Janine Bacher

Facial emotion recognition (FER) biases refer to systematic tendencies to recognize specific emotions when processing facial expressions. In youths with conduct disorder (CD), who are characterized by highly impairing antisocial behavior, research on FER biases has focused on hostile attribution biases. This work has shown that youths with CD perceive ambiguous social cues as angry. However, youths with CD may not only show biases towards anger, which is why we investigated FER biases in youths with CD towards the six basic emotions. Within the European FemNAT-CD study, we analyzed data from 610 youths with CD (60% female) and 818 typically developing controls (TDCs; 68% female), aged 9 to 18 years ( M = 14.1, SD = 2.41 years). FER biases were assessed using the Emotion Hexagon Task by showing morphed emotional expressions and asking participants to choose the predominant emotion. Biases were calculated as tendency towards an emotion shown at 0%, 10%, 30%, or 50% intensity. Our findings from hierarchical linear modelling indicate that youths with CD exhibited stronger FER biases than TDCs across all emotions, meaning that they misclassified each emotion more often. However, this difference varied by intensity, with youths with CD displaying weaker biases at higher intensity levels and a smaller increase in bias with increasing intensity level. Our findings indicate that youths with CD not only show a hostile attribution bias but rather misclassify emotions as predominant when they are present at low intensity, regardless of type of emotion.

Background: Adolescent refugees are particularly vulnerable to mental health problems, as they experience many risk factors associated with their resettlement at crucial stages of their physical and emotional development. However, despite having a greater healthcare needs than others, they face significant barriers to accessing healthcare services. Therefore, this study aims to test the effectiveness of a low-threshold, culturally adapted version of the skills training START NOW – START NOW Adapted - in reducing mental health problems among adolescent refugees.Methods: We will recruit 80 adolescent refugees (15–18 years) with symptoms of anxiety and depression or high perceived stress in Northwestern Switzerland. They will be randomly assigned to one of two study groups: an intervention group, receiving START NOW Adapted, and a control group, receiving treatment as usual (TAU). The intervention will last 10 weeks and will consist of one-hour sessions per week provided by a trained facilitator with the same cultural background, in the respective language. Assessments to collect depressive and anxious symptoms, perceived stress, social-ecological resilience, and emotion recognition abilities will be conducted pre-intervention, post-intervention (11 weeks later) and at the 3-month follow-up. Multilevel models will be computed with primary and secondary outcome measures as dependent variables. An effect of at least moderate size will be considered clinically relevant.Discussion: This randomized controlled trial aims to investigate the effectiveness of a culturally adapted version of START NOW, providing valuable insights to improve current health promotion for adolescent refugees in Switzerland (or rather lack thereof). Ultimately, the effects of START NOW may facilitate integration and promote healthy development while decreasing costs associated with treating migration- or conflict-related trauma.Clinical trial registration:ClinicalTrials.gov, identifier: NCT06324864.