Abstract

Developmental prosopagnosia (DP) is a condition that indicates the inability to recognize individuals by their faces from birth, without any history of brain damage. The assessment of face recognition ability and diagnosis of DP involve the use of face tests such as the Cambridge Face Memory Test (CFMT) and the Cambridge Face Perception Test, along with self-reported measures like the 20-Item Prosopagnosia Index (PI20). Face recognition accuracy is affected by anxiety. However, previous studies on the relationship between face recognition ability and anxiety have not used the PI20 measure. This study aimed to investigate the relationship between self-reported measures of face recognition ability and anxiety tendencies among healthy young individuals for DP diagnosis and its implications. We used a face recognition test, involving the PI20, CFMT, Visual Perception Test for Agnosia–Famous Face Test (VPTA–FFT), and State-Trait Anxiety Inventory (STAI). We assessed the performance of 116 Japanese young adults (75 females, median age of 20.7 years, with a standard deviation of 1.2). Subsequently, we conducted a statistical analysis to examine the relationship between the outcomes of the face recognition tests and STAI scores using Pearson correlation analysis and single correlation coefficients. The results showed a positive correlation between state anxiety and PI20 (r = 0.308, p = 0.007), and a weak positive correlation was also observed between trait anxiety and PI20 (r = 0.268, p = 0.04). In contrast, there was no correlation between CFMT and VPTA–FFT with respect to STAI. The results of the hierarchical multiple regression analysis also suggested that the correlation between the performance on the PI20 (self-report) and objective measures of face recognition performance (the CFMT and the VPTA–FFT) are driven by differences in anxiety. This study is the first to explore the relationship between face recognition abilities and anxiety using the PI20 self-report measure. There are implications for future research on the diagnosis of DP and the relationship between anxiety and face recognition.

Introduction

Face recognition ability enables individuals to differentiate and identify faces, playing a crucial role in interpersonal recognition and everyday communication. Clinical and functional imaging studies have highlighted that brain lesions, particularly in regions such as the fusiform gyrus, can lead to face recognition impairment. In recent years, there has been a growing interest in the field of face recognition research regarding developmental prosopagnosia (DP). DP refers to a condition in which individuals experience lifelong impairments in face recognition despite possessing normal visual and intellectual capabilities since birth. Clinically, there is no indication of overt central nervous system disorders, and neuroimaging studies also reveal the absence of organic brain lesions (Bate & Tree, 2017; Behrmann & Avidan, 2005; Cook & Biotti, 2016; Duchaine & Nakayama, 2006a). Epidemiological studies in Europe and Asia have reported a prevalence rate of approximately 1.9 %–۲٫۹ % of the population (Bowles et al., 2009; Kennerknecht et al., 2006; Kennerknecht et al., 2008). People with DP encounter challenges and psychosocial difficulties in their interpersonal interactions due to impaired face recognition (Yardley et al., 2008). Early diagnosis and support are crucial, especially before adulthood and entering the workforce.

Currently, diagnosing DP presents challenges due to the absence of established strict objective criteria or biological markers (Barton & Corrow, 2016; Susilo & Duchaine, 2013). Previous studies have revealed ambiguous criteria for diagnosing DP and differentiating it from conditions other than DP in face recognition tests (Bate & Tree, 2017; Dalrymple & Palermo, 2016). Dalrymple and Palermo (2016) provided guidelines that define DP as objectively poor performance on face memory tests and a subjective feeling of repeated face recognition failures in daily life. The authors emphasized the importance of using questionnaires and interviews to assess face recognition difficulties in daily life and highlighted the limitations of relying solely on questionnaires for DP diagnosis, as individuals with DP may lack accurate insight into their own face recognition abilities.

Conclusions

The present study is the first to investigate the relationship between self-reported face recognition abilities and anxiety in young, healthy Japanese individuals using the self-perception face recognition test PI20. The findings indicated that unlike the objective face recognition tests CFMT and VPTA–FFT that showed no association with anxiety, the self-perception test scores may be influenced by state anxiety. Self-reporting, at least in its current form, provides limited insights into predicting face recognition performance in young individuals and diagnosing DP. Therefore, self-reporting is insufficient to evaluate face recognition abilities in young individuals, and DP cannot be diagnosed solely based on self-perception tests. It is necessary to combine self-perceived indicators of face recognition impairment with other perception-based face recognition function tests and consider the presence and extent of anxiety tendencies. Our findings have significant psychological implications for understanding face recognition impairments, DP diagnosis, and clinical practices. In the future, expanding research to investigate the interaction between facial and expression recognition abilities and anxiety is expected to enhance the accurate diagnosis and support for young individuals with facial recognition impairments.