Perceptual and emotional processing deficits in severe alcohol use disorder: The role of spatial frequency

Emotional facial expression decoding deficits are consistently reported in severe Alcohol Use Disorder (sAUD), hampering social interactions and promoting relapse. Individuals with sAUD also exhibit visuo-perceptive deficits, persisting despite abstinence. However, these two key impairments of sAUD have never been considered simultaneously. We explored the role of perception in emotional facial expression processing by directly manipulating the spatial frequency of emotional faces. Thirty-one patients and 30 matched healthy controls performed emotional detection, discrimination, and labeling tasks involving low-pass, high-pass, and unfiltered faces (expressing anger, disgust, fear, and happiness). Results revealed that decoding impairments in sAUD were modulated by spatial frequencies and perceptual demands of the tasks. They also indicated a predominant role for high spatial frequencies in emotional decoding deficits, suggesting that patients have specific difficulties to process fine emotional facial cues, particularly those conveying disgust and anger. This study highlights the need to reconsider the role of low-level processes, and particularly perception, in the socio-affective profile of patients, and supports a combined perceptual-emotional interpretation of the deficits. • Severe alcohol use disorder is linked to deficits in facial expression decoding. • Current explanations focus on impaired decision-making, neglecting perception. • We found alterations for basic visual content, especially high spatial frequency. • Processing of facial details could be impaired, especially for anger and disgust. • This may have implications for daily functioning and inform therapeutic strategies.