Recognition of facial expressions by alcoholic patients: a systematic literature review

Figures & data

Figure 1 Flowchart of the inclusion and exclusion process.

Table 1 Sample composition and countries of origin in the analyzed studies

Author	Country	Clinical group							Control group
		n	Age, mean (SD) (years)	Education level (years)	PWC (weeks)	Consumption time (years)	Drinks per day (mean)	REC	n	Age mean (SD) (years)	Education level (years)	Type
Kornreich et al^Citation3	Belgium	9 M; 13 F	38.1 (7.7)	2.31	2–3	10.6	18.7	IN	9 M; 13 F	37.2 (9.0)	2.50	HS
Maurage et al^Citation4	Belgium	9 M; 9 F	50.7 (9.8)	13.39	2	–	14.3	IN	9 M; 9 F	48.0 (10.6)	13.22	SD
O’Daly et al^Citation6	England	17 M	37.6 (9.6)	–	2	16.3	39.1	–	31 M	40.2 (8.7)	–	HS
Townshend and Duka^Citation7	England	8 M; 6 F	47.9 (10.3)	–	2	–	15.0	IN	8 M; 6 F	42.1 (9.9)	–	SD
Philippot et al^Citation9	Belgium	18 M; 7 F	43.0 (6.4)	2.95	3	–	–	IN	18 M; 7 F	43.8 (6.4)	2.91	HS
Frigerio et al^Citation10	Italy	13 M; 12 F	46.7 (10.1)	12.5	4	–	–	OUT	11 M; 12 F	46.6 (8.8)	–	HS
Maurage et al^Citation11	Belgium	9 M; 1 F	46.9 (11.3)	13.4	2	–	–	IN	9 M; 1 F	43.9 (9.5)	13.5	HS
Maurage et al^Citation12	Belgium	10 M; 5 F	46.7 (12.0)	13.46	2	–	15.4	IN	10 M; 5 F	42.1 (14.2)	14.47	HS
Maurage et al^Citation13	Belgium	7 M; 8 F	49.1 (8.0)	13	2	19.5	16.7	IN	7 M; 8 F	48.1 (7.2)	13.5	HS
Maurage et al^Citation14	Belgium	7 M; 5 F	41.8 (6.6)	12.67	2.5	9.4	27.3	IN	7 M; 5 F	41.8 (9.1)	12.92	HS
Salloum et al^Citation15	United States	11 M	35.7 (5.6)	–	4	–	13.6	IN	11 M	36.2 (5.8)	–	HS
Kornreich et al^Citation19	Belgium	18 M; 7 F	43.0 (6.4)	2.96	2–3	–	–	IN	18 M; 7 F	43.8 (6.4)	2.91	HS
		18 M; 7 F	44.6 (6.7)	2.95	8–486	–	–
Kornreich et al^Citation20	Belgium	20 M; 10 F	44.1 (10.7)	12.55	3–4	10–12	12.8	IN	20 M; 10 F	42.1 (11.2)	12.55	HS
Kornreich et al^Citation21	Belgium	18 M; 12 F	43.9 (9.8)	13.06	3	13.5	19.7	IN	16 M; 14 F	37.1 (10.4)	14.38	HS
Foisy et al^Citation22	Belgium	16 M; 9 F	46.8 (9.3)	13.04	3	16.8	18.8	IN	16 M; 10 F	44.1 (9.5)	13.48	HS
Foisy et al^Citation23	Belgium	15 M; 12 F	42.4 (8.1)	12.64	4	13.0	18.0	IN	12 M; 10 F	44.9 (9.3)	14.9	HS
		13 M; 9 F	46.4 (7.9)	13.27	8	13.0	14.7
Maurage et al^Citation24	Belgium	17 M; 3 F	44.6 (13.1)	14.35	2–3	15.6	17.9	IN	17 M; 3 F	44.6 (13.1)	14.45	HS
Sprah and Novak^Citation25	Slovenia	33 M	45.0 (1.6)	11.88	8	13.6	–	IN	36 M	40.4 (11.2)	11.72	HS
Maurage et al^Citation26	Belgium	14 M; 4 F	47.1 (10.3)	13.17	2	9.6	26.7	IN	14 M; 4 F	47.9 (11.9)	13.78	HS
Fein et al^Citation27	United States	28 M; 24 F	45.5 (6.8)	15.5	24–1,134	–	–	NET	25 M; 22 F	45.5 (6.8)	16.2	HS
Acharya et al^Citation28	England	23 M	39.3 (10.8)	–	3	–	–	IN	26 M	33.7 (10.7)	–	HS
Kumar et al^Citation29	India	30 M	36.8 (5.5)	–	2	–	–	OUT	30 M	34.5 (4.8)	–	HS
Steinmet and Federspiel^Citation30	Luxembourg	5 M; 3 F	60.8 (8.5)	–	3.1	20.5	–	RZP	NA	NA	NA	NA
Kornreich et al^Citation31	Belgium	17 M; 8 F	42.1 (9.6)	17.56	3	12.1	16.2	IN	17 M; 8 F	43.5 (9.1)	17.08	HS
Charlet et al^Citation32	Germany	25 M; 8 F	44.8 (9.8)	15.7	1	11.6	–	IN	25 M; 8 F	46.1 (9.8)	15.8	HS
Carmona-Perera et al^Citation33	Spain	31 M	52.0 (6.5)	13.7	2	26.5	18.8	IN	34 M	48.7 (10.6)	17.1	HS

Abbreviations: M, male; F, female; SD, standard deviation; PWC, period without consumption; HS, healthy subjects; SD, social drinkers; NA, not applicable; REC, recruitment source; RZP, rural zone population; NET, Internet; IN, hospitalized patients; OUT, outpatients.

Table 2 Main characteristics of stimuli and procedures used for FERT

			Studies (n)	References
FERT stimuli
Standardized
Yes	Ekman and Friesen		12	^Citation4,Citation6,Citation7,Citation11,Citation12,Citation14,Citation24,Citation25,Citation26,Citation30^–^Citation32
	Matsumoto and Ekman		9	^Citation3,Citation9,Citation15,Citation19^–^Citation23,Citation28
	Others		3	^Citation13,Citation29,Citation33
No	–––––––––		2	^Citation10,Citation27
Number of stimuli	Mean 33, median 28		–––––––––	–––––––––
Evaluated emotions (*)	Happiness		22	^Citation3,Citation4,Citation7,Citation9^–^Citation12,Citation14,Citation15,Citation19^–^Citation24,Citation26^–^Citation31,Citation33
	Sadness		19	^Citation7,Citation9^–^Citation11,Citation14,Citation15,Citation19^–^Citation23,Citation25^–^Citation31,Citation33
	Fear		16	^Citation3,Citation6,Citation7,Citation9,Citation11,Citation14,Citation15,Citation19,Citation25,Citation26,Citation28^–^Citation33
	Anger		22	^Citation3,Citation4,Citation7,Citation9,Citation10,Citation12,Citation13,Citation15,Citation19^–^Citation26,Citation28^–^Citation33
	Surprise		8	^Citation7,Citation25,Citation28^–^Citation33
	Disgust		15	^Citation7,Citation9,Citation10,Citation13,Citation15,Citation19^–^Citation23,Citation25,Citation28^–^Citation30,Citation33
	Neutral		7	^Citation6,Citation11,Citation12,Citation14,Citation24,Citation27,Citation29
Actors	Number of actors	Mean 17.1, median 5
	Ethnicity	Caucasian	8	^Citation3,Citation4,Citation9,Citation19^–^Citation23
		Noninformed	18	^Citation6,Citation7,Citation10,Citation11^–^Citation15,Citation24^–^Citation33
	Sex	Both	18	^Citation3,Citation6,Citation9,Citation10,Citation12,Citation13,Citation15,Citation19^–^Citation21,Citation23^–^Citation25,Citation27^–^Citation29,Citation31,Citation32
		Male	4	^Citation7,Citation11,Citation14,Citation26
		Noninformed	4	^Citation4,Citation20,Citation22,Citation33
FERT procedures
Standardized
Yes	Hess and Blairy		9	^Citation3,Citation4,Citation9,Citation19^–^Citation23,Citation15
	Others		7	^Citation7,Citation10,Citation11,Citation13,Citation28,Citation30,Citation33
No	–––––––––		10	^Citation6,Citation12,Citation14,Citation24^–^Citation27,Citation29,Citation31,Citation32
Means of performing task	Computer		21	^Citation3,Citation4,Citation6,Citation9,Citation13^–^Citation15,Citation19^–^Citation32
	Slide/card		2	^Citation7,Citation10
	Noninformed		3	^Citation11,Citation12,Citation33
Task type	Static		12	^Citation3,Citation7,Citation15,Citation20^–^Citation23,Citation26,Citation27,Citation29^–^Citation31
	Dynamic		5	^Citation9,Citation10,Citation13,Citation19,Citation28
	Noninformed		8	^Citation4,Citation11,Citation12,Citation14,Citation24,Citation25,Citation32,Citation33
Stimulus presentation	Randomized		22	^Citation3,Citation4,Citation6,Citation7,Citation10,Citation11,Citation13,Citation15,Citation19^–^Citation24,Citation26^–^Citation33
	Noninformed		4	^Citation9,Citation12,Citation14,Citation25
Emotional intensity	30% and 70%		6	^Citation3,Citation15,Citation20^–^Citation23
	100%		3	^Citation27,Citation29,Citation31
	Others		4	^Citation6,Citation7,Citation14,Citation32
	Noninformed		8	^Citation4,Citation11,Citation12,Citation20,Citation25,Citation26,Citation32,Citation33
Response time	Controlled		8	^Citation9,Citation22,Citation11,Citation13,Citation14,Citation26,Citation27,Citation32
	No time limit		4	^Citation6,Citation30,Citation31,Citation33
	Noninformed		14	^Citation3,Citation4,Citation7,Citation10,Citation12,Citation15,Citation19^–^Citation23,Citation25,Citation28,Citation29
Outcome variables (*)	Accuracy		23	^Citation3,Citation4,Citation6,Citation7,Citation9,Citation10,Citation12^–^Citation15,Citation19^–^Citation25,Citation27,Citation28,Citation30^–^Citation33
	Intensity		8	^Citation3,Citation7,Citation9,Citation15,Citation19,Citation23,Citation26,Citation31
	Latency time		11	^Citation4,Citation11^–^Citation15,Citation22,Citation24,Citation29,Citation31,Citation32

Note:

* Nonexclusive categories.

Abbreviation: FERT, facial expression recognition task.

Table 3 Results according to the outcome variables analyzed

Outcome variables (*)	Emotions	A > C		A < C		A = C
		Studies (n)	References	Studies (n)	References	Studies (n)	References
Accuracy (N=23)	Happiness	–	–	7	^Citation3,Citation4,Citation9,Citation12,Citation19,Citation20,Citation30	7	^Citation10,Citation7,Citation15,Citation27,Citation28,Citation31,Citation33
	Sadness	–	–	6	^Citation9,Citation10,Citation19,Citation20,Citation28,Citation30	5	^Citation7,Citation15,Citation27,Citation31,Citation33
	Fear	–	–	5	^Citation6,Citation7,Citation30,Citation31,Citation33	5	^Citation3,Citation9,Citation15,Citation19,Citation28
	Anger	–	–	6	^Citation3,Citation12,Citation19,Citation20,Citation28,Citation30	7	^Citation7,Citation9,Citation10,Citation13,Citation15,Citation31,Citation33
	Surprise	–	–	3	^Citation4,Citation28,Citation30	4	^Citation7,Citation15,Citation31,Citation33
	Disgust	–	–	6	^Citation9,Citation13,Citation19,Citation20,Citation30,Citation33	4	^Citation10,Citation7,Citation15,Citation28
	Neutral	–	–	2	^Citation12,Citation31	2	^Citation6,Citation27
	Total score	–	–	3	^Citation21,Citation23,Citation24	4	^Citation14,Citation22,Citation25,Citation32
Intensity (N=8)	Happiness	2a	^Citation3,Citation9	–	–	6b	^Citation3,Citation7,Citation19,Citation23,Citation26,Citation31
	Sadness	3	^Citation9,Citation26,Citation31	–	–	3	^Citation19,Citation7,Citation23
	Fear	4	^Citation9,Citation7,Citation26,Citation31	–	–	2	^Citation3,Citation19
	Anger	3	^Citation9,Citation7,Citation23	–	–	1	^Citation19
	Surprise	4	^Citation9,Citation7,Citation23,Citation26	–	–	3	^Citation3,Citation19,Citation31
	Disgust	–	–	–	–	1	^Citation7
	Neutral	2	^Citation26,Citation31	–	–	–	–
	Total score	–	–	–	–	1	^Citation28
Latency time (N=1)	Happiness	2	^Citation27,Citation37	1	^Citation24	1	^Citation15
	Sadness	2	^Citation27,Citation29	–	–	1	^Citation15
	Fear	–	–	–	–	2	^Citation15,Citation29
	Anger	1	^Citation13	–	–	2	^Citation15,Citation29
	Surprise	2	^Citation24,Citation29	–	–	2	^Citation15,Citation13
	Disgust	–	–	–	–	1	^Citation29
	Neutral	2	^Citation27,Citation29	–	–	–	–
	Total score	5	^Citation4,Citation11,Citation12,Citation14,Citation22	–	–	1	^Citation32

Notes:

* Nonexclusive categories

a emotion at 30% intensity

b emotion at 70% intensity.

Abbreviations: A, alcoholics; C, controls.

KornreichCBlairySPhilippotPImpaired emotional facial expression recognition in alcoholism compared with obsessive-compulsive disorder and normal controlsPsychiatr Res20011023235248

 PubMed Web of Science ®Google Scholar

MauragePCampanellaSPhilippotPFace processing in chronic alcoholism: a specific deficit for emotional featuresAlcohol Clin Exp Res200832460060618241315

 PubMed Web of Science ®Google Scholar

O’DalyOGTrickLScaifeJWithdrawal-associated increases and decreases in functional neural connectivity associated with altered emotional regulation in alcoholismNeuropsychopharmacol2012371022672276

 PubMed Web of Science ®Google Scholar

TownshendJMDukaTMixed emotions: alcoholics’ impairments in the recognition of specific emotional facial expressionsNeuropsychologia200341777378212631528

 PubMed Web of Science ®Google Scholar

PhilippotPKornreichCBlairySAlcoholics’ deficits in the decoding of emotional facial expressionAlcohol Clin Exp Res19992361031103810397287

 PubMed Web of Science ®Google Scholar

FrigerioEBurtMDMontagneBFacial affect perception in alcoholicsPsychiatr Res20021131161171

 PubMed Web of Science ®Google Scholar

MauragePPhilippotPVerbanckPIs the P300 deficit in alcoholism associated with early visual impairments (P100, N170)? An oddball paradigmClin Neurophysiol2006118363364417208045

 PubMed Web of Science ®Google Scholar

MauragePPhilippotPJoassinFThe auditory-visual integration of anger is impaired in alcoholism: an event-related potentials studyJ Psychiatry Neurosci200733211112218330457

 PubMed Web of Science ®Google Scholar

MauragePCampanellaSPhilippotPElectrophysiological correlates of the disrupted processing of anger in alcoholismInt J Psychophysiol2008701506218577404

 PubMed Web of Science ®Google Scholar

MauragePCampanellaSPhilippotPAlcoholism leads to early perceptive alterations, independently of comorbid depressed state: an ERP studyClin Neurophysiol20083828397

 Web of Science ®Google Scholar

SalloumJBRamchandaniVABodukaJBlunted rostral anterior cingulate response during a simplified decoding task of negative emotional facial expressions in alcoholic patientsAlcohol Clin Exp Res20073191490150417624997

 PubMed Web of Science ®Google Scholar

KornreichCBlairySPhilippotPDeficits in recognition of emotional facial expression are still present in alcoholics after mid- to long-term abstinenceJ Stud Alcohol200162453354211513232

 PubMed Web of Science ®Google Scholar

KornreichCPhilippotPFoisyMLImpaired emotional facial expression recognition is associated with interpersonal problems in alcoholismAlcohol Alcohol200237439440012107044

 PubMed Web of Science ®Google Scholar

KornreichCFoisyMLPhilippotPImpaired emotional facial expression recognition in alcoholics, opiate dependence subjects, methadone maintained subjects and mixed alcohol-opiate antecedents subjects compared with normal controlsPsychiatr Res20031193251260

 PubMed Web of Science ®Google Scholar

FoisyMLKornreichCFobeAImpaired emotional facial expression recognition in alcohol dependence: do these deficits persist with midterm abstinence?Alcohol Clin Exp Res200531340441017295724

 PubMed Web of Science ®Google Scholar

FoisyMLKornreichCPetiauCImpaired emotional facial expression recognition in alcoholics: are these deficits specific to emotional cues?Psychiatr Res200715013341

 Web of Science ®Google Scholar

MauragePCampanellaSPhilippotPThe crossmodal facilitation effect is disrupted in alcoholism: a study with emotional stimuliAlcohol Alcohol200742655255917878215

 PubMed Web of Science ®Google Scholar

SprahLNovakTBehavioural inhibition system (BIS) and behavioural activation system (BAS) as predictors of emotional and cognitive deficits observed in alcohol abstainersPsychiatr Danub200820218419318587289

 PubMed Web of Science ®Google Scholar

MauragePCampanellaSPhilippotPImpaired emotional facial expression decoding in alcoholism is also present for emotional prosody and body posturesAlcohol Alcohol200944547648519535496

 PubMed Web of Science ®Google Scholar

FeinGKeyKSzymanskiMDERP and RT delays in long-term abstinent alcoholics in processing of emotional facial expressions during gender and emotion categorization tasksAlcohol Clin Exp Res20103471127113920477779

 PubMed Web of Science ®Google Scholar

AcharyaRDolanMImpact of antisocial and psychopathic traits on emotional facial expression recognition in alcohol abusersPersonal Ment Health200162126137

 Web of Science ®Google Scholar

KumarSKhessCRJSinghARFacial emotion recognition in alcohol dependence syndrome: intensity effects and error patternIndian Journal of Community Psychology2011712025

 Google Scholar

SteinmetzJPFederspielCAlcohol-related cognitive and affective impairments in a sample of long-term care residentsGeroPsych20122528395

 Google Scholar

KornreichCBreversDCanivetDImpaired processing of emotion in music, faces and voices supports a generalized emotional decoding deficit in alcoholismAddict201210818088

 Web of Science ®Google Scholar

CharletKSchlagenhaufFRichterANeural activation during processing of aversive faces predicts treatment outcome in alcoholismAddict Biol201419343945123469861

 PubMed Web of Science ®Google Scholar

Carmona-PereraMClarkLYoungLImpaired decoding of fear and disgust predicts utilitarian moral judgment in alcohol dependent individualsAlcohol Clin Exp Res20143811724033426

 PubMed Web of Science ®Google Scholar

AlvesNTRecognition of static and dynamic facial expressions: a study reviewPsicol Estud2013181125130 Spanish

 Google Scholar