Borderline Personality and the Detection of Angry Faces

12 Pages·2016·0.38 MB·English

RESEARCHARTICLE
Borderline Personality and the Detection of
Angry Faces
JohannaHepp1*,BenjaminE.Hilbig2,PascalJ.Kieslich3,JuliaHerzog1,StefanieLis1,
ChristianSchmahl1,IngaNiedtfeld1
1 DepartmentofPsychosomaticMedicine,CentralInstituteofMentalHealth,MedicalFacultyMannheim/
HeidelbergUniversity,Mannheim,Germany,2 DepartmentofPsychology,UniversityofKoblenz-Landau,
Landau,Germany,3 DepartmentofPsychology,UniversityofMannheim,Mannheim,Germany
*[email protected]
Abstract
Background
ManystudieshaveassessedemotionrecognitioninpatientswithBorderlinePersonality
Disorderandconsiderableevidencehasbeenaccumulatedonpatients’abilitytocategorize
OPENACCESS
emotions.Incontrast,theirabilitytodetectemotionshasbeeninvestigatedsparsely.The
Citation:HeppJ,HilbigBE,KieslichPJ,HerzogJ,
onlytwostudiesthatassessedemotiondetectionabilitiesfoundcontradictoryevidenceon
LisS,SchmahlC,etal.(2016)BorderlinePersonality
andtheDetectionofAngryFaces.PLoSONE11(3): patients’abilitytodetectangryfaces.
e0152947.doi:10.1371/journal.pone.0152947
Methods
Editor:KimFelmingham,UniversityofTasmania,
AUSTRALIA ToclarifywhetherpatientswithBorderlinePersonalityDisordershowenhanceddetection
Received:January14,2016 ofangryfaces,weconductedthreeexperiments:alaboratorystudy(n=53)withaclinical
sampleandtwohighlypoweredwebstudiesthatmeasuredBorderlinefeatures(n =342,
Accepted:March20,2016 1
n =220).Participantsinallstudiescompletedavisualsearchparadigm,andthereaction
Published:March31,2016 2
timesforthedetectionofangryvs.happyfacesweremeasured.
Copyright:©2016Heppetal.Thisisanopen
accessarticledistributedunderthetermsofthe
Results
CreativeCommonsAttributionLicense,whichpermits
unrestricteduse,distribution,andreproductioninany Consistently,dataspokeagainstenhanceddetectionofangryfacesintheBorderlinegroups,
medium,providedtheoriginalauthorandsourceare
indicatedbynon-significantgroup(Borderlinevs.healthycontrol)×target(angryvs.happy)
credited.
interactions,despitehighlysatisfactorystatisticalpowertodetectevensmalleffects.
DataAvailabilityStatement:Allrelevantdataare
withinthepaperanditsSupportingInformationfiles.
Conclusions
Funding:Theresearchreportedonwassupported
Incontrasttoemotioncategorization,emotiondetectionappearstobeintactinpatientswith
bygrantstoProf.BenjaminE.HilbigfromtheBaden-
WürttembergFoundation,Germany(http://www. BorderlinePersonalityDisorderandindividualshighinBorderlinefeatures.Theimportance
bwstiftung.de/forschung/)andfromtheGerman ofdistinguishingbetweenthesetwoprocessesinfuturestudiesisdiscussed.
ResearchFoundation[HI1600/1-1](http://www.dfg.
de/).Thefundershadnoroleinstudydesign,data
collectionandanalysis,decisiontopublish,or
Introduction
preparationofthemanuscript.
BorderlinePersonalitydisorder(BPD)isaseverepsychiatricdisorderthataffectsaround1to
CompetingInterests:Theauthorshavedeclared
thatnocompetinginterestsexist. 3%oftheadultpopulationandischaracterizedbymarkedaffectiveinstability,impulsivity,
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AngerDetectioninBPD
andinterpersonalproblems[1,2].Dysfunctionalemotionprocessingisconsideredoneofthe
centralfactorsthatcontributetothephenomenologyofthisdisorder.Asafirststepintheemo-
tionprocessingcontinuum,thequestionofhowwellBPDpatientscanrecognizeemotionsin
othershasgainedparticularinterestinthepast[3].Numerousstudiesonemotionrecognition
inBPDhavebeenconductedandfinallysummarizedintwocomprehensiveliteraturereviews
[4,5]aswellastworecentmeta-analyses[6,7].Wearguethatthestudiessummarizedtherein
actuallycapturetwodistinctaspectsofemotionrecognition,namelyemotioncategorization
andemotiondetection,andpresentnewevidenceontherelativelyunder-researchedaspectof
emotiondetection.
Accordingtoarecentseriesofexperiments,emotioncategorizationanddetectionaredis-
tinctprocessesthatrequiredistinctabilitiesandshouldthusbediscriminatedfromeachother
[8].Emotioncategorizationrequirestheabilitytocorrectlyidentifyandverballylabelapre-
sentedemotion.InpreviousstudiesonBPDsamples,thisabilitywasmeasuredbyaskingpar-
ticipantstoindicatewhichemotiontheysawinafacebychoosingthecorrecttermfromaset
ofpre-definedansweringoptions.Ameta-analysisonthesestudiesrevealedanemotioncate-
gorizationdeficitacrossallemotionsandselectivedeficitsfordifferentiatingbetweendisgust
andanger[5].
Incontrast,emotiondetectiondoesnotrequirespecificemotionstobenamedanddistin-
guishedfromoneanother;itsimplycomprisestheabilitytoaccuratelyperceivewhetherany
emotionalcontentispresentinafaceornot.Emotiondetectionhaspreviouslybeencaptured
usingmorphingparadigmsinwhichaninitiallyneutralfacegraduallychangesintoanemo-
tionalone.Theearlieststageinthemorphingprocessatwhichparticipantsperceivesome
degreeofemotionintheface(andthereforestoppedthemorphingprocess)thusindicates
theiremotiondetectionabilities.EvidenceonBPDpatients’performanceinthistaskwas
mixed.Twostudiesfoundnodifferenceregardingemotiondetectionbetweenhealthycontrols
(HC)andBPDpatients[9]oryouthwithBPDsymptoms[10].Othersfoundsuperior[11]and
stillothersfoundinferior[12]emotiondetectionperformanceintheincludedBPDgroups.
Finally,highBPDsymptomcountspredictedalowerdetectionthresholdforangrymalefaces
inanon-patientsample[13].Evidently,clearconclusionsregardingBPDpatients’emotion
detectionabilitiesarenotpossiblebasedonthisbodyofwork.Onepotentialproblemwith
morphingstudiesisthattheyassessnotonlyemotiondetectionbutalsoanadditionalelement
ofemotioncategorization,because,oncethemorphingprocessisstopped,participantsstill
havetolabelthedisplayedemotion.TogainabetterunderstandingofBPDpatients’emotion
detectionabilitiesitthusseemsnecessarytoassessdetectioninparadigmsthatdonotalso
includecategorization.
Sofar,onlytwostudieshaveaddressedemotiondetectionoutsideofmorphingstudies.The
firststudybySchulzeandcolleaguesusedarapid,continuousstreamofstimuliconsistingof
facialphotographsthatwerecroppedintoastandardovalshape[14].Severaltrialsincludeda
happyorangryface,whereasothersincludedonlyneutrallookingfaces.Aftereachtrial,partic-
ipantsindicatedwhetheranemotionalfacewaspresentornot.Nomaineffectofgroupwas
found,butBPDpatientswereselectivelymoresensitivetowardsangrystimuli,producing
greaterhitratesforangryfacesthantheHCgroup.AsecondstudybyHagenhoffandcol-
leagues[15]assessedemotiondetectionabilitiesforhappyandangryfacesusingtheface-in-
the-crowd-paradigm[16].Inthisparadigm,emotionalfaceshavetobedetectedin“crowds”
(i.e.matrices)ofneutralfaces.Inthepast,theface-in-the-crowdparadigmhasrepeatedly
revealedanangersuperiorityeffect(ASE):angryfacesinneutralcrowdsweredetectedfaster
andwithfewererrorsthanhappyfacesinneutralcrowds[17].Hagenhoffandcolleagues
employedlinedrawingsofroundfaces(“smileyfaces”)andanalyzedthereactiontimeswith
whichparticipantswereabletodetectangryfaces.Theyfoundnooverallgroupdifferencebut
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alsonodetectionadvantageforangryfacesintheBPDgroup,whichstandsincontrasttothe
previousfindingsbySchulzeandcolleagues.
Insum,whilethereisconsiderablepreviousevidenceonemotioncategorizationinBPD[6,
7],evidenceonemotiondetectionissparse.Moreover,theonlytwoexistingstudiesthathave
usedparadigmsthatassessemotiondetectiondirectlyfoundcontradictingevidenceforthe
angrycondition[14,15].Schulzeandcolleaguesfoundanincreasedsensitivityforangryfaces
whileHagenhoffandcolleaguesfoundnospecificadvantageforangryfaces.Asaresultofthis,
itremainsentirelyunclearwhetherpatients’detectionabilitiesareinfactaltered,particularly
forangryfaces,andfurtherstudiesareclearlyneededtoresolvethis.
Inanefforttoshedfurtherlightonthistopicweconductedadetection-onlystudy.Inline
withtheprocedureofthetwopreviousdetectionstudies,wefocusedonhappyandangrysti-
muli.Specifically,wechosetouseaface-in-the-crowd-paradigmsimilartotheoneHagenhoff
andcolleaguesused.WepreferredthisparadigmtotheoneemployedbySchulzeandcol-
leaguesbecauseitisamoreimmediatemeasureofemotiondetection:intheface-in-the-crowd
paradigmparticipantsrespondimmediatelytoadetectedface,whereasintheotherparadigm
participantsindicatewhethertheyhavedetectedanemotionalfacewithdelay,attheendofa
picturesequence.Fortheface-in-the-crowdparadigm,weintendedtoimproveuponprevious
materialbycreatinganewsetofgeometricallycontrolledfacialstimulithatwouldminimize
confoundingvisualeffects:whenhappystimuliaredrawnsuchthateyebrowsandmouthare
paralleltothefacialsurround,thiscancausegreatersensitivityfortheangryfacessimply
becausethesearemoresalient[18].Inlinewithpreviousstudiesusingtheface-in-the-crowd
paradigm,weexpectedthat(1)BPDandHCparticipantswouldallshowanASEregarding
reactiontimes,thusdetectingangryfacesfasterthanhappyfaces.Additionallyweassessed
whetherusinggeometricallycontrolledstimuli(2)BPDpatientswouldshowanangerdetec-
tionadvantageintheformofastrongerASEintheface-in-the-crowdparadigm,mirroringthe
onepreviouslyfoundbySchulzeandcolleagues.
MethodsStudy1
Participants
Twenty-ninefemaleBPDpatientsand28femaleHCswererecruitedbetweenMay2011and
December2011.PatientswererecruitedthroughapatientdatabaseattheCentralInstituteof
MentalHealth,Mannheim,Germany,andhealthycontrolparticipantswererecruitedthrough
advertisementsinlocalnewspapersAfterapplyingacriterionforaminimalusabletrialnum-
berof90%percondition,twenty-sevenparticipantsremainedintheBPDgroupand26partici-
pantscomprisedthecontrolgroup.BPDpatientswerediagnosedbyanexperiencedclinician
usingtheGermanversionofthestructuredclinicalinterviewfortheDSM-IV[19]andthe
InternationalPersonalityDisorderExamination[20].Generalexclusioncriteriawerecomorbid
diagnosesofschizophrenia,bipolardisorder,developmentaldisorder,orsubstancedepen-
dency.Themajorityofpatientswereunmedicated(61.5%);severaltookantidepressants
(19.2%),neuroleptics(7.7%),oracombinationofboth(11.5%).Patientshadonaverage1.9
comorbiddisorders(SD=1.5),whichincludedmainlyanxietydisorders(n=19),mooddisor-
ders(n=12),eatingdisorders(n=4),otherpersonalitydisorders(n=3),andeachonecaseof
paindisorder,alcoholabuse,andtrichotillomania.Patientsmeanscoreof2.05(SD=0.84)on
theBorderline-Symptom-List,indicatedsymptomseveritysimilartothatobservedinother
patientsamples[21].Patientsfurtherhadameanscoreof27.48(SD=10.14)ontheBeck-
Depression-Inventory[22],indicatingclinicallyrelevantdepressivesymptoms.Controls’mean
scoreof0.37ontheBorderline-Symptom-List(SD=0.41)and5.27(SD=5.22)ontheBeck-
Depression-InventoryindicatedtheabsenceofclinicallyrelevantBPDanddepressive
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Fig1.Exemplaryface-in-the-crowdmatrixwithangrytargetforstudies1/2(left)andstudy3(right).
doi:10.1371/journal.pone.0152947.g001
symptoms.Further,HCfulfillednocriteriaforanypresentorpastmentaldisorder.Patients
(aged18to42,M=26.63,SD=6.15)werematchedtoHC(aged18to38,M=25.19,
SD=5.43)forageandlevelofeducation.
Material
Intheface-in-the-crowdparadigm,eachtrailconsistedofa3×3matrixoffaceswhichfollowed
a1000msinter-trail-interval.Participantswereinstructedtoindicateasfastandaccuratelyas
possiblewhetheratargetfacewaspresentinthematrix(pressA=“targetpresent”,pressL=
“targetabsent”).Targetfacesincludedahappy,angryandabluebaselinestimulus.Stimuli
wereschematicfacesdesignedusingthevectordrawingprogramInkscape[23].Importantly,
angryandhappystimuliweregeometricallycontrolledvariantsoftheneutralface:Theireye-
browsandmouthwereexactmirrorimagesofeachother.Thus,ingeometricalterms,theydif-
feredfromtheneutralfacetoexactlythesameextent.Parallelismofeyebrowsandfacial
surroundwasminimizedbyincludinghair.Thebluestimulus,whichservedasaneutralbase-
line,wasanexactcopyoftheneutralstimulus,butwithblueeyebrowsandmouth.Anexem-
plarymatrixwiththestimuliincludedhereispresentedinFig1.
Procedure
ThestudywasreviewedandethicsapprovalwasgrantedbytheethicscommitteeoftheUni-
versityofHeidelbergbeforethestudybegan(committeename:MedizinischeEthik-Kommis-
sionIIderMedizinischenFakultätMannheimderUniversitätHeidelberg).Atthebeginningof
thestudyallparticipantsprovidedinformedwrittenconsentafterobtainingdetailed
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informationaboutthestudyprocedure.Theethicscommitteeapprovedofthisprocedure.
Capacitytoconsentwasdeterminedbythepatient’sdiagnosticianandwasgivenforallpartici-
pants.Next,participantsprovideddemographicalinformationandthenfilledinseveralques-
tionnairesnotpertinenttothecurrentinvestigation.Next,participantscompletedfourpractice
trialsoftheface-in-the-crowdparadigm,followedbyasetof216experimentaltrials,consisting
of108noisetrials(notarget)and36targettrialsforeachtypeoftarget(angry/happy/blue).
ResultsStudy1
ThedatasetforStudy1canbeaccessedinS1Dataset.Reactiontimes(inms)werelog-trans-
formedduetonon-normality.Extremeoutlierswithareactiontimemorethan2.5SDabove
thesamplemeanwereexcluded(1.2%oftrials).Allstatisticalanalyseswereconductedforcor-
rectlyansweredtrialsonly(M=93.6%ofalltrials,SD=14.0%).Allmeans,standarddeviations
andconfidenceintervalsarepresentedseparatelyforbothgroupsinTable1.Datawasanalyzed
usingarepeatedmeasuresANOVAwithreactiontimesasthedependentvariable(see
Table2).
Hypothesis1:Ashypothesized,theASEwaspresentforbothgroups,indicatedbyasignifi-
cantmaineffectoftargettype(seeTable2).Post-hoct-testsconfirmedtheexpectedorderof
means:angryfacesweredetectedsignificantlyfasterthanhappyfaces,t(52)=-10.04,p<.001,
d=-1.38,95%CI[-1.76,-0.99],andbluefaces,t(52)=-5.68,p<.001,d=-0.78,95%CI
[-1.09,-0.46].
Hypothesis2:Contrarytothishypothesis,BPDpatientsdidnotshowastrongerASEthan
HCs,indicatedbyanon-significantgroup×targetinteraction(seeFig2).Notethatallresult
patternsremainedunchangedwhenrepeatinganalyses(i)withoutthebluecondition,(ii)
whendummy-codingforparticipants’medicationstatus,(iii)whenusingnon-transformed
reactiontimes,and(iv)whenusinghitratesasthedependentvariable.
DiscussionStudy1
Thenon-significantgroup×targetinteractionpointstoanequallystrongASEforbothBPD
patientsandHCs.Thisisinlinewithapreviousstudyemployingthesameparadigmbutdif-
ferentstimuli[15]andspeaksagainstenhancedemotiondetectionforangryfacesinBPD.
However,uponcloseinspectionthisfindingcannotbetakenasconclusiveevidencethatthere
Table1. Means(M),standarddeviations(SD),and95%confidenceintervals(95%CI)ofthemean(log-transformed)reactiontimesinallstudies,
presentedforthedifferenttargettypesintheBorderlinePersonalityDisordergroup(BPD)andhealthycontrolgroup(HC).
HC BPD
target M(SD) 95%CI M(SD) 95%CI
Study1
angry 3.04(0.09) [3.03,3.06] 3.04(0.07) [3.03,3.06]
happy 3.10(0.07) [3.08,3.11] 3.10(0.08) [3.08,3.11]
blue 3.09(0.08) [3.07,3.10] 3.08(0.07) [3.06,3.10]
Study2
angry 3.01(0.08) [3.00,3.02] 3.04(0.08) [3.02,3.05]
happy 3.06(0.09) [3.05,3.07] 3.08(0.08) [3.07,3.09]
blue 3.05(0.10) [3.04,3.06] 3.09(0.12) [3.07,3.10]
Study3
angry 3.12(0.08) [3.11,3.13] 3.14(0.08) [3.13,3.15]
happy 3.15(0.07) [3.14,3.16] 3.18(0.08) [3.17,3.19]
doi:10.1371/journal.pone.0152947.t001
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Table2. Test-statisticsfortherepeatedmeasuresANOVAmaineffectsoftargettype,groupandtheir
interactionforstudies1,2,and3.
Study F df p effectsizef[90%CI]
Maineffectoftarget(within)
Study1 33.45 (1.74,88.52) <.001 0.29[0.21,0.36]
Study2 92.94 (1.36,461.65) <.001 0.22[0.18,0.25]
Study3 124.72 (1,218) <.001 0.23[0.19,0.27]
Maineffectofgroup(between)
Study1 0.03 (1,51) .86 0.02[0.00,0.19]
Study2 8.70 (1,340) .003 0.15[0.06,0.23]
Study3 6.35 (1,218) .012 0.16[0.05,0.27]
Interactioneffectofgroup×target
Study1 0.16 (1.74,88.52) .85 0.02[0.00,0.06]
Study2 2.37 (1.36,461.65) .11 0.04[0.00,0.06]
Study3 0.36 (1,218) .55 0.01[0.00,0.05]
Note.Degreesoffreedomforstudy1and2areGreenhouse-Geissercorrected.
doi:10.1371/journal.pone.0152947.t002
isnosucheffect:Withthegivensampleofn=53,α=.05andβ=.05,theempiricalcorrelation
amongrepeatedmeasuresofr=.80,andanon-sphericitycorrectionofε=.87,asensitivity
(cid:1)
poweranalysisconductedwithg Power[24]indicatedthattheinteractioneffectthatcanbe
ruledoutwithinaconventionallevelofstatisticalconfidenceisCohen’sf=0.15(allreportedf
valuesinthefollowinganalysesrefertothesquarerootoftheratioofeffectvarianceand
(cid:1)
pooledwithingroupsvariancesasimplementeding Power3.0).Statedsimply,thisisthe
smallesteffectforwhichwehavesufficientpower(1-ß(cid:3).95).Consequently,atrulysmall
effectoff=0.10orlessaccordingtoCohen[25]cannotbeexcludedwithsufficientcertainty
giventhesamplesize.Thus,wecannotdeterminewhethertherereallywerenodifferencesin
emotiondetectionbetweenthegroups,orwhetherwelackedthesamplesizetofindanexisting
smalleffect.
Consequently,itappearedappropriatetoconductasecondstudywithsufficientstatistical
powertodetectevenasmalleffect.Tothisend,werecruitedalargeonline-sampleinwhichwe
measuredBPDfeatures,amethodthathasbeensuccessfullyappliedinotherstudiesofBPD
[26].Wehypothesizedthat(1)thegeneralASEwouldbereplicatedandsetouttotestwhether,
inthismuchlargersample,(2)theASEwouldbestrongerinthegroupwithhighBPDscores
thaninthatwithlowscores.
MethodsStudy2
Participants
Todeterminethenecessarysamplesizeforrulingoutsmalleffects,anaprioripoweranalysis
wasconducted.Tomakethisreplicationdirectlycomparabletostudy1,wemaintainedthe
analyticalframeworkofarepeatedmeasuresANOVAwithtwogroups.Thenecessarysample
sizetodetectasmalleffectoff=0.10,withα=.05and1–β=.95fortheinteractiontermofthe
(cid:1)
repeatedmeasuresANOVAisn=338.Poweranalysiswasbasedontheg Powerdefaultvalue
forthecorrelationamongrepeatedmeasuresofr=.50andaconservativevalueofε=.70.
Sinceweexpecteddrop-outandthatsomecaseswouldnotmeettherequirementsforadequate
dataquality,weoversampledbyapproximately15%.
Three-hundred-and-ninety-oneGermanspeakingparticipantswererecruitedviasocialnet-
worksandBPD-relatedwebsitessuchasself-helpgroups.Weensuredthatthefinaldataset
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Fig2.Meanlog-transformedreactiontimes(with95%CI)fortheangry,happyandbluetargetsconditionalongroup:BorderlinePersonality
DisorderorhighinBorderlinefeatures(BPD/highBPD)vs.healthycontrolsorlowinBorderlinefeatures(HC/lowBPD).
doi:10.1371/journal.pone.0152947.g002
containednorepeatedparticipations(identifiedbyanidenticalIPaddress,sex,andage)and
onlyretainedparticipantswhoconfirmedtohaveparticipatedseriously.Afterapplyingfilters
foraminimaltrialnumberof90%pertargettype,342participantsremainedinthefinaldata-
set.Participantswereaged18to60(M=25.5,SD=6.7),75.7%werefemale,and28.9%ofpar-
ticipantswererecruitedfromBPDforumsorBPDself-helpgroups.
Material
BPDfeatureswereassessedusingtheBorderlinescaleoftheVerhaltens-Erlebens-Inventar
(VEI)[27],whichistheGermanadaptationofthePersonalityAssessmentInventory[28].The
scaleconsistsof24itemsmeasuringthefacetsidentityproblems,self-harm,negativerelation-
ships,andaffectiveinstability,answeredonafourpointLikert-typescale.TheBorderlinescale
oftheVEIhasshownagoodinternalconsistencyof.84[27]andvalidityoftheEnglishPAI--
BORhasbeendemonstratedrepeatedly[29,30].Theface-in-the-crowdparadigmwasapplied
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intheexactsamewayasinstudy1.Reactiontimemeasurementusedclient-sideJavaScript
whichprovidesmillisecondaccuracy.
Procedure
Whilecollectingdataonline,wecarefullyfollowedthestandardsforweb-basedexperiments
[31].Atthebeginningofthestudyallparticipantsprovidedinformedwrittenconsentafter
obtainingdetailedinformationaboutthestudyprocedure.Next,participantscompletedaper-
sonalityinventorytheresultsofwhicharereportedelsewhere[32],followedbytheVEI.Next,
210trialsoftheface-in-the-crowdparadigmwerepresented;35foreachtargettype(angry,
happy,blue)and105noisetrials.Uponcompletingthistask,participantsansweredseveral
controlquestionstoensureseriousparticipation.
ResultsStudy2
ThedatasetforStudy2canbeaccessedinS2Dataset.Datawerefilteredandlog-transformed
exactlyasinStudy1.Next,agroupwithVEIscoresbelowtheclinicalcut-offscoreof38[28]
andonewithparticipantsscoringabovewereformed.Thegroupbelowcut-offcomprised203
participants,theirVEIscoresrangingfrom7to37,M=24.3,SD=7.3,and139participants
scoredabovecut-offwithscoresfrom38to69,M=50.1,SD=8.7.TheVEIshowedahigh
internalconsistencyofα=.92inthissample.
Hypothesis1:TheASEfoundinstudy1wasreplicatedacrossgroups.Again,post-hoct-tests
showedangryfacesweredetectedfasterthanhappyfaces,t(341)=-22.1,p<.001,d=-1.20,95%
CI[-1.34,-1.05],andbluefaces,t(341)=-9.88,p<.001,d=-0.53,95%CI[-0.65,-0.42].
Hypothesis2:AsinStudy1,themagnitudeoftheASEdidnotdifferbetweengroups(see
Table2;Fig2).Notethattheresultpatternsremainedunchangedwhenrepeatinganalyses(i)
withoutthebluecondition,(ii)usingnon-transformedreactiontimes,(iii)usingextreme
groupsofparticipantswithaVEIscore(cid:4)24(averageratingofmaximal1onallVEIitems)in
onegroupandwithascore(cid:3)48intheother(averageratingofminimal2onallVEIitems),
(iv)whenusinghitratesasthedependentvariable,(v)inalinearmixedmodelwiththecontin-
uousVEIscoreandtargettypeaspredictors.
DiscussionStudy2
AsinStudy1,theASEdidnotdifferbetweengroups.However,forthecurrentsample,
(cid:1)
G Power[24]sensitivityanalysisfortheinteractiontermindicatedthataneffectassmallas
f=0.07couldberuledout.Thepoweranalysiswasbasedontheobservedcorrelationamong
repeatedmeasuresofr=.74,anon-sphericitycorrectionofε=.68andaconventionallevelof
α=.05.Thus,thecurrentsamplesizeimpliedsufficientpowertodetectevensmalleffects.
Nonetheless,anull-findingsuchasthepresentoneshouldbeasrigorouslysubjecttoreplica-
tionasastudyshowinganeffect.Thus,tofurthertestthepreliminaryconclusionthatthereis
nogroup×targetinteraction,wedecidedtoreplicateourownresultsinathirdstudy,using
anotherlarge,web-basedsample.Moreover,toensurethatthenullfindingwasnotlimitedto
thespecificmaterialweused[18],wecreatedasecondsetofstimulusmaterialwithdifferent
identitiesandvaryingemotionalintensities.
MethodsStudy3
Participants
AnalogoustoStudy2,weperformedanaprioripoweranalysis.Thenecessarysamplesizeto
detectasmalleffectoff=0.10with1–β=.95andα=.05wasdeterminedasn=198.Assuming
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acorrelationamongrepeatedmeasuresinasimilarrangeasinStudy1andStudy2(bothr=
.75),weadoptedtheslightlymoreconservativevalueofr=.70.Werecruitedparticipantsin
thesamefashionasinStudy2andagainoversampledbyapproximately15%.Two-hundred-
and-twenty-eightparticipantscompletedtheentirestudy.Allparticipantsprovidedinformed
writtenconsentatthebeginningofthestudyandafterhavingobtaineddetailedinformation
aboutthestudyprocedure.Afterapplyingthepreviousfilterforaminimaltrialnumber,220
participantsremainedinthefinaldataset.Oftheremainingparticipants(aged18to58,
M=28.1,SD=8.6),82.7%werefemale,and35.0%wererecruitedfromBPD-relatedwebsites.
ProcedureandMaterial
BPDfeatureswereagainassessedusingtheborderlinescaleoftheVEI[27].Thenewmaterial
fortheface-in-the-crowdparadigmwascreatedusingInkscape[23].Twelvedifferentidentities
(sixfemale,sixmale)wereconstructedinthevariantsangry,happyandneutral.Theintensity
oftheemotionalexpression,thatis,thedegreetowhichmouthsandeyebrowswerecurved,
wasvaried.Tocreateunsystematicandheterogeneouscrowds,neutralfaceswererandomly
selectedfromthestimulussetpertrialandrandomlyassignedtoapositioninthe3×3matrix
(seeFig1foranexemplarymatrix).Eachofthe12angry/happytargetfaceswaspresented3
times,alwaysinarandompositioninthematrix,withinacrowdofrandomlyselectedneutral
faces.Hence,participantscompleted36targettrialsshowingangry/happyfaceseach.Theblue
baselinestimuluswasnolongerincluded,thusparticipantscompleted72noisetrialswithneu-
tralmatrices.TheprocedurewasidenticaltothatinStudy2.
ResultsStudy3
ThedatasetforStudy3canbeaccessedinS3Dataset.
Dataweretransformed,filteredandparticipantsweredividedintotwogroupsexactlyasin
Study2,with119participantsscoringaboveand101scoringbelowtheclinicalcut-offofthe
VEI.VEIscoresrangedfrom38to68,M=51.5,SD=8.0,inthegroupabovetheclinicalcut-
offandfrom5to37,M=24.7,SD=7.9,inthegroupbelowthecut-off.Inthissample,the
VEI’sinternalconsistencywasα=.93.
Hypothesis1:TheASEwasreplicatedacrossgroups.Post-hoct-testsshowedthatangrysti-
muliweredetectedfasterthanhappyones,t(219)=-11.27,p<.001,d=-0.76,95%CI[-0.91,-
0.60].Asinstudy2,theresultpatternsremainedunchangedwhenrepeatinganalyses(i)using
non-transformedreactiontimes,(ii)usingextremegroupsofparticipantswithaVEI
score(cid:4)24inonegroupandwithascore(cid:3)48intheother,(iii)whenusinghitratesasthe
dependentvariable,(iv)inalinearmixedmodelwiththecontinuousVEIscoreandtargettype
aspredictors.Hypothesis2:Aspreviously,therewasnosignificantgroup×targetinteraction.
(cid:1)
G Powersensitivityanalysisfortheinteractiontermindicatedthatinthissampleaneffectas
smallasf=0.07couldberuledout.Power-analysisbasedontheempiricalcorrelationamong
repeatedmeasuresofr=.81andα=.05.
GeneralDiscussion
Inalaboratoryexperiment(Study1),wetestedthehypothesisthatBPDpatientsmightdiffer
fromHCsindetectingangryfaces,indicatedbyanincreasedASEintheface-in-the-crowdpar-
adigm.WedidobserveastrongASE,butitdidnotdifferbetweenBPDpatientsandcontrols.
However,aspoweranalysesrevealed,thisfindingwasinconclusiveasitmayhavebeenthe
resultofthesmallsamplesizeandthusinherentlylowstatisticalpowertodetectsmalleffects.
Hence,weconductedtwofurtherstudieswithlargesamplesandthussufficientpowertorule
outevensmalleffects.
PLOSONE|DOI:10.1371/journal.pone.0152947 March31,2016 9/12
AngerDetectioninBPD
Forstudies2and3,participantswererecruitedonlineandBPDfeaturesweremeasured.Par-
ticipantsweredividedintotwogroupsbasedontheclinicalcut-offscore(onegroupwith,one
withoutclinicallysignificantBPDfeatures).Itisimportanttonotethat41%ofthesamplein
study2and54%ofthesampleinstudy3hadclinicallyrelevantBPDfeaturesabovetheclinical
cut-off,duetorecruitmenteffortsintheBPDonlinecommunity.Studies2and3replicatedthe
patternobservedinstudy1:ageneralASEwasfound,butnoindicationofagroup×targettype
interactionwaspresent,speakingagainstenhancedangerdetectioninBPD.Duetothelarger
samplesize,evenasmall(interaction)effectcouldberuledout.Thus,thenullfindingsyieldsup-
portforthenullhypothesiswithinaconventionallevelofstatisticalcertainty.Notethatstudy3
replicatedthispatternusingheterogeneousstimuliwithdifferentidentitiesandvaryingemo-
tionalintensities.Thefindingisinlinewithapreviousstudythatemployedthesameparadigm
[15],yetdifferentstimuli,andstandsincontrasttothefindingbySchulzeandcolleagues[14].
Regardinglimitationsofthestudy,thesamplesofStudies2and3mustbeviewedwithsome
caution.AlthoughmeasuringBPDfeaturesintwolargeonlinesamplessolvedtheproblemof
insufficientstatisticalpower,theVEI’sclinicalthresholdisofcoursenotequivalenttoaclinical
diagnosis,eventhoughtheVEIcut-offisknowntocorrespondverywellwithdiagnosesbased
ontheDSM-IV(82%accordance)[29],(73%accordance)[30].Also,theinfluenceofthirdvar-
iablessuchascomorbiddiagnoses,substanceabuse,medicationstatusetc.couldnotbecon-
trolledforinthewebsamples.
Theresultsimplythatitisnecessarytodifferentiatebetweenemotiondetectionandemo-
tioncategorizationinBPD.Thefirstrequirestheabilitytoperceivethemerepresenceofan
emotion,whereasemotioncategorizationrequiresfurthercognitiveprocessing.Ourexperi-
mentsrepeatedlyrevealednodifferencebetweenpatientsandcontrolsforthedetectionof
angryfaces,whichsuggeststhatimpairmentsinemotionprocessingmayonlyariselater,when
facesareevaluatedandcategorized[6,7].ArecentstudythatmeasuredBPDfeaturesinastu-
dentsamplesupportsthenotionofnormalemotiondetectionyetaltered(thatis,greater)emo-
tionrecognitionabilities[33].
Ourresultsfurtherhaveimplicationsforclinicalresearch.Itisourviewthatpatient-based,
fully-controlledlab-studiesandlarge-scaleweb-studiescouldserveascomplementary
approaches.Indeed,mostconclusiveevidencewillnecessarilyentailcompatiblefindingsfrom
bothsources.Giventhatsmall-sample,patient-basedstudiesareclearlymorecommoninclini-
calresearch,ourrecommendationistocomplementthesewithlarge-scale,web-basedsamples
moreoftenandthustestwhethereffects(ornullfindings)holdwhenboththetype-Iandtype-
IIerrorarelow.
SupportingInformation
S1Dataset.Datasetforstudy1.
(CSV)
S2Dataset.Datasetforstudy2.
(CSV)
S3Dataset.Datasetforstudy3.
(CSV)
AuthorContributions
Conceivedanddesignedtheexperiments:J.HeppBEHSLIN.Performedtheexperiments:J.
HeppBEHJ.HerzogIN.Analyzedthedata:J.HeppPJK.Contributedreagents/materials/anal-
ysistools:J.HeppBEHPJKCSIN.Wrotethepaper:J.HeppBEHPJKJ.HerzogSLCSIN.
PLOSONE|DOI:10.1371/journal.pone.0152947 March31,2016 10/12