Deficits in recognition of emotional facial expression are still present in alcoholics after mid- to long-term abstinence

Objective: Emotional facial expression (EFE) decoding skills play a key rol e in interpersonal relationships. Decoding errors have been described in se veral pathological conditions, including alcoholism. The aim of this study was to investigate whether EFE decoding skill deficits persist after absten tion from alcohol of at least 2 months. Method: Alcoholic patients abstinen t for at least 2 months (n = 25) were compared with 25 recently detoxified patients and with 25 normal controls matched for age, gender and educationa l level. Subjects were presented with 40 photographs of facial expressions portraying happiness, anger, sadness, disgust and fear, Each emotion was di splayed with neutral, mild, moderate and strong emotional intensity. Each f acial expression was judged successively on eight scales labeled happiness, sadness, fear, anger, disgust, surprise, shame and contempt. For each scal e, subjects rated the estimated intensity level. A complementary scale asse ssed the self-estimated difficulty in performing the task. Results: Recentl y detoxified alcoholics were significantly less accurate than controls, mak ing more EFE labeling errors and overestimating the intensity of the portra yed emotions. Deficits in decoding accuracy for anger and disgust were pres ent in mid- to long-term abstinent patients; intensity overestimation was p resent in the former and absent in the latter. Conclusions: Deficits in dec oding accuracy for anger and disgust, and to a lesser degree sadness, persi st with an abstinence of 2 months and beyond. Right frontotemporal regions and cingulate could be implicated. These deficits may contribute to the soc ial skills deficits frequently encountered in alcoholic patients.