ORIGINAL RESEARCH ARTICLE PSYCHIATRY published: 20 January 2014doi: 10.3389/fpsyt.2014.00004 Major depressive disorder alters perception of emotional body movements Morten Kaletsch1*, Sebastian Pilgramm2,3, Matthias Bischoff 2,3,4, Stefan Kindermann2, Isabell Sauerbier 2, Rudolf Stark 3, Stefanie Lis5, Bernd Gallhofer 1, Gebhard Sammer 1, Karen Zentgraf 3,4, Jörn Munzert 2 and Britta Lorey 2,3 1 Cognitive Neuroscience Group, Center for Psychiatry and Psychotherapy, Justus Liebig University Giessen, Giessen, Germany 2 Institute for Sports Science, Justus Liebig University Giessen, Giessen, Germany 3 Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany 4 Institute for Sports Science, University of Münster, Münster, Germany 5 Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Edited by: Much recent research has shown an association between mood disorders and an altered Francis E. Lotrich, University of emotion perception. However, these studies were conducted mainly with stimuli such as Pittsburgh Medical Center, USA faces. This is the first study to examine possible differences in how people with major Reviewed by: Mir Mazhar, Queen’s University, depressive disorder (MDD) and healthy controls perceive emotions expressed via body Canada movements. Thirty patients with MDD and thirty healthy controls observed the video Casimiro Cabrera Abreu, Queen’s scenes of human interactions conveyed by point-light displays (PLDs). They rated the University and Providence Care, depicted emotions and judged their confidence in their rating. Results showed that patients Canada with MDD rated the depicted interactions more negatively than healthy controls. They *Correspondence: Morten Kaletsch, Cognitive also rated interactions with negative emotionality as being more intense and were more Neuroscience Group, Center for confident in their ratings. It is concluded that patients with MDD exhibit an altered emo- Psychiatry and Psychotherapy, Justus tion perception compared to healthy controls when rating emotions expressed via body Liebig University Giessen, Am Steg movements depicted in PLDs. 28, Giessen 35392, Germany e-mail: morten.kaletsch@psychol. Keywords: major depressive disorder, emotion perception, point-light displays, social cognition, embodiment, body uni-giessen.de movements, kinematics INTRODUCTION information processing and an altered negative biased view of the As social beings, it is important for us to recognize and properly world compared to healthy controls (15–17). assess the emotions of our conspecifics, so that we can adapt our Additionally, on a neural level, altered neural activation pat- own behavior accordingly. This can be advantage to us, because we terns have been reported in those areas responsible for processing would approach people who seem to be in a good mood or are sad emotional stimuli (limbic structures, prefrontal regions such as and needing comfort or help, but avoid contact with those who the ventromedial prefrontal cortex) and higher cognitive processes are angry, threatening, or dangerous in order to protect ourselves. (dorsolateral prefrontal cortex). These have been associated espe- We learn about the meaning of emotions by observing others’ cially with the onset and persistence of mood disorders such as emotions and the behavior that accompanies them. Implicit and MDD (18, 19). explicit processes of mentalization such as imitating and mirror- Most research on this topic has focused on emotions expressed ing emotions play an important role in helping us to judge our via facial expression and prosody. This neglects an important interaction partners’ emotional state and intentions accurately, so human emotion expressing system: the human body, that is, body that we can predict their prospective behavior and respond to it language and body movements. Human body movement can also appropriately (1–3). convey emotions, and observers can infer the emotional state of Past research has indicated repeatedly that people with mood an individual or interacting partners from movements even when disorders such as major depressive disorder (MDD) exhibit alter- they are at a distance and the faces of the interacting persons ations and deficits in areas of social cognition, empathy, emotion are not clearly visible (20–25). Like the face, the body is a source processing, and emotion perception (4–7) “irrespective of age of of information on a person’s internal emotional state. When this onset/duration of illness, task type, diagnosis, sex, and hospitaliza- emotional state leads to a corresponding body gesture, this ges- tion status” (8). More precisely, people with MDD show a negative ture, in turn, functions as a signal to any observer. The observers’ response bias, pay greater attention, attend more selectively, and reactions to this signal will be very fast and may help to protect show stronger emotional reactions when processing emotional them, even without seeing the other person’s facial expression. and particularly negative stimuli; and, in addition, they remember Emotional body movements not only just provide information negative stimuli better than positive stimuli (4, 9–14). Forty years on the threat, as a facial expression does, but also a direct cue ago, Beck already formulated his cognitive theory of depression regarding an adequate behavioral response (26). Bearing in mind postulating that people with depression show a negative biased that people with MDD show altered emotion perceptions of facial www.frontiersin.org January 2014 | Volume 5 | Article 4 | 1 Kaletsch et al. Emotion perception in point-light displays expressions, and bearing in mind that not only the face but also antipsychotic drug and/or mood stabilizer). Seven patients met the entire body – especially body movements – express emotions, the criteria for another mental disorder: anxiety disorder (n= 2), it would seem important to investigate whether and how mood post-traumatic stress disorder (n= 1), eating disorder (n= 1), disorders such as MDD influence the perception of emotions in persistent somatoform pain disorder (n= 1), anxious avoidant body movements in order to increase our scientific knowledge and personality disorder (n= 1), and dependent personality disorder better understand the complex process of emotion perception. (n= 1). To investigate the perception of emotional body movements Diagnoses of MDD were conducted by experienced psychia- with a complete exclusion of facial information and other dis- trists and psychologists. Patients with present or previous neuro- tracting variables, this study exploits the advantages of point-light logical disease or trauma, alcohol or drug dependence, acute and displays (PLDs). Since the seminal work of Johansson in 1973 (20), chronic psychotic disorders, bipolar disorders, as well as other it is known that human actions can be perceived intuitively even medical conditions that could influence cognitive functioning when the only information available to an observer comes from were excluded. just a few points representing the joints of the body. Experimen- The 30 age-matched healthy adults (14 female, mean tally, such research is implemented with the so-called point-light age= 49.9 years, SD= 9.1) were recruited as a control group. Their technique. This method records the kinematics of a few dots placed data has also been used for a preceding study (24). The same on a model’s body and uses these to reconstruct PLDs. PLDs have exclusion criteria were applied as for patients. In addition, healthy been applied to study not only gait direction or gender recognition controls were excluded if they had any history of psychiatric or (27, 28) but also how human movements represent an individual’s neurological disorders, any history or current use of any psychoac- emotional state. The latter research has revealed that emotions tive medication, or a score higher than 13 on the Beck Depression can be detected reliably even when no facial expression is seen Inventory (BDI-II) and emotion perception and recognition can draw only on the biological movement and its kinematics (29). The advantage of PRODUCING PLDs using such highly simplified PLDs is that they provide only kine- The procedure of creating and validating of stimuli is the same as matic movement information. This ensures that the perception that described by Lorey et al. (24). Seven pairs of two actors pro- process is not influenced by confounding variables in the stimulus vided the movements for PLDs. Each pair was asked to perform an material such as attractiveness, sympathy, and the cultural aspects interaction portraying one of the following four emotions: anger, found in the complex and natural stimuli of, for example, faces or sadness, joy, and love. Interactions with anger and sadness were whole-body presentations (30). pooled in the category “negative” and interactions with love and Against the background of previous research on emotion per- joy were pooled in the category “positive.” Prior to acting, both ception among people with MDD, we studied whether people actors were given a script instructing them to perform the same with MDD would show altered emotion perception of the emo- emotion in order to produce a behavioral pattern that was as sym- tional body movements conveyed by PLDs. We hypothesized that metrical as possible. Actors were asked to act out the emotion (a) patients with MDD would show a negative bias when rating immediately. They were completely free to express their emotions the emotional valence of the depicted interactions compared to in whatever way they liked – for example, by overt symbolic ges- healthy controls; (b) patients with MDD would perceive negative tures. At least four clips of each pair and each emotional scene interactions more intensely than positive interactions and healthy were produced. In addition, for each of the dyadic PLDs (scene controls; and (c) patients with MDD would differ from controls in with two actors: dyad), a monadic PLD version was created con- how confident they were about their ratings of emotional valence. sisting of the dots of one of the two individuals alone (scene with one actor: monad). Apart from this, they still displayed the same MATERIALS AND METHODS emotion with the same movements. This resulted in a corpus of ETHICAL STATEMENT 96 recordings with 8 recordings for each category (monad vs. The study was specifically approved by the local ethics commit- dyad× positive vs. negative× three difficulty Levels, see section tees (local ethics commissions, Department of Psychology and below). The factors difficulty (easy, medium, difficult) and Social Sports Science, Department of Medicine, Justus Liebig University context (monad, dyad) were used in another part of this project Giessen), and all participants gave their informed written consent and are therefore not analyzed and discussed here. in accordance with the Declaration of Helsinki. All participants All interactions were recorded with a 12-camera VICON MX gave written consent to participate in the study. system (Oxford Metrics, Oxford, England) operating at 100 Hz. Thirteen reflective markers were attached to defined anatomical PARTICIPANTS landmarks on the upper body (including the shoulders, the elbow The total sample consisted of 60 middle-aged adults: 30 patients joints, the wrists, and the forehead) and the lower body (including receiving treatment at the Centre of Psychiatry and Psychotherapy the hips, the knee joints, and the ankles) of each actor (Figure 1). at the university hospital of Justus Liebig University Giessen and After capturing, data post-processing was conducted with Nexus 30 healthy controls. 1.5.2 (Vicon Motion Systems, Oxford, England) in order to calcu- The 30 patients (16 female, mean age= 50.5 years, SD= 11.25) late 3-D coordinates of the markers. The video files were created were diagnosed with MDD according to DSM-IV criteria. At the in a two-step process using Matlab software (MathWorks, Natick, time of testing, 21 patients were taking antidepressants; 9 patients, MA, USA). First, for each point in time, the 3-D coordinates of the a combination of drugs (antidepressant and/or sedative and/or 13 markers were plotted as white spheres on a black background. Frontiers in Psychiatry | Affective Disorders and Psychosomatic Research January 2014 | Volume 5 | Article 4 | 2 Kaletsch et al. Emotion perception in point-light displays started with the experiment and the other-half with the control session in order to control for sequence effects. The experiment presented a series of 96 video trials (8 sequences per condition: monads vs. dyads× negative vs. positive emotions× three difficulty levels). Conditions were presented in a pseudorandomized order counterbalanced across participants. Each trial started with a fixation phase (1 s), followed by the instruction (3 s) and the respective video sequence (4 s). After observing this sequence, participants were asked to assess the depicted emotional valence of the videos on a seven-point scale ranging from 1 (negative) to 7 (positive) with 4 marking the neu- tral center of the scale. The position of the valence label (negative) was altered from the left to the right side for one-half of the partic- ipants and from right to left for the other half of the participants. After each valence rating, participants were asked to report how confident they were about their rating on an 11-point scale ranging from 1 (0% confidence) to 11 (100% confidence). DATA ANALYSIS AND STATISTICS To control for sequence effects, prior to testing scale, labels (“nega- tive” and “positive”) were reversed for one-half of the participants. Subsequent, in order to conduct statistical analysis of differences in rated valence, data for half of the participants had to be reversed again, so that scores of 1–3 always reflected a negative rating and scores from 5 to 7 a positive rating. For statistical analysis, we calcu- lated mean scores for each rating and each experimental condition. FIGURE 1 | Preparation of stimuli. To create the point-light displays, 13 reflective markers were attached to an actor’s head, shoulders, elbows, Mean scores for the perceived valence were calculated by summing wrists, hips, knees, and ankles. They were then tracked using a Vicon up all responses from the 7-point scale (most negative= 1, most motion-capture system. (A) Examples of dyadic and monadic point-light positive= 7) and dividing the sum by the number of displayed displays. (B) Temporal structure of one trial of the experiment. videos. Intensity of ratings was operationalized as the extent par- ticipants used to rate closer to the maximum value of the 7-point scale, to say that intensity was coded higher when the rating was Then, the frames of the captured scenes were rendered as audio– closer to the ends of the scale. To create mean scores of intensity video interleaved (avi) movie files at a frame rate of 25 Hz. For of ratings, all scores on the 7-point scale for ratings of perceived each scene, video files with a duration of 4 s were created from a valence of negative videos were reversed (1 into 7, 2 into 6, and so front view. In all presented PLDs, the dots appeared white against on), to receive scores, which were comparable to scores for pos- a black background at an approximate viewing distance of 50 cm. itive videos, i.e., for both kinds of videos (negative and positive) higher scores meant higher intensity of ratings. Mean scores for STIMULI: VALIDATION AND DETERMINATION OF ITEM DIFFICULTY the confidence were calculated by summing up all responses from Prior to the experiment, an index of item difficulty was determined the 11-point scale (1= 0% confidence to 11= 100% confidence) for all recorded PLDs in order to separate the recordings into three and dividing the sum by the number of displayed videos. classes (easy, medium, and difficult to recognize). We asked 30 par- To explore the potential differences between patients with ticipants who did not participate in the present study to evaluate MDD and healthy controls in perceiving emotional valence, per- the negativity or the positivity of the emotions displayed in the ceived intensity of emotions, and the confidence in emotion videos in a forced-choice paradigm. The three categories of item perception, we computed three repeated-measures ANOVAs for difficulty were created by calculating the percentage of people who perceived valence, intensity, and confidence to examine the effects agreed on the depicted emotion of the video scene. Thus, easy of the depicted emotion of interaction (positive vs. negative), the videos were defined by a consensus of 91–100%; medium videos, social context (monads vs. dyads), the difficulty of videos (easy, by a consensus of 71–90%; and difficult videos, by a consensus of medium, difficult), and group as a categorical between-group 50–70%. factor (Table 1). All statistics were calculated using SPSS software (Versions 19 PROCEDURE and 20), and an alpha level of 0.05 was used for all statistical tests. Prior to or after the actual experiment, participants attended a control session, so that experimenters could assess data ensuring RESULTS that all participants were able to recognize movements from PLDs. CONTROL DATA They were given control stimuli depicting sports movements such Control session: biological motion recognition test as juggling and basketball, and asked to give a brief definition of Participants were able to identify each of the actions reliably and each movement as quickly as possible. One-half of the participants far above chance level. On average, 93.24% (range: 67–100%) of www.frontiersin.org January 2014 | Volume 5 | Article 4 | 3 Kaletsch et al. Emotion perception in point-light displays Table 1 | Statistical data of depicted emotion × social context × difficulty repeated-measures ANOVA for rating of valence, intensity of ratings, and confidence rating in ratings. df F η2 p RATING OF EMOTIONAL VALENCE Group (between-group factor) 1, 58 8.60 0.13 0.005* Depicted emotion 1, 58 1190.02 0.95 0.000* Depicted emotion*group 1, 58 8.50 0.13 0.005* Social context 1, 58 0.11 0.00 0.74 Social context*group 1, 58 0.32 0.00 0.58 Difficulty 2, 116 13.93 0.19 0.000* Difficulty*group 2, 116 1.95 0.03 0.15 Depicted emotion*social context 1, 58 420.38 0.88 0.000* Depicted emotion*social context*group 1, 58 0.11 0.00 0.75 Depicted emotion*difficulty 2, 116 256.23 0.82 0.000* Depicted emotion*difficulty*group 2, 116 0.16 0.00 0.85 Social context*difficulty 2, 116 23.10 0.29 0.000* Social context*difficulty*group 2, 116 0.54 0.01 0.58 Depicted emotion*social context*difficulty 2, 116 9.54 0.14 0.000* Depicted emotion*social context*difficulty*group 2, 116 0.74 0.01 0.48 INTENSITY OF RATINGS Group (between-group factor) 1, 58 8.50 0.13 0.005* Depicted emotion 1, 58 0.09 0.00 0.77 Depicted emotion*group 1, 58 8.60 0.13 0.005* Social context 1, 58 420.37 0.88 0.000* Social context*group 1, 58 0.11 0.00 0.75 Difficulty 2, 116 256.23 0.82 0.000* Difficulty*group 2, 116 0.16 0.00 0.85 Depicted emotion*social context 1, 58 0.11 0.00 0.74 Depicted emotion*social context*group 1, 58 0.32 0.00 0.32 Depicted emotion*difficulty 2, 116 13.93 0.19 0.000* Depicted emotion*difficulty*group 2, 116 1.95 0.03 0.15 Social context*difficulty 2, 116 9.54 0.14 0.000* Social context*difficulty*group 2, 116 0.75 0.01 0.48 Depicted emotion*social context*difficulty 2, 116 23.10 0.29 0.000* Depicted emotion*social context*difficulty*group 2, 116 0.54 0.00 0.58 CONFIDENCE IN RATING Group (between-group factor) 1, 58 0.20 0.00 0.66 Depicted emotion 1, 58 25.51 0.31 0.000* Depicted emotion*group 1, 58 4.23 0.07 0.04* Social context 1, 58 175.51 0.75 0.000* Social context*group 1, 58 0.13 0.00 0.72 Difficulty 2, 116 95.311 0.62 0.000* Difficulty*group 2, 116 1.53 0.03 0.22 Depicted emotion*social context 1, 58 1.15 0.02 0.29 Depicted emotion*social context*group 1, 58 0.06 0.00 0.81 Depicted emotion*difficulty 2, 116 2.58 0.04 0.08 Depicted emotion*difficulty*group 2, 116 0.37 0.00 0.69 Social context*difficulty 2, 116 14.30 0.20 0.000* Social context*difficulty*group 2, 116 0.80 0.01 0.45 Depicted emotion*social context*difficulty 2, 116 21.43 0.27 0.000* Depicted emotion*social context*difficulty*group 2, 116 0.39 0.00 0.68 ANOVA, *p < 0.05. Frontiers in Psychiatry | Affective Disorders and Psychosomatic Research January 2014 | Volume 5 | Article 4 | 4 Kaletsch et al. Emotion perception in point-light displays FIGURE 3 | Differences in rating intensity of patients with MDD and FIGURE 2 | Differences in rating of valence of patients with MDD and healthy controls for positive and negative emotional interactions. healthy controls for positive and negative emotional interactions. Average intensity ratings and their standard deviations are displayed as a Average valence ratings and their standard deviations are displayed as a function of participant group (healthy controls vs. patients with MDD) and function of participant group (healthy controls vs. patients with MDD) and valence of depicted emotional scene (positive vs. negative). The difference valence of depicted emotional scene (positive vs. negative). The difference is significant at the 0.05 level. is significant at the 0.05 level. depicted emotion of the emotional interactions was negative, classifications was correct. Implementing the control session either but not when it was positive. Patients with MDD rated emo- before or after the main experimental session did not result in any tional negative interactions more intensely (M = 5.74, SD= 0.52) significant difference in the ratings of either emotional valence, than healthy controls (M = 5.21, SD= 0.49). None of the two- t (58)= 0.62, p > 0.05 or confidence, t (58)= 0.94, p > 0.05. way, three-way, or four-way interactions (depicted emotion, social context, difficulty) with group turned significant. Position of valence label during valence rating Position of the valence labels (negative and positive left or INFLUENCE OF GROUP ON CONFIDENCE IN RATINGS right) did not produce systematically different valence rat- There was no significant main effect of group membership on ings, t (58)= 0.80, p > 0.05, or confidence ratings, t (58)= 0.15, confidence in the rating of emotional valence F(1, 58) < 1, ns, p > 0.05, in the main trail. but a significant two-way interaction between group and valence, F(1, 58)= 4.22, p < 0.05, η2= 0.07 (Figure 4). When the emo- INFLUENCE OF GROUP ON RATED VALENCE (NEGATIVE OR POSITIVE) tional scene was positive, patients with MDD rated valence just There was a significant effect of group membership on rat- as confidently as healthy controls. In contrast, when the valence ing of perceived emotional valence, F(1, 58)= 8.60, p < 0.05, was negative, patients with MDD were more confident about their η2= 0.13. Patients with MDD rated depicted scenes more neg- perceptions and ratings than healthy controls. None of the two- atively than healthy controls. Interestingly, the significant two- way, three-way, or four-way interactions (depicted emotion, social way interaction between depicted emotion and group revealed context, difficulty) with group turned significant. that patients with MDD rated only negative emotional inter- Interestingly, even though they were not the main subject of actions more negatively than healthy controls but not posi- this study, depicted emotion was the only one of the three design tive emotional interactions, F(1, 58)= 8.50, p < 0.05, η2= 0.13 factors to produce a group difference. Neither difficulty of stimuli (Figure 2). See Table 1 for all results of the repeated-measures nor the number of interaction partners resulted in group differ- ANOVAs. None of the two-way, three-way, or four-way interac- ences in rating either valence, intensity of ratings, or confidence in tions (depicted emotion, social context, difficulty) with group ratings. Furthermore, the statistical analysis revealed neither a con- turned significant. founding effect of the variable gender nor an effect of comorbidity on all outcome variables. INFLUENCE OF GROUP ON INTENSITY OF RATINGS Regarding the intensity of participants’ ratings on depicted DISCUSSION valence, ANOVAs again revealed a significant main effect of group, The present study investigated differences in the perception of F(1, 58) 2= 8.50, p < 0.05, η = 0.13. Similar to the prior analysis of emotional body movements in patients with MDD compared to rated valence, the two-way interaction between group and depicted healthy controls. Point-light video scenes of human interactions emotion attained significance, F(1, 58)= 8.60, p < 0.05, η2= 0.13 including only emotional body movements with no information (Figure 3), showing that the difference occurred only when the on facial expression were used to determine possible differences. www.frontiersin.org January 2014 | Volume 5 | Article 4 | 5 Kaletsch et al. Emotion perception in point-light displays bias occurs only when perceiving negative emotional interactions. Further research could examine whether this bias influences social approach and avoidance behavior, and how this more negative per- ception influences state and mood and, therefore, the symptoms and maintaining of MDD. Regarding the intensity of responses, we found more intense responses to negative emotional interactions from people with MDD compared to healthy controls. This is similar to the stronger emotional reaction to negative stimuli among depressed people reported by Persad and Polivy (31). It could be discussed within the context of the negative potentiation hypothesis proposing that potentiated emotional reactivity to negative emotional stimuli is elicited by negative mood or emotional states (32, 33). However, it has to be pointed out here that most studies on the negative potentiation hypothesis did not investigate the perceived intensity of observed interpersonal interactions. The subjective emotional reactivity to these interactions might well differ from the judgment of their intensity. In contrast, no difference was found for positive FIGURE 4 | Differences in rating confidence of patients with MDD and emotional interactions. This might be interpreted and discussed healthy controls for positive and negative emotional interactions. in light of previous research indicating that the higher salience Average confidence ratings and their standard deviations are displayed as a of negative emotions combined with negative bias leads to higher function of participant group (healthy controls vs. patients with MDD) and valence of depicted emotional scene (positive vs. negative). The difference perceived intensity of such interactions, whereas positive interac- is significant at the 0.05 level. tions are less salient. As a result, their emotional intensity may well tend to be missed. The effect that people with MDD are more confident about Despite the importance of body language in social functioning, rating the valence of negative emotional interactions could be this is the first study to examine the relationship between affective interpreted in line with previous findings reporting an increased disorders and the perception of emotions expressed through body vigilance and selective attention toward negative emotions in this movements. It is also the first study to use PLDs to investigate patient group (4, 12, 34, 35). People with depression may be more the differential effects of MDD on emotion perception, inten- vigilant and pay more attention when perceiving negative emo- sity of emotion, and confidence in rating the emotions present tional interactions, and therefore more confident when rating their in observed interactions. These displays of either one or two valence. They may be more familiar with experiencing negative persons interacting emotionally provided exclusively kinematic stimuli and therefore more confident about such perceptions. movement information and no facial expression. As predicted, The present data demonstrate a differentiated emotion per- the results show altered emotion perception in patients with ception in people with MDD compared to healthy controls. It is MDD compared to healthy controls. More precisely, a negative important to mention that emotions were perceived on the basis bias when rating negative emotional body movements emerged. of emotional body movements. Of course, facial expressions have People with MDD reported a higher intensity when perceiv- the function of imparting information about a person’s emotional ing negative emotional movements and were more confident state. However, body gestures do more than just that; they can about their ratings of negative emotional interactions than healthy also deliver cues on how best to behave in a certain situation. The controls. negatively biased misinterpretation of these “negative” behavioral Just like research on emotion perception of facial expression in cues can lead an observer to withdraw, because the expected conse- persons with MDD (4, 9–14), our findings show the same negative quences of approaching or staying are interpreted more negatively response bias toward interactions containing negative emotional than they really are (26). body movements in patients with MDD. Within this patient group, Especially, a negative bias could discourage patients with MDD interactions with aggressive, angry, or sad content led to more neg- from establishing social contacts, particularly when they observe ative evaluations than in a group of healthy controls. As in previous another person’s emotional body movements from a distance and research, this negative response bias occurred only when the emo- perceive and misinterpret those as negative or more negative than tional content of the interactions was negative but not when it was they actually are. This could lead them to avoid approaching this positive. The results can be interpreted in line with Beck’s cognitive person. Without active attempts to get in touch with other peo- theory of depression, in which people with depression are consid- ple, it is difficult to establish or broaden a social network that ered to hold dysfunctional attitudes that are activated by stressful could, in turn, lead to greater social support, a sense of belong- events and result in a negative cognitive bias (17). This then leads ing, and well-being. Hence, becoming aware that one’s judgments to the following interesting questions: how does this negative bias are based on a false interpretation of the emotion perception of influence social behavior? Which direction does this bias take? Is body movements could be another step toward reconsidering and it advantageous or disadvantageous to show this bias? These ques- maybe altering these judgments in order to avoid their negative tions are especially relevant when – as in the present study – the consequences (36, 37). Frontiers in Psychiatry | Affective Disorders and Psychosomatic Research January 2014 | Volume 5 | Article 4 | 6 Kaletsch et al. Emotion perception in point-light displays This is where a training could help to improve emotion percep- 9. Hale WW III, Jansen JHC, Bouhuys AL,Van Den Hoofdakker RH. The judgment tion and reduce negative misinterpretation and thereby eventually of facial expressions by depressed patients, their partners and controls. 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The effectiveness of training author(s) or licensor are credited and that the original publication in this journal is cited, to improve person perception accuracy: a meta-analysis. Basic Appl Soc Psych in accordance with accepted academic practice. No use, distribution or reproduction is (2012) 34:483–98. doi:10.1080/01973533.2012.728122 permitted which does not comply with these terms. Frontiers in Psychiatry | Affective Disorders and Psychosomatic Research January 2014 | Volume 5 | Article 4 | 8