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Zhao W, Zhang Q, An H, Yun Y, Fan N, Yan S, Gan M, Tan S, Yang F. Vocal emotion perception in schizophrenia and its diagnostic significance. BMC Psychiatry 2023; 23:760. [PMID: 37848849 PMCID: PMC10580536 DOI: 10.1186/s12888-023-05110-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 08/13/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Cognitive and emotional impairment are among the core features of schizophrenia; assessment of vocal emotion recognition may facilitate the detection of schizophrenia. We explored the differences between cognitive and social aspects of emotion using vocal emotion recognition and detailed clinical characterization. METHODS Clinical symptoms and social and cognitive functioning were assessed by trained clinical psychiatrists. A vocal emotion perception test, including an assessment of emotion recognition and emotional intensity, was conducted. One-hundred-six patients with schizophrenia (SCZ) and 230 healthy controls (HCs) were recruited. RESULTS Considering emotion recognition, scores for all emotion categories were significantly lower in SCZ compared to HC. Considering emotional intensity, scores for anger, calmness, sadness, and surprise were significantly lower in the SCZs. Vocal recognition patterns showed a trend of unification and simplification in SCZs. A direct correlation was confirmed between vocal recognition impairment and cognition. In diagnostic tests, only the total score of vocal emotion recognition was a reliable index for the presence of schizophrenia. CONCLUSIONS This study shows that patients with schizophrenia are characterized by impaired vocal emotion perception. Furthermore, explicit and implicit vocal emotion perception processing in individuals with schizophrenia are viewed as distinct entities. This study provides a voice recognition tool to facilitate and improve the diagnosis of schizophrenia.
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Affiliation(s)
- Wenxuan Zhao
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Qi Zhang
- Wuxi Mental Health Center, Wuxi, China
| | - Huimei An
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Yajun Yun
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Ning Fan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Shaoxiao Yan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Mingyuan Gan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China.
| | - Fude Yang
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, No 7, HuangtuNandian, ChangPing District, Beijing, 100096, China.
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Robin M, Surjous L, Belbèze J, Bonnardel L, Lamas C, Silva J, Peres V, Corcos M. Four attachment-based categories of emotion regulation in adolescent psychic troubles. Front Psychol 2023; 14:1133980. [PMID: 37275718 PMCID: PMC10237043 DOI: 10.3389/fpsyg.2023.1133980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/06/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction Emotion regulation is altered in many psychiatric disorders in adolescence, but the understanding of mechanisms that underlie this alteration is still poor. Methods The PERCEPT study explores alexithymia, empathy, facial emotion recognition (FER) and defence mechanisms in a sample of adolescents in psychiatric care (n = 61, 74% of girls, mean age = 15.03 y.o.), in relation with participants' attachment styles. Results Results revealed correlations between attachment dimensions and all of the emotion regulation variables, suggesting that attachment modalities have functional links with emotional regulation at its different levels: FER accuracy was inversely correlated with avoidant attachment, while affective empathy, difficulty in identifying feelings (alexithymia) and immature as well as neurotic defence mechanisms were positively correlated with anxious attachment. Moreover, attachment categories delineated distinct emotional perception profiles. In particular, preoccupied attachment included adolescents with the highest levels of facial emotion perception (sensitivity and accuracy) and of affective empathy, whereas detached attachment included adolescents with the lowest levels of these variables. Neurotic defence mechanisms and difficulty to identify feelings were correlated with preoccupied attachment; immature defence mechanisms and difficulty to describe feelings to others characterized fearful attachment. Discussion These results suggest that attachment categories underlie emotion regulation processes in psychiatric disorders in adolescence. Theoretical and clinical implications are discussed.
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Affiliation(s)
- Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- CESP, INSERM U1178, Paris-Saclay University, Villejuif, France
| | - Luc Surjous
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
| | - Jean Belbèze
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
| | - Lucile Bonnardel
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Claire Lamas
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Jérôme Silva
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Victoire Peres
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
| | - Maurice Corcos
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, Paris, France
- Paris Cité University, Paris, France
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Xu YM, Deng F, Zhong BL. Facial emotion identification impairments in Chinese persons living with schizophrenia: A meta-analysis. Front Psychiatry 2022; 13:1097350. [PMID: 36606133 PMCID: PMC9807786 DOI: 10.3389/fpsyt.2022.1097350] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Facial emotion identification (FEI) deficits are associated with impaired social functioning in persons living with schizophrenia (PLwS), but the research on emotion-specific FEI deficits remains inconclusive. Furthermore, existing studies on FEI deficits are limited by their small sample sizes. We performed a meta-analysis of studies comparing the FEI abilities between Chinese PLwS and healthy controls in terms of the six basic facial emotions (happiness, sadness, fear, disgust, anger, and surprise), as well as contempt, calmness, and neutral facial expressions. METHODS Major Chinese- and English-language databases were searched to retrieve case-control studies that compared the FEI task performance between Chinese PLwS and healthy controls (HCs) and reported the emotion-specific correct identification scores for PLwS and HCs. The Joanna Briggs Institute Critical Appraisal Checklist for Case-control Studies ("JBI checklist," hereafter) was used to assess the risk of bias (RoB) of the included studies. Statistical analysis was performed using the "meta" package of R 4.1.2. RESULTS Twenty-three studies with a total of 28 case-control cohorts and 1,894 PLwS and 1,267 HCs were included. The RoB scores of the included studies ranged from two to seven. PLwS had statistically significantly lower FEI scores than HCs and the corresponding emotion-specific pooled standard mean differences (95% confidence intervals) were -0.69 (-0.88, -0.50) for happiness, -0.88 (-1.12, -0.63) for sadness, -1.44 (-1.83, -1.06) for fear, -1.18 (-1.60, -0.76) for disgust, -0.91 (-1.24, -0.57) for anger, -1.09 (-1.39, -0.78) for surprise, -0.26 (-0.51, -0.01) for contempt, -0.31 (-0.52, -0.09) for calmness, and -0.42 (-0.65, -0.18) for neutral. In the analyses of sources of heterogeneity, drug-naïve status, clinical setting, positive and negative psychotic symptoms, and RoB were significant moderators of the magnitudes of FEI deficits. CONCLUSIONS Chinese PLwS have significant FEI impairments in terms of recognizing the six basic facial emotions, contempt, calmness, and neutral emotions, and the magnitude of impairment varies depending on the type of emotion, clinical characteristics, and the level of RoB of the study. It is necessary to consider the characteristics of FEI deficits and the clinical moderators in the FEI deficits to develop remediation strategies targeting FEI deficits in schizophrenia.
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Affiliation(s)
- Yan-Min Xu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Fang Deng
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bao-Liang Zhong
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan, China.,Department of Clinical Psychology, Wuhan Hospital for Psychotherapy, Wuhan, China
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Lin Y, Ding H, Zhang Y. Multisensory Integration of Emotion in Schizophrenic Patients. Multisens Res 2020; 33:865-901. [PMID: 33706267 DOI: 10.1163/22134808-bja10016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/24/2020] [Indexed: 01/04/2023]
Abstract
Multisensory integration (MSI) of emotion has been increasingly recognized as an essential element of schizophrenic patients' impairments, leading to the breakdown of their interpersonal functioning. The present review provides an updated synopsis of schizophrenics' MSI abilities in emotion processing by examining relevant behavioral and neurological research. Existing behavioral studies have adopted well-established experimental paradigms to investigate how participants understand multisensory emotion stimuli, and interpret their reciprocal interactions. Yet it remains controversial with regard to congruence-induced facilitation effects, modality dominance effects, and generalized vs specific impairment hypotheses. Such inconsistencies are likely due to differences and variations in experimental manipulations, participants' clinical symptomatology, and cognitive abilities. Recent electrophysiological and neuroimaging research has revealed aberrant indices in event-related potential (ERP) and brain activation patterns, further suggesting impaired temporal processing and dysfunctional brain regions, connectivity and circuities at different stages of MSI in emotion processing. The limitations of existing studies and implications for future MSI work are discussed in light of research designs and techniques, study samples and stimuli, and clinical applications.
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Affiliation(s)
- Yi Lin
- 1Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, 800 Dong Chuan Rd., Minhang District, Shanghai, 200240, China
| | - Hongwei Ding
- 1Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, 800 Dong Chuan Rd., Minhang District, Shanghai, 200240, China
| | - Yang Zhang
- 2Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Twin Cities, MN 55455, USA
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Tyburski E, Karabanowicz E, Mak M, Lebiecka Z, Samochowiec A, Pełka-Wysiecka J, Sagan L, Samochowiec J. Color Trails Test: A New Set of Data on Cognitive Flexibility and Processing Speed in Schizophrenia. Front Psychiatry 2020; 11:521. [PMID: 32581889 PMCID: PMC7296107 DOI: 10.3389/fpsyt.2020.00521] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 05/21/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Although schizophrenia patients have been reported to manifest deficits in cognitive flexibility and lower processing speed (measured with i.a., the Color Trails Test, CTT), there still remain a few matters that require further investigation. We have therefore formulated three research aims: 1) to examine the factor structure of CTT in schizophrenia patients and healthy controls, 2) to compare different CTT performance measures in the two groups, 3) to investigate the relationship between these measures and selected psychopathological symptoms in the patient group. METHODS Sixty-seven patients with paranoid schizophrenia and 67 healthy controls, matched for gender, age, number of years of education, and overall cognitive functioning underwent assessment of cognitive flexibility and processing speed with the CTT. RESULTS Factor analysis of CTT variables based on the principal component method revealed a four-factor solution in both groups. Compared with healthy controls, the patients performed poorer on CTT 1 time, CTT 2 time, 2-1 difference, prompts in CTT 2, and had higher regression factor scores for Factor 1 (reflecting the slower speed of perceptual tracking). Furthermore, significant links were found between some CTT measures, and negative and disorganization symptoms. CONCLUSIONS Schizophrenia patients exhibit problems with speed of perceptual tracking and executive processes dependent on processing speed. Our results may be useful for the development of neuropsychological diagnostic methods for schizophrenia patients. It seems that, compared to other CTT indices, CTT 1 time, CTT 2 time, and 2-1 difference are more appropriate measures of cognitive performance in schizophrenia patients.
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Affiliation(s)
- Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Poznań, Poland
| | - Ewa Karabanowicz
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Monika Mak
- Independent Clinical Psychology Unit, Pomeranian Medical University, Szczecin, Poland
| | - Zofia Lebiecka
- Independent Clinical Psychology Unit, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Leszek Sagan
- Department of Neurosurgery, Pomeranian Medical University, Szczecin, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
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6
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Lin Y, Ding H, Zhang Y. Emotional Prosody Processing in Schizophrenic Patients: A Selective Review and Meta-Analysis. J Clin Med 2018; 7:jcm7100363. [PMID: 30336573 PMCID: PMC6210777 DOI: 10.3390/jcm7100363] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 10/10/2018] [Accepted: 10/14/2018] [Indexed: 12/11/2022] Open
Abstract
Emotional prosody (EP) has been increasingly recognized as an important area of schizophrenic patients’ dysfunctions in their language use and social communication. The present review aims to provide an updated synopsis on emotional prosody processing (EPP) in schizophrenic disorders, with a specific focus on performance characteristics, the influential factors and underlying neural mechanisms. A literature search up to 2018 was conducted with online databases, and final selections were limited to empirical studies which investigated the prosodic processing of at least one of the six basic emotions in patients with a clear diagnosis of schizophrenia without co-morbid diseases. A narrative synthesis was performed, covering the range of research topics, task paradigms, stimulus presentation, study populations and statistical power with a quantitative meta-analytic approach in Comprehensive Meta-Analysis Version 2.0. Study outcomes indicated that schizophrenic patients’ EPP deficits were consistently observed across studies (d = −0.92, 95% CI = −1.06 < δ < −0.78), with identification tasks (d = −0.95, 95% CI = −1.11 < δ < −0.80) being more difficult to process than discrimination tasks (d = −0.74, 95% CI = −1.03 < δ < −0.44) and emotional stimuli being more difficult than neutral stimuli. Patients’ performance was influenced by both participant- and experiment-related factors. Their social cognitive deficits in EP could be further explained by right-lateralized impairments and abnormalities in primary auditory cortex, medial prefrontal cortex and auditory-insula connectivity. The data pointed to impaired pre-attentive and attentive processes, both of which played important roles in the abnormal EPP in the schizophrenic population. The current selective review and meta-analysis support the clinical advocacy of including EP in early diagnosis and rehabilitation in the general framework of social cognition and neurocognition deficits in schizophrenic disorders. Future cross-sectional and longitudinal studies are further suggested to investigate schizophrenic patients’ perception and production of EP in different languages and cultures, modality forms and neuro-cognitive domains.
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Affiliation(s)
- Yi Lin
- Institute of Cross-Linguistic Processing and Cognition, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Hongwei Ding
- Institute of Cross-Linguistic Processing and Cognition, School of Foreign Languages, Shanghai Jiao Tong University, Shanghai 200240, China.
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences & Center for Neurobehavioral Development, University of Minnesota, Twin Cities, MN 55455, USA.
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Hu X, Yin L, Situ M, Guo K, Yang P, Zhang M, Huang Y. Parents' impaired emotion recognition abilities are related to children's autistic symptoms in autism spectrum disorder. Neuropsychiatr Dis Treat 2018; 14:2973-2980. [PMID: 30464482 PMCID: PMC6223345 DOI: 10.2147/ndt.s174538] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE We aimed to explore whether parents of children with autism spectrum disorder (ASD) had impaired emotion recognition abilities and whether this deficit was related to their children's autistic symptoms. METHODS The autistic symptoms of 31 ASD children were assessed using the Autism Diagnostic Interview-Revised (ADI-R). Fifty parents of ASD children and 34 parents of typically developing (TD) children completed an emotion recognition task (ERT). RESULTS The numbers of correct ERT responses were lower for parents of ASD children than for parents of TD children with respect to recognizing sadness, disgust, fear, and all emotions (P=0.01, 0.04, 0.02, and 0.00, respectively). Controlled for parental age, gender, and the intelligence quotients of both the parents and children, a negative correlation was found between the total number of correct ERT responses for parents of ASD children and these children's "restricted, repetitive, and stereotyped patterns of behavior" scores on the ADI-R (r=-0.32; P=0.03). CONCLUSION Parents of ASD children showed impaired emotion recognition abilities compared with parents of TD children. This parental deficit in emotion recognition ability was related to the autistic symptoms of ASD children.
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Affiliation(s)
- Xiao Hu
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Li Yin
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Mingjing Situ
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Kuifang Guo
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Pingyuan Yang
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Manxue Zhang
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
| | - Yi Huang
- Department of Psychiatry, Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China, .,Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China, .,Brain Research Center, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China,
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8
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Chan SC, Chan CC, Derbie AY, Hui I, Tan DG, Pang MY, Lau SC, Fong KN. Chinese Calligraphy Writing for Augmenting Attentional Control and Working Memory of Older Adults at Risk of Mild Cognitive Impairment: A Randomized Controlled Trial. J Alzheimers Dis 2017; 58:735-746. [DOI: 10.3233/jad-170024] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sam C.C. Chan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Chetwyn C.H. Chan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Abiot Y. Derbie
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Irene Hui
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Davynn G.H. Tan
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Marco Y.C. Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Stephen C.L. Lau
- Applied Cognitive Neuroscience Laboratory, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Kenneth N.K. Fong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
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9
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Bratton H, O'Rourke S, Tansey L, Hutton P. Social cognition and paranoia in forensic inpatients with schizophrenia: A cross-sectional study. Schizophr Res 2017; 184:96-102. [PMID: 27979698 DOI: 10.1016/j.schres.2016.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/25/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND People diagnosed with schizophrenia have difficulties in emotion recognition and theory of mind, and these may contribute to paranoia. The aim of this study was to determine whether this relationship is evident in patients residing in a secure forensic setting. METHOD Twenty-seven male participants with a diagnosis of schizophrenia and a history of offending behaviour were assessed using The Awareness of Social Inference Test (TASIT), The Ambiguous Intentions Hostility Questionnaire (AIHQ) and The Green et al. Paranoid Thought Scales (G-PTS). Individuals were recruited from two medium secure and one high secure forensic hospital in Scotland. RESULTS Correlation, logistic and multiple regression analyses did not find that emotion recognition and theory of mind were associated with indices of paranoid thinking. CONCLUSION Social cognition did not appear to be related to indices of paranoia in this forensic sample. Although participants reported low levels of paranoia overall, the results are consistent with recent conclusions that theory of mind impairments are not specifically linked to paranoia in people diagnosed with schizophrenia.
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Affiliation(s)
- Helen Bratton
- Forensic Clinical Psychology, Forensic Community Mental Health Service, Ward 17 Falkirk Community Hospital, Westburn Avenue, Falkirk FK1 5SU, United Kingdom.
| | - Suzanne O'Rourke
- Department of Clinical and Health Psychology, The School of Health in Social Science, University of Edinburgh, United Kingdom
| | - Louise Tansey
- The Orchard Clinic, NHS Lothian, Edinburgh, United Kingdom
| | - Paul Hutton
- Department of Clinical and Health Psychology, The School of Health in Social Science, University of Edinburgh, United Kingdom
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10
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Tang XW, Yu M, Duan WW, Zhang XR, Sha WW, Wang X, Zhang XB. Facial emotion recognition and alexithymia in Chinese male patients with deficit schizophrenia. Psychiatry Res 2016; 246:353-359. [PMID: 27770713 DOI: 10.1016/j.psychres.2016.09.055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 06/28/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
Abstract
Deficit schizophrenia (DS) has been proposed as a pathophysiologically distinct schizophrenia subtype. This study investigated facial emotion recognition deficits and alexithymia in DS and non-deficit schizophrenia patients (NDS) and their relationships with other clinical variables. The Brief Psychiatric Rating Scale (BPRS), Scale for the Assessment of Negative Symptoms (SANS), and Scale for the Assessment of Positive Symptoms (SAPS) were employed to evaluate the psychiatric symptoms in patients with schizophrenia. Facial emotion recognition deficits and Alexithymia were assessed in DS, NDS, and control groups by The Chinese Facial Emotion Test (CFET) and the Toronto Alexithymia Scale-20 (TAS-20). Compared with control group, both DS and NDS patients exhibited more severe facial emotion recognition impairments, with the exception of "happy faces" in NDS patients, as well as higher alexithymia scores. In DS patients, correct frequency for fear recognition and total CFET score were negatively correlated with TAS-20 Factor 3 subscore for "externally oriented thinking". Total TAS-20 score was positively correlated with BPRS negative symptom and SANS score in DS patients. In contrast, there were no correlations between TAS-20 scores/subscores and psychiatric symptoms in NDS patients. These findings indicated distinct facial emotion recognition impairments in DS and NDS patients. Alexithymia might be specifically related to the negative symptom in DS patients, suggesting DS as a unique schizophrenic subtype.
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Affiliation(s)
- Xiao Wei Tang
- Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu 225003, China
| | - Miao Yu
- Department of Neuropsychiatry, Affiliated ZhongDa Hospital and School of Medical, Southeast University, Nanjing, Jiangsu 210009, China
| | - Wei Wei Duan
- Xuzhou Medical College, Xuzhou, Jiangsu 221000, China
| | - Xiang Rong Zhang
- Department of Geriatric Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jaingsu 210029, China.
| | - Wei Wei Sha
- Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu 225003, China
| | - Xiang Wang
- Medical Psychological Institute of the Second Xiangya Hospital, Central South University, 139 Renmin (M) Road, Changsha, Hunan 410011, China
| | - Xiao Bin Zhang
- Department of Psychiatry, Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, Yangzhou, Jiangsu 225003, China.
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11
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Facial emotion perception impairments in schizophrenia patients with comorbid antisocial personality disorder. Psychiatry Res 2016; 236:22-27. [PMID: 26778631 DOI: 10.1016/j.psychres.2016.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 11/19/2015] [Accepted: 01/04/2016] [Indexed: 10/22/2022]
Abstract
Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD.
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Pinkham AE, Harvey PD, Penn DL. PARANOID INDIVIDUALS WITH SCHIZOPHRENIA SHOW GREATER SOCIAL COGNITIVE BIAS AND WORSE SOCIAL FUNCTIONING THAN NON-PARANOID INDIVIDUALS WITH SCHIZOPHRENIA. SCHIZOPHRENIA RESEARCH-COGNITION 2016; 3:33-38. [PMID: 27990352 PMCID: PMC5156478 DOI: 10.1016/j.scog.2015.11.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia.
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Affiliation(s)
- Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, 75080; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, 75390
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, 33136; Research Service, Bruce W Carter VA Medical Center, Miami, FL, 33125
| | - David L Penn
- Department of Psychology, University of North Carolina, Chapel Hill, NC, 27599; Australian Catholic University, Melbourne, VIC 3065
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Facial emotion recognition in paranoid schizophrenia and autism spectrum disorder. Schizophr Res 2014; 159:509-14. [PMID: 25278104 DOI: 10.1016/j.schres.2014.08.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 08/18/2014] [Accepted: 08/19/2014] [Indexed: 11/20/2022]
Abstract
Schizophrenia (SZ) and autism spectrum disorder (ASD) share deficits in emotion processing. In order to identify convergent and divergent mechanisms, we investigated facial emotion recognition in SZ, high-functioning ASD (HFASD), and typically developed controls (TD). Different degrees of task difficulty and emotion complexity (face, eyes; basic emotions, complex emotions) were used. Two Benton tests were implemented in order to elicit potentially confounding visuo-perceptual functioning and facial processing. Nineteen participants with paranoid SZ, 22 with HFASD and 20 TD were included, aged between 14 and 33 years. Individuals with SZ were comparable to TD in all obtained emotion recognition measures, but showed reduced basic visuo-perceptual abilities. The HFASD group was impaired in the recognition of basic and complex emotions compared to both, SZ and TD. When facial identity recognition was adjusted for, group differences remained for the recognition of complex emotions only. Our results suggest that there is a SZ subgroup with predominantly paranoid symptoms that does not show problems in face processing and emotion recognition, but visuo-perceptual impairments. They also confirm the notion of a general facial and emotion recognition deficit in HFASD. No shared emotion recognition deficit was found for paranoid SZ and HFASD, emphasizing the differential cognitive underpinnings of both disorders.
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Yalcin-Siedentopf N, Hoertnagl CM, Biedermann F, Baumgartner S, Deisenhammer EA, Hausmann A, Kaufmann A, Kemmler G, Mühlbacher M, Rauch AS, Fleischhacker WW, Hofer A. Facial affect recognition in symptomatically remitted patients with schizophrenia and bipolar disorder. Schizophr Res 2014; 152:440-5. [PMID: 24361305 DOI: 10.1016/j.schres.2013.11.024] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 11/05/2013] [Accepted: 11/12/2013] [Indexed: 10/25/2022]
Abstract
Both schizophrenia and bipolar disorder (BD) have consistently been associated with deficits in facial affect recognition (FAR). These impairments have been related to various aspects of social competence and functioning and are relatively stable over time. However, individuals in remission may outperform patients experiencing an acute phase of the disorders. The present study directly contrasted FAR in symptomatically remitted patients with schizophrenia or BD and healthy volunteers and investigated its relationship with patients' outcomes. Compared to healthy control subjects, schizophrenia patients were impaired in the recognition of angry, disgusted, sad and happy facial expressions, while BD patients showed deficits only in the recognition of disgusted and happy facial expressions. When directly comparing the two patient groups individuals suffering from BD outperformed those with schizophrenia in the recognition of expressions depicting anger. There was no significant association between affect recognition abilities and symptomatic or psychosocial outcomes in schizophrenia patients. Among BD patients, relatively higher depression scores were associated with impairments in both the identification of happy faces and psychosocial functioning. Overall, our findings indicate that during periods of symptomatic remission the recognition of facial affect may be less impaired in patients with BD than in those suffering from schizophrenia. However, in the psychosocial context BD patients seem to be more sensitive to residual symptomatology.
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Affiliation(s)
- Nursen Yalcin-Siedentopf
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria.
| | - Christine M Hoertnagl
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, General and Social Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Falko Biedermann
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Susanne Baumgartner
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Eberhard A Deisenhammer
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, General and Social Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Armand Hausmann
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, General and Social Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Alexandra Kaufmann
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Georg Kemmler
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, General and Social Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Moritz Mühlbacher
- Private Medical University Salzburg, Department of Psychiatry and Psychotherapy, Ignaz Harrerstrasse 79, A-5020 Salzburg, Austria
| | - Anna-Sophia Rauch
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - W Wolfgang Fleischhacker
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria; Medical University Innsbruck, Department of Psychiatry and Psychotherapy, General and Social Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
| | - Alex Hofer
- Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Biological Psychiatry Division, Anichstrasse 35, A-6020 Innsbruck, Austria
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Pan YJ, Tseng HH, Liu SK. Affect recognition across manic and euthymic phases of bipolar disorder in Han-Chinese patients. J Affect Disord 2013; 151:791-794. [PMID: 23871128 DOI: 10.1016/j.jad.2013.06.053] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 05/15/2013] [Accepted: 06/28/2013] [Indexed: 10/26/2022]
Abstract
Patients with bipolar disorder (BD) have affect recognition deficits. Whether affect recognition deficits constitute a state or trait marker of BD has great etiopathological significance. The current study aims to explore the interrelationships between affect recognition and basic neurocognitive functions for patients with BD across different mood states, using the Diagnostic Analysis of Non-Verbal Accuracy-2, Taiwanese version (DANVA-2-TW) as the index measure for affect recognition. To our knowledge, this is the first study examining affect recognition deficits of BPD across mood states in the Han Chinese population. Twenty-nine manic patients, 16 remitted patients with BD, and 40 control subjects are included in the study. Distinct association patterns between affect recognition and neurocognitive functions are demonstrated for patients with BD and control subjects, implicating alternations in emotion associated neurocognitive processing. Compared to control subjects, manic patients but not remitted subjects perform significantly worse in the recognition of negative emotions as a whole and specifically anger, after adjusting for differences in general intellectual ability and basic neurocognitive functions. Affect recognition deficit may be a relatively independent impairment in BD rather than consequences arising from deficits in other basic neurocognition. The impairments of manic patients in the recognition of negative emotions, specifically anger, may further our understanding of core clinical psychopathology of BD and have implications in treating bipolar patients across distinct mood phases.
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Affiliation(s)
- Yi-Ju Pan
- Far Eastern Memorial Hospital, Taipei, Taiwan; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huai-Hsuan Tseng
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Shi-Kai Liu
- Far Eastern Memorial Hospital, Taipei, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan; Centre for Addiction and Mental Health, Toronto, ON, Canada.
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Are there differential deficits in facial emotion recognition between paranoid and non-paranoid schizophrenia? A signal detection analysis. Psychiatry Res 2013; 209:424-30. [PMID: 23598059 DOI: 10.1016/j.psychres.2013.03.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 03/21/2013] [Accepted: 03/24/2013] [Indexed: 11/23/2022]
Abstract
This study assessed facial emotion recognition abilities in subjects with paranoid and non-paranoid schizophrenia (NPS) using signal detection theory. We explore the differential deficits in facial emotion recognition in 44 paranoid patients with schizophrenia (PS) and 30 non-paranoid patients with schizophrenia (NPS), compared to 80 healthy controls. We used morphed faces with different intensities of emotion and computed the sensitivity index (d') of each emotion. The results showed that performance differed between the schizophrenia and healthy controls groups in the recognition of both negative and positive affects. The PS group performed worse than the healthy controls group but better than the NPS group in overall performance. Performance differed between the NPS and healthy controls groups in the recognition of all basic emotions and neutral faces; between the PS and healthy controls groups in the recognition of angry faces; and between the PS and NPS groups in the recognition of happiness, anger, sadness, disgust, and neutral affects. The facial emotion recognition impairment in schizophrenia may reflect a generalized deficit rather than a negative-emotion specific deficit. The PS group performed worse than the control group, but better than the NPS group in facial expression recognition, with differential deficits between PS and NPS patients.
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Irani F, Seligman S, Kamath V, Kohler C, Gur RC. A meta-analysis of emotion perception and functional outcomes in schizophrenia. Schizophr Res 2012; 137:203-11. [PMID: 22341200 PMCID: PMC3351501 DOI: 10.1016/j.schres.2012.01.023] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 01/12/2012] [Accepted: 01/17/2012] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Emotion perception (EP) is impaired in schizophrenia, is stable across clinical state, resistant to antipsychotic treatment and linked to symptom severity. Given its pervasive nature, there is a need to quantitatively examine whether this dysfunction impacts functional outcomes. We used a meta-analytic strategy to combine results from several studies and examine synthesized effect sizes. METHODS A Meta-analysis of Observational Studies in Epidemiology standard was used to extract data following a PubMed and PsychInfo search. Studies reporting correlations between measures of EP and functional outcomes in schizophrenia spectrum disorders were selected. The impact of potential methodological (task type), demographic (sex, age, race, education, marital status) and clinical (age of onset, duration of illness, setting, symptoms, anti-psychotic medication) moderators on effect sizes were examined. RESULTS Twenty-five studies met inclusion criteria and included 1306 patients who were 37 years old, with 12 years of education, 64% male and 63% Caucasian. There was a significant relationship between EP and functional outcomes in individuals with schizophrenia or schizoaffective disorder, with effect sizes in the medium range. Medium to large range positive correlations were observed between emotion identification and functional outcome domains involving social problem solving, social skills and community functioning. Significant moderators included task type (emotion identification tasks), sex (% male in sample), race (% Caucasian in sample) and clinical symptoms (negative and positive). CONCLUSIONS Emotion identification deficits are associated with functional impairments in schizophrenia and moderated by sex, race and symptoms. This has implications for treatment efforts to improve outcomes.
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Affiliation(s)
- Farzin Irani
- Neuropsychiatry Section, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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Facial emotion recognition in Chinese with schizophrenia at early and chronic stages of illness. Psychiatry Res 2011; 190:172-6. [PMID: 21856020 DOI: 10.1016/j.psychres.2011.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2010] [Revised: 05/13/2011] [Accepted: 07/02/2011] [Indexed: 12/14/2022]
Abstract
Deficits in facial emotion recognition have been recognised in Chinese patients diagnosed with schizophrenia. This study examined the relationship between chronicity of illness and performance of facial emotion recognition in Chinese with schizophrenia. There were altogether four groups of subjects matched for age and gender composition. The first and second groups comprised medically stable outpatients with first-episode schizophrenia (n=50) and their healthy controls (n=26). The third and fourth groups were patients with chronic schizophrenic illness (n=51) and their controls (n=28). The ability to recognise the six prototypical facial emotions was examined using locally validated coloured photographs from the Japanese and Caucasian Facial Expressions of Emotion. Chinese patients with schizophrenia, in both the first-episode and chronic stages, performed significantly worse than their control counterparts on overall facial emotion recognition, (P<0.001), with specific impairment in identifying surprise, fear and disgust. The level of deficit was similar at the two stages of illness. Findings suggest that impaired recognition of facial emotion did not appear to have worsened over the course of disease progression, suggesting that recognition of facial emotion is a rather stable trait of the illness. The emotion-specific deficit may have implications for understanding the social difficulties in schizophrenia.
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Pinkham AE, Brensinger C, Kohler C, Gur RE, Gur RC. Actively paranoid patients with schizophrenia over attribute anger to neutral faces. Schizophr Res 2011; 125:174-8. [PMID: 21112186 PMCID: PMC3031724 DOI: 10.1016/j.schres.2010.11.006] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 10/29/2010] [Accepted: 11/01/2010] [Indexed: 10/18/2022]
Abstract
Previous investigations of the influence of paranoia on facial affect recognition in schizophrenia have been inconclusive as some studies demonstrate better performance for paranoid relative to non-paranoid patients and others show that paranoid patients display greater impairments. These studies have been limited by small sample sizes and inconsistencies in the criteria used to define groups. Here, we utilized an established emotion recognition task and a large sample to examine differential performance in emotion recognition ability between patients who were actively paranoid (AP) and those who were not actively paranoid (NAP). Accuracy and error patterns on the Penn Emotion Recognition test (ER40) were examined in 132 patients (64 NAP and 68 AP). Groups were defined based on the presence of paranoid ideation at the time of testing rather than diagnostic subtype. AP and NAP patients did not differ in overall task accuracy; however, an emotion by group interaction indicated that AP patients were significantly worse than NAP patients at correctly labeling neutral faces. A comparison of error patterns on neutral stimuli revealed that the groups differed only in misattributions of anger expressions, with AP patients being significantly more likely to misidentify a neutral expression as angry. The present findings suggest that paranoia is associated with a tendency to over attribute threat to ambiguous stimuli and also lend support to emerging hypotheses of amygdala hyperactivation as a potential neural mechanism for paranoid ideation.
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Affiliation(s)
- Amy E. Pinkham
- Department of Psychology; Southern Methodist University, Dallas, TX, Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX
| | - Colleen Brensinger
- Schizophrenia Research Center, Department of Psychiatry; University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Christian Kohler
- Schizophrenia Research Center, Department of Psychiatry; University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Raquel E. Gur
- Schizophrenia Research Center, Department of Psychiatry; University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Ruben C. Gur
- Schizophrenia Research Center, Department of Psychiatry; University of Pennsylvania School of Medicine, Philadelphia, PA
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Huang J, Chan RC, Gollan JK, Liu W, Ma Z, Li Z, Gong QY. Perceptual bias of patients with schizophrenia in morphed facial expression. Psychiatry Res 2011; 185:60-5. [PMID: 20646764 PMCID: PMC3805827 DOI: 10.1016/j.psychres.2010.05.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2009] [Revised: 05/20/2010] [Accepted: 05/21/2010] [Indexed: 10/19/2022]
Abstract
Limited research has specifically examined the nature of the dysfunction in emotion categorization representation in schizophrenia. The current study aimed to investigate the perception bias of morphed facial expression in subjects with schizophrenia and healthy controls in the emotion continua. Twenty-eight patients with schizophrenia and thirty-one healthy controls took part in this study. They were administered a standardized set of morphed photographs of facial expressions with varying emotional intensities between 0% and 100% of the emotion, in 10% increments to provide a range of intensities from pleasant to unpleasant and approach to withdraw. Shift points, indicating the time point that the subjects' emotion identification begins to change, and response slopes, indicating how rapidly these changes have happened at the shift points in the emotion continuum, were measured. Patients exhibited a significantly greater response slope (i.e., patients' perception changed more rapidly) and greater shift point (i.e., patients still perceived mild expressions of anger as happy faces) with increasing emotion signal compared with healthy controls when the facial expression morphed from happy to angry. Furthermore, patients with schizophrenia still perceived mild expressions of fear as angry faces(a greater shift point) and were less discriminative from angry to fearful emotion(a flatter response slope). They were sensitive to sadness (a smaller shift point) and the perception changed rapidly (a sharper response slope) as compared with healthy controls in the emotion continuum of happy to sad. In conclusion, patients with schizophrenia demonstrated impaired categorical perception of facial expressions, with generally 'rapid' but 'late' discrimination towards social threat-related stimuli such as angry facial expression. Compared with healthy controls, these patients have a sharper discrimination perception pattern in the emotion continua from positive valence to negative valence.
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Affiliation(s)
- Jia Huang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
,Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Raymond C.K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
,Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
,Corresponding author. Institute of Psychology, Chinese Academy of Sciences, 4A Datun Road, Beijing, China. Tel./fax: +86 10 64836274. , (R.C.K. Chan).
| | - Jackie K. Gollan
- Department of Psychiatry and Behavioral Sciences, Northwestern University, Chicago, United States
| | - Wenhua Liu
- Faculty of Life Sciences, Sun Yat-Sen University, Guangzhou, China
,Faculty of Humanities and Social Sciences, Guangzhou Medical College, Guangzhou
| | - Zheng Ma
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Zhanjiang Li
- Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Qi-yong Gong
- Huaxi MR Research Centre, Department of Radiology, West China Hospital / West China School of Medicine, Sichuan University, Chengdu, China
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Wylie KP, Tregellas JR. The role of the insula in schizophrenia. Schizophr Res 2010; 123:93-104. [PMID: 20832997 PMCID: PMC2957503 DOI: 10.1016/j.schres.2010.08.027] [Citation(s) in RCA: 253] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Revised: 08/11/2010] [Accepted: 08/16/2010] [Indexed: 11/30/2022]
Abstract
Involvement of the insular cortex is a common finding in neuroanatomical studies of schizophrenia, yet its contribution to disease pathology remains unknown. This review describes the normal function of the insula and examines pathology of this region in schizophrenia. The insula is a cortical structure with extensive connections to many areas of the cortex and limbic system. It integrates external sensory input with the limbic system and is integral to the awareness of the body's state (interoception). Many deficits observed in schizophrenia involve these functions and may relate to insula pathology. Furthermore, reports describing deficits caused by lesions of the insula parallel deficits observed in schizophrenia. Examples of insula-related functions that are altered in schizophrenia include the processing of both visual and auditory emotional information, pain, and neuronal representations of the self. The last of these functions, processing representations of the self, plays a key role in discriminating between self-generated and external information, suggesting that insula dysfunction may contribute to hallucinations, a cardinal feature of schizophrenia.
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Affiliation(s)
- Korey P Wylie
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 E. 17th Place, Aurora, CO 80045, United States
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Li H, Chan RCK, Zhao Q, Hong X, Gong QY. Facial emotion perception in Chinese patients with schizophrenia and non-psychotic first-degree relatives. Prog Neuropsychopharmacol Biol Psychiatry 2010; 34:393-400. [PMID: 20079792 DOI: 10.1016/j.pnpbp.2010.01.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Revised: 11/19/2009] [Accepted: 01/08/2010] [Indexed: 10/20/2022]
Abstract
Although there is a consensus that patients with schizophrenia have certain deficits in perceiving and expressing facial emotions, previous studies of facial emotion perception in schizophrenia do not present consistent results. The objective of this study was to explore facial emotion perception deficits in Chinese patients with schizophrenia and their non-psychotic first-degree relatives. Sixty-nine patients with schizophrenia, 56 of their first-degree relatives (33 parents and 23 siblings), and 92 healthy controls (67 younger healthy controls matched to the patients and siblings, and 25 older healthy controls matched to the parents) completed a set of facial emotion perception tasks, including facial emotion discrimination, identification, intensity, valence, and corresponding face identification tasks. The results demonstrated that patients with schizophrenia performed significantly worse than their siblings and younger healthy controls in accuracy in a variety of facial emotion perception tasks, whereas the siblings of the patients performed as well as the corresponding younger healthy controls in all of the facial emotion perception tasks. Patients with schizophrenia also showed significantly reduced speed than younger healthy controls, while siblings of patients did not demonstrate significant differences with both patients and younger healthy controls in speed. Meanwhile, we also found that parents of the schizophrenia patients performed significantly worse than the corresponding older healthy controls in accuracy in terms of facial emotion identification, valence, and the composite index of the facial discrimination, identification, intensity and valence tasks. Moreover, no significant differences were found between the parents of patients and older healthy controls in speed after controlling the years of education and IQ. Taken together, the results suggest that facial emotion perception deficits may serve as potential endophenotypes for schizophrenia.
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Affiliation(s)
- Huijie Li
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Pan YJ, Chen SH, Chen WJ, Liu SK. Affect recognition as an independent social function determinant in schizophrenia. Compr Psychiatry 2009; 50:443-52. [PMID: 19683615 DOI: 10.1016/j.comppsych.2008.11.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 10/15/2008] [Accepted: 11/02/2008] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Facial affect recognition deficits may represent specific deficits and contribute to social dysfunction in patients with schizophrenia. Whether their impacts on social dysfunction are independent to those caused by deficits in basic neurocognition and clinical symptoms needs to be further delineated. METHOD Association patterns between affect recognition and basic neurocognitive abilities in 40 acute and 33 stable patients with schizophrenia were compared to explore whether their interrelationships changed across clinical stages. The independent contribution of affect recognition deficits to social dysfunction was explored by multivariate models controlling for general intellectual ability, basic neurocognition, and clinical symptoms. RESULTS Affect recognition deficits were associated with social role performances, self-care, and contributed independently to global social functioning in stable patients but not in acute patients. Conversely, affect recognition deficits were associated with impaired basic neurocognitions in acute patients but not in stable patients. CONCLUSION In stabilized community patients with schizophrenia, affect recognition deficits were relatively independent to basic neurocognition and had significant social functional consequences.
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Affiliation(s)
- Yi-Ju Pan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
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Effects of sad mood on facial emotion recognition in Chinese people. Psychiatry Res 2008; 159:37-43. [PMID: 18329723 DOI: 10.1016/j.psychres.2007.04.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2006] [Revised: 01/05/2007] [Accepted: 04/22/2007] [Indexed: 11/23/2022]
Abstract
This study examined the influence of sad mood on the judgment of ambiguous facial emotion expressions among 47 healthy volunteers who had been induced to feel sad (n=13), neutral (n=15), or happy (n=19) emotions by watching video clips. The findings suggest that when the targets were ambiguous, participants who were in a sad mood tended to classify them in the negative emotional categories rather than the positive emotional categories. Also, this observation indicates that emotion-specific negative bias in the judgment of facial expressions is associated with a sad mood. The finding argues against a general impairment in decoding facial expressions. Furthermore, the observed mood-congruent negative bias was best predicted by spatial perception. The findings of this study provide insights into the cognitive processes underlying the interpersonal difficulties experienced by people in a sad mood, which may be predisposing factors in the development of clinical depression.
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