University of Massachusetts, Amherst.
University of Pittsburgh School of Medicine.
Behav Ther. 2020 Mar;51(2):253-267. doi: 10.1016/j.beth.2019.08.004. Epub 2019 Aug 17.
Standardized developmentally based assessment systems have transformed the capacity to identify transdiagnostic behavioral markers of mental disorder risk in early childhood, notably, clinically significant irritability and externalizing behaviors. However, behavior-based instruments that both differentiate risk for persistent psychopathology from normative misbehavior, and are feasible for community clinicians to implement, are in nascent phases of development. Young children's facial expressions during frustration challenges may form the basis for novel assessments tools that are flexible, quick, and easy to implement as markers of psychopathology to complement validated questionnaires. However, the accuracy of facial expressions to correctly classify young children falling above and below clinical cut-offs is unknown. Our goal was to test how facial expressions during frustration, defined by different facial muscular movements, related to individual differences in irritability and externalizing behaviors and discriminated children with clinically significant levels from peers. Participants were 79 children (ages 3-7) who completed a short, moderately frustrating computer task while facial expressions were recorded. Only negative facial expressions that included eye constriction related to irritability and externalizing behaviors and were clinically discriminating. Moreover, these expressions significantly discriminated children with and without clinically significant irritability and externalizing symptoms with high Area Under the Curve (AUC) values (> .75) indicating good clinical utility. In contrast, expressions without eye constriction showed no clinical utility. The presence of negative expressions with eye constriction in response to a short frustration prompt may serve as an indicator of early psychopathology, raising the potential for novel assessment tools that may enhance precision of early identification.
标准化的基于发展的评估系统改变了识别儿童早期精神障碍风险的跨诊断行为标志物的能力，特别是明显的临床显著易激惹和外化行为。然而，能够区分持续性精神病理学风险和正常行为偏差，且适用于社区临床医生实施的基于行为的工具仍处于初级开发阶段。幼儿在挫折挑战中的面部表情可能成为新的评估工具的基础，这些工具灵活、快速且易于实施，可作为补充验证问卷的精神病理学标志物。然而，面部表情在正确分类高于和低于临床截止值的幼儿方面的准确性尚不清楚。我们的目标是测试挫折期间的面部表情（由不同的面部肌肉运动定义）如何与易激惹和外化行为的个体差异相关，以及如何区分具有临床显著水平的儿童与同龄人。参与者为 79 名儿童（年龄 3-7 岁），他们在完成一项短暂的、中等程度的挫折计算机任务时记录了面部表情。只有包括眼缩在内的负性面部表情与易激惹和外化行为相关，并且具有临床区分能力。此外，这些表情可以显著区分具有和不具有临床显著易激惹和外化症状的儿童，曲线下面积（AUC）值较高（>.75），表明具有良好的临床应用价值。相比之下，没有眼缩的表情则没有临床应用价值。在短时间的挫折刺激下，出现具有眼缩的负性表情可能是早期精神病理学的一个指标，这为可能增强早期识别精度的新型评估工具提供了潜力。
