The Impact of Self-Reported Depression Severity and Age on Facial Emotion Recognition in Outpatients with Anxiety and Mood Disorders

In non-clinical community samples, older adults are less accurate at identifying others' emotional expressions than younger adults. Less is known about the effects of age on facial emotion recognition (ER) in clinical samples. We explored ER in outpatients presenting for assessment/treatment of emotional disorders. We predicted that depression severity would be associated with slower, less accurate ER. We expected to find an effect for age, with younger adults showing superior ER performance for negative emotions (fear, anger, sadness). 644 outpatients (57.6% female, M age 31.31, range = 18-76) completed an ER task and a self-report measure of depression severity, the Beck Depression Inventory (BDI-II). The BDI-II was rescored (BDI-R), using only the 10 items specific to unipolar depression, as determined by factor analysis. 34.6% of participants had a clinical depressive disorder. All other participants had a clinical anxiety disorder or not otherwise specified mood disorder. Depression severity, based on the BDI-R, did not predict ER accuracy or intensity for any face type. Age was associated with lower ER accuracy and higher intensity scores for sad and fearful faces, and lower overall accuracy of ER. In a large, transdiagnostic clinical sample of adults with emotional disorders, we found a decline in ER performance with age, particularly for negative emotions (sadness, fear). There was no significant association between depression and ER in our sample, suggesting the importance of considering additional variables such as state affect, attention, and arousal.