Classification of facial expressions of emotion and risk for suicidal ideation in children of depressed mothers: Evidence from cross-sectional and prospective analyses

Background Despite the increased risk for suicidal ideation (SI) in children of mothers with a history of major depressive disorder (MDD), little is known about specific risk factors for SI in these children. The present study is the first to our knowledge to examine the potential role of biases in the identification of facial expressions of emotion. Methods Participants were 202 children (aged 8-14 years) and their mothers (aged 24-55 years) that comprised three groups based on maternal history of MDD and children's history of SI: Mom MDD/Child SI (n=35); Mom MDD/No Child SI (n=76); and Controls (i.e., no mom MDD and no child SI; n=91). Results We found that children in the Mom MDD/Child SI group were more likely to misclassify full-intensity angry emotions as sad than children in the other groups. Among children in the two mother MDD groups, both the overall proportion of full-intensity angry emotions misclassified and the proportion of full-intensity angry emotions misclassified specifically as sad predicted the occurrence of SI over a 2-year follow-up, even after accounting for the impact of children's own diagnoses of MDD during the follow up. Limitations Our findings might not generalize to other negative emotions, such as fear or disgust. Conclusion This highlights specific emotion identification abnormalities that could be targeted in early suicide prevention efforts and suggests that these abnormalities are at least partially independent of children's risk for MDD.