Impact of Clinical Complexity on Fear Prediction and Face Recognition in Emotional Processing

Poster Session D - Monday, March 31, 2025, 8:00 – 10:00 am EDT, Back Bay Ballroom/Republic Ballroom

Hamza Suhail¹, Ali Arain¹, Paige Broski¹, Luna Malloy¹, Elizabeth A. Bauer¹, John Leri¹, Josh Cisler¹; ¹The University of Texas at Austin Dell Medical School

This study examined how psychiatric comorbidity—including multiple diagnostic categories and cumulative disorder burden—modulates neurocircuitry engagement as predicted by support vector machine (SVM) classifiers. Given evidence of threat-related hypervigilance in anxiety and posttraumatic stress disorder, we hypothesized that comorbidity would predict higher neurocircuitry engagement in emotion-processing regions towards social threat signals. Adult participants (N=134) completed an emotional face processing task during fMRI, viewing facial stimuli of distinct valence (fearful, neutral) and duration (overt/500ms, covert/33ms). SVM were used to build classifiers to predict fear vs. neutral faces, or neutral faces from fixation, based on multivariate patterns of brain activity within three networks of interest: bilateral amygdala, salience, and ventral visual network. Linear mixed-effects models were used to assess interactions between psychiatric diagnoses, stimulus duration, and valence on neural activation. Higher comorbidity, anxiety disorders, and cumulative disorder burden were associated with reduced fear predictions from the SVM classifier using multivariate patterns from the bilateral amygdala network (p<0.05). In the salience network, a duration × comorbidity interaction (p=0.040) demonstrated diminished SVM fear predictions in highly comorbid individuals for overt fear faces. Anxiety disorders predicted greater amygdala and salience network SVM face predictions (p<0.05). These findings indicate that comorbidity is associated with altered neural responses to emotional faces and face processing, such that distinct comorbidity profiles were associated with diminished fear-related amygdala engagement. However, heightened amygdala and salience engagement was demonstrated toward social stimuli. These results provide insight into disorder-specific neural mechanisms underlying emotional dysregulation in psychiatric populations.

Topic Area: EMOTION & SOCIAL: Emotional responding