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Chiang SK, Lai SM, Hu TM. Social cognition and apathy between two cognitive subtypes of schizophrenia: Are there the same or different profiles? Schizophr Res Cogn 2023; 33:100287. [PMID: 37214255 PMCID: PMC10196718 DOI: 10.1016/j.scog.2023.100287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 04/30/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023]
Abstract
Objective Cognitive impairment is an essential feature of schizophrenia, and it involves a broad array of nonsocial and social cognitive domains. This study aimed to examine whether there are the same or different social cognition profiles between two cognitive subtypes of schizophrenia. Method There were one hundred and two chronic and institutionalized patients with schizophrenia from two referral tracks. One group is "Cognitively Normal Range" (CNR) (N = 52), and another group is "Below Normal Range" (BNR) (N = 50). We assessed or collected their apathy, emotional perception judgment, facial expression judgment, and empathy by the Apathy Evaluation Scale, the International Affective Picture System, the Japanese and Caucasian Facial Expression of Emotion, and the Interpersonal Reactivity Index, respectively. Results We found different impairment profiles depending on the cognitive subtypes of the patient with schizophrenia. Surprisingly, the CNR presented impairments in apathy, emotional perception judgment, facial expression judgment, and empathy and feature impairment in empathy and affective apathy. In contrast, even though the BNR had significant neurocognition impairments, they had almost intact empathy with significantly impaired cognitive apathy. Both groups' global deficit scores (GDSs) were comparable, and all reached at least a mild impairment level. Conclusions The CNR and the BNR had similar abilities in emotional perception judgment and facial emotion recognition. They also had differentiable deficits in apathy and empathy. Our findings provide important clinical implications for neuropsychological pathology and treatment in schizophrenia.
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Affiliation(s)
- Shih-Kuang Chiang
- Department of Counselling and Clinical Psychology, National Dong Hwa University, No. 1, Sec. 2, Da Hsueh Rd., Shoufeng, Hualien county 974301, Taiwan, ROC
| | - Shih-Min Lai
- Department of Counselling and Clinical Psychology, National Dong Hwa University, No. 1, Sec. 2, Da Hsueh Rd., Shoufeng, Hualien county 974301, Taiwan, ROC
| | - Tsung-Ming Hu
- Department of Psychiatry, Taipei Veterans General Hospital Yuli Branch, No. 91, Xinxing St., Yuli Township, Hualien County 98142, Taiwan, ROC
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Specific facial emotion recognition deficits across the course of psychosis: A comparison of individuals with low-risk, high-risk, first-episode psychosis and multi-episode schizophrenia-spectrum disorders. Psychiatry Res 2023; 320:115029. [PMID: 36586376 DOI: 10.1016/j.psychres.2022.115029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 12/26/2022]
Abstract
Our study aimed to explore the recognition of specific emotions across the course of psychosis. A visual task representing the six basic emotions was used to assess facial emotion recognition (FER) in 204 healthy controls classified into 152 low-risk (LR) and 52 high-risk for psychosis (HR), following a psychometric risk approach; and 100 patients: 44 with first-episode psychosis (FEP) and 56 with multi-episode schizophrenia-spectrum disorders (MES). First, we performed a MANCOVA to compare the four conditions. Next, we conducted a logistic regression to explore whether specific FER deficits predicted the presence of psychosis. Finally, we investigated the relationships of FER with psychosis-like experiences (PLEs) and psychotic symptoms. Global FER, anger and fear recognition were impaired in HR, FEP and MES. No differences between HR and FEP appeared. Moreover, fear and anger correctly classified 83% of individuals into LR or psychosis. FER was associated with PLEs and psychotic symptoms. Concluding, FER is early impaired in HR individuals and increases along the psychosis continuum. However, fear recognition is similarly impaired throughout the illness, suggesting a possible vulnerability marker. Furthermore, deficits in anger and fear recognition predicted the presence of psychosis. Therefore, we suggest that FER may be essential in detecting psychosis risk.
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Wang YH, Wang XF, Shi LD, Xu XM, Wei LN, Li SS, Li XP, Ma XL, Li ZM, Wei XZ, Wang Q, Wang KQ. A retrospective case-control study of facial emotion recognition in male veterans with chronic schizophrenia and its correlation with interpersonal communication. BMC Psychiatry 2023; 23:47. [PMID: 36653828 PMCID: PMC9847099 DOI: 10.1186/s12888-022-04498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/26/2022] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To understand the facial emotion recognition of male veterans with chronic schizophrenia and the relationship between facial emotion recognition and interpersonal communication to provide a reference for designing social skills training programmes. METHOD Fifty-six eligible male patients with chronic schizophrenia who were admitted to our hospital from October 2020 to April 2021 were selected, and 24 healthy people were selected as controls. Facial emotion recognition, social communication skills and self-perceived interpersonal disturbance were assessed using a facial emotion recognition stimulus manual, the Social Skills Checklist (SSC) and the Interpersonal Relationship Integrative Diagnostic Scale (IRIDS). Disease status was assessed using the Positive and Negative Syndrome Scale. RESULTS Both the control group and the patient group had the highest recognition accuracy for neutral faces. The recognition rate for neutral expression was higher in the control group than in the patient group (p = 0.008). The rate of neutral expressions identified as happiness was higher in the patient group than in the control group (p = 0.001). The identification of anger as happiness was higher in the control group than in the patient group (p = 0.026), and the pattern of misidentification was similar between the control group and the patient group. The accuracy of facial emotion recognition was negatively associated with the age of onset (p < 0.05). The recognition accuracy for happiness was negatively associated with negative symptoms, general pathological symptoms and total scale scores (p < 0.05). The total score for expression recognition was negatively associated with the negative symptom subscale scores (p < 0.05), and there was no correlation between expression recognition and positive symptoms (p > 0.05). The recognition accuracy for happiness was negatively correlated with the IRIDS conversation factor (p < 0.05). The recognition accuracy for happiness and anger and the total scores for facial emotion recognition were negatively correlated with the SSC subscale score and the total score (p < 0.05 and p < 0.01, respectively). The main influencing factors on facial emotion recognition were the SSC total score (p < 0.001) and the positive factor score (p = 0.039). CONCLUSION Veterans with chronic schizophrenia have facial emotion recognition impairments affected by negative symptoms. There is a correlation between facial emotion recognition and interpersonal communication. HIGHLIGHTS 1. There are extensive facial expression recognition disorders in schizophrenia. 2. The pattern of misidentification was similar in both the control group and the patient group, with the tendency for happiness to be identified as a neutral emotion, anger as happiness, and fear as neutral emotion and anger. 3. Based on the comprehensive assessment of social cognitive impairment in patients with schizophrenia, prospective studies of standardised interventions are designed to provide support for clinical practice.
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Affiliation(s)
- Yu-Hong Wang
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Xin-Fu Wang
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000, China.
| | - Li-Da Shi
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Xiao-Mei Xu
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Li-Ning Wei
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Shan-Shan Li
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Xi-Po Li
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Xin-Li Ma
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Zhan-Min Li
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Xin-Zhen Wei
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Qian Wang
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000 China
| | - Ke-Qiang Wang
- Department of Psychiatric rehabilitation, Hebei Province Veterans Hospital, No. 2396 Lianchi South Street, Baoding City, Baoding, 071000, China.
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Romagnano V, Sokolov AN, Steinwand P, Fallgatter AJ, Pavlova MA. Face pareidolia in male schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:112. [PMID: 36517504 PMCID: PMC9751144 DOI: 10.1038/s41537-022-00315-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 05/22/2023]
Abstract
Faces are valuable signals for efficient social interaction. Yet, social cognition including the sensitivity to a coarse face scheme may be deviant in schizophrenia (SZ). Tuning to faces in non-face images such as shadows, grilled toasts, or ink blots is termed face pareidolia. This phenomenon is poorly investigated in SZ. Here face tuning was assessed in 44 male participants with SZ and person-by-person matched controls by using recently created Face-n-Thing images (photographs of non-face objects to a varying degree resembling a face). The advantage of these images is that single components do not automatically trigger face processing. Participants were administered a set of images with upright and inverted (180° in the image plane) orientation. In a two-alternative forced-choice paradigm, they had to indicate whether an image resembled a face. The findings showed that: (i) With upright orientation, SZ patients exhibited deficits in face tuning: they provided much fewer face responses than controls. (ii) Inversion generally hindered face pareidolia. However, while in neurotypical males, inversion led to a drastic drop in face impression, in SZ, the impact of orientation was reduced. (iii) Finally, in accord with the signal detection theory analysis, the sensitivity index (d-prime) was lower in SZ, whereas no difference occurred in decision criterion. The outcome suggests altered face pareidolia in SZ is caused by lower face sensitivity rather than by alterations in cognitive bias. Comparison of these findings with earlier evidence confirms that tuning to social signals is lower in SZ, and warrants tailored brain imaging research.
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Affiliation(s)
- Valentina Romagnano
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Alexander N Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Patrick Steinwand
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany
| | - Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, and Tübingen Center for Mental Health (TüCMH), Tübingen, Germany.
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Beals K, Sperry SH, Sheffield JM. Empathy, Emotion Recognition, and Paranoia in the General Population. Front Psychol 2022; 13:804178. [PMID: 35282255 PMCID: PMC8908382 DOI: 10.3389/fpsyg.2022.804178] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/28/2022] [Indexed: 11/14/2022] Open
Abstract
Background Paranoia is associated with a multitude of social cognitive deficits, observed in both clinical and subclinical populations. Empathy is significantly and broadly impaired in schizophrenia, yet its relationship with subclinical paranoia is poorly understood. Furthermore, deficits in emotion recognition - a very early component of empathic processing - are present in both clinical and subclinical paranoia. Deficits in emotion recognition may therefore underlie relationships between paranoia and empathic processing. The current investigation aims to add to the literature on social cognition and paranoia by: (1) characterizing the relationship between paranoia and empathy, and (2) testing whether there is an indirect effect of emotion recognition on the relationship between empathy and paranoia. Methods Paranoia, empathy, and emotion recognition were assessed in a non-clinical sample of adults (n = 226) from the Nathan Kline Institute-Rockland (NKI-Rockland) dataset. Paranoia was measured using the Peters Delusions Inventory-21 (PDI-21). Empathy was measured using the Interpersonal Reactivity Index (IRI), a self-report instrument designed to assess empathy using four subscales: Personal Distress, Empathic Concern, Perspective Taking, and Fantasy. Emotion recognition was assessed using the Penn Emotion Recognition Test (ER-40). Structural equation modeling (SEM) was used to estimate relationships between paranoia, the four measures of empathy and emotion recognition. Results Paranoia was associated with the Fantasy subscale of the IRI, such that higher Fantasy was associated with more severe paranoia (p < 0.001). No other empathy subscales were associated with paranoia. Fantasy was also associated with the emotion recognition of fear, such that higher Fantasy was correlated with better recognition of fear (p = 0.008). Paranoia and emotion recognition were not significantly associated. The Empathic Concern subscale was negatively associated with emotion recognition, with higher empathic concern related to worse overall emotion recognition (p = 0.002). All indirect paths through emotion recognition were non-significant. Discussion These results suggest that imaginative perspective-taking contributes to paranoia in the general population. These data do not, however, point to robust global relationships between empathy and paranoia or to emotion recognition as an underlying mechanism. Deficits in empathy and emotion recognition observed in schizophrenia may be associated with the broader pathology of schizophrenia, and therefore not detectable with subclinical populations.
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Affiliation(s)
- Kendall Beals
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Sarah H. Sperry
- Michigan Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Julia M. Sheffield
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
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Abstract
The aim of this study was to explore gender differences in social cognition in a sample of first-episode psychosis (FEP). An observational descriptive study was performed with 191 individuals with FEP. Emotion perception was assessed using the Faces Test, theory of mind was assessed using the Hinting Task, and attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire. No gender differences were found in any of the social cognitive domains. Our results suggest that men and women with FEP achieve similar performances in social cognition. Therefore, targeting specific needs in social cognition regarding gender may not be required in early interventions for psychosis.
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Caruana N, Seymour K. Bottom-up processing of fearful and angry facial expressions is intact in schizophrenia. Cogn Neuropsychiatry 2021; 26:183-198. [PMID: 33752551 DOI: 10.1080/13546805.2021.1902794] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Judgments of emotion from faces are reportedly impaired in schizophrenia. However, it is unclear whether this is due to a top-down cognitive deficit in evaluating sensory information or a fundamental bottom-up perturbation in the early stages of face encoding. This study examined whether deficits in emotion processing reflect imprecision in the initial preconscious registration of emotional face expressions within the visual system. METHODS Using continuous flash suppression (CFS), we presented participants (18 patients with schizophrenia, 8M/10F; 20 healthy controls, 13M/7F) with fearful and angry faces. Previous CFS research on healthy participants reveals that fearful facial expressions gain privileged access to awareness over angry faces-demonstrating the visual system's ability to discriminate these emotions at a preconscious level. We used this same approach to probe the integrity of early emotion encoding whilst minimising the potential contribution of any top-down cognitive biases on perceptual judgments. RESULTS In both groups, fearful faces were perceived faster than angry faces, with no differences observed between patients and controls. CONCLUSIONS Emotion processing difficulties in schizophrenia are unlikely to reflect an early sensory deficit, but rather a deficit in social cognition that has a top-down impact on the conscious evaluation of facial expressions.
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Affiliation(s)
- Nathan Caruana
- Department of Cognitive Science, Macquarie University, Sydney, Australia.,Perception in Action Research Centre, Macquarie University, Sydney, Australia
| | - Kiley Seymour
- School of Psychology, Western Sydney University, Sydney, Australia.,The MARCS Institute for Brain, Behaviour and Development, Western Sydney University, Sydney, Australia.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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8
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Gao Z, Zhao W, Liu S, Liu Z, Yang C, Xu Y. Facial Emotion Recognition in Schizophrenia. Front Psychiatry 2021; 12:633717. [PMID: 34017272 PMCID: PMC8129182 DOI: 10.3389/fpsyt.2021.633717] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/22/2021] [Indexed: 01/17/2023] Open
Abstract
Deficits in facial emotion recognition are one of the most common cognitive impairments, and they have been extensively studied in various psychiatric disorders, especially in schizophrenia. However, there is still a lack of conclusive evidence about the factors associated with schizophrenia and impairment at each stage of the disease, which poses a challenge to the clinical management of patients. Based on this, we summarize facial emotion cognition among patients with schizophrenia, introduce the internationally recognized Bruce-Young face recognition model, and review the behavioral and event-related potential studies on the recognition of emotions at each stage of the face recognition process, including suggestions for the future direction of clinical research to explore the underlying mechanisms of schizophrenia.
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Affiliation(s)
- Zhiyun Gao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Department of Humanities and Social Science, Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Wentao Zhao
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Chengxiang Yang
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China.,Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China
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Stone BA, Markham R, Wilhelm K. When Words Are Not Enough: A Validated Nonverbal Vocabulary of Feelings (Pictured Feelings Instrument). AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Beth A Stone
- School of Psychology, University of Sydney,
- School of Psychiatry, University of NSW,
| | - Roslyn Markham
- School of Psychology, University of Sydney,
- NSW Institute of Psychiatry,
| | - Kay Wilhelm
- Faculty of Psychiatry, School of Psychiatry, University of New South Wales,
- Faces In the Street, St Vincent's Hospital,
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10
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Hofer A, Benecke C, Edlinger M, Huber R, Kemmler G, Rettenbacher MA, Schleich G, Wolfgang Fleischhacker W. Facial emotion recognition and its relationship to symptomatic, subjective, and functional outcomes in outpatients with chronic schizophrenia. Eur Psychiatry 2020; 24:27-32. [DOI: 10.1016/j.eurpsy.2008.06.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2008] [Revised: 06/01/2008] [Accepted: 06/21/2008] [Indexed: 10/21/2022] Open
Abstract
AbstractOutcome in schizophrenia is multidimensional and consists of clinical and psychosocial domains. Difficulties in affect recognition are a hallmark of schizophrenia, but there is little research investigating the consequences of this deficit on patients’ psychosocial status. This cross-sectional study examined the relationship of facial affect recognition and treatment outcomes in terms of psychopathology, quality of life (QOL), and psychosocial functioning.We investigated 40 regular attendees of a specialized schizophrenia outpatient clinic who had been stable both from a symptomatic and a medication perspective for a minimum of 6 months and 40 healthy volunteers who were chosen to match patients in age, sex, and education. Affect recognition was positively associated with patients’ level of education and negatively with increasing age. Deficits in this area corresponded to the severity of negative and affective symptoms as well as to poor work and global functioning. These findings suggest that affect recognition is an important aspect of psychosocial functioning in stable outpatients with schizophrenia.
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11
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Rolf R, Sokolov AN, Rattay TW, Fallgatter AJ, Pavlova MA. Face pareidolia in schizophrenia. Schizophr Res 2020; 218:138-145. [PMID: 32057538 DOI: 10.1016/j.schres.2020.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 01/17/2020] [Accepted: 01/19/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Faces convey valuable daily life social signals. As in most psychiatric conditions, non-verbal social cognition or its components including face processing may be aberrant in schizophrenia (SZ). Social participation of individuals with SZ is vital for their quality of life, and remediation of social abilities in this population is of high relevance both for society and clinical care. METHOD Tuning to faces in non-face images such as shadows, grilled toasts, or ink blots is called face pareidolia. Humans possess high sensitivity to facial signals: even fetuses and infants are well tuned to coarse face cues. Here we assessed face tuning in individuals with SZ and person-by-person matched controls by using a new experimental tool, a set of food-plate images bordering on the Giuseppe Arcimboldo style. The key benefit of these images is that single components do not trigger face processing. RESULTS AND CONCLUSIONS The outcome indicates that individuals with SZ exhibit aberrant face tuning in face-like non-face images (χ2(1) = 17.44, p = 0.0001) that can hamper adaptive interaction with peers and social participation hindering, in turn, clinical remediation. Face response rate in SZ patients was related to the scores on the event arrangement task tapping social cognition (Pearson product-moment correlation, r = 0.602, p = 0.01) and on picture completion task assessing visual perceptual organization (Spearman's rho = 0.614, p = 0.009). Therefore, poor performance on the face tuning task is unlikely to be accounted for by deviant general cognitive abilities, but rather by impairments in perceptual integration and social cognition. Comparison of these findings with data in autism and other neuropsychiatric conditions provides novel insights on the origins of face tuning in SZ and triggers brain imaging research.
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Affiliation(s)
- Rebecca Rolf
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Alexander N Sokolov
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Tim W Rattay
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany; Department of Neurodegenerative Diseases, Hertie-Institute for Clinical Brain Research, and Center for Neurology, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany; German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Marina A Pavlova
- Department of Psychiatry and Psychotherapy, Medical School and University Hospital, Eberhard Karls University of Tübingen, Tübingen, Germany.
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12
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Lakhlifi M, Laprevote V, Schwan R, Schwitzer T. Free viewing exploration in schizophrenia: Review of evidence from laboratory settings to natural environment. Encephale 2020; 46:115-122. [PMID: 32057409 DOI: 10.1016/j.encep.2019.11.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 11/26/2019] [Accepted: 11/28/2019] [Indexed: 10/25/2022]
Abstract
Several studies have investigated visual processing impairment in schizophrenia. The literature on visual exploration has described restricted scanning in schizophrenia patients. This gaze behavior is characterized by increased fixation duration, a reduced scan path length and avoidance of salient features of the face with emotional content. The aim of this paper is to give an insight on the latest update on scan path deficit. Abnormal gaze exploration was replicated in various visual stimuli. This review describes gaze patterns with stimuli that imply minimal to high cognitive process: figures, objects, faces, and scenes. Interestingly, schizophrenia patients have shown cognitive flexibility by modulating gaze scanning when they are involved in an active assignment. We will also consider scanning abnormalities in real-life environment and discuss the potential therapeutic use of eye tracking in schizophrenia. The therapeutic application of eye tracking in schizophrenia is a young emerging field in psychiatry research. The recent remediation program is based on the reorientation of visual attention on the salient features of faces. For now, this program has shown encouraging results. Further studies are needed to explore behavior in real-world situations to complement laboratory measurements to move toward a full understanding of the mechanisms underlying atypical scanning in patients with schizophrenia.
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Affiliation(s)
- M Lakhlifi
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand-Nancy, centre psychothérapique de Nancy, Laxou, France.
| | - V Laprevote
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand-Nancy, centre psychothérapique de Nancy, Laxou, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, département de psychiatrie, centre hospitalier régional universitaire de Strasbourg, Strasbourg, France; Maison des addictions, CHRU de Nancy, Nancy, France
| | - R Schwan
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand-Nancy, centre psychothérapique de Nancy, Laxou, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, département de psychiatrie, centre hospitalier régional universitaire de Strasbourg, Strasbourg, France; Maison des addictions, CHRU de Nancy, Nancy, France
| | - T Schwitzer
- Pôle hospitalo-universitaire de psychiatrie d'adultes du Grand-Nancy, centre psychothérapique de Nancy, Laxou, France; Inserm U1114, fédération de médecine translationnelle de Strasbourg, département de psychiatrie, centre hospitalier régional universitaire de Strasbourg, Strasbourg, France; Maison des addictions, CHRU de Nancy, Nancy, France
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13
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The Longitudinal Association Between Preadolescent Facial Emotion Identification and Family Factors, and Psychotic Experiences in Adolescence (The TRAILS Study). Child Psychiatry Hum Dev 2020; 51:187-199. [PMID: 31485859 PMCID: PMC7067727 DOI: 10.1007/s10578-019-00922-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study examines whether facial emotion identification and family factors at preadolescence (age 11) predict psychotic experiences 5 years later during adolescence (age 16) and whether family factors may mediate the association between facial emotion identification and psychotic experiences. Data was obtained from the epidemiological cohort TRAILS (N = 2059). At preadolescence, a facial emotion identification test and three questionnaires to assess family functioning, perceived parenting styles and parenting stress, were administered. At adolescence, a questionnaire on psychotic experiences was administered. Facial emotion identification at preadolescence was not associated with psychotic experiences at adolescence, and the mediational role of family functioning was not further explored. However, increased overprotective parenting at preadolescence was associated with a higher frequency of psychotic experiences and delusions at adolescence. Future research may examine the mechanism behind the role of overprotective parenting on psychotic experiences during adolescence.
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Emotion identification among people with serious mental illnesses: The role of specific emotions and sex. Psychiatry Res 2019; 279:378-379. [PMID: 30722988 DOI: 10.1016/j.psychres.2019.01.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/22/2022]
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Baskak NS, Özateş ME, Herdi O, Sonel E, Ulusan A, Baskak B. The Relation Between Functional Anatomy of the Face and Threat Perception Evoked by Facial Expression of Anger in Schizophrenia. ACTA ACUST UNITED AC 2019; 56:7-12. [PMID: 30911230 DOI: 10.29399/npa.21632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 10/21/2017] [Indexed: 11/07/2022]
Abstract
Introduction It is well known that patients with schizophrenia are more sensitive to negative rather than positive feelings. In this study, we aimed to evaluate the degree of explicitly perceived threat against facial expressions of anger. We were also interested in the association between perceived threat, and both the objective intensity of facial expression of anger and the functional anatomy of the perceived faces. Method Forty-eight patients with schizophrenia and 51 healthy controls were enrolled. Participants were presented a total of 21 sequences of anger including six different face images, which were selected from The Cohn-Kanade AU-Coded Facial Expression Database with emotions gradually changing from neutral to peak expression of anger. We measured when [time to threat (TtT)] and to which degree [Total perception of threat (TPoT)] threat was perceived by participants. The relation between perceived threat with the involvement of functional anatomic units among the face stimuli was also investigated. Results TPoT was higher in the index compared to the control group. TtT was comparable in two groups and was associated with the severity of hallucinations among the index group. Total emotion intensity was lower in the sequences that evoked more threat in the index group. Functional contribution of the eyes and the upper lip to expression of anger were associated with TPoT among the index group. Conclusion Schizophrenia subjects may be prone to perceive more threat in response to facial expression of anger. This proneness may be evident in response to less intense expression of anger, particularly via eyes and the upper lip.
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Affiliation(s)
| | | | - Oğuzhan Herdi
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankarı, Turkey
| | - Eda Sonel
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankarı, Turkey
| | - Asena Ulusan
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankarı, Turkey
| | - Bora Baskak
- Ankara University, Faculty of Medicine, Department of Psychiatry, Ankarı, Turkey
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Mossaheb N, Kaufmann RM, Schlögelhofer M, Aninilkumparambil T, Himmelbauer C, Gold A, Zehetmayer S, Hoffmann H, Traue HC, Aschauer H. The Impact of Sex Differences on Odor Identification and Facial Affect Recognition in Patients with Schizophrenia Spectrum Disorders. Front Psychiatry 2018; 9:9. [PMID: 29445345 PMCID: PMC5797769 DOI: 10.3389/fpsyt.2018.00009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 01/12/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social interactive functions such as facial emotion recognition and smell identification have been shown to differ between women and men. However, little is known about how these differences are mirrored in patients with schizophrenia and how these abilities interact with each other and with other clinical variables in patients vs. healthy controls. METHODS Standardized instruments were used to assess facial emotion recognition [Facially Expressed Emotion Labelling (FEEL)] and smell identification [University of Pennsylvania Smell Identification Test (UPSIT)] in 51 patients with schizophrenia spectrum disorders and 79 healthy controls; furthermore, working memory functions and clinical variables were assessed. RESULTS In both the univariate and the multivariate results, illness showed a significant influence on UPSIT and FEEL. The inclusion of age and working memory in the MANOVA resulted in a differential effect with sex and working memory as remaining significant factors. Duration of illness was correlated with both emotion recognition and smell identification in men only, whereas immediate general psychopathology and negative symptoms were associated with emotion recognition only in women. CONCLUSION Being affected by schizophrenia spectrum disorder impacts one's ability to correctly recognize facial affects and identify odors. Converging evidence suggests a link between the investigated basic and social cognitive abilities in patients with schizophrenia spectrum disorders with a strong contribution of working memory and differential effects of modulators in women vs. men.
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Affiliation(s)
- Nilufar Mossaheb
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University Vienna, Vienna, Austria
| | | | - Monika Schlögelhofer
- Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria
| | | | | | - Anna Gold
- Hospital Oberpullendorf, Oberpullendorf, Burgenland, Austria
| | - Sonja Zehetmayer
- Section of Medical Statistics, Medical University Vienna, Vienna, Austria
| | - Holger Hoffmann
- Department of Psychosomatic Medicine and Psychotherapy, Section for Medical Psychology, University Ulm, Ulm, Germany
| | - Harald C Traue
- Department of Psychosomatic Medicine and Psychotherapy, Section for Medical Psychology, University Ulm, Ulm, Germany
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A systematic review comparing sex differences in cognitive function in schizophrenia and in rodent models for schizophrenia, implications for improved therapeutic strategies. Neurosci Biobehav Rev 2016; 68:979-1000. [DOI: 10.1016/j.neubiorev.2016.06.029] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 06/11/2016] [Accepted: 06/20/2016] [Indexed: 01/07/2023]
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Marcos-Pablos S, González-Pablos E, Martín-Lorenzo C, Flores LA, Gómez-García-Bermejo J, Zalama E. Virtual Avatar for Emotion Recognition in Patients with Schizophrenia: A Pilot Study. Front Hum Neurosci 2016; 10:421. [PMID: 27616987 PMCID: PMC4999437 DOI: 10.3389/fnhum.2016.00421] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/08/2016] [Indexed: 11/13/2022] Open
Abstract
Persons who suffer from schizophrenia have difficulties in recognizing emotions in others’ facial expressions, which affects their capabilities for social interaction and hinders their social integration. Photographic images have traditionally been used to explore emotion recognition impairments in schizophrenia patients, but they lack of the dynamism that is inherent to facial expressiveness. In order to overcome those inconveniences, over the last years different authors have proposed the use of virtual avatars. In this work, we present the results of a pilot study that explored the possibilities of using a realistic-looking avatar for the assessment of emotion recognition deficits in patients who suffer from schizophrenia. In the study, 20 subjects with schizophrenia of long evolution and 20 control subjects were invited to recognize a set of facial expressions of emotions showed by both the said virtual avatar and static images. Our results show that schizophrenic patients exhibit recognition deficits in emotion recognition from facial expressions regardless the type of stimuli (avatar or images), and that those deficits are related with the psychopathology. Finally, some improvements in recognition rates (RRs) for the patient group when using the avatar were observed for sadness or surprise expressions, and they even outperform the control group in the recognition of the happiness expression. This leads to conclude that, apart from the dynamism of the shown expression, the RRs for schizophrenia patients when employing animated avatars may depend on other factors which need to be further explored.
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Affiliation(s)
| | | | - Carlos Martín-Lorenzo
- Research Unit, Hermanas Hospitalarias Centro Sociosanitario Palencia Palencia, Spain
| | - Luis A Flores
- Cartif Foundation, Parque Tecnológico de Boecillo Valladolid, Spain
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Barbato M, Liu L, Cadenhead KS, Cannon TD, Cornblatt BA, McGlashan TH, Perkins DO, Seidman LJ, Tsuang MT, Walker EF, Woods SW, Bearden CE, Mathalon DH, Heinssen R, Addington J. Theory of Mind, Emotion Recognition and Social Perception in Individuals at Clinical High Risk for Psychosis: findings from the NAPLS-2 cohort. SCHIZOPHRENIA RESEARCH-COGNITION 2015; 2:133-139. [PMID: 27695675 PMCID: PMC5041592 DOI: 10.1016/j.scog.2015.04.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Social cognition, the mental operations that underlie social interactions, is a major construct to investigate in schizophrenia. Impairments in social cognition are present before the onset of psychosis, and even in unaffected first-degree relatives, suggesting that social cognition may be a trait marker of the illness. In a large cohort of individuals at clinical high risk for psychosis (CHR) and healthy controls, three domains of social cognition (theory of mind, facial emotion recognition and social perception) were assessed to clarify which domains are impaired in this population. Six-hundred and seventy-five CHR individuals and 264 controls, who were part of the multi-site North American Prodromal Longitudinal Study, completed The Awareness of Social Inference Test, the Penn Emotion Recognition task, the Penn Emotion Differentiation task, and the Relationship Across Domains, measures of theory of mind, facial emotion recognition, and social perception, respectively. Social cognition was not related to positive and negative symptom severity, but was associated with age and IQ. CHR individuals demonstrated poorer performance on all measures of social cognition. However, after controlling for age and IQ, the group differences remained significant for measures of theory of mind and social perception, but not for facial emotion recognition. Theory of mind and social perception are impaired in individuals at CHR for psychosis. Age and IQ seem to play an important role in the arising of deficits in facial affect recognition. Future studies should examine the stability of social cognition deficits over time and their role, if any, in the development of psychosis.
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Affiliation(s)
- Mariapaola Barbato
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Lu Liu
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, 140 Arbor Drive, San Diego, CA 92103, United States
| | - Tyrone D Cannon
- Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, 75-59 263rd St, Queens, NY 11004, United States
| | - Thomas H McGlashan
- Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511 United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, 101 Manning Dr, Chapel Hill, NC 27514, United States
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Landmark Building, 401 Park Drive, 2 East, Boston, MA 02215 United States
| | - Ming T Tsuang
- Department of Psychiatry, University of California San Diego, 140 Arbor Drive, San Diego, CA 92103, United States; Institute of Genomic Medicine, University of California, San Diego, 9500 Gilman Drive #0761, La Jolla, CA 92093-0761, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, 487 Psychology Building, 36 Eagle Row, Atlanta, GA 30322, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, 300 George St., Suite 901, New Haven, CT 06511 United States
| | - Carrie E Bearden
- Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, 300 Building Medical Plaza, Suite 2265, Los Angeles, CA 90095, United States
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, 401 Parnassus Avenue, San Francisco, CA 94143, United States; Psychiatry Service, 116d, San Francisco VA Medical Center, 4150 Clement St. San Francisco, CA 94121 United States
| | - Robert Heinssen
- Division of Adult Translational Research and Treatment Development, National Institute of Mental Health, 6001 Executive Boulevard, Room 7141, Bethesda, MSC 9629, United States
| | - Jean Addington
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N4Z6, Canada
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Dondaine T, Robert G, Péron J, Grandjean D, Vérin M, Drapier D, Millet B. Biases in facial and vocal emotion recognition in chronic schizophrenia. Front Psychol 2014; 5:900. [PMID: 25202287 PMCID: PMC4141280 DOI: 10.3389/fpsyg.2014.00900] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 07/29/2014] [Indexed: 01/26/2023] Open
Abstract
There has been extensive research on impaired emotion recognition in schizophrenia in the facial and vocal modalities. The literature points to biases toward non-relevant emotions for emotional faces but few studies have examined biases in emotional recognition across different modalities (facial and vocal). In order to test emotion recognition biases, we exposed 23 patients with stabilized chronic schizophrenia and 23 healthy controls (HCs) to emotional facial and vocal tasks asking them to rate emotional intensity on visual analog scales. We showed that patients with schizophrenia provided higher intensity ratings on the non-target scales (e.g., surprise scale for fear stimuli) than HCs for the both tasks. Furthermore, with the exception of neutral vocal stimuli, they provided the same intensity ratings on the target scales as the HCs. These findings suggest that patients with chronic schizophrenia have emotional biases when judging emotional stimuli in the visual and vocal modalities. These biases may stem from a basic sensorial deficit, a high-order cognitive dysfunction, or both. The respective roles of prefrontal-subcortical circuitry and the basal ganglia are discussed.
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Affiliation(s)
- Thibaut Dondaine
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Gabriel Robert
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Julie Péron
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology, University of Geneva Switzerland ; Swiss Center for Affective Sciences, University of Geneva Switzerland
| | - Didier Grandjean
- 'Neuroscience of Emotion and Affective Dynamics' Laboratory, Department of Psychology, University of Geneva Switzerland ; Swiss Center for Affective Sciences, University of Geneva Switzerland
| | - Marc Vérin
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Neurology Unit, University Hospital of Rennes France
| | - Dominique Drapier
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
| | - Bruno Millet
- EA 4712 'Behavior and Basal Ganglia' Laboratory, Université de Rennes 1 Rennes, France ; Psychiatry Unit, Guillaume Régnier Hospital Rennes, France
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Abu-Akel A, Bo S. Superior mentalizing abilities of female patients with schizophrenia. Psychiatry Res 2013; 210:794-9. [PMID: 24103909 DOI: 10.1016/j.psychres.2013.09.013] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 08/30/2013] [Accepted: 09/11/2013] [Indexed: 11/28/2022]
Abstract
Mentalizing abilities are severely disrupted in patients with schizophrenia, but gender-related differences in this domain are virtually unexplored. Given the importance of these abilities in understanding psychopathology, social functioning and outcome, this study aimed to examine the mentalizing abilities of male and female patients with schizophrenia. The cognitive and affective mentalizing abilities of self and other of clinically stable male and female patients with schizophrenia were analyzed using the abbreviated version of the Metacognitive Assessment Scale (MAS-A). Compared to their male counterparts, the female patients demonstrated superior overall mentalizing abilities. This advantage was also evident when mentalizing about the Self or the Other. When examining cognitive versus affective mentalizing, women were significantly better in their ability to attribute and understand the affective mental states of others. These differences were unrelated to intelligence or psychopathology. The superior mentalizing abilities of female patients extend gender-related differences in schizophrenia to include social cognition. This suggests that our current knowledge of socio-cognitive abilities in schizophrenia is generalizable to male but not to female patients. The findings also provide important insights to understanding how etiological differences affect social cognition. Awareness to such differences has important implications for diagnosis and clinical treatment.
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Affiliation(s)
- Ahmad Abu-Akel
- School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
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22
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Fischer-Shofty M, Shamay-Tsoory SG, Levkovitz Y. Characterization of the effects of oxytocin on fear recognition in patients with schizophrenia and in healthy controls. Front Neurosci 2013; 7:127. [PMID: 23882178 PMCID: PMC3714571 DOI: 10.3389/fnins.2013.00127] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Accepted: 06/30/2013] [Indexed: 01/03/2023] Open
Abstract
Individuals who suffer from schizophrenia often show a marked deficit in recognition of emotional facial expressions, as part of broader impairment of social cognition. Research has shown that recognition of negative emotions, specifically fear recognition, is particularly impaired among patients with schizophrenia. Recently we reported that intranasal administration of OT (IN OT) increased the ability to correctly recognize fear in a group of healthy men. The aim of the current study was to examine the effects of IN OT administration on fear recognition among patients with schizophrenia. Based on previous research, we also sought to examine a possible selective effect of OT dependent on baseline performance, hypothesizing that IN OT would have a greater enhancement effect on less proficient individuals. It was thus hypothesized that patients will show more improvement in fear recognition following the administration of IN OT as compared to controls. Sixty six participants (31 schizophrenia patients, 35 healthy controls) were enrolled in the current study. All participants received treatment of a single dose of 24 IU IN OT and an equivalent amount of placebo, 1 week apart. The participants' ability to accurately recognize fear and happiness was evaluated using a face morphing task. Overall, as a group, both patients and healthy control participants were more accurate in recognizing fearful facial expressions, but not happy faces, following IN OT administration, as compared to their performance following placebo. IN OT did not differentially affect emotion recognition in patients and healthy controls. Yet, the results indicated a selective effect for IN OT, in which the hormone improves fear recognition only among individuals whose baseline performance was below the median, regardless of their psychiatric status.
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Fischer-Shofty M, Brüne M, Ebert A, Shefet D, Levkovitz Y, Shamay-Tsoory SG. Improving social perception in schizophrenia: the role of oxytocin. Schizophr Res 2013; 146:357-62. [PMID: 23433504 DOI: 10.1016/j.schres.2013.01.006] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 12/29/2012] [Accepted: 01/06/2013] [Indexed: 12/22/2022]
Abstract
Previous research has shown that patients with schizophrenia are impaired in a wide range of social cognitive abilities, including emotion recognition, empathy for others, and mental perspective-taking. Recent studies suggest that a dysfunction of the oxytocinergic system contributes to the social impairment in schizophrenia. Accordingly, the present study sought to examine whether patients with schizophrenia would improve in a social perception task after taking a single dose of oxytocin, as compared to a placebo. Thirty-five patients diagnosed with schizophrenia were compared with 46 psychologically healthy matched controls on their recognition of kinship and intimacy, using the Interpersonal Perception Task. All participants received a single intranasal dose of 24 IU oxytocin or placebo, one week apart. Overall, the participants were more accurate in judging intimacy and kinship following the administration of oxytocin, as opposed to a placebo. However, when comparing patients with controls, only the recognition of kinship improved significantly in the patient group, whereas no such effect was observed in the control group or in the recognition of intimacy in either group. This is one of the first studies to demonstrate that social perception in schizophrenia can be improved by the administration of oxytocin and that patients show a greater treatment effect than controls.
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Affiliation(s)
- M Fischer-Shofty
- Department of Psychology, University of Haifa, Haifa 31905, Israel
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Janssens M, Lataster T, Simons CJP, Oorschot M, Lardinois M, van Os J, Myin-Germeys I. Emotion recognition in psychosis: no evidence for an association with real world social functioning. Schizophr Res 2012; 142:116-21. [PMID: 23122740 DOI: 10.1016/j.schres.2012.10.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2012] [Revised: 08/20/2012] [Accepted: 10/01/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patients with psychotic disorders show impairments in the recognition of emotions in other people. These impairments have been associated with poor social functioning as measured by self-report questionnaires, clinical interviews and laboratory-based tests of social skills. The ecological validity of these tests, however, is low. Associations were examined between emotion recognition and daily life social interactions in 50 patients diagnosed with a non-affective psychotic disorder and 67 healthy controls. METHODS All participants were assessed with the Degraded Facial Affect Recognition Task (DFAR), a computer test measuring the recognition of emotional facial expressions. Social functioning in daily life was assessed using the Experience Sampling Method (a random time sampling technique) with focus on measures of social context and appraisal of the social situation. RESULTS Groups differed significantly in the recognition of angry faces, whereas no differences existed for other emotions. There were no associations between emotion recognition and social functioning in daily life and there was no evidence for differential associations in patients as compared to controls. DISCUSSION Social functioning, when assessed in an ecologically valid fashion, is not sensitive to variation in the traditional experimental assessment of emotion recognition. Real life measures of functioning should guide research linking the handicaps associated with psychosis to underlying cognitive and emotional dysregulation.
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Affiliation(s)
- M Janssens
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht, The Netherlands
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Effects of facial emotion recognition remediation on visual scanning of novel face stimuli. Schizophr Res 2012; 141:234-40. [PMID: 22959743 DOI: 10.1016/j.schres.2012.08.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 07/20/2012] [Accepted: 08/11/2012] [Indexed: 11/23/2022]
Abstract
Previous research shows that emotion recognition in schizophrenia can be improved with targeted remediation that draws attention to important facial features (eyes, nose, mouth). Moreover, the effects of training have been shown to last for up to one month after training. The aim of this study was to investigate whether improved emotion recognition of novel faces is associated with concomitant changes in visual scanning of these same novel facial expressions. Thirty-nine participants with schizophrenia received emotion recognition training using Ekman's Micro-Expression Training Tool (METT), with emotion recognition and visual scanpath (VSP) recordings to face stimuli collected simultaneously. Baseline ratings of interpersonal and cognitive functioning were also collected from all participants. Post-METT training, participants showed changes in foveal attention to the features of facial expressions of emotion not used in METT training, which were generally consistent with the information about important features from the METT. In particular, there were changes in how participants looked at the features of facial expressions of emotion surprise, disgust, fear, happiness, and neutral, demonstrating that improved emotion recognition is paralleled by changes in the way participants with schizophrenia viewed novel facial expressions of emotion. However, there were overall decreases in foveal attention to sad and neutral faces that indicate more intensive instruction might be needed for these faces during training. Most importantly, the evidence shows that participant gender may affect training outcomes.
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Bragado-Jimenez MD, Taylor PJ. Empathy, schizophrenia and violence: a systematic review. Schizophr Res 2012; 141:83-90. [PMID: 22917950 DOI: 10.1016/j.schres.2012.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 06/29/2012] [Accepted: 07/16/2012] [Indexed: 12/14/2022]
Abstract
BACKGROUND A small but significant association between schizophrenia and violence is open to a number of explanations. Impaired empathy has been associated with schizophrenia, and with violence in the general population. Our aim was to conduct a systematic review of any research into relationships between schizophrenia, empathy and violence. METHODS The electronic databases Medline, Psychinfo, Embase, Cochrane and DARE were searched using combinations of terms for schizophrenia, empathy and violence, as were selected journals and reference lists of relevant articles. Selection of studies and data extraction was done by each of us, blind to the other. RESULTS Six studies were identified, but sample selection, research procedures and empathy, illness and violence measures differed sufficiently between them that only descriptive analysis was possible. Apart from one single case study, sample sizes were between 24 (12 violent) and 116 (35 violent). A component of emotional empathy (emotion recognition) was measured in three of the studies, all of which showed some specific dysfunctional recognition related to violence. Cognitive empathy was measured in three studies, two linking impairments to violence and one not. Emotional responsiveness was measured in one study and no association with violence was found. CONCLUSION Although evidence is inconclusive on empathy impairment as a mediator of violence by people with chronic psychosis, it's likely relevance is most apparent in the better controlled studies. Larger scale studies are indicated with rigorous control for comorbidities.
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Affiliation(s)
- Maria D Bragado-Jimenez
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, 1st Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
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Subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. Eur Arch Psychiatry Clin Neurosci 2012; 262:59-68. [PMID: 21792533 DOI: 10.1007/s00406-011-0227-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2011] [Accepted: 07/12/2011] [Indexed: 10/18/2022]
Abstract
From the clinical practice and some experimental studies, it is apparent that paranoid schizophrenia patients tend to assign emotional salience to neutral social stimuli. This aberrant cognitive bias has been conceptualized to result from increased emotional arousal, but direct empirical data are scarce. The aim of the present study was to quantify the subjective emotional arousal (SEA) evoked by emotionally non-salient (neutral) compared to emotionally salient (negative) social stimuli in schizophrenia patients and healthy controls. Thirty male inpatients with paranoid schizophrenia psychosis and 30 demographically matched healthy controls rated their level of SEA in response to neutral and negative social scenes from the International Affective Picture System and the Munich Affective Picture System. Schizophrenia patients compared to healthy controls had an increased overall SEA level. This relatively higher SEA was evoked only by the neutral but not by the negative social scenes. To our knowledge, the present study is the first designed to directly demonstrate subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. This finding might explain previous clinical and experimental data and could be viewed as the missing link between the primary neurobiological and secondary psychological mechanisms of paranoid psychotic-symptom formation. Furthermore, despite being very short and easy to perform, the task we used appeared to be sensitive enough to reveal emotional dysregulation, in terms of emotional disinhibition/hyperactivation in paranoid schizophrenia patients. Thus, it could have further research and clinical applications, including as a neurobehavioral probe for imaging studies.
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Sex differences in facial, prosodic, and social context emotional recognition in early-onset schizophrenia. SCHIZOPHRENIA RESEARCH AND TREATMENT 2012; 2012:584725. [PMID: 22970365 PMCID: PMC3420677 DOI: 10.1155/2012/584725] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 11/12/2011] [Accepted: 11/15/2011] [Indexed: 01/08/2023]
Abstract
The purpose of the present study was to determine sex differences in facial, prosodic, and social context emotional recognition in schizophrenia (SCH). Thirty-eight patients (SCH, 20 females) and 38 healthy controls (CON, 20 females) participated in the study. Clinical scales (BPRS and PANSS) and an Affective States Scale were applied, as well as tasks to evaluate facial, prosodic, and within a social context emotional recognition. SCH showed lower accuracy and longer response times than CON, but no significant sex differences were observed in either facial or prosody recognition. In social context emotions, however, females showed higher empathy than males with respect to happiness in both groups. SCH reported being more identified with sad films than CON and females more with fear than males. The results of this study confirm the deficits of emotional recognition in male and female patients with schizophrenia compared to healthy subjects. Sex differences were detected in relation to social context emotions and facial and prosodic recognition depending on age.
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Martín-Reyes M, Mendoza R, Domínguez M, Caballero A, Bravo TM, Díaz T, Gerra S, Ibáñez A, Linares AR. Depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS): genetic vulnerability and sex effects. Psychiatry Res 2011; 189:55-61. [PMID: 21196052 DOI: 10.1016/j.psychres.2010.11.026] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 11/09/2010] [Accepted: 11/11/2010] [Indexed: 11/18/2022]
Abstract
The present study compares the occurrence of depressive symptoms evaluated by the Calgary Depression Scale for Schizophrenia (CDSS) in patients of Multiplex (MS) and Simplex Schizophrenia families (SS). The Positive and Negative Syndrome Scale (PANSS) was used to evaluate psychopathology. A total of 206 paranoid schizophrenia patients were studied according DSM-IV criteria. The Family Interview for Genetic Studies (FIGS) was used to study the families. A result in the FIGS for a positive family history of schizophrenia was referred as MS (patients); its lack as SS (patients). CDSS scores were compared among MS and SS patients and possible sex differences intra- and inter-groups were explored. In the analysis of our sample (30) 19% of the total persons with schizophrenia group was depressed. The depressive symptoms measured by the CDSS were higher in females and the MS males group. Males from MS group showed more depressive symptoms than males from SS group. No differences with females from both groups were found. Findings in this study underscore the importance of gender and family history in understanding the heterogeneity of schizophrenia. This study suggests that sex and familiar history are important to consider in studying depressive symptoms.
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30
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Chang WC, Tang JYM, Hui CLM, Chiu CPY, Lam MML, Wong GHY, Chung DWS, Law CW, Tso S, Chan KPM, Hung SF, Chen EYH. Gender differences in patients presenting with first-episode psychosis in Hong Kong: a three-year follow up study. Aust N Z J Psychiatry 2011; 45:199-205. [PMID: 21261552 DOI: 10.3109/00048674.2010.547841] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of the current study was to investigate gender differences with respect to pre-treatment characteristics, clinical presentation, service utilization and functional outcome in patients presenting with first-episode psychosis. METHODS A total of 700 participants (men, n = 360; women, n = 340) aged 15 to 25 years consecutively enrolled in a territory-wide first-episode psychosis treatment programme in Hong Kong from July 2001 to August 2003 were studied. Baseline and three-year follow up variables were collected via systematic medical file review. RESULTS At service entry, men had significantly lower educational attainment (p < 0.01), longer median duration of untreated psychosis (p < 0.001), fewer past suicidal attempts (p < 0.01), more severe negative symptoms (p < 0.05) and fewer affective symptoms (p < 0.01) than women. There was no significant gender difference in age of onset. In three-year follow up, men had more prominent negative symptoms (p < 0.001), fewer affective symptoms (p < 0.01), more violent behaviour and forensic records (p < 0.01), and higher rate of substance abuse (p < 0.01). Women achieved higher levels of functioning than men (Social Occupational Functioning Assessment Scale (SOFAS), p < 0.001) and a significantly higher proportion of women than men engaged in full-time employment or study for at least 12 consecutive months (p < 0.001) in the initial three years after psychiatric treatment. CONCLUSION Notable gender differences in clinical profiles, illness trajectory and functional outcome were demonstrated in Chinese young people suffering from first-episode psychosis. Differential needs between men and women and hence gender-specific therapeutic strategies should be considered in early intervention service.
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Porter MA, Shaw TA, Marsh PJ. An unusual attraction to the eyes in Williams-Beuren syndrome: a manipulation of facial affect while measuring face scanpaths. Cogn Neuropsychiatry 2010; 15:505-30. [PMID: 20432078 DOI: 10.1080/13546801003644486] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
INTRODUCTION This study aimed to investigate face scanpaths and emotion recognition in Williams-Beuren syndrome (WBS) and whether: (1) the eyes capture the attention of WBS individuals faster than typically developing mental age-matched controls; (2) WBS patients spend abnormally prolonged periods of time viewing the eye region; and (3) emotion recognition skills or eye gaze patterns change depending on the emotional valance of the face. METHODS Visual scanpaths were recorded while 16 WBS patients and 16 controls passively viewed happy, angry, fearful, and neutral faces. Emotion recognition was subsequently measured. RESULTS The eyes did not capture the attention of WBS patients faster than controls, but once WBS patients attended to the eyes, they spent significantly more time looking at this region. Unexpectedly, WBS patients showed an impaired ability to recognise angry faces, but face scanpaths were similar across the different facial expressions. CONCLUSIONS Findings suggest that face processing is atypical in WBS and that emotion recognition and eye gaze abnormalities in WBS are likely to be more complex than previously thought. Findings highlight the need to develop remediation programmes to teach WBS patients how to explore all facial features, enhancing their emotion recognition skills and "normalising" their social interactions.
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Kohler CG, Walker JB, Martin EA, Healey KM, Moberg PJ. Facial emotion perception in schizophrenia: a meta-analytic review. Schizophr Bull 2010; 36:1009-19. [PMID: 19329561 PMCID: PMC2930336 DOI: 10.1093/schbul/sbn192] [Citation(s) in RCA: 648] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005). RESULTS The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race. CONCLUSION Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.
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Affiliation(s)
- Christian G Kohler
- Schizophrenia Research Center, Department of Psychiatry, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Lee SH, Kim EY, Kim S, Bae SM. Event-related potential patterns and gender effects underlying facial affect processing in schizophrenia patients. Neurosci Res 2010; 67:172-80. [DOI: 10.1016/j.neures.2010.03.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 02/28/2010] [Accepted: 03/01/2010] [Indexed: 11/25/2022]
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Abstract
Facial emotion recognition deficits have been widely investigated in individuals with schizophrenia; however, it remains unclear whether these deficits reflect a trait-like vulnerability to schizophrenia pathology present in individuals at risk for the disorder. Although some studies have investigated emotion recognition in this population, findings have been mixed. The current study uses a well-validated emotion recognition task, a relatively large sample, and examines the relationship between emotion recognition, symptoms, and overall life quality. Eighty-nine individuals with psychometrically defined schizotypy and 27 controls completed the Schizotypal Personality Questionnaire, Penn Emotion Recognition Test, and a brief version of Lehman's Quality of Life Interview. In addition to labeling facial emotions, participants rated the valence of faces using a Likert rating scale. Individuals with schizotypy were significantly less accurate than controls when labeling emotional faces, particularly neutral faces. Within the schizotypy sample, both disorganization symptoms and lower quality of life were associated with a bias toward perceiving facial expressions as more negative. Our results support previous research suggesting that poor emotion recognition is associated with vulnerability to psychosis. Although emotion recognition appears unrelated to symptoms, it probably operates by means of different processes in those with particular types of symptoms.
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Abstract
Socio-emotional competence is a key aspect of schizophrenia, both in terms of psychopathological vulnerability and outcome. In this respect, current research increasingly emphasizes the importance of deficits in facial expression recognition. The focus of the present study is the performance in recognizing 6 basic emotions (sadness, anger, happiness, fear, disgust, surprise) which play an essential role in shaping daily function and interpersonal interactions. A group of 20 patients diagnosed with DSM-IV schizophrenia were compared with a group of 20 matched controls on a facial expression recognition task, derived from the Karolinska Directed Emotional Faces (Lundqvist D, Flykt A, Ohmann A (1998) The Karolinska Directed Emotional Faces (KDEF). Stockholm (Sweden): Karolinska Institute), and were subsequently assessed with the Positive and Negative Syndrome Scale (PANSS). Facial expression recognition performance was significantly more impaired in patients, and was selectively correlated with the positive and cognitive dimensions of the positive and negative syndrome scale. Furthermore, significant group differences were found with respect to happiness and surprise.
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Burt SA, Mikolajewski AJ, Larson CL. Do aggression and rule-breaking have different interpersonal correlates? A study of antisocial behavior subtypes, negative affect, and hostile perceptions of others. Aggress Behav 2009; 35:453-61. [PMID: 19780037 DOI: 10.1002/ab.20324] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is mounting evidence that physical aggression and nonaggressive, rule-breaking delinquency constitute two separable though correlated subtypes of antisocial behavior. Even so, it remains unclear whether these behavioral subtypes have meaningfully different interpersonal correlates, particularly as they are subsumed within the same broad domain of antisocial behavior. To evaluate this, we examined whether hostile perceptions of others (assessed via exposure to a series of neutral unknown faces) were linked to level and type of antisocial behavior aggression vs. rule-breaking, and moreover, whether this association persisted even when also considering the common association with negative affect (as manipulated via written recollection of one's best and worst life experiences). Analyses revealed that aggression, but not rule-breaking, was uniquely tied to hostile perceptions of others. Furthermore, this association persisted over and above the common association of both hostile perceptions and aggression with negative affect (at both trait and state levels). Such results provide additional support for clinically meaningful differences between the behavioral subtypes of aggression and nonaggressive rule-breaking and for the independent role of hostile perceptions in aggressive behavior.
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Affiliation(s)
- S Alexandra Burt
- Department of Psychology, Michigan State University, East Lansing, Michigan 48824, USA.
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Derntl B, Windischberger C, Robinson S, Kryspin-Exner I, Gur RC, Moser E, Habel U. Amygdala activity to fear and anger in healthy young males is associated with testosterone. Psychoneuroendocrinology 2009; 34:687-93. [PMID: 19136216 DOI: 10.1016/j.psyneuen.2008.11.007] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2008] [Revised: 10/27/2008] [Accepted: 11/23/2008] [Indexed: 11/29/2022]
Abstract
Neuroimaging studies have documented modulation of the activity of the amygdala - a key node in the neural network underlying emotion perception and processing, and one that has also been associated with regulating aggression - by exogenous testosterone. However, results on the impact of normal range testosterone levels on explicit emotion recognition as a prerequisite for social interaction and amygdala activation in healthy young males are missing. Hence, we performed functional MRI at 3T in a group of 21 healthy males during explicit emotion recognition with a protocol specifically optimized to reliably detect amygdala activation. We observed similar amygdala activation to all emotions presented without any effect of gender of poser or laterality. Reaction times to fearful male faces were found negatively correlated to testosterone concentration, while no significant effects emerged for other emotions and neutral expressions. Correlation analyses revealed a significant positive association between testosterone levels and amygdala response to fearful and angry facial expressions, but not to other expressions. Hence, our results demonstrate that testosterone levels affect amygdala activation and also behavioral responses particularly to threat-related emotions in healthy young males. We conclude that these findings add to our understanding of emotion processing and its modulation by neuroendocrine factors.
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Affiliation(s)
- Birgit Derntl
- MR Centre of Excellence, Medical University of Vienna, Vienna, Austria.
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38
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Kohler CG, Walker JB, Martin EA, Healey KM, Moberg PJ. Facial emotion perception in schizophrenia: a meta-analytic review. Schizophr Bull 2009. [PMID: 19329561 DOI: 10.1093/schbul/sbn19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005). RESULTS The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race. CONCLUSION Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.
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Affiliation(s)
- Christian G Kohler
- Schizophrenia Research Center, Department of Psychiatry, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Derntl B, Finkelmeyer A, Toygar TK, Hülsmann A, Schneider F, Falkenberg DI, Habel U. Generalized deficit in all core components of empathy in schizophrenia. Schizophr Res 2009; 108:197-206. [PMID: 19087898 DOI: 10.1016/j.schres.2008.11.009] [Citation(s) in RCA: 157] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2008] [Revised: 10/08/2008] [Accepted: 11/06/2008] [Indexed: 11/25/2022]
Abstract
Empathy is a multidimensional construct composed of several components such as emotion recognition, emotional perspective taking and affective responsiveness. Patients with schizophrenia demonstrate deficits in several domains of emotion processing and perspective taking, thus suggesting a dysfunctional emotional competence. We assessed empathic abilities via three paradigms measuring emotion recognition, perspective taking and affective responsiveness as well as self-report empathy questionnaires in 24 (12 females, 12 males) schizophrenia patients meeting the DSM-IV criteria for schizophrenia and 24 matched healthy volunteers. Patients were recruited from the Department of Psychiatry and Psychotherapy, RWTH Aachen University and healthy volunteers were recruited via advertisement. Groups were matched for age, gender and parental education. Data analysis indicates a significant empathic deficit in patients, reflected in worse performance in all three domains. This deficit was only partly reflected in the self-report empathy questionnaires. Comparing the different tasks, emotional perspective taking was the most difficult task for all subjects and symptomatology worsened affective responsiveness. Schizophrenia patients not only struggle to correctly identify emotions, but also have difficulties in spontaneously simulating another person's subjective world (perspective taking) and might not be able to respond adequately in terms of their own emotional experience (affective responsiveness), which are not caused by emotion perception deficits. The results suggest that all domains of empathy are affected in schizophrenia and have to be addressed independently in behavioral therapies, thereby offering a possibility to improve socio-occupational life.
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Affiliation(s)
- Birgit Derntl
- Department of Psychiatry and Psychotherapy, RWTH Aachen University, Aachen, Germany.
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40
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Müller MJ. Gender-specific associations of depression with positive and negative symptoms in acute schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:1095-100. [PMID: 17493732 DOI: 10.1016/j.pnpbp.2007.03.014] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2006] [Revised: 03/19/2007] [Accepted: 03/20/2007] [Indexed: 10/23/2022]
Abstract
This clinical study analyzed gender-specific relationships of depression with other psychopathological and clinical variables in hospitalized patients with schizophrenia. During clinical routine treatment 119 inpatients with acute schizophrenia (DSM-IV) were investigated with the Calgary Depression Rating Scale for Schizophrenia (CDSS), the Clinical Global Impressions (CGI), and the Positive and Negative Syndrome Scale (PANSS). Depression scores of 77 male and 42 female patients (mean age 31.6+/-10.3 years) were related to background variables and to positive and negative symptom scores. Mean CDSS (5.8+/-5.6) and PANSS scores (total 76.9+/-22.1, positive symptoms 17.6+/-7.6, negative symptoms 20.5+/-7.8) were not significantly different between males and females. In females, depression was independently associated with higher negative symptom scores (P<0.01) and younger age (P<0.05) whereas in males positive symptoms (P<0.05) and short hospitalization (P<0.05) were the main factors associated with depression. The study revealed gender-specific differences in the relationship of depression with negative and positive symptoms.
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Affiliation(s)
- Matthias J Müller
- Department of Psychiatry, University of Mainz, Untere Zahlbacher Strasse 8, Mainz, Germany.
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