Perception bias of disgust in ambiguous facial expressions in obsessive–compulsive disorder

Impaired recognition of facial expressions of disgust has been suggested for patients with obsessive–compulsive disorder (OCD). This study aimed to compare the perception of negative emotions by OCD patients and controls using both non-ambiguous and ambiguous facial expressions. Forty-one OCD patients and thirty-seven controls performed the computerised emotion perception task. There were no differences between OCD patients and controls in the frequency of correct identification of non-ambiguous facial expressions. However, OCD patients were more likely to perceive disgust and less likely to perceive anger in response to ambiguous facial expressions when controlling for covariates. In OCD patients, a higher cleaning dimension was associated with a lower perception of anger and a higher perception of disgust when presented with ambiguous facial expressions. The domains of core disgust and contamination-based disgust domains of disgust sensitivity were positively correlated with the perception of ambiguous facial expressions as disgust, as well as cleaning symptom dimension scores. Our findings suggest that OCD patients, particularly those with higher washing/contamination symptoms, are more likely to perceive disgust in ambiguous facial expressions.