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Emotional Priming With Facial Exposures in Euthymic Patients With Bipolar Disorder

Su Kim, Taek MD*; Young Lee, Su MD*; Yeon Ha, Ra MD*; Kim, Eosu MD*†; Kyoon, Suk An MD, PhD*†; Ha, Kyooseob MD, PhD; Cho, Hyun-Sang MD, PhD*†

The Journal of Nervous and Mental Disease: December 2011 - Volume 199 - Issue 12 - p 971–977
doi: 10.1097/NMD.0b013e3182392903
Original Articles

People with bipolar disorder have abnormal emotional processing. We investigated the automatic and controlled emotional processing via a priming paradigm with subliminal and supraliminal facial exposure. We compared 20 euthymic bipolar patients and 20 healthy subjects on their performance in subliminal and supraliminal tasks. Priming tasks consisted of three different primes according to facial emotions (happy, sad, and neutral) followed by a neutral face as a target stimulus. The prime stimuli were presented subliminally (17 msec) or supraliminally (1000 msec). In subliminal tasks, both patients and controls judged the neutral target face as significantly more unpleasant (negative judgment shift) when presented with negative emotion primes compared with positive primes. In supraliminal tasks, bipolar subjects showed significant negative judgment shift, whereas healthy subjects did not. There was a significant group × emotion interaction for the judgment rate in supraliminal tasks. Our finding of persistent affective priming even at conscious awareness may suggest that bipolar patients have impaired cognitive control on emotional processing rather than automatically spreading activation of emotion.

*Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; †Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; and ‡Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea.

Send reprint requests to Hyun-Sang Cho, MD, PhD, Department of Psychiatry, Yonsei University College of Medicine, Severance Mental Health Hospital, 696-6 Tanbeol-dong, Gwangju-si, Gyeonggi-do, 464-100 Korea. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.