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Increasing numbers of youths are diagnosed with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>, and many adults with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> report that their symptoms started in childhood, suggesting that <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> can be a developmental disorder. Studies advancing our understanding of <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> have shown alterations in facial emotion recognition both in children and adults with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> compared to healthy comparison (<jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content>) participants, but none have evaluated the development of these deficits. To address this, we examined the effect of age on facial emotion recognition in a sample that included children and adults with confirmed childhood\u2010onset type\u2010I <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content>, with the adults having been diagnosed and followed since childhood by the Course and Outcome in Bipolar Youth study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using the Diagnostic Analysis of Non\u2010Verbal Accuracy, we compared facial emotion recognition errors among participants with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> (n\u00a0=\u00a066; ages 7\u201326\u00a0years) and <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content> participants (n\u00a0=\u00a087; ages 7\u201325\u00a0years). Complementary analyses investigated errors for child and adult faces.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A significant diagnosis\u2010by\u2010age interaction indicated that younger <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> participants performed worse than expected relative to <jats:styled-content style=\"fixed-case\">HC<\/jats:styled-content> participants their own age. The deficits occurred both for child and adult faces and were particularly strong for angry child faces, which were most often mistaken as sad. Our results were not influenced by medications, comorbidities\/substance use, or mood state\/global functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Younger individuals with <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> are worse than their peers at this important social skill. This deficit may be an important developmentally salient treatment target \u2013 that is, for cognitive remediation to improve <jats:styled-content style=\"fixed-case\">BD<\/jats:styled-content> youths\u2019 emotion recognition abilities.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bdi.12312","type":"journal-article","created":{"date-parts":[[2015,5,8]],"date-time":"2015-05-08T09:19:02Z","timestamp":1431076742000},"page":"471-485","source":"Crossref","is-referenced-by-count":25,"title":["Facial emotion recognition in childhood\u2010onset bipolar I disorder: an evaluation of developmental differences between youths and adults"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5887-1392","authenticated-orcid":false,"given":"Ezra","family":"Wegbreit","sequence":"first","affiliation":[{"name":"Pediatric Mood, Imaging, and NeuroDevelopment (PediMIND) Program Bradley Hospital East Providence RI USA"},{"name":"Department of Psychiatry and Human Behavior Division 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