Altered emotion regulation at the earliest stage of visual perception in adolescents with non-suicidal self-injury.

Background: Deviating emotion perception affects the interpretation of emotional stimuli and is linked to maladaptive emotion regulation. In adolescents with non-suicidal self-injury (NSSI), it remains unclear whether emotion regulation is altered from the earliest stage of visual emotion perception. The early visual system decomposes visual scenes into various spatial frequencies, processes these components individually, and then integrates them to form perception. Altered processing of these frequencies impacts the decoding of emotional stimuli, influencing emotion regulation from the onset of perception.

Methods: This study explored emotion perception in 42 adolescent patients with NSSI and 43 healthy controls. Participants judged images of faces for emotional or neutral expressions across sessions featuring happy and sad valence. Gaussian apertures at random locations unveiled different facial areas at distinct spatial frequencies in each trial for emotion classification. Images from correct emotion classification were used to train an image classifier distinguishing emotional from neutral facial expressions in >33,000 trials per group and valence.

Results: Cross-validation demonstrated deviating performances between the NSSI and control models in classifying sad facial expressions, with the NSSI model more frequently misclassifying sad expressions as neutral. Layer-wise relevance propagation identified the underutilization of key facial features as contributors to the lower accuracy in the NSSI model. Further analyses revealed components of emotional competence as predictors of the utilization of specific facial regions for the classification of sad expressions.

Conclusions: The disparity in identifying sad emotions suggests the utilization of different spatial frequency information as an emotion-specific avoidance strategy among adolescents with NSSI.