Neutral face distractors differentiate performance between depressed and healthy adolescents during an emotional working memory task

Lucy R. Tavitian, Cecile D. Ladouceur, Ziad Nahas, Beatrice Khater, David A. Brent, Fadi T. Maalouf

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21 Scopus citations


The aim of the present study is to examine the effect of neutral and emotional facial expressions on voluntary attentional control using a working memory (WM) task in adolescents with major depressive disorder (MDD). We administered the Emotional Face n-back (EFNBACK) task, a visual WM task with neutral, happy and angry faces as distractors to 22 adolescents with MDD (mean age 15.7 years) and 21 healthy controls (HC) (mean age 14.7 years). There was a significant group by distractor type interaction (p = 0.045) for mean percent accuracy rates. Group comparisons showed that MDD youth were less accurate on neutral trials than HC (p = 0.027). The two groups did not differ on angry, happy and blank trials (p > 0.05). Reaction time did not differ across groups. In addition, when comparing the differences between accuracies on neutral trials and each of the happy and angry trials, respectively [(HAP-NEUT) and (ANG-NEUT)], there was a group effect on (HAP-NEUT) where the difference was larger in MDD than HC (p = 0.009) but not on ANG-NEUT (p > 0.05). Findings were independent of memory load. Findings indicate that attentional control to neutral faces is impaired and negatively affected performance on a WM task in adolescents with MDD. Such an impact of neutral faces on attentional control in MDD may be at the core of the social-cognitive impairment observed in this population.

Original languageEnglish (US)
Pages (from-to)659-667
Number of pages9
JournalEuropean Child and Adolescent Psychiatry
Issue number8
StatePublished - Aug 2014

Bibliographical note

Funding Information:
The authors would like to acknowledge the grant support from the American Foundation for Suicide Prevention (PI: F. Maalouf) and the Medical Practice Plan-Faculty of Medicine at the American University of Beirut (PI: F. Maalouf). The authors would also like to acknowledge the contribution of the research team (Ms. Mia Atwi, Ms. Camelia Hatoum and Dr. Nayla Hariz) for their help in recruiting and conducting the clinical and neuropsychiatric assessments and would like to thank the participating adolescents and their families.

Funding Information:
Dr. Maalouf has received research funding from the American Foundation of Suicide Prevention. He has consulted Eli Lilly and is on the speaker bureau of Servier and Hikma pharmaceuticals. Dr. Brent works for the University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Western Psychiatric Institute in Clinic. He also has research projects funded by the National Institute of Mental Health. Dr. Brent has received royalties from Guilford Press and eResearch Technology. He is the editor of UpToDate Psychiatry and receives Honoraria from Oxford Press and Honoraria for presenting at Continuing Medical Education events. Ms. Tavitian, Dr. Ladouceur, Dr. Khater and Dr. Nahas declare no conflict of interest.


  • Adolescent
  • Attentional control
  • Depression
  • Emotion processing
  • Emotional distracters


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