Background: Depressed patients show mood-congruent errors in the identification of emotion in facial expressions. Errors consist of impaired performance (recognition errors) and negative bias (seeing faces as sadder than they are). This abnormal processing may both reflect and contribute to the negative affective state. In this study, we administered an emotional recognition in facial expression task to women with premenstrual dysphoric disorder (PMDD) to determine whether processing errors similar to those in depression were present and whether they were confined to the luteal phase (i.e., state dependent).
Methods: The Facial Discrimination Task (FDT) was administered in the follicular and luteal phases to women with PMDD (n=28) and asymptomatic controls (n=27).
Results: ANOVA with repeated measures identified significantly increased negative judgments (both performance errors and bias) in women with PMDD during the luteal phase (more neutral to sad misjudgments and higher negative bias index) as well as impaired "specificity" of judgments [an inability to discriminate neutral from emotional stimuli] (diagnosis by phase interactions, p<0.05), findings similar to those observed in depression. No menstrual cycle effects were seen in controls, and no differences between patients and controls were seen on a control task (age assessment of pictured subjects).
Limitations: The levels of significance obtained were modest and would not withstand correction for multiple comparisons.
Conclusion: Women with PMDD display a luteal phase-dependent impairment (negative bias) in the processing of non-verbal affective information. This negative bias may contribute to the generation of negative mood states during the luteal phase and could suggest the presence of dysfunction in those brain regions whose coordinated activity mediates the recognition of emotion in facial expression.