Online Supplement: Examination of the role ofcategorical MDD and GAD diagnosis on emotional face identification ability in adolescents who have attempted suicide or engage in non-suicidal self-injury (NSSI).
Follow-up Analyses of SA and NSSI participants with MDD
Given small subject numbers in each cell and lack of power, a follow up2 (MDD/no MDD) x 2 (NSSI /SA) ANOVA was precluded. Therefore, we compared emotional face identification ability in SA (n=22)and NSSI(n=28) participants diagnosed with MDD.
On child faces, group comparisons showed no significant group differences on total face errors (U=299.50, Z=-0.17, p=0.87) or errors on child happy (U=277.00, Z=-1.29, p=0.20), angry (U=281.00, Z=-0.56, p=0.58), sad (U=293.00, Z=-0.42, p=0.67) or fearful (U=282.00, Z=-0.55, p=0.59) faces.
On adult faces, no significant group differences were found for total errors (U=273.50, Z=-0.70, p=0.49) or errors on adult happy (U=287.00, Z=-0.49, p=0.63), angry (U=223.50, Z=-1.86, p=0.06), sad (U=268.00, Z=-0.83, p=0.41) or fearful (U=221.50, Z=-1.79, p=0.07) faces.
Follow-up Analyses of SA and NSSI participants with GAD
Afollow up2 (GAD/no GAD) x 2 (NSSI /SA) ANOVA was precludedgiven small subject numbers in each cell and lack of power. Instead, we compared DANVA performance between SA participants with GAD (n=6) and NSSI participants with GAD(n=12). Results showed no significant between group differences on child face total errors (U=36.00, Z=-0.00, p=1.00) or errors on child happy (U=30.00, Z=-1.41, p=0.16), angry (U=35.50, Z=-0.05, p=0.96), sad (U=30.00, Z=-1.03, p=0.30) or fearful (U=35.50, Z=-0.05, p=0.96) faces.Similarly, we did not find significant between-group differences on adult face total errors (U=26.00, Z=-0.98, p=0.33) or errors on adult happy (U=30.00, Z=-1.03, p=0.30), angry (U=20.50, Z=-1.57, p=0.12), sad (U=34.50, Z=-0.15, p=0.88) or fearful (U=28.00, Z=-0.83, p=0.41) faces.
Examination of SSRI medication status on emotional face processing.
Since the large majority of our SA and NSSI participants were being treated with SSRI medication, we examined the effects of SSRI medication on emotional face identification. Specifically, 73% (22/30) of the NSSI group and 47% (14/30) of the SA group were receiving SSRI medication. A group comparison showed that significantly more NSSI than SA participants were receiving SSRIs, χ2(1,N=60)=0.04.
Group comparisons for child and adult emotional face recognition variables are presented in Table S1.
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Examination of child emotional faces showed no significant group differences for child happy, sad, angry or fearful face recognition.
Examination of adult emotional face recognition showed a significant group difference between the NSSI and TDC group on adult sad faces in which adolescents in the NSSI group made significantly more recognition errors for adult sad faces than TDC adolescents (d=0.29, p=0.013). Further, adolescents in the SA group also made significantly more recognition errors for adult sad faces than TDC adolescents (d =.14, p= 0.046) NSSI and SA groups did not differ on adult sad face recognition. SA and TDC groups did not differ on adult sad face recognition errors. No group differences were shown for adult happy, angry or fearful faces.
Table S1. Table 3. Group differences in emotional face recognition controlling for MDD and GAD diagnosis and SSRI status
Groups / Group Comparisons(p-values)
SA (n=30) / NSSI (n=30) / TDC (n=30) / TDC vs NSSI / TDC vs. SA / SA vs. NSSI
Child Face Errors
Happy / 0.02 ± 0.42 / −0.10 ± 0.22 / 0.09 ± 0.56 / .24 / .55 / .29
Angry / −0.07 ± 0.52 / 0.02 ± 0.55 / 0.05 ± 0.62 / .67 / .48 / .78
Sad / 0.04 ± 0.64 / −0.00 ± 0.62 / −0.03 ± 0.54 / .53 / .66 / .68
Fearful / 0.04 ± 0.88 / 0.06 ± 0.71 / −0.10 ± 0.74 / .97 / .89 / .80
Adult Face Errors
Happy / −0.03 ± 0.32 / 0.01 ± 0.30 / 0.02 ± 0.38 / .83 / .43 / .47
Angry / 0.05 ± 0.18 / −0.04 ± 0.25 / −0.01 ± 0.34 / .54 / .85 / .22
Sad / −0.00 ± 0.29 / 0.04 ± 0.29 / −0.04 ± 0.28 / .013 / .046 / .19
Fearful / 0.03 ± 0.30 / −0.09 ± 0.30 / 0.05 ± 0.39 / .13 / .39 / .20
Note. Results presented as Mean±Standard Deviation of Rasch modeling derived factor scores with higher values indicating greater errors. P-values refer to the probability of observing a test statistic with an absolute value as or more extreme as estimated for the given contrast. Values less than p<0.05 are presented in bold typeface. GAD = generalized anxiety disorder, MDD= major depressive disorder, NSSI= non-suicidal self-injury, SA= suicide attempt, SSRI= selective serotonin reuptake inhibitor, TDC= typically developing controls.