The Effect of Internalizing Symptoms on Affect Recognition and Theory of Mind Performance in a Community Sample of Adolescents
Difficulties with social interaction are a hallmark feature of many clinical disorders, and one factor that may contribute to these difficulties is a deficit in social perception skills, such as affect recognition and theory of mind (ToM) The present study examines the effect of depressive and anxiety symptoms on social perception in a community sample of adolescents. Based on past research, we hypothesized that greater levels of internalizing symptoms would predict poorer performance on an affect recognition and ToM task. Twenty nine adolescent participants completed dimensional measures of depressive symptoms, worry, and anxiety sensitivity, as well as a standardized neuropsychological assessment of social perception. Regression analyses revealed that greater levels of internalizing symptoms did not significantly predict a global impairment of either affect recognition or ToM. However, greater levels of worry predicted an increased number of sad errors (b 0.10, SE 0.02, b .70, p .001) while greater levels of anxiety sensitivity predicted a decreased number of fear errors (b 0.05, SE 0.02, b .46, p .05) Greater levels of worry also predicted deficits in affective, but not cognitive, ToM (b 0.04, SE 0.02, b .50, p .05) These findings suggest that subclinical internalizing symptoms may have specific, but not global, effects on social perception in adolescents. Overall, this study highlights the importance of transdiagnostic research in adolescent populations to elucidating risk factors for clinical disorder and identifying appropriate targets for intervention. INTERNALIZING SYMPTOMS AND SOCIAL PERCEPTION 3 The Effect of Internalizing Symptoms on Affect Recognition and Theory of Mind Performance in a Community Sample of Adolescents Difficulties with social interaction are a hallmark feature of many mental health problems, such as depression, anxiety, autism, aggression, and schizophrenia (Armijo, 2017; Saris et al. 2017; Van Meter et al. 2016) Beyond their impact on risk for clinical disorder, poor social skills can contribute to wide ranging distress and impairment in individuals' personal and professional lives, including higher levels of stress and loneliness (Segrin, 2017) a lack of close relationships (Davila Beck, 2002; Oltmanns, Melley, Turkheimer, 2002) and poorer performance at work (Muller, Schuler, Burton, Yates, 2003; Sperry Mesibov, 2005) Indeed, successful social interactions are critical in determining one's quality of life, and therefore much research has been devoted to examining the origins of social impairment across clinical disorders in an effort to identify targets for prevention and intervention. Deficits in Social Perception One important factor known to influence an individual's interpersonal success is social perception. Social perception is defined as the process of forming impressions of and making inferences about other people (Aronson, Wilson, Akert, 2010) In order to successfully make these judgments, humans, like many other species, rely on a variety of cues in their environment to help them interpret and predict others' behaviors. These cues may be external, such as a person's facial expression, body posture, or tone of voice. On the other hand, they may also be internal, such as a person's mood, intentions, feelings, or desires. Accurate interpretation of both these external and internal cues allows humans to interact socially and respond appropriately in different situations. Thus, deficits in the ability to carry out social perception are likely to play a key role in clinical disorders where individuals demonstrate an impairment in social skills INTERNALIZING SYMPTOMS AND SOCIAL PERCEPTION 4 (Morrison Bellack, 1981) Difficulties with two specific components of social perception have been most well studied with respect to risk for mental health problems: poor affect recognition, which corresponds to an individual's ability to interpret external cues, and deficits in theory of mind (ToM) which corresponds to an individual's ability to interpret internal cues. Affect recognition, or the ability to identify others' emotions from their facial expressions, is one of the most well studied components of social perception. Ever since Darwin suggested that facial expressions of emotion are universal (Darwin, 1872) this topic has been given much attention. Researchers around the world have corroborated Darwin's proposal, demonstrating high cross cultural agreement in the judgment of emotions based on facial expressions (Ekman, Sorenson, Friesen, 1969; Ekman, 1971; Ekman Friesen, 1971; Ekman, 1973; Izard, 1971) In fact, there are now seven emotions shown to be universally recognized by facial expression: anger, contempt, disgust, fear, joy, sadness, and surprise (Biehl et al. 1997) indicating that a consistent ability to recognize emotional facial expressions that has been conserved across cultures and generations. Furthermore, the development of affect recognition skills occurs early in childhood, with six year old children demonstrating near adult levels of accuracy on the recognition of sad and angry faces (Lawrence, Campbell, Skuse, 2015) These findings indicate that the ability to recognize others' emotions is critical to survival within a social species such as humans (Ekman, 1984) Affect recognition allows individuals to respond to others' emotions appropriately in different situations, and it also supports feelings of empathy, which are critical to building relationships (Davis, 1994) In sum, a deficit in affect recognition could have widespread impacts on one's social functioning. Another component of social perception that is critical to interpersonal success is theory of mind (ToM) or the ability to attribute unobservable mental states, such as belief, desires, and INTERNALIZING SYMPTOMS AND SOCIAL PERCEPTION 5 intention, to ourselves and others (Wellman, 1990) Recent models of ToM suggest that this complex ability is actually composed of two parts: cognitive ToM and affective ToM. Cognitive ToM refers to the ability to make inferences about others' beliefs and motivations, while affective ToM refers to the ability to infer what a person is feeling. According to the model developed by Shamay Tsoory and colleagues (Shamay Tsoory, Harari, Aharon Peretz, Levkovitz, 2010) cognitive ToM is a prerequisite for affective ToM, which also requires intact emotional empathy. This theory is supported by the fact that cognitive ToM is developed early in childhood, typically by age 5 (Astington Dack, 2008; Astington, Hughes, Zelazo, 2013) while affective ToM is thought to develop later in life, between adolescence and adulthood (Blakemore, 2008; Sebastian et al. 2011) The impact of ToM on social interaction can be seen across all age groups. Kids with good ToM abilities are better communicators (Slomkowski Dunn, 1996) more effectively resolve conflicts with friends (Dunn, 1996) are happier in school and more confident with their peers (Astington, 2004) and have better academic competence (Astington Pelletier, 2005) Likewise, in adults, this ability underlies human cooperation, deception, communication, and cultural learning (Liu, Sabbagh, Gehring, Wellman, 2009) The Impact of Mood on Social Perception Deficits Theoretical models posit that an individual's mood and affect play a key role in influencing accurate social perception. The most widely accepted theory to account for the various influences that affect may have on social judgments, called the Affect Infusion Model (AIM) was proposed by Forgas in 1995. According to the AIM, there are two informationprocessing strategies that are most likely to be influenced by one's mood or affect. First, in heuristic processing, individuals seek to construct a judgment using various shortcuts, and feelings are often used as one such shortcut to infer one's evaluative reactions to a target. For INTERNALIZING SYMPTOMS AND SOCIAL PERCEPTION 6 instance, in one study researchers found that participants reported more happiness and satisfaction with their life as a whole when in a good mood than when in a bad mood (Schwarz Clore, 1983) Thus, their feelings at the time of the call directly influenced their judgment of their overall happiness and life satisfaction via heuristic processing. Second, in substantive processing, individuals engage in the selective, constructive processing of available information that relies on a variety of learning, associative, and memory processes. Within this type of social judgment process, emotions influence judgment indirectly through their impact on processes like attention, encoding, and retrieval of specific pieces of information (Forgas, 1995) For instance, one study asked participants to watch a videotape of their own interactions the previous day and judge their own behaviors and those of their partner as either positive or negative. Happy subjects judged more behaviors as positive in both themselves and their partners, while sad subjects were more critical of their own behavior versus their partner's (Forgas, Bower, Krantz, 1984) This reflects the selective priming of self deprecatory but other enhancing cognitions, which often occurs in depressed individuals (Blaney, 1986) and demonstrates how mood indirectly affects judgment via memory and attentional processes in substantive processing. Several studies have provided empirical support for the AIM using mood induction experiments, where participants are manipulated to feel happy or sad for a brief period of time and then make social judgments. For example, a study done in 1984 by Clark and colleagues demonstrated that one's own arousal impacts the judgment of another's emotion, such that individuals with high arousal levels are more likely to judge another's positive emotions as joy, an emotion associated with high arousal, rather than serenity, an emotion associated wit