Deficits in recognition of emotional facial expression are still present in alcoholics after mid- to long-term abstinence.

OBJECTIVE Emotional facial expression (EFE) decoding skills play a key role in interpersonal relationships. Decoding errors have been described in several pathological conditions, including alcoholism. The aim of this study was to investigate whether EFE decoding skill deficits persist after abstention from alcohol of at least 2 months. METHOD Alcoholic patients abstinent for at least 2 months (n = 25) were compared with 25 recently detoxified patients and with 25 normal controls matched for age, gender and educational level. Subjects were presented with 40 photographs of facial expressions portraying happiness, anger, sadness, disgust and fear. Each emotion was displayed with neutral, mild, moderate and strong emotional intensity. Each facial expression was judged successively on eight scales labeled happiness, sadness, fear, anger, disgust, surprise, shame and contempt. For each scale, subjects rated the estimated intensity level. A complementary scale assessed the self-estimated difficulty in performing the task. RESULTS Recently detoxified alcoholics were significantly less accurate than controls, making more EFE labeling errors and overestimating the intensity of the portrayed emotions. Deficits in decoding accuracy for anger and disgust were present in mid- to long-term abstinent patients; intensity overestimation was present in the former and absent in the latter. CONCLUSIONS Deficits in decoding accuracy for anger and disgust, and to a lesser degree sadness, persist with an abstinence of 2 months and beyond. Right frontotemporal regions and cingulate could be implicated. These deficits may contribute to the social skills deficits frequently encountered in alcoholic patients.