与者观看了三个电影片段（有趣、中性、悲伤），同时记录他们的面部表情，并完成积极和消极情绪量表（PANAS）以记录主观体验。随后，对面部表情进行编码，以记录积极和消极表情的频率以及目光回避的频率。
在回应有趣的片段时，AN 参与者的积极表情明显少于 HC 和 RecAN 组，而 AN 和 RecAN 组的消极表情多于 HC 组，且两组在目光回避方面没有差异。在回应悲伤的片段时，各组在积极表情方面没有差异，但目前患有 AN 的参与者的消极表情明显少于 HC，且比 RecAN 或 HC 更多地回避刺激。就其主观情绪体验而言，目前患有 AN 的患者在回应有趣和悲伤的电影片段时报告的积极情绪较少。各组在主观消极体验方面没有差异。
目前患有 AN 的患者的面部表情改变存在，这导致了 AN 中发现的社交困难，并可能加剧对治疗的抵制。在过去患有 AN 的女性中发现了一些面部表情改变，但程度不如目前患病组。未来的研究需要使用更广泛的涉及不同情绪的刺激来证实这些发现。
