Exploring the nature of facial affect processing deficits in schizophrenia (original) (raw)

Facial emotion processing in schizophrenia: a non-specific neuropsychological deficit?

BACKGROUND: Identification of facial emotions has been found to be impaired in schizophrenia but there are uncertainties about the neuropsychological specificity of the finding. METHOD: Twenty-two patients with schizophrenia and 20 healthy controls were given tests requiring identification of facial emotion, judgement of the intensity of emotional expressions without identification, familiar face recognition and the Benton Facial Recognition Test (BFRT). The schizophrenia patients were selected to be relatively intellectually preserved. RESULTS: The patients with schizophrenia showed no deficit in identifying facial emotion, although they were slower than the controls. They were, however, impaired on judging the intensity of emotional expression without identification. They showed impairment in recognizing familiar faces but not on the BFRT. CONCLUSIONS: When steps are taken to reduce the effects of general intellectual impairment, there is no deficit in identifying facial emotions in schizophrenia. There may, however, be a deficit in judging emotional intensity. The impairment found in naming familiar faces is consistent with other evidence of semantic memory impairment in the disorder.

Exploring the role of face processing in facial emotion recognition in schizophrenia

Acta Neuropsychiatrica, 2009

Objective: Impairment in emotion perception represents a fundamental feature of schizophrenia with important consequences in social functioning. A fundamental unresolved issue is the relationship between emotion perception and face perception. The aim of the present study was to examine whether facial identity recognition (Identity Discrimination) is a factor predicting facial emotion recognition in the context of the other factors, known as contributing to emotion perception, such as cognitive functions and symptoms. Methods: We enrolled 58 stable schizophrenic out-patients and 47 healthy subjects. Facial identity recognition and emotion perception were assessed with the Comprehensive Affect Testing System. Different multiple regression models with backward elimination were performed in order to discover the relation of each significant variable with emotion perception. Results: In a regression including the six significant variables (age, positive symptomatology, Identity Discrimination, attentive functions, verbal memory-learning, executive functions) versus emotion processing, only attentive functions (standardised β = 0.264, p = 0.038) and Identity Discrimination (standardised β = 0.279, p = 0.029) reached a significant level. Two partial regressions were performed including five variables, one excluding attentive functions and the other excluding Identity Discrimination. When we excluded attentive functions, the only significant variable was Identity Discrimination (standardised β = 0.278, p = 0.032). When we excluded Identity Discrimination, both verbal memory-learning (standardised β = 0.261, p = 0.042) and executive functions (standardised β = 0.253, p = 0.048) were significant. Conclusions: Our results emphasised the role of face perception and attentional abilities on affect perception in schizophrenia. We additionally found a role of verbal memory-learning and executive functions on emotion perception. The relationship between those above-mentioned variables and emotion processing could have implications for cognitive rehabilitation.

Facial Emotion Recognition in Schizophrenia: Intensity Effects and Error Pattern

American Journal of Psychiatry, 2003

ObjectiveaaPrevious studies reported gender differences for facial emotion recognition in healthy people, with women performing better than men. Few studies that examined gender differences for facial emotion recognition in schizophrenia brought out inconsistent findings. The aim of this study is to investigate gender differences for facial emotion identification and discrimination abilities in patients with schizophrenia. Methodsaa35 female and 35 male patients with schizophrenia, along with 35 female and 35 male healthy controls were included in the study. All the subjects were evaluated with Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT), and Benton Facial Recognition Test (BFRT). Patients' psychopathological symptoms were rated by means of the Positive and Negative Syndrome Scale (PANSS). ResultsaaMale patients performed significantly worse than female patients on FEIT total, and negative scores. Male controls performed significantly worse than female controls on FEIT total and negative scores. On all tasks, female patients performed comparable with controls. Male patients performed significantly worse than controls on FEIT, and FEDT. ConclusionaaWomen with schizophrenia outperformed men for facial emotion recognition ability in a pattern that is similar with the healthy controls. It could be claimed that male patients with schizophrenia need special consideration for emotion perception deficits. Psychiatry Investig 2013;10:69-74

Facial emotion processing in schizophrenia: a review of behavioural and neural correlates

International Journal of Clinical Neurosciences and Mental Health, 2017

Schizophrenia is one of the most severe psychiatric conditions, often associated with deficits in social cognition. Social cognition deficits are predictors of functionality in patients and involve theory of mind, attributional style, social perception , and emotional processing. In particular, facial emotion processing (an important domain of emotional processing) seems to be particularly related to cognitive and social functioning, and to positive and negative symptoms. Patients with schizophrenia have difficulties in processing emotional faces; however, those impairments are still far from fully understood. In this review, we addressed the behavioural and neural correlates of facial emotion processing in schizophrenia. Despite studies showing impairments in both positive and negative faces, the most consistent findings involved negative faces. Moreover, patients with schizophrenia showed abnormalities in the social brain neural circuit during facial emotion processing. While some studies described hypoactivation of brain areas related to emotional processing, such as the amygdala, others reported hyperactivation, leading to a high number of inconsistencies. The findings are limited by the experimental designs used, and the clinical and demographic characteristics of patients. Despite such variable findings, there has been growing interest in developing psychosocial interventions focused directly on social cognitive impairments in schizophrenia, with potential impact on patient's ability to perceive emotional faces. We provide a critical perspective on current evidence and suggest new pathways of research. The understanding of the mechanisms underlying facial emotion processing in schizophrenia could enhance functionality and quality of life by providing innovative approaches to the interpersonal difficulties patients frequently experience.

Selective attention to facial emotion and identity in schizophrenia

Neuropsychologia, 2002

The selective attention to facial emotion and identity was investigated in 12 patients with schizophrenia and 12 healthy participants. Both patients and controls were required to perform two classification tasks (according either to identity or emotion). Two separate values for identity (person A/person B) and for emotion (fear/anger) were used. When the classification task was on one dimension, the other dimension was either correlated, constant, or orthogonal (Garner WR. The Processing of Information and Structure. Potomac, MD: Erlbaum, 1974, Garner WR. Interaction of stimulus dimensions in concept and choice processes. Cognitive Psychology 1976;8:98-123). Results indicated that both patients and healthy participants had an asymmetrical pattern of performance: they were able to selectively attend to the identity of the face presented, regardless of the emotion expressed on the face, but variation in identity interfered with the classification of facial emotion. Moreover, a correlational study indicated that the identity interference on emotion classification for schizophrenic patients covaried with the severity of their negative symptoms. The selective attention competencies in schizophrenia and the independence hypothesis of emotion and face recognition are discussed in the framework of current face recognition models.

Deficits in Facial-affect Recognition and Schizophrenia

Schizophrenia Bulletin, 1988

It has been widely demonstrated that schizophrenic patients show a broad range of deficits in interpersonal skills. Recently, considerable attention has been focused on the ability of these patients to decode affective cues. This article reviews findings about facial-affect recognition in schizophrenia. While the literature on this topic is extensive, many investigations have suffered from significant methodological shortcomings. Strategies to resolve these shortcomings are presented. Possible relationships between problems of affect recognition and other symptoms that characterize schizophrenia are discussed. Neurological mechanisms of facial-affect recognition are reviewed and related to data on lateralized neurological impairment in schizophrenia. Suggestions for future research emphasize careful consideration of affect-recognition deficits in relation to other parameters of schizophrenia.

Deficits in Degraded Facial Affect Labeling in Schizophrenia and Borderline Personality Disorder

PLOS ONE, 2016

Although deficits in facial affect processing have been reported in schizophrenia as well as in borderline personality disorder (BPD), these disorders have not yet been directly compared on facial affect labeling. Using degraded stimuli portraying neutral, angry, fearful and angry facial expressions, we hypothesized more errors in labeling negative facial expressions in patients with schizophrenia compared to healthy controls. Patients with BPD were expected to have difficulty in labeling neutral expressions and to display a bias towards a negative attribution when wrongly labeling neutral faces. Patients with schizophrenia (N = 57) and patients with BPD (N = 30) were compared to patients with somatoform disorder (SoD, a psychiatric control group; N = 25) and healthy control participants (N = 41) on facial affect labeling accuracy and type of misattributions. Patients with schizophrenia showed deficits in labeling angry and fearful expressions compared to the healthy control group and patients with BPD showed deficits in labeling neutral expressions compared to the healthy control group. Schizophrenia and BPD patients did not differ significantly from each other when labeling any of the facial expressions. Compared to SoD patients, schizophrenia patients showed deficits on fearful expressions, but BPD did not significantly differ from SoD patients on any of the facial expressions. With respect to the type of misattributions, BPD patients mistook neutral expressions more often for fearful expressions compared to schizophrenia patients and healthy controls, and less often for happy compared to schizophrenia patients. These findings suggest that although schizophrenia and BPD patients demonstrate different as well as similar facial affect labeling deficits, BPD may be associated with a tendency to detect negative affect in neutral expressions.