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Description: One of the largest concerns after the task of finding a treatment for depression that seems to relieve symptoms has been accomplished is wondering whether the individual will suffer a relapse of their depressive symptoms at some future point. Markers that could be used to monitor for the likelihood of relapse would be valuable, especially if they did not require expensive or complicated tests and could be administered in a physician’s office. With such markers, appropriate follow-up and monitoring plans for patients who have struggled with depression could be made. The article linked below describes research conducted looking at pupil responses (dilation) in relation to the presentation of angry or sad faces. Before you read the article think about two things. First of all, what possible relationship might there be between pupil dilation and the presentation of facial expressions? Second, why might there be a relationship between these things? Once you have thought about these two questions read the article and see whether one or both or neither of them are answered by the research described.

Source: Pupil Response to Sad, Angry Faces May Determine Risk for Depression Relapse, Traci Pedersen, PsychCentral.

Date: November 6, 2016


Links:  Article Link —

The research described in the article linked above showed that there was a clear relationship between responsivity to angry facial expressions as indicated by higher or lower than average levels of pupil dilation and relapse or recurrence of depressive symptoms in the women in the study who had previously been treated for a major depressive disorder (MDD). Low rates of dilation to the presentation of sad faces also predicted depressive relapse whereas high rates of dilation to the presentation of sad faces actually seem to predict lower than average rates of recurrence of depressive symptoms. Taken together these results positively answer the first question that I raised above. That is, that these reactions can be relatively easily assessed in a physician’s office and used to plan follow-up protocols for patients who have been treated for clinical depression in the past. What the linked article does not do as even remotely address the second question of why this connection was hypothesized to exist in the first place. The authors of the research article (which you can access a PDF in the references section below) indicate in their write-up of their research that there’s been a history of research showing a relationship between differential pupil responses to facial expressions and images with emotional content and that the pupil responses are the result of a number of connections between the eye and various processing centres higher up in the brain. Based on what you know about the various centres of the brain and the types of processing they are involved in you could speculate a little bit about what the pupil responses might actually be linked to at the level of emotional processing in the brain.

Questions for Discussion:

  1. What advantages would there be to being able to use a pupil response test when planning follow-up protocols for people treated for MDD??
  2. Why might it be that the pupils of our eyes show a response when we are presented with happy or sad faces?
  3. Can you think of any other conditions or circumstances where the sort of pupil reaction test might be helpful in planning follow-up or interventions with medical patients or clinical psychological clients?

References (Read Further):

Kudinova, A. Y., Burkhouse, K. L., Siegle, G., Owens, M., Woody, M. L., & Gibb, B. E. (2016). Pupillary reactivity to negative stimuli prospectively predicts recurrence of major depressive disorder in women. Psychophysiology. doi: 10.1093/bmb/65.1.193

Mayberg, H. S., 2003. Modulating dysfunctional limbic-cortical circuits in depression: Towards development of brain-based algorithms for diagnosis and optimized treatment. British Medical Bulletins, 65, 193–207.


Urry, H. L., van Reekum, C. M., Johnstone, T., Kalin, N. H., Thurow, M. E., Schaefer, H. S., Davidson, R. J. (2006). Amygdala and ventromedial prefrontal cortex are inversely coupled during regulation of negative affect and predict the diurnal pattern of cortisol secretion among older adults. Journal of Neuroscience, 26, 4415–4425. doi: 10.1523/JNEUROSCI.3215-05.2006


Siegle, G. J., Steinhauer, S. R., Carter, C. S., Ramel, W., & Thase, M. E. (2003). Do the seconds turn into hours? Relationships between sustained pupil dilation in response to emotional information and self-reported rumination. Cognitive Therapy Research, 27, 365–382.


Siegle, G. J., Steinhauer, S. R., Friedman, E. S., Thompson, W. S.,& Thase, M. E. (2011). Remission prognosis for cognitive therapy for recurrent depression using the pupil: Utility and neural correlates. Biological Psychiatry, 69, 726–733. doi: 10.1016/j.biopsych.2010.12.041


Siegle, G. J., Steinhauer, S. R., Stenger, V. A., Konecky, R., & Carter, C. S. (2003). Use of concurrent pupil dilation assessment to inform interpretation and analysis of fMRI data. NeuroImage, 20, 114–124. doi:10.1016/S1053-8119(03)00298-2