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High Levels of Anxiety Can Make You

Misinterpret Facial Expressions
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Arick Wang, Ph.D.  

from Emory University

The Science Behind

Emotional Face
Processing
Scienti+c Results
and What They
Reveal
What This Means
for Anxiety Research of emotional face
Treatment processing can help explain
another piece in the
negative cycle of anxiety.

It may not seem

entirely obvious, but
being able to understand facial expressions is one
of the most basic forms of communication that
we have as humans. These expressions allow us
to infer thoughts, intentions, and emotional states
of others that can inGuence how we act around
them1,2. You may say "hello" to a fellow coworker
but infer from their facial expressions that they
have had a rough day; this may make you more
sympathetic when interacting with them.

While this is information that many of us innately

perceive and react to, we do not all get the same
information from the same emotional expressions.
Scienti+c studies have looked at how individuals
with autism spectrum disorder3, childhood
antisocial behaviors4, schizophrenia5, and other
extreme social disorders affect how they perceive
emotions. The failure to properly recognize and
categorize emotions (i.e., recognize a smile as
happy) is believed to be a root cause of many
behaviors associated with these social disorders.
When we discuss people not reading emotional
facial expressions, we tend to assume that one of
these social disorders is at work — most likely
autism spectrum disorder. However, anxiety,
anxiety disorders, and other mood disorders such
as major depression also inGuence how we read
emotional faces6,7. Speci+cally, people who have
high levels of anxiety or depression often
categorize faces as fearful or angry.

The Science Behind Emotional Face

Processing
Studies of emotional face processing often use a
version of a forced-choice task: Participants are
presented with a face on the screen and asked to
categorize the emotion. Common facial
expressions tested are fear, happiness, sadness,
surprise, disgust, and anger. For each one, the face
is digitally manipulated to show levels of the
emotion. Through several trials scientists can
determine how sensitive a person is to certain
emotions. The picture below (reproduced under
Creative Commons license) shows such examples
for disgust and anger8.

The step number at the bottom (3, 7, 11, 15)

identi+ed is the sensitivity to that emotion. When
an emotion is incorrectly identi+ed, it is considered
miscategorization. Scientists use this information
to determine emotional face recognition. Then
they will examine whether personality traits can
explain differences or stress the body more in
some way (for example, by reducing the oxygen in
the air). This method is shown to be a reliable way
to measure emotional processing. (Its main
limitation is that there's no known facial
movement that also provides information. Despite
this, a study of this type can be reliably replicated,
meaning that several scientists will show the
same results.)

Scienti6c Results and What They Reveal

Many studies have shown that adults with
clinically diagnosable anxiety generally have worse
emotional recognition6. If we look at speci+c types
of anxiety, we see some differences in how
emotional faces are interpreted. People with social
anxiety disorder are more sensitive to anger and
disgust. Also, they are more likely to falsely
attribute another emotion; for example, that a
surprise face shows anger or disgust11,12,13. Even
in healthy adults without clinically diagnosable
anxiety, studies have shown that those who rate
anxiety more highly on a personality test were
more sensitive to fearful faces9,10.

These studies have changed how some

psychologists and other scientists think about
anxiety disorders. As researchers further study
this relationship between anxiety and emotional
recognition, they view the misinterpretation of
emotion less as a symptom of anxiety and more of
an initiating cause14.

This suggests that when a person becomes more

sensitive to emotions such as anger, fear, or
disgust, they're also more likely to attribute
different expressions to them, which may cause
greater anxiety. Think of it as accidentally spilling
a drink on the Goor at a party. In reality people are
being kind and trying to help you, but you may
misidentify their facial expressions and think they
are angry. This makes you more anxious and less
likely to go to a party in the future, negatively
feeding into your social anxieties.

What This Means for Anxiety Treatment

Modern anxiety treatment techniques focus on
breaking this cycle. They teach people to have
more conscious awareness of negative thoughts
and to form a habit of reframing them positively.

The studies of emotional face processing help us

understand another piece in the negative cycle of
anxiety. The +ndings suggest that a very
fundamental negative thought in those who have
anxiety disorders is perceiving anger, fear, or
disgust in others even when those emotions are
not present. Nobody can fully understand another
person's state of mind, but those with anxiety
disorders may automatically assume the worst.
Armed with this knowledge, it's important to be
more mindful of how anxiety affects the
recognition of emotions and help curb negative
perceptions and behaviors.

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Sources

1. Horstmann, G. (2003). What do facial

expressions convey: feeling states, behavioral
intentions, or action requests? Emotion. 3, 150–
166.

2. Seidel, E.M., Habel, U., Kirschner, M., et al.

(2010). The impact of facial emotional
expressions on behavioral tendencies in women
and men. Journal of Experimental Psychology:
Human Perception and Performance. 36, 500-507.

3. Corbett, B.A., Newsom, C., Key, A.P., et al.

(2014). Examining the relationship between face
processing and social interaction behavior in
children with and without autism spectrum
disorder. Journal of Neurodevelopmental
Disorders. 6(35).

4. Bowen, E., & Dixon, L. (2010). Concurrent and

prospective associations between facial affect
recognition accuracy and childhood antisocial
behavior. Aggressive Behavior. 36, 305–314.

5. Marwick, K., & Hall, J. (2008). Social cognition in

schizophrenia: a review of face processing. British
Medical Bulletin. 88, 43–58.

6. Demenescu, L.R., Kortekaas, R., den Boer, J.A., &

Aleman, A. (2010). Impaired attribution of emotion
to facial expressions in anxiety and major
depression. PLoS ONE. 5, e15058.

7. Fox, E. (2002). Processing emotional facial

expressions: the role of anxiety and awareness.
Cognitive, Affective, and Behavioral Neuroscience.
2, 52–63.

8. Attwood, A.S., Easey, K.E., Dalili, M.N., et al.

(2017). State anxiety and emotional face
recognition in healthy volunteers. Royal Society
Open Science. 4, DOI: 10.1098/rsos.160855.

9. Doty, T.J., Japee, S., Ingvar, M., Ungerleider, L.G.

(2013). Fearful face detection sensitivity in healthy
adults correlates with anxiety-related traits.
Emotion. 13, 183–188.

10. Surcinelli, P., Codispoti, M., Montebarocci, O.,

Rossi, N., & Baldaro, B. (2006). Facial emotion
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11. Mohlman, J., Carmin, C.N., & Price, R.B. (2007).

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Deighton, R.M., & Traue, H.C. (2007). Emotion
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Becker, E.S. (2010). Morphed emotional faces:
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(2009). Why do antidepressants take so long to
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Date of original publication: September 04, 2017

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