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Karl V, Engen H, Beck D, Norbom LB, Ferschmann L, Aksnes ER, Kjelkenes R, Voldsbekk I, Andreassen OA, Alnæs D, Ladouceur CD, Westlye LT, Tamnes CK. The role of functional emotion circuits in distinct dimensions of psychopathology in youth. Transl Psychiatry 2024; 14:317. [PMID: 39095355 PMCID: PMC11297301 DOI: 10.1038/s41398-024-03036-1] [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: 09/13/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/04/2024] Open
Abstract
Several mental disorders emerge during childhood or adolescence and are often characterized by socioemotional difficulties, including alterations in emotion perception. Emotional facial expressions are processed in discrete functional brain modules whose connectivity patterns encode emotion categories, but the involvement of these neural circuits in psychopathology in youth is poorly understood. This study examined the associations between activation and functional connectivity patterns in emotion circuits and psychopathology during development. We used task-based fMRI data from the Philadelphia Neurodevelopmental Cohort (PNC, N = 1221, 8-23 years) and conducted generalized psycho-physiological interaction (gPPI) analyses. Measures of psychopathology were derived from an independent component analysis of questionnaire data. The results showed positive associations between identifying fearful, sad, and angry faces and depressive symptoms, and a negative relationship between sadness recognition and positive psychosis symptoms. We found a positive main effect of depressive symptoms on BOLD activation in regions overlapping with the default mode network, while individuals reporting higher levels of norm-violating behavior exhibited emotion-specific lower functional connectivity within regions of the salience network and between modules that overlapped with the salience and default mode network. Our findings illustrate the relevance of functional connectivity patterns underlying emotion processing for behavioral problems in children and adolescents.
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Affiliation(s)
- Valerie Karl
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.
| | - Haakon Engen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- Institute of Military Psychiatry Norwegian Armed Forces Joint Medical Services, Oslo, Norway
| | - Dani Beck
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Linn B Norbom
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Lia Ferschmann
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
| | - Eira R Aksnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Rikka Kjelkenes
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Irene Voldsbekk
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Dag Alnæs
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cecile D Ladouceur
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lars T Westlye
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Christian K Tamnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Substance Abuse, Diakonhjemmet Hospital, Oslo, Norway
- NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Abo Foul Y, Arkadir D, Demikhovskaya A, Noyman Y, Linetsky E, Abu Snineh M, Aviezer H, Eitan R. Perception of emotionally incongruent cues: evidence for overreliance on body vs. face expressions in Parkinson's disease. Front Psychol 2024; 15:1287952. [PMID: 38770252 PMCID: PMC11103677 DOI: 10.3389/fpsyg.2024.1287952] [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: 09/03/2023] [Accepted: 04/08/2024] [Indexed: 05/22/2024] Open
Abstract
Individuals with Parkinson's disease (PD) may exhibit impaired emotion perception. However, research demonstrating this decline has been based almost entirely on the recognition of isolated emotional cues. In real life, emotional cues such as expressive faces are typically encountered alongside expressive bodies. The current study investigated emotion perception in individuals with PD (n = 37) using emotionally incongruent composite displays of facial and body expressions, as well as isolated face and body expressions, and congruent composite displays as a baseline. In addition to a group of healthy controls (HC) (n = 50), we also included control individuals with schizophrenia (SZ) (n = 30), who display, as in PD, similar motor symptomology and decreased emotion perception abilities. The results show that individuals with PD showed an increased tendency to categorize incongruent face-body combinations in line with the body emotion, whereas those with HC showed a tendency to classify them in line with the facial emotion. No consistent pattern for prioritizing the face or body was found in individuals with SZ. These results were not explained by the emotional recognition of the isolated cues, cognitive status, depression, or motor symptoms of individuals with PD and SZ. As real-life expressions may include inconsistent cues in the body and face, these findings may have implications for the way individuals with PD and SZ interpret the emotions of others.
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Affiliation(s)
- Yasmin Abo Foul
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - David Arkadir
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Anastasia Demikhovskaya
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yehuda Noyman
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eduard Linetsky
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Muneer Abu Snineh
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Hillel Aviezer
- Department of Psychology, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Renana Eitan
- Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
- Neuropsychiatry Unit, Jerusalem Mental Health Center, Hebrew University of Jerusalem, Jerusalem, Israel
- Department of Medical Neurobiology (Physiology), Institute for Medical Research Israel-Canada, Hebrew University-Hadassah Medical School, Jerusalem, Israel
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Hirano Y, Nakamura I, Tamura S. Abnormal connectivity and activation during audiovisual speech perception in schizophrenia. Eur J Neurosci 2024; 59:1918-1932. [PMID: 37990611 DOI: 10.1111/ejn.16183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/23/2023]
Abstract
The unconscious integration of vocal and facial cues during speech perception facilitates face-to-face communication. Recent studies have provided substantial behavioural evidence concerning impairments in audiovisual (AV) speech perception in schizophrenia. However, the specific neurophysiological mechanism underlying these deficits remains unknown. Here, we investigated activities and connectivities centered on the auditory cortex during AV speech perception in schizophrenia. Using magnetoencephalography, we recorded and analysed event-related fields in response to auditory (A: voice), visual (V: face) and AV (voice-face) stimuli in 23 schizophrenia patients (13 males) and 22 healthy controls (13 males). The functional connectivity associated with the subadditive response to AV stimulus (i.e., [AV] < [A] + [V]) was also compared between the two groups. Within the healthy control group, [AV] activity was smaller than the sum of [A] and [V] at latencies of approximately 100 ms in the posterior ramus of the lateral sulcus in only the left hemisphere, demonstrating a subadditive N1m effect. Conversely, the schizophrenia group did not show such a subadditive response. Furthermore, weaker functional connectivity from the posterior ramus of the lateral sulcus of the left hemisphere to the fusiform gyrus of the right hemisphere was observed in schizophrenia. Notably, this weakened connectivity was associated with the severity of negative symptoms. These results demonstrate abnormalities in connectivity between speech- and face-related cortical areas in schizophrenia. This aberrant subadditive response and connectivity deficits for integrating speech and facial information may be the neural basis of social communication dysfunctions in schizophrenia.
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Affiliation(s)
- Yoji Hirano
- Department of Psychiatry, Division of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Institute of Industrial Science, The University of Tokyo, Tokyo, Japan
| | - Itta Nakamura
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Tamura
- Department of Psychiatry, Division of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Lyu X, Chi Y, Wang Z, Shao X, Zhang G, Li C, Dong C, Wang X, Li X, Zhu C, Xu X, Du X. Abnormal ambiguous facial expression recognition in Chinese patients with schizophrenia. BMC Psychiatry 2024; 24:226. [PMID: 38532335 DOI: 10.1186/s12888-024-05685-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 03/14/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Patients with schizophrenia (SCZ) exhibit difficulties deficits in recognizing facial expressions with unambiguous valence. However, only a limited number of studies have examined how these patients fare in interpreting facial expressions with ambiguous valence (for example, surprise). Thus, we aimed to explore the influence of emotional background information on the recognition of ambiguous facial expressions in SCZ. METHODS A 3 (emotion: negative, neutral, and positive) × 2 (group: healthy controls and SCZ) experimental design was adopted in the present study. The experimental materials consisted of 36 images of negative emotions, 36 images of neutral emotions, 36 images of positive emotions, and 36 images of surprised facial expressions. In each trial, a briefly presented surprised face was preceded by an affective image. Participants (36 SCZ and 36 healthy controls (HC)) were required to rate their emotional experience induced by the surprised facial expressions. Participants' emotional experience was measured using the 9-point rating scale. The experimental data have been analyzed by conducting analyses of variances (ANOVAs) and correlation analysis. RESULTS First, the SCZ group reported a more positive emotional experience under the positive cued condition compared to the negative cued condition. Meanwhile, the HC group reported the strongest positive emotional experience in the positive cued condition, a moderate experience in the neutral cued condition, and the weakest in the negative cue condition. Second, the SCZ (vs. HC) group showed longer reaction times (RTs) for recognizing surprised facial expressions. The severity of schizophrenia symptoms in the SCZ group was negatively correlated with their rating scores for emotional experience under neutral and positive cued condition. CONCLUSIONS Recognition of surprised facial expressions was influenced by background information in both SCZ and HC, and the negative symptoms in SCZ. The present study indicates that the role of background information should be fully considered when examining the ability of SCZ to recognize ambiguous facial expressions.
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Affiliation(s)
- Xiaoli Lyu
- Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, 225003, Yangzhou, Jiangsu, China
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Yuyan Chi
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Zhenyu Wang
- Wujiang District Mental Rehabilitation Hospital, 215200, Suzhou, Jiangsu, China
| | - Xinyan Shao
- School of Educational Science, Yangzhou University, 225002, Yangzhou, Jiangsu, China
| | - Guangya Zhang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Chuanwei Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Chenglong Dong
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Xuqin Wang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China
| | - Xin Li
- Wujiang District Mental Rehabilitation Hospital, 215200, Suzhou, Jiangsu, China
| | - Chuanlin Zhu
- School of Educational Science, Yangzhou University, 225002, Yangzhou, Jiangsu, China.
| | - Xiaofeng Xu
- Affiliated WuTaiShan Hospital of Medical College of Yangzhou University, 225003, Yangzhou, Jiangsu, China.
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, 215137, Suzhou, Jiangsu, China.
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González-Gualda LM, Vicente-Querol MA, García AS, Molina JP, Latorre JM, Fernández-Sotos P, Fernández-Caballero A. An exploratory study of the effect of age and gender on face scanning during affect recognition in immersive virtual reality. Sci Rep 2024; 14:5553. [PMID: 38448515 PMCID: PMC10918108 DOI: 10.1038/s41598-024-55774-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/26/2024] [Indexed: 03/08/2024] Open
Abstract
A person with impaired emotion recognition is not able to correctly identify facial expressions represented by other individuals. The aim of the present study is to assess eyes gaze and facial emotion recognition in a healthy population using dynamic avatars in immersive virtual reality (IVR). For the first time, the viewing of each area of interest of the face in IVR is studied by gender and age. This work in healthy people is conducted to assess the future usefulness of IVR in patients with deficits in the recognition of facial expressions. Seventy-four healthy volunteers participated in the study. The materials used were a laptop computer, a game controller, and a head-mounted display. Dynamic virtual faces randomly representing the six basic emotions plus neutral expression were used as stimuli. After the virtual human represented an emotion, a response panel was displayed with the seven possible options. Besides storing the hits and misses, the software program internally divided the faces into different areas of interest (AOIs) and recorded how long participants looked at each AOI. As regards the overall accuracy of the participants' responses, hits decreased from the youngest to the middle-aged and older adults. Also, all three groups spent the highest percentage of time looking at the eyes, but younger adults had the highest percentage. It is also noteworthy that attention to the face compared to the background decreased with age. Moreover, the hits between women and men were remarkably similar and, in fact, there were no statistically significant differences between them. In general, men paid more attention to the eyes than women, but women paid more attention to the forehead and mouth. In contrast to previous work, our study indicates that there are no differences between men and women in facial emotion recognition. Moreover, in line with previous work, the percentage of face viewing time for younger adults is higher than for older adults. However, contrary to earlier studies, older adults look more at the eyes than at the mouth.Consistent with other studies, the eyes are the AOI with the highest percentage of viewing time. For men the most viewed AOI is the eyes for all emotions in both hits and misses. Women look more at the eyes for all emotions, except for joy, fear, and anger on hits. On misses, they look more into the eyes for almost all emotions except surprise and fear.
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Affiliation(s)
- Luz M González-Gualda
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
| | - Miguel A Vicente-Querol
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
| | - Arturo S García
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
| | - José P Molina
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
| | - José M Latorre
- Departmento de Psicología, Universidad de Castilla-La Mancha, 02071, Albacete, Spain
| | - Patricia Fernández-Sotos
- Servicio de Salud de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete, Servicio de Salud Mental, 02004, Albacete, Spain
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain
| | - Antonio Fernández-Caballero
- Neurocognition and Emotion Unit, Instituto de Investigación en Informática de Albacete, 02071, Albacete, Spain.
- Departmento de Sistemas Informáticos, Universidad de Castilla-La Mancha, 02071, Albacete, Spain.
- CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health, Instituto de Salud Carlos III), 28016, Madrid, Spain.
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Liu H, Tang E, Guan C, Li J, Zheng J, Zhou D, Shen M, Chen H. Not socially blind: Unimpaired perception of social interaction in schizophrenia. Schizophr Res 2024; 264:448-450. [PMID: 38262311 DOI: 10.1016/j.schres.2023.12.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 12/01/2023] [Accepted: 12/25/2023] [Indexed: 01/25/2024]
Affiliation(s)
- Huiying Liu
- Department of Psychology and Behavioral Sciences, Zhejiang University, China
| | - Enze Tang
- Department of Psychology and Behavioral Sciences, Zhejiang University, China
| | - Chenxiao Guan
- Department of Psychology and Behavioral Sciences, Zhejiang University, China
| | - Jian Li
- Department of Psychology and Behavioral Sciences, Zhejiang University, China
| | - Jiewei Zheng
- Department of Psychology and Behavioral Sciences, Zhejiang University, China
| | | | - Mowei Shen
- Department of Psychology and Behavioral Sciences, Zhejiang University, China.
| | - Hui Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University, China.
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González-Rodríguez A, García-Pérez Á, Godoy-Giménez M, Sayans-Jiménez P, Cañadas F, Estévez AF. The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions. Sci Rep 2024; 14:2322. [PMID: 38282111 PMCID: PMC10822869 DOI: 10.1038/s41598-024-52893-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 01/24/2024] [Indexed: 01/30/2024] Open
Abstract
Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.
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Affiliation(s)
- Antonio González-Rodríguez
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain
- CEINSA Health Research Centre, University of Almería, Almería, Spain
| | - Ángel García-Pérez
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain
- CIBIS Research Centre, University of Almería, Almería, Spain
| | - Marta Godoy-Giménez
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain
- CEINSA Health Research Centre, University of Almería, Almería, Spain
| | - Pablo Sayans-Jiménez
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain
- CEINSA Health Research Centre, University of Almería, Almería, Spain
| | - Fernando Cañadas
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain
- CIBIS Research Centre, University of Almería, Almería, Spain
| | - Angeles F Estévez
- Department of Psychology, University of Almería, Ctra Sacramento S/N, La Cañada de San Urbano, CP: 04120, Almería, Spain.
- CIBIS Research Centre, University of Almería, Almería, Spain.
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8
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Yeung MK. The prefrontal cortex is differentially involved in implicit and explicit facial emotion processing: An fNIRS study. Biol Psychol 2023; 181:108619. [PMID: 37336356 DOI: 10.1016/j.biopsycho.2023.108619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/14/2023] [Accepted: 06/15/2023] [Indexed: 06/21/2023]
Abstract
Despite extensive research, the differential roles of the prefrontal cortex (PFC) in implicit and explicit facial emotion processing remain elusive. Functional near-infrared spectroscopy (fNIRS) is a neuroimaging technique that can measure changes in both oxyhemoglobin (HbO) and deoxyhemoglobin (HbR) concentrations. Currently, how HbO and HbR change during facial emotion processing remains unclear. Here, fNIRS was used to examine and compare PFC activation during implicit and explicit facial emotion processing. Forty young adults performed a facial-matching task that required either emotion discrimination (explicit task) or age discrimination (implicit task), and the activation of their PFCs was measured by fNIRS. Participants attempted the task on two occasions to determine whether their activation patterns were maintained over time. The PFC displayed increases in HbO and/or decreases in HbR during the implicit and explicit facial emotion tasks. Importantly, there were significantly greater changes in PFC HbO during the explicit task, whereas no significant difference in HbR changes between conditions was found. Between sessions, HbO changes were reduced across tasks, but the difference in HbO changes between the implicit and explicit tasks remained unchanged. The test-retest reliability of the behavioral measures was excellent, whereas that of fNIRS measures was mostly poor to fair. Thus, the PFC plays a specific role in recognizing facial expressions, and its differential involvement in implicit and explicit facial emotion processing can be consistently captured at the group level by changes in HbO. This study demonstrates the potential of fNIRS for elucidating the neural mechanisms underlying facial emotion recognition.
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Affiliation(s)
- Michael K Yeung
- Department of Psychology, The Education University of Hong Kong, Hong Kong, China; University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Hong Kong, China.
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Zhang L, Qi X, Wen L, Hu X, Mao H, Pan X, Zhang X, Fang X. Identifying risk factors to predict violent behaviour in community patients with severe mental disorders: A retrospective study of 5277 patients in China. Asian J Psychiatr 2023; 83:103507. [PMID: 36796125 DOI: 10.1016/j.ajp.2023.103507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/07/2023] [Accepted: 02/06/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Patients with Severe Mental Disorders (SMD) have a higher risk of violent behaviour than the general population. The study aimed to investigate the predictive factors for the occurrence of violent behaviour in community SMD patients. METHODS The cases and follow-up data were collected from SMD patient Information Management system in Jiangning District, Jiangsu Province. The incidence of violent behaviours was described and analyzed. Logistic regression model was used to examine the influencing factors for violent behaviours in those patients. RESULTS Among 5277 community patients with SMD in Jiangning District, 42.4% (2236/5277) had violent behaviours. The stepwise logistic regression analysis revealed that the disease-related factors (including disease type, disease course, times of hospitalization, medication adherence, past violent behaviours), the demographic factors (age, male sex, educational level, economic and social living status), and the policy-related factors (like free treatment, annual physical check, disability certificate, family physician services, and community interviews) were significantly related to the violent behaviours in community SMD patients. After gender stratification, we found that male patients with unmarried status and with a longer course of disease were more likely to violent. However, we found that female patients with lower economic status and educational experience were more likely to violent. CONCLUSION Our results suggest that community SMD patients had a high incidence of violent behaviour. The findings may provide valuable information for policymakers and mental health professionals worldwide taking a number of measures to reduce the incidence of violence in community SMD patients and to better maintain social security.
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Affiliation(s)
- Lin Zhang
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xin Qi
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Lu Wen
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiuxiu Hu
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Hongjun Mao
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xinming Pan
- Department of Psychiatry, the Second People's Hospital of Jiangning District, Nanjing, Jiangsu, China
| | - Xiangrong Zhang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China; Department of Psychiatry, The Affiliated Xuzhou Oriental Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.
| | - Xinyu Fang
- Department of Geriatric Psychiatry, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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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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Mandal MK, Habel U, Gur RC. Facial expression-based indicators of schizophrenia: Evidence from recent research. Schizophr Res 2023; 252:335-344. [PMID: 36709656 DOI: 10.1016/j.schres.2023.01.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 01/03/2023] [Accepted: 01/07/2023] [Indexed: 01/28/2023]
Abstract
Impaired ability to recognize emotion in other's face (decoding) or to express emotion through the face (encoding) are considered critical in schizophrenia. The topic of research draws considerable attention since clinicians rely heavily on the patient's facial expressions for diagnosis and on the patient's ability to understand the clinician's communicative intent. While most researchers argue in favor of a generalized emotion deficit, others indicate an emotion-specific deficit in schizophrenia. An early review (Mandal et al., 1998) indicated a possible breakdown in perception-expression-experience link of emotion; later reviews (Kohler et al., 2010; Chan et al., 2010) pointed to a generalized emotion processing deficit due to perceptual deficits in schizophrenia. The present review (2010-2022) revisits this controversy with 47 published studies (37 decoding, 10 encoding) conducted on 2364 patients in 20 countries. Schizophrenia is characterized by reduced emotion processing ability, especially with negative symptoms and at an acute state of illness. It is however still unclear whether this dysfunction is independent of a generalized face perception deficit or of subjective experience of emotion in schizophrenia.
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Affiliation(s)
- Manas K Mandal
- Department of Humanities & Social Sciences, Indian Institute of Technology-Kharagpur, India.
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Germany
| | - Ruben C Gur
- Department of Psychiatry, Brain Behavior Laboratory, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Lifespan Brain Institute (LiBI), Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA 19104, USA
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Fiorito AM, Aleman A, Blasi G, Bourque J, Cao H, Chan RCK, Chowdury A, Conrod P, Diwadkar VA, Goghari VM, Guinjoan S, Gur RE, Gur RC, Kwon JS, Lieslehto J, Lukow PB, Meyer-Lindenberg A, Modinos G, Quarto T, Spilka MJ, Shivakumar V, Venkatasubramanian G, Villarreal M, Wang Y, Wolf DH, Yun JY, Fakra E, Sescousse G. Are Brain Responses to Emotion a Reliable Endophenotype of Schizophrenia? An Image-Based Functional Magnetic Resonance Imaging Meta-analysis. Biol Psychiatry 2023; 93:167-177. [PMID: 36085080 DOI: 10.1016/j.biopsych.2022.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Impaired emotion processing constitutes a key dimension of schizophrenia and a possible endophenotype of this illness. Empirical studies consistently report poorer emotion recognition performance in patients with schizophrenia as well as in individuals at enhanced risk of schizophrenia. Functional magnetic resonance imaging studies also report consistent patterns of abnormal brain activation in response to emotional stimuli in patients, in particular, decreased amygdala activation. In contrast, brain-level abnormalities in at-risk individuals are more elusive. We address this gap using an image-based meta-analysis of the functional magnetic resonance imaging literature. METHODS Functional magnetic resonance imaging studies investigating brain responses to negative emotional stimuli and reporting a comparison between at-risk individuals and healthy control subjects were identified. Frequentist and Bayesian voxelwise meta-analyses were performed separately, by implementing a random-effect model with unthresholded group-level T-maps from individual studies as input. RESULTS In total, 17 studies with a cumulative total of 677 at-risk individuals and 805 healthy control subjects were included. Frequentist analyses did not reveal significant differences between at-risk individuals and healthy control subjects. Similar results were observed with Bayesian analyses, which provided strong evidence for the absence of meaningful brain activation differences across the entire brain. Region of interest analyses specifically focusing on the amygdala confirmed the lack of group differences in this region. CONCLUSIONS These results suggest that brain activation patterns in response to emotional stimuli are unlikely to constitute a reliable endophenotype of schizophrenia. We suggest that future studies instead focus on impaired functional connectivity as an alternative and promising endophenotype.
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Affiliation(s)
- Anna M Fiorito
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France.
| | - André Aleman
- University of Groningen, University Medical Center Groningen, Department of Biomedical Sciences of Cells & Systems, Groningen, The Netherlands
| | - Giuseppe Blasi
- Group of Psychiatric Neuroscience, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Josiane Bourque
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Hengyi Cao
- Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Asadur Chowdury
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Patricia Conrod
- CHU Sainte-Justine Research Center, Department of Psychiatry and Addiction, University of Montréal, Montreal, Quebec, Canada
| | - Vaibhav A Diwadkar
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Vina M Goghari
- Department of Psychological Clinical Science, University of Toronto, Toronto, Ontario, Canada
| | | | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Johannes Lieslehto
- University of Eastern Finland, Department of Forensic Psychiatry, Niuvanniemi Hospital, Kuopio, Finland
| | - Paulina B Lukow
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andreas Meyer-Lindenberg
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | | | - Michael J Spilka
- Department of Psychology, University of Georgia, Athens, Georgia
| | - Venkataram Shivakumar
- Department of Integrative Medicine, National Institute of Mental Health and Neuro Sciences, Bengaluru, India
| | | | - Mirta Villarreal
- Instituto de Neurociencias FLENI-CONICET, Facultad de Ciencias Exactas y Naturales, UBA, Buenos Aires, Argentina
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Chinese Academy of Sciences Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Je-Yeon Yun
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eric Fakra
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Department of Psychiatry, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Guillaume Sescousse
- Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR 5292, PSYR2 Team, University of Lyon, Lyon, France; Centre Hospitalier Le Vinatier, Bron, France
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Larsson C, Lee M, Lundgren T, Erhardt S, Sellgren CM, Cervenka S, Borg J, Bölte S, Fatouros-Bergman H. Facial affect recognition in first-episode psychosis is impaired but not associated with psychotic symptoms. Heliyon 2022; 8:e10424. [PMID: 36097491 PMCID: PMC9463369 DOI: 10.1016/j.heliyon.2022.e10424] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/31/2022] [Accepted: 08/18/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Aims Method Results Discussion Impaired affect recognition (FAR) present already in first episode psychosis (FEP). Preserved FAR of happiness found in individuals with FEP. Individuals with FEP mainly have impaired FAR of negative affects. Both FEP and controls mainly mistook negative affects for other negative affects. Psychotic symptoms are not associated with FAR in individuals with FEP.
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Affiliation(s)
- Cornelia Larsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Corresponding author.
| | - Maria Lee
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Tobias Lundgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sophie Erhardt
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Carl M. Sellgren
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Simon Cervenka
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Jacqueline Borg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research; Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Helena Fatouros-Bergman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
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Zeng Y, Liu X, Cheng L. Facial Emotion Perceptual Tendency in Violent and Non-violent Offenders. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15058-NP15074. [PMID: 33480321 DOI: 10.1177/0886260521989848] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
All three authors share equal authorship in this paper.Emotion perception has a vital influence on social interaction. Previous studies discussed mainly the relationship between facial emotion perception and aggressive behavior from the perspective of hostile attributional bias and the impaired violence inhibition mechanism. The present study aims to provide new evidence of different emotion perception patterns between the violent and non-violent criminal samples through a new indicator of the facial emotion recognition test, Facial Emotion Perception Tendency (FEPT), calculated by counting the times a participant recognizes a set of emotional stimuli as a particular specific emotion, and to further examine the association between aggressive behaviors and FEPT. 101 violent and 171 non-violent offenders, as well as 81 non-offending control participants, were recruited to complete the emotion recognition task with morphed stimuli (Study 1). We further recruited 62 non-offending healthy male participants to finish the Buss -Perry Aggression Questionnaire (BPAQ) after the emotion recognition task in Study 2. Both non-violent and violent offenders were significantly lower in overall accuracy of emotion recognition and disgust FEPT, but higher in happy FEPT, than non-offending healthy controls. Non-violent offenders had significantly lower fear FEPT than violent offenders, and had higher anger FEPT than non-offending controls. The results also revealed that the level of physical aggression was positively correlated with fear FEPT, while negatively correlated with anger FEPT. The current study demonstrated that FEPT was associated with aggressive behavior and implies the importance of improving the emotion decoding ability of offenders. Also, the concept "FEPT" proposed in this study is of significance for further exploration of how individuals' tendency to perceiving a particular emotion can be correlated with social behaviors.
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Affiliation(s)
- Yun Zeng
- Sun Yat-sen University, Guangzhou, China
| | - Xilin Liu
- Sun Yat-sen University, Guangzhou, China
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15
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Fujii Y, Asakura S, Dat NT, Takanobu K, Watanabe S, Toyoshima K, Mitsui N, Toyomaki A, Hashimoto N, Kako Y, Kusumi I. Comparison of convinced subtype of Taijin-kyofu and schizophrenia on cognitive assessments of Japanese patients. Asian J Psychiatr 2022; 75:103215. [PMID: 35870311 DOI: 10.1016/j.ajp.2022.103215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/15/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Yutaka Fujii
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Health Care Center of Hokkaido University, Sapporo, Hokkaido, Japan.
| | - Satoshi Asakura
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan; Health Care Center of Hokkaido University, Sapporo, Hokkaido, Japan
| | - Nguyen Tan Dat
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Keisuke Takanobu
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Shinya Watanabe
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Kuniyoshi Toyoshima
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Nobuyuki Mitsui
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Atsuhito Toyomaki
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Yuki Kako
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
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Ruiz-Castañeda P, Santiago Molina E, Aguirre Loaiza H, Daza González MT. Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions. Cogn Res Princ Implic 2022; 7:78. [PMID: 35960384 PMCID: PMC9374871 DOI: 10.1186/s41235-022-00428-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Positive symptoms of schizophrenia are associated with significant difficulties in daily functioning, and these difficulties have been associated with impaired executive functions (EEFF). However, specific cognitive and socio-emotional executive deficits have not been fully established. OBJECTIVE The present study has several objectives. First, we aimed to examine the specific deficits in cognitive and socio-emotional EEFF in a group of patients with schizophrenia with a predominance of positive symptoms, as well as to determine if these patients present clinically significant scores in any of the three fronto-subcortical behavioral syndromes: Dorsolateral, Orbitofrontal, or Anterior Cingulate. METHOD The sample consisted of 54 patients, 27 with a predominance of positive symptoms, and 27 healthy controls matched for gender, age, and education. The two groups completed four cognitive and three socio-emotional EEFF tasks. In the group of patients, positive symptoms were evaluated using the scale for the Evaluation of Positive Symptoms (SANS), while the behavioral alterations associated with the three fronto-subcortical syndromes were evaluated using the Frontal System Behavior Scale (FrSBe). RESULTS The patients, in comparison with a control group, presented specific deficits in cognitive and socio-emotional EEFF. In addition, a high percentage of patients presented clinically significant scores on the three fronto-subcortical syndromes. CONCLUSION The affectation that these patients present, in terms of both cognitive and emotional components, highlights the importance of developing a neuropsychological EEFF intervention that promotes the recovery of the affected cognitive capacities and improves the social and emotional functioning of the affected patients.
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Affiliation(s)
- Pamela Ruiz-Castañeda
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain
| | - Encarnación Santiago Molina
- Mental Health Hospitalization Unit of Torrecárdenas University Hospital, Calle Hermandad de Donantes de Sangre, s/n, 04009, Almería, Spain
| | - Haney Aguirre Loaiza
- Department of Psychology, Catholic University of Pereira, Avenida Sur/Las Americas Cra 21 # 49-95, Pereira, Colombia
| | - María Teresa Daza González
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain.
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain.
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Zhao X, Yao J, Lv Y, Zhang X, Han C, Chen L, Ren F, Zhou Q, Jin Z, Li Y, Du Y, Sui Y. Facial emotion perception abilities are related to grey matter volume in the culmen of cerebellum anterior lobe in drug-naïve patients with first-episode schizophrenia. Brain Imaging Behav 2022; 16:2072-2085. [PMID: 35751735 DOI: 10.1007/s11682-022-00677-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/02/2022]
Abstract
Impaired capability for understanding and interpreting the expressions on other people's faces manifests itself as a core feature of schizophrenia, contributing to social dysfunction. With the purpose of better understanding of the neurobiological basis of facial emotion perception deficits in schizophrenia, we investigated facial emotion perception abilities and regional structural brain abnormalities in drug-naïve patients with first-episode schizophrenia, and then examined the correlation between them. Fifty-two drug-naive patients with first-episode schizophrenia and 29 group-matched healthy controls were examined for facial emotion perception abilities assessed with the Facial Emotion Categorization and performed magnetic resonance imaging. The Facial Emotion Categorization data were inserted into a logistic function model so as to calculate shift point and slope as outcome measurements. Voxel-based morphometry was applied to investigate regional grey matter volume (GMV) alterations. The relationship between facial emotion perception and GMV was explored in patients using voxel-wise correlation analysis within brain regions that showed a significant GMV alterations in patients compared with controls. The schizophrenic patients performed differently on Facial Emotion Categorization tasks from the controls and presented a higher shift point and a steeper slope. Relative to the controls, patients showed GMV reductions in the superior temporal gyrus, middle occipital gyrus, parahippocampa gyrus, posterior cingulate, the culmen of cerebellum anterior lobe, cerebellar tonsil, and the declive of cerebellum posterior lobe. Importantly, abnormal performance on Facial Emotion Categorization was found correlated with GMV alterations in the culmen of cerebellum anterior lobe in schizophrenia. This study suggests that reduced GMV in the culmen of cerebellum anterior lobe occurs in first-episode schizophrenia, constituting a potential neuropathological basis for the impaired facial emotion perception in schizophrenia.
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Affiliation(s)
- Xiaoxin Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
| | | | - Yiding Lv
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | | | - Chongyang Han
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Lijun Chen
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Fangfang Ren
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Qun Zhou
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Zhuma Jin
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Yuan Li
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China
| | - Yasong Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
| | - Yuxiu Sui
- Nanjing Brain Hospital, Nanjing Medical University, Nanjing, 210029, China.
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18
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Real-time facial emotion recognition deficits across the psychosis spectrum: A B-SNIP Study. Schizophr Res 2022; 243:489-499. [PMID: 34887147 PMCID: PMC9236198 DOI: 10.1016/j.schres.2021.11.027] [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: 06/22/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022]
Abstract
Affective and non-affective psychotic disorders are associated with variable levels of impairment in affective processing, but this domain typically has been examined via presentation of static facial images. We compared performance on a dynamic facial expression identification task across six emotions (sad, fear, surprise, disgust, anger, happy) in individuals with psychotic disorders (bipolar with psychotic features [PBD] = 113, schizoaffective [SAD] = 163, schizophrenia [SZ] = 181) and healthy controls (HC; n = 236) derived from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP). These same individuals with psychotic disorders were also grouped by B-SNIP-derived Biotype (Biotype 1 [B1] = 115, Biotype 2 [B2] = 132, Biotype 3 [B3] = 158), derived from a cluster analysis applied to a large biomarker panel that did not include the current data. Irrespective of the depicted emotion, groups differed in accuracy of emotion identification (P < 0.0001). The SZ group demonstrated lower accuracy versus HC and PBD groups; the SAD group was less accurate than the HC group (Ps < 0.02). Similar overall group differences were evident in speed of identifying emotional expressions. Controlling for general cognitive ability did not eliminate most group differences on accuracy but eliminated almost all group differences on reaction time for emotion identification. Results from the Biotype groups indicated that B1 and B2 had more severe deficits in emotion recognition than HC and B3, meanwhile B3 did not show significant deficits. In sum, this characterization of facial emotion recognition deficits adds to our emerging understanding of social/emotional deficits across the psychosis spectrum.
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Tripoli G, Quattrone D, Ferraro L, Gayer-Anderson C, La Cascia C, La Barbera D, Sartorio C, Seminerio F, Rodriguez V, Tarricone I, Berardi D, Jamain S, Arango C, Tortelli A, Llorca PM, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Luis Santos J, Arrojo M, Marta Del-Ben C, Rossi Menezes P, van der Ven E, Jones PB, Jongsma HE, Kirkbride JB, Tosato S, Lasalvia A, Richards A, O’Donovan M, Rutten BPF, van Os J, Morgan C, Sham PC, Di Forti M, Murray RM, Murray GK. Facial Emotion Recognition in Psychosis and Associations With Polygenic Risk for Schizophrenia: Findings From the Multi-Center EU-GEI Case-Control Study. Schizophr Bull 2022; 48:1104-1114. [PMID: 35325253 PMCID: PMC9434422 DOI: 10.1093/schbul/sbac022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND HYPOTHESIS Facial Emotion Recognition is a key domain of social cognition associated with psychotic disorders as a candidate intermediate phenotype. In this study, we set out to investigate global and specific facial emotion recognition deficits in first-episode psychosis, and whether polygenic liability to psychotic disorders is associated with facial emotion recognition. STUDY DESIGN 828 First Episode Psychosis (FEP) patients and 1308 population-based controls completed assessments of the Degraded Facial Affect Recognition Task (DFAR) and a subsample of 524 FEP and 899 controls provided blood or saliva samples from which we extracted DNA, performed genotyping and computed polygenic risk scores for schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MD). STUDY RESULTS A worse ability to globally recognize facial emotion expressions was found in patients compared with controls [B= -1.5 (0.6), 95% CI -2.7 to -0.3], with evidence for stronger effects on negative emotions (fear [B = -3.3 (1.1), 95% CI -5.3 to -1.2] and anger [B = -2.3 (1.1), 95% CI -4.6 to -0.1]) than on happiness [B = 0.3 (0.7), 95% CI -1 to 1.7]. Pooling all participants, and controlling for confounds including case/control status, facial anger recognition was associated significantly with Schizophrenia Polygenic Risk Score (SZ PRS) [B = -3.5 (1.7), 95% CI -6.9 to -0.2]. CONCLUSIONS Psychosis is associated with impaired recognition of fear and anger, and higher SZ PRS is associated with worse facial anger recognition. Our findings provide evidence that facial emotion recognition of anger might play a role as an intermediate phenotype for psychosis.
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Affiliation(s)
- Giada Tripoli
- To whom correspondence should be addressed; Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Via G. La Loggia 1, 90129 Palermo, Italy, tel: +39(0)916555641, e-mail:
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK,Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany and National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, UK
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Crocettarachele Sartorio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Fabio Seminerio
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and NeuroMotor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Stéphane Jamain
- Institut National de la Santé et de la Recherche Médicale, Faculté de Médecine, Université Paris-Est, Creteil, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health. Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, CIBERSAM, Madrid, Spain
| | | | | | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NY
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Oviedo, Spain
| | - Miquel Bernardo
- Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital clinic, Department of Medicine, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital “Virgen de la Luz”, Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade of São Paulo, São Paulo, Brazil
| | - Els van der Ven
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Vrije Universiteit Amsterdam, Department of Clinical, Neuro- and Developmental Psychology
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Hannah E Jongsma
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - James B Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London, UK
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Azienda Ospedaliera Universitaria Integrata di Verona, Verona, Italy
| | - Alex Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Michael O’Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim van Os
- Department of Biomedicine, Neuroscience, and Advanced Diagnostics, University of Palermo, Palermo, Italy,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, Maastricht, The Netherlands,Department Psychiatry, Brain Centre Rudolf Magnus, Utrecht University Medical Centre, Utrecht, The Netherlands
| | - Craig Morgan
- Department of Health Service and Population Research, Institute of Psychiatry, King’s College London, London, UK
| | - Pak C Sham
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,Centre for Genomic Sciences, Li KaShing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, King’s College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK
| | - Graham K Murray
- Department of Psychiatry, University of Cambridge, Cambridge, UK,CAMEO Early Intervention Service, Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK,Institute for Molecular Bioscience, University of Queensland, Australia
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Priyesh C, Suryavanshi CA, Sasidharan A, Bhandary R, Behere RV, Nayak KR. Facial Emotion Recognition, Misattribution, and Response Time in Schizophrenia and Bipolar Disorder. NEUROPHYSIOLOGY+ 2022. [DOI: 10.1007/s11062-022-09923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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21
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Osborne KJ, Kraus B, Curran T, Earls H, Mittal VA. An Event-Related Potential Investigation of Early Visual Processing Deficits During Face Perception in Youth at Clinical High Risk for Psychosis. Schizophr Bull 2022; 48:90-99. [PMID: 34111294 PMCID: PMC8781328 DOI: 10.1093/schbul/sbab068] [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] [Indexed: 11/13/2022]
Abstract
Impairments in early visual face perception are well documented in patients with schizophrenia. Specifically, event-related potential (ERP) research in patients with schizophrenia has demonstrated deficits in early sensory processing of stimulus properties (P1 component) and the structural encoding of faces (N170 component). However, it is not well understood if similar impairments are present in individuals at clinical high risk (CHR) for psychosis (ie, those in the putative prodromal stage of the illness). Thus, it is unknown if face perception deficits are the result of illness onset or are present in the high-risk period for the illness. The present study used the ERP technique to examine neural activation when viewing facial emotion expressions and objects in 44 CHR and 47 control adolescents and young adults (N = 91). P1 amplitude was similar across groups, indicating that early sensory processing impairments did not substantially contribute to face perception deficits in CHR youth. CHR youth exhibited reduced N170 amplitude compared to controls when viewing faces but not objects, implicating a specific deficit in the structural encoding of faces rather than a general perceptual deficit. Further, whereas controls demonstrated the expected face-selective N170 effect (ie, larger amplitude for faces than objects), CHR youth did not, which suggests that facial emotion expressions do not elicit the expected preferential perceptual processing for critical social information in individuals at CHR for psychosis. Together, these findings provide valuable information regarding the specific impairments contributing to face perception deficits in the high-risk period where treatment stands to aid in preventing illness progression.
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Affiliation(s)
- K Juston Osborne
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Brian Kraus
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Tim Curran
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Boulder, CO, USA
| | - Holly Earls
- Department of Psychology and Neuroscience, University of Colorado, Boulder, Boulder, CO, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
- Department of Psychiatry, Northwestern University, Evanston, IL, USA
- Institute for Policy Research, Northwestern University, Evanston, IL, USA
- Department of Medical Social Sciences, Evanston, IL, USA
- Institute for Innovations in Developmental Sciences (DevSci), Evanston, Chicago, IL, USA
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22
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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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23
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Gennarelli M, Monteleone P, Minelli A, Monteleone AM, Rossi A, Rocca P, Bertolino A, Aguglia E, Amore M, Bellino S, Bellomo A, Biondi M, Bucci P, Carpiniello B, Cascino G, Cuomo A, Dell'Osso L, di Giannantonio M, Giordano GM, Marchesi C, Oldani L, Pompili M, Roncone R, Rossi R, Siracusano A, Tenconi E, Vita A, Zeppegno P, Galderisi S, Maj M. Genome-wide association study detected novel susceptibility genes for social cognition impairment in people with schizophrenia. World J Biol Psychiatry 2022; 23:46-54. [PMID: 34132174 DOI: 10.1080/15622975.2021.1907722] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES People with schizophrenia (SCZ) present serious and generalised deficits in social cognition (SC), which affect negatively patients' functioning and treatment outcomes. The genetic background of SC has been investigated in disorders other than SCZ providing weak and sparse results. Thus, our aim was to explore possible genetic correlates of SC dysfunctions in SCZ patients with a genome-wide study (GWAS) approach. METHODS We performed a GWAS meta-analysis of data coming from two cohorts made of 242 and 160 SCZ patients, respectively. SC was assessed with different tools in order to cover its different domains. RESULTS We found GWAS significant association between the TMEM74 gene and the patients' ability in social inference as assessed by The Awareness of Social Inference Test; this association was confirmed by both SNP-based analysis (lead SNP rs3019332 p-value = 5.24 × 10-9) and gene-based analysis (p-value = 1.09 × 10-7). Moreover, suggestive associations of other genes with different dimensions of SC were also found. CONCLUSIONS Our study shows for the first time GWAS significant or suggestive associations of some gene variants with SC domains in people with SCZ. These findings should stimulate further studies to characterise the genetic underpinning of SC dysfunctions in SCZ.
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Affiliation(s)
- Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.,Genetics Unit, IRCCS Istituto Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Alessio Maria Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Silvio Bellino
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Massimo Biondi
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | | | - Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - Lucio Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Elena Tenconi
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy.,Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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24
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Vita A, Gaebel W, Mucci A, Sachs G, Erfurth A, Barlati S, Zanca F, Giordano GM, Birkedal Glenthøj L, Nordentoft M, Galderisi S. European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia. Eur Psychiatry 2022; 65:e58. [PMID: 36059109 PMCID: PMC9532219 DOI: 10.1192/j.eurpsy.2022.2316] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Background Impairment in a wide range of cognitive abilities has been consistently reported in individuals with schizophrenia. Both neurocognitive and social cognitive deficits are thought to underlie severe functional disabilities associated with schizophrenia. Despite the key role in schizophrenia outcome, cognition is still poorly assessed in both research and clinical settings. Methods In this guidance paper, we provide a systematic review of the scientific literature and elaborate several recommendations for the assessment of cognitive functions in schizophrenia both in research settings and in real-world clinical practice. Results Expert consensus and systematic reviews provided guidance for the optimal assessment of cognitive functions in schizophrenia. Based on the reviewed evidence, we recommend a comprehensive and systematic assessment of neurocognitive and social cognitive domains in schizophrenia, in all phases of the disorder, as well as in subjects at risk to develop psychosis. This European Psychiatric Association guidance recommends not only the use of observer reports but also self-reports and interview-based cognitive assessment tools. The guidance also provides a systematic review of the state of the art of assessment in the first episode of psychosis patients and in individuals at risk for psychosis. Conclusion The comprehensive review of the evidence and the recommendations might contribute to advance the field, allowing a better cognitive assessment, and avoiding overlaps with other psychopathological dimensions. The dissemination of this guidance paper may promote the development of shared guidelines concerning the assessment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to obtain recovery.
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25
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Narita Z, Yang K, Kuga H, Piancharoen P, Etyemez S, Faria A, Mihaljevic M, Longo L, Namkung H, Coughlin JM, Nestadt G, Nucifora FC, Sedlak TW, Schaub R, Crawford J, Schretlen DJ, Miyata J, Ishizuka K, Sawa A. Face processing of social cognition in patients with first episode psychosis: Its deficits and association with the right subcallosal anterior cingulate cortex. Schizophr Res 2021; 238:99-107. [PMID: 34649085 DOI: 10.1016/j.schres.2021.09.027] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/13/2021] [Accepted: 09/30/2021] [Indexed: 12/28/2022]
Abstract
The clinical importance of social cognition is well acknowledged in patients with psychosis, in particular those with first episode psychosis (FEP). Nevertheless, its brain substrates and circuitries remain elusive, lacking precise analysis between multimodal brain characteristics and behavioral sub-dimensions within social cognition. In the present study, we examined face processing of social cognition in 71 FEP patients and 77 healthy controls (HCs). We looked for a possible correlation between face processing and multimodal MRI characteristics such as resting-state functional connectivity (rsFC) and brain volume. We observed worse recognition accuracy, longer recognition response time, and longer memory response time in FEP patients when compared with HCs. Of these, memory response time was selectively correlated with specific rsFCs, which included the right subcallosal sub-region of BA24 in the ACC (scACC), only in FEP patients. The volume of this region was also correlated with memory response time in FEP patients. The scACC is functionally and structurally important in FEP-associated abnormalities of face processing measures in social cognition.
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Affiliation(s)
- Zui Narita
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Kun Yang
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Hironori Kuga
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Peeraya Piancharoen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Semra Etyemez
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Andreia Faria
- Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Marina Mihaljevic
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Luisa Longo
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Ho Namkung
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America
| | - Jennifer M Coughlin
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Gerald Nestadt
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Frederik C Nucifora
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Thomas W Sedlak
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Rebecca Schaub
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Jeff Crawford
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - David J Schretlen
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Jun Miyata
- Department of Psychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koko Ishizuka
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America
| | - Akira Sawa
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States of America; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America.
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26
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Raucher-Chéné D, Thibaudeau E, Sauvé G, Lavigne KM, Lepage M. Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder. J Psychiatr Res 2021; 143:429-435. [PMID: 34656875 DOI: 10.1016/j.jpsychires.2021.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/05/2021] [Accepted: 10/10/2021] [Indexed: 11/17/2022]
Abstract
From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (β = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.
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Affiliation(s)
- Delphine Raucher-Chéné
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France
| | - Elisabeth Thibaudeau
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Geneviève Sauvé
- Douglas Mental Health University Institute, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada
| | - Katie M Lavigne
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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27
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Darke H, Sundram S, Cropper SJ, Carter O. Dynamic face processing impairments are associated with cognitive and positive psychotic symptoms across psychiatric disorders. NPJ SCHIZOPHRENIA 2021; 7:36. [PMID: 34376686 PMCID: PMC8355323 DOI: 10.1038/s41537-021-00166-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 07/07/2021] [Indexed: 02/07/2023]
Abstract
Impairments in social cognition-including recognition of facial expressions-are increasingly recognised as a core deficit in schizophrenia. It remains unclear whether other aspects of face processing (such as identity recognition) are also impaired, and whether such deficits can be attributed to more general cognitive difficulties. Moreover, while the majority of past studies have used picture-based tasks to assess face recognition, literature suggests that video-based tasks elicit different neural activations and have greater ecological validity. This study aimed to characterise face processing using video-based stimuli in psychiatric inpatients with and without psychosis. Symptom correlates of face processing impairments were also examined. Eighty-six psychiatric inpatients and twenty healthy controls completed a series of tasks using video-based stimuli. These included two emotion recognition tasks, two non-emotional facial identity recognition tasks, and a non-face control task. Symptoms were assessed using the Positive and Negative Syndrome Scale. Schizophrenia and bipolar disorder groups were significantly impaired on the emotion-processing tasks and the non-face task compared to healthy controls and patients without psychosis. Patients with other forms of psychosis performed intermediately. Groups did not differ in non-emotional face processing. Positive symptoms of psychosis correlated directly with both emotion-processing performance and non-face discrimination across patients. We found that identity processing performance was inversely associated with cognition-related symptoms only. Findings suggest that deficits in emotion-processing reflect symptom pathology independent of diagnosis. Emotion-processing deficits in schizophrenia may be better accounted for by task-relevant factors-such as attention-that are not specific to emotion processing.
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Affiliation(s)
- Hayley Darke
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
| | - Suresh Sundram
- grid.418025.a0000 0004 0606 5526The Florey Institute of Neuroscience and Mental Health, Parkville, VIC Australia ,grid.1002.30000 0004 1936 7857Department of Psychiatry, School of Clinical Sciences, Monash University, Melbourne, VIC Australia ,grid.419789.a0000 0000 9295 3933Mental Health Program, Monash Health, Melbourne, VIC Australia
| | - Simon J. Cropper
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
| | - Olivia Carter
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC Australia
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Grave J, Madeira N, Martins MJ, Silva S, Korb S, Soares SC. Slower access to visual awareness but otherwise intact implicit perception of emotional faces in schizophrenia-spectrum disorders. Conscious Cogn 2021; 93:103165. [PMID: 34274640 DOI: 10.1016/j.concog.2021.103165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 11/28/2022]
Abstract
Schizophrenia-spectrum disorders are characterized by deficits in social domains. Extant research has reported an impaired ability to perceive emotional faces in schizophrenia. Yet, it is unclear if these deficits occur already in the access to visual awareness. To investigate this question, 23 people with schizophrenia or schizoaffective disorder and 22 healthy controls performed a breaking continuous flash suppression task with fearful, happy, and neutral faces. Response times were analysed with generalized linear mixed models. People with schizophrenia-spectrum disorders were slower than controls in detecting faces, but did not show emotion-specific impairments. Moreover, happy faces were detected faster than neutral and fearful faces, across all participants. Although caution is needed when interpreting the main effect of group, our findings may suggest an elevated threshold for visual awareness in schizophrenia-spectrum disorders, but an intact implicit emotion perception. Our study provides a new insight into the mechanisms underlying emotion perception in schizophrenia-spectrum disorders.
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Affiliation(s)
- Joana Grave
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Center for Health Technology and Services Research, Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
| | - Nuno Madeira
- Psychiatry Department, Centro Hospitalar e Universitário de Coimbra, Praceta Prof. Mota Pinto, 3000-075 Coimbra, Portugal; Institute of Psychological Medicine, Faculty of Medicine - University of Coimbra, Portugal, Rua Larga, 3004-504 Coimbra, Portugal
| | - Maria João Martins
- Institute of Psychological Medicine, Faculty of Medicine - University of Coimbra, Portugal, Rua Larga, 3004-504 Coimbra, Portugal; Ocupational Health and Safety Management Services, University of Coimbra Social Services, Rua Doutor Guilherme Moreira 12, 3000-210 Coimbra, Portugal
| | - Samuel Silva
- Department of Electronics, Telecommunication and Informatics (DETI)/Institute of Electronics and Informatics Engineering (IEETA), University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Sebastian Korb
- Department of Psychology, University of Essex, CO4 3SQ Colchester, United Kingdom; Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Liebiggasse 5 1010, Vienna, Austria
| | - Sandra Cristina Soares
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; Center for Health Technology and Services Research, Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal.
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Monteleone P, Cascino G, Monteleone AM, Rocca P, Rossi A, Bertolino A, Aguglia E, Amore M, Collantoni E, Corrivetti G, Cuomo A, Bellomo A, D'Ambrosio E, Dell'Osso L, Frascarelli M, Giordano GM, Giuliani L, Marchesi C, Montemagni C, Oldani L, Pinna F, Pompili M, Roncone R, Rossi R, Siracusano A, Vita A, Zeppegno P, Galderisi S, Maj M. Prevalence of antipsychotic-induced extrapyramidal symptoms and their association with neurocognition and social cognition in outpatients with schizophrenia in the "real-life". Prog Neuropsychopharmacol Biol Psychiatry 2021; 109:110250. [PMID: 33484755 DOI: 10.1016/j.pnpbp.2021.110250] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 01/10/2021] [Accepted: 01/13/2021] [Indexed: 12/14/2022]
Abstract
First generation antipsychotics (FGAs) are more likely to induce extrapyramidal side-effects (EPS) than second generation antipsychotics (SGAs), and EPS have been shown associated to cognitive deficits in schizophrenia. So far, no study has explored the relationships between EPS and social cognition (SC) in people with schizophrenia. Therefore, we assessed the prevalence of EPS in a large sample of drug-treated community-dwelling persons with schizophrenia and explored their relationships with patients' neurocognitive and SC abilities. 875 patients underwent EPS, psychopathological, neurocognitive and SC assessments by means of standardized measures. Relationships between EPS, psychopathology and neurocognitive and SC measures were investigated by correlation tests. Moreover, a partial correlation network was computed by means of a network analysis. 256 patients were treated with FGAs alone or in combination with SGA and 619 with SGAs. EPS were significantly more frequent in FGA-treated group than in the SGA-treated one. Patients with EPS disclosed a more severe psychopathology and were more impaired in neurocognitive and SC measures compared to those without EPS. Disorganization, expressive deficit, and duration of illness were significantly associated to both neurocognitive and SC measures while EPS were associated to neurocognitive measures only. The network analysis showed that parkinsonism was the sole EPS directly connected to both psychopathological and neurocognitive indices whereas no direct connection emerged between EPS and SC measures. Present findings confirm that EPS are still present in the era of SGAs and contribute, together with other clinical variables, to the neurocognitive but not to the SC impairment of patients with schizophrenia.
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Affiliation(s)
- Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy.
| | - Giammarco Cascino
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessio Maria Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandro Bertolino
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Enrico Collantoni
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Giulio Corrivetti
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Alessandro Cuomo
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Enrico D'Ambrosio
- Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marianna Frascarelli
- Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | | | - Luigi Giuliani
- Department of Psychiatry, University of Campania "Luigi Vanvitelli" Naples, Italy
| | - Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - Cristiana Montemagni
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Lucio Oldani
- Department of Psychiatry, University of Milan, Milan, Italy
| | - Federica Pinna
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Rita Roncone
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, Tor Vergata University of Rome, Rome, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy; Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli" Naples, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli" Naples, Italy
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Selvanayagam J, Johnston KD, Wong RK, Schaeffer D, Everling S. Ketamine disrupts gaze patterns during face viewing in the common marmoset. J Neurophysiol 2021; 126:330-339. [PMID: 34133232 DOI: 10.1152/jn.00078.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Faces are stimuli of critical importance for primates. The common marmoset (Callithrix jacchus) is a promising model for investigations of face processing, as this species possesses oculomotor and face-processing networks resembling those of macaques and humans. Face processing is often disrupted in neuropsychiatric conditions such as schizophrenia (SZ), and thus, it is important to recapitulate underlying circuitry dysfunction preclinically. The N-methyl-d-aspartate (NMDA) noncompetitive antagonist ketamine has been used extensively to model the cognitive symptoms of SZ. Here, we investigated the effects of a subanesthetic dose of ketamine on oculomotor behavior in marmosets during face viewing. Four marmosets received systemic ketamine or saline injections while viewing phase-scrambled or intact videos of conspecifics' faces. To evaluate effects of ketamine on scan paths during face viewing, we identified regions of interest in each face video and classified locations of saccade onsets and landing positions within these areas. A preference for the snout over eye regions was observed following ketamine administration. In addition, regions in which saccades landed could be significantly predicted by saccade onset region in the saline but not the ketamine condition. Effects on saccade control were limited to an increase in saccade peak velocity in all conditions and a reduction in saccade amplitudes during viewing of scrambled videos. Thus, ketamine induced a significant disruption of scan paths during viewing of conspecific faces but limited effects on saccade motor control. These findings support the use of ketamine in marmosets for investigating changes in neural circuits underlying social cognition in neuropsychiatric disorders.NEW & NOTEWORTHY Face processing, an important social cognitive ability, is impaired in neuropsychiatric conditions such as schizophrenia. The highly social common marmoset model presents an opportunity to investigate these impairments. We administered subanesthetic doses of ketamine to marmosets to model the cognitive symptoms of schizophrenia. We observed a disruption of scan paths during viewing of conspecifics' faces. These findings support the use of ketamine in marmosets as a model for investigating social cognition in neuropsychiatric disorders.
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Affiliation(s)
- Janahan Selvanayagam
- Graduate Program in Neuroscience, Western University, London, Ontario, Canada.,Center for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Kevin D Johnston
- Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.,Center for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Raymond K Wong
- Graduate Program in Neuroscience, Western University, London, Ontario, Canada.,Center for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
| | - David Schaeffer
- Department of Neurobiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Stefan Everling
- Graduate Program in Neuroscience, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.,Center for Functional and Metabolic Mapping, Robarts Research Institute, Western University, London, Ontario, Canada
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31
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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32
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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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33
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Lukow PB, Kiemes A, Kempton MJ, Turkheimer FE, McGuire P, Modinos G. Neural correlates of emotional processing in psychosis risk and onset - A systematic review and meta-analysis of fMRI studies. Neurosci Biobehav Rev 2021; 128:780-788. [PMID: 33722617 PMCID: PMC8345001 DOI: 10.1016/j.neubiorev.2021.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 11/17/2020] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
The neural bases of altered emotion processing in psychosis are still unclear. Systematic review indicated widespread activation decreases to emotion in first-episode psychosis. Evidence in people at clinical high-risk for psychosis lacked convergence. These findings were corroborated by image-based meta-analyses.
Aberrant emotion processing is a well-established component of psychotic disorders and is already present at the first episode of psychosis (FEP). However, the role of emotion processing abnormalities in the emergence of psychosis and the underlying neurobiology remain unclear. Here, we systematically reviewed functional magnetic resonance studies that used emotion processing task paradigms in FEP patients, and in people at clinical high-risk for psychosis (CHRp). Image-based meta-analyses with Seed-based d Mapping on available studies (n = 6) were also performed. Compared to controls, FEP patients showed decreased neural responses to emotion, particularly in the amygdala and anterior cingulate cortex. There were no significant differences between CHRp subjects and controls, but a high degree of heterogeneity was identified across studies. The role of altered emotion processing in the early phase of psychosis may be clarified through more homogenous experimental designs, particularly in the CHRp population.
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Affiliation(s)
- P B Lukow
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - A Kiemes
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - M J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - F E Turkheimer
- Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK.
| | - G Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK; Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, SE5 8AF, London, UK; MRC Centre for Neurodevelopmental Disorders, King's College London, new hunt's House, Guy's Campus, SE1 1UL, London, UK.
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34
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Oliver LD, Moxon-Emre I, Lai MC, Grennan L, Voineskos AN, Ameis SH. Social Cognitive Performance in Schizophrenia Spectrum Disorders Compared With Autism Spectrum Disorder: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Psychiatry 2021; 78:281-292. [PMID: 33291141 PMCID: PMC7724568 DOI: 10.1001/jamapsychiatry.2020.3908] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
IMPORTANCE Schizophrenia spectrum disorders (SSDs) and autism spectrum disorder (ASD) both feature social cognitive deficits; however, these disorders historically have been examined separately using a range of tests and subdomain focus and at different time points in the life span. Moving beyond diagnostic categories and characterizing social cognitive deficits can enhance understanding of shared pathways across these disorders. OBJECTIVE To investigate how deficits in social cognitive domains diverge or overlap between SSDs and ASD based on the extant literature. DATA SOURCES Literature searches were conducted in MEDLINE, PsycInfo, Embase, and Web of Science from database inception until July 26, 2020. STUDY SELECTION Original research articles were selected that reported performance-based measures of social cognition in both SSDs and ASD samples. Selected articles also had to be published in English and use International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, DSM-IV, or more recent diagnostic criteria. DATA EXTRACTION AND SYNTHESIS This systematic review and meta-analysis was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses and Meta-analysis of Observational Studies in Epidemiology reporting guidelines, including data extraction and quality assessment using a modified version of the Newcastle-Ottawa Scale. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES Effect sizes were calculated as Hedges g (SSDs vs ASD). The primary outcomes were performance on emotion processing tasks, theory of mind (ToM) tasks, and the Reading the Mind in the Eyes Test (RMET) in SSDs compared with ASD. Meta-regressions were performed for age difference, publication year, quality assessment scores, and antipsychotic medication use. RESULTS Of the 4175 screened articles, 36 studies directly comparing social cognitive performance in individuals with SSDs vs ASD were included in the qualitative analysis (n = 1212 for SSDs groups and n = 1109 for ASD groups), and 33 studies were included in the quantitative analyses (n = 1113 for SSDs groups and n = 1015 for ASD groups). Most study participants were male (number of studies [k] = 36, 72% [878 of 1212] in SSDs groups and 82% [907 of 1109] in ASD groups), and age (k = 35) was older in SSDs groups (mean [SD], 28.4 [9.5] years) than in ASD groups (mean [SD], 23.3 [7.6] years). Included studies highlighted the prevalence of small, male-predominant samples and a paucity of cross-disorder clinical measures. The meta-analyses revealed no statistically significant differences between SSDs and ASD on emotion processing measures (k = 15; g = 0.12 [95% CI, -0.07 to 0.30]; P = .21; I2 = 51.0%; 1 outlier excluded), ToM measures (k = 17; g = -0.01 [95% CI, -0.21 to 0.19]; P = .92; I2 = 56.5%; 1 outlier excluded), or the RMET (k = 13; g = 0.25 [95% CI, -0.04 to 0.53]; P = .10; I2 = 75.3%). However, SSDs vs ASD performance differences between studies were statistically significantly heterogeneous, which was only minimally explained by potential moderators. CONCLUSIONS AND RELEVANCE In this analysis, similar levels of social cognitive impairment were present, on average, in individuals with SSDs and ASD. Cross-disorder studies of social cognition, including larger samples, consensus batteries, and consistent reporting of measures, as well as data across multiple levels of analysis, are needed to help identify subgroups within and across disorders that may be more homogeneous in etiology and treatment response.
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Affiliation(s)
- Lindsay D. Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Iska Moxon-Emre
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom,Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan
| | - Laura Grennan
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Aristotle N. Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stephanie H. Ameis
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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35
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Todeva-Radneva A, Paunova R, Kandilarova S, St Stoyanov D. The Value of Neuroimaging Techniques in the Translation and Transdiagnostic Validation of Psychiatric Diagnoses - Selective Review. Curr Top Med Chem 2021; 20:540-553. [PMID: 32003690 DOI: 10.2174/1568026620666200131095328] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/09/2019] [Accepted: 12/12/2019] [Indexed: 01/05/2023]
Abstract
Psychiatric diagnosis has long been perceived as more of an art than a science since its foundations lie within the observation, and the self-report of the patients themselves and objective diagnostic biomarkers are lacking. Furthermore, the diagnostic tools in use not only stray away from the conventional medical framework but also remain invalidated with evidence-based concepts. However, neuroscience, as a source of valid objective knowledge has initiated the process of a paradigm shift underlined by the main concept of psychiatric disorders being "brain disorders". It is also a bridge closing the explanatory gap among the different fields of medicine via the translation of the knowledge within a multidisciplinary framework. The contemporary neuroimaging methods, such as fMRI provide researchers with an entirely new set of tools to reform the current status quo by creating an opportunity to define and validate objective biomarkers that can be translated into clinical practice. Combining multiple neuroimaging techniques with the knowledge of the role of genetic factors, neurochemical imbalance and neuroinflammatory processes in the etiopathophysiology of psychiatric disorders is a step towards a comprehensive biological explanation of psychiatric disorders and a final differentiation of psychiatry as a well-founded medical science. In addition, the neuroscientific knowledge gained thus far suggests a necessity for directional change to exploring multidisciplinary concepts, such as multiple causality and dimensionality of psychiatric symptoms and disorders. A concomitant viewpoint transition of the notion of validity in psychiatry with a focus on an integrative validatory approach may facilitate the building of a collaborative bridge above the wall existing between the scientific fields analyzing the mind and those studying the brain.
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Affiliation(s)
- Anna Todeva-Radneva
- Department of Psychiatry and Medical Psychology and Scientific Research Institute, The Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Rositsa Paunova
- Department of Psychiatry and Medical Psychology and Scientific Research Institute, The Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Sevdalina Kandilarova
- Department of Psychiatry and Medical Psychology and Scientific Research Institute, The Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Drozdstoy St Stoyanov
- Department of Psychiatry and Medical Psychology and Scientific Research Institute, The Medical University of Plovdiv, Plovdiv, Bulgaria
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36
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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: 33] [Impact Index Per Article: 11.0] [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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37
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Jeong JW, Kim HT, Lee SH, Lee H. Effects of an Audiovisual Emotion Perception Training for Schizophrenia: A Preliminary Study. Front Psychiatry 2021; 12:522094. [PMID: 34025462 PMCID: PMC8131526 DOI: 10.3389/fpsyt.2021.522094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 03/18/2021] [Indexed: 11/13/2022] Open
Abstract
Individuals with schizophrenia show a reduced ability to integrate facial and vocal information in emotion perception. Although emotion perception has been a target for treatment, no study has yet examined the effect of multimodal training on emotion perception in schizophrenia. In the present study, we developed an audiovisual emotion perception training and test in which a voice and a face were simultaneously presented, and subjects were asked to judge whether the emotions of the voice and the face matched. The voices were either angry or happy, and the faces were morphed on a continuum ranging from angry to happy. Sixteen patients with schizophrenia participated in six training sessions and three test sessions (i.e., pre-training, post-training, and generalization). Eighteen healthy controls participated only in pre-training test session. Prior to training, the patients with schizophrenia performed significantly worse than did the controls in the recognition of anger; however, following the training, the patients showed a significant improvement in recognizing anger, which was maintained and generalized to a new set of stimuli. The patients also improved the recognition of happiness following the training, but this effect was not maintained or generalized. These results provide preliminary evidence that a multimodal, audiovisual training may yield improvements in anger perception for patients with schizophrenia.
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Affiliation(s)
- Ji Woon Jeong
- Department of Psychology, Korea University, Seoul, South Korea
| | - Hyun Taek Kim
- Department of Psychology, Korea University, Seoul, South Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Ilsan-Paik Hospital, Inje University, Goyang, South Korea
| | - Hyejeen Lee
- Department of Psychology, Chonnam National University, Gwangju, South Korea
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Lim JE, Kwon YJ, Jung SY, Park K, Lee W, Lee SH, P Horan W, Choi KH. Benefits of social cognitive skills training within routine community mental health services: Evidence from a non-randomized parallel controlled study. Asian J Psychiatr 2020; 54:102314. [PMID: 32739862 DOI: 10.1016/j.ajp.2020.102314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/11/2020] [Accepted: 07/13/2020] [Indexed: 02/08/2023]
Abstract
Although social cognitive impairments are evident in patients with schizophrenia across many cultures, psychosocial interventions are less used in Eastern countries. Despite a growing emphasis on community care in mental health services in Eastern countries, the synergistic effects of social cognitive intervention strategies on routine community mental health services are not well documented. This study aimed to adapt a group-based social cognitive skills training (SCST) program for use in a Korean context and evaluate its feasibility and preliminary effects among community-dwelling individuals with schizophrenia. Forty-seven patients were assigned to either the SCST + treatment as usual (TAU) group (n = 21) or the TAU only group (n = 24). Participants completed tasks to assess social cognition, social functioning, neurocognition, and psychiatric symptoms before and after treatment. Over a period of approximately 12 weeks, drop-out rates were comparably low in both groups, and the attendance rates for the SCST program were high (85.7 %, mean sessions attended = 20.56/24 sessions). The SCST + TAU group demonstrated significant improvements in facial affect recognition, social functioning, and psychiatric symptoms compared to the TAU only group. A non-significant trend in theory of mind was observed, along with no improvements in social perception and neurocognition. The adapted version of the SCST program is feasible for implementation and demonstrates promise for enhancing social cognition and functioning in Korean outpatients with schizophrenia.
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Affiliation(s)
- Jae Eun Lim
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Ye-Jin Kwon
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Soo-Yun Jung
- Department of Psychology, Korea University, Seoul, Republic of Korea
| | - Kiho Park
- Department of Psychology, Korea University, Seoul, Republic of Korea; Korea University Mind Health Institute, Seoul, Republic of Korea
| | - Wonhye Lee
- Department of Clinical Psychology, National Center for Mental Health, Seoul, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan-Paik Hospital, Goyang, Republic of Korea
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Kee-Hong Choi
- Department of Psychology, Korea University, Seoul, Republic of Korea; Korea University Mind Health Institute, Seoul, Republic of Korea; Department of Psychology, Wesleyan University, Middletown, USA.
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39
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San-Martin R, Castro LA, Menezes PR, Fraga FJ, Simões PW, Salum C. Meta-Analysis of Sensorimotor Gating Deficits in Patients With Schizophrenia Evaluated by Prepulse Inhibition Test. Schizophr Bull 2020; 46:1482-1497. [PMID: 32506125 PMCID: PMC8061122 DOI: 10.1093/schbul/sbaa059] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Prepulse inhibition (PPI) of startle is an operational measure of sensorimotor gating that is often impaired in patients with schizophrenia. Despite the large number of studies, there is considerable variation in PPI outcomes reported. We conducted a systematic review and meta-analysis investigating PPI impairment in patients with schizophrenia compared with healthy control subjects, and examined possible explanations for the variation in results between studies. Major databases were screened for observational studies comparing healthy subjects and patients with schizophrenia for the prepulse and pulse intervals of 60 and 120 ms as primary outcomes, ie, PPI-60 and PPI-120. Standardized mean difference (SMD) and 95% confidence intervals (CI) were extracted and pooled using random effects models. We then estimated the mean effect size of these measures with random effects meta-analyses and evaluated potential PPI heterogeneity moderators, using sensitivity analysis and meta-regressions. Sixty-seven primary studies were identified, with 3685 healthy and 4290 patients with schizophrenia. The schizophrenia group showed reduction in sensorimotor gating for both PPI-60 (SMD = -0.50, 95% CI = [-0.61, -0.39]) and PPI-120 (SMD = -0.44, 95% CI = [-0.54, -0.33]). The sensitivity and meta-regression analysis showed that sample size, gender proportion, imbalance for gender, source of control group, and study continent were sources of heterogeneity (P < .05) for both PPI-60 and PPI-120 outcomes. Our findings confirm a global sensorimotor gating deficit in schizophrenia patients, with overall moderate effect size for PPI-60 and PPI-120. Methodological consistency should decrease the high level of heterogeneity of PPI results between studies.
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Affiliation(s)
- Rodrigo San-Martin
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Leonardo Andrade Castro
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Population Mental Health Research Center, Universidade de São Paulo, São Paulo, Brazil
| | - Francisco José Fraga
- Engineering, Modeling and Applied Social Sciences Center, Universidade Federal do ABC, Santo André, Brazil
| | - Priscyla Waleska Simões
- Engineering, Modeling and Applied Social Sciences Center, Universidade Federal do ABC, Santo André, Brazil
| | - Cristiane Salum
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, Santo André, Brazil
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Drucaroff LJ, Fazzito ML, Castro MN, Nemeroff CB, Guinjoan SM, Villarreal MF. Insular functional alterations in emotional processing of schizophrenia patients revealed by Multivariate Pattern Analysis fMRI. J Psychiatr Res 2020; 130:128-136. [PMID: 32818661 DOI: 10.1016/j.jpsychires.2020.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/22/2020] [Accepted: 06/24/2020] [Indexed: 11/30/2022]
Abstract
Emotion perception is impaired in schizophrenia patients (SP) and related to reduced social skills performance. There is a remarkable variability across subjects for functional neuroimaging alterations related to this phenomenon. In contrast to the univariate approaches of fMRI, Multivariate Pattern Analysis (MVPA) maintains the within-subject voxel-level variability. The purpose of this study was to assess emotion processing in SP, in previously identified ROIs -i.e. amygdala, hippocampus, insula, and thalamus-, while retaining the functional heterogeneity that may exist between subjects. We evaluated 23 SP and 23 healthy controls (HC). Happy, sad, and neutral faces were presented. A single trial fMRI model was applied. Patterns of activation within each ROI were classified at the subject level. Within each group, stimuli classification scores were tested against random label classification scores. In ROIs with significant results, a whole ROI classification was performed, to test whether en bloc stimuli discrimination was present. A between-group analysis was conducted also. For the classification of stimuli above chance, in the HC results were significant in the left insula in all of the stimuli dichotomies, but were non-significant in SP for happy vs. sad. In whole ROI classification, SP had significant results in bilateral insular cortex for happy vs. neutral. The left amygdala showed diminished stimuli classification scores in SP for sad vs. neutral. In conclusion, MVPA seems useful to study emotional processing in schizophrenia. In SP, either en bloc or no stimuli discrimination was seen in the insula, and reduced stimuli discrimination was seen in the left amygdala.
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Affiliation(s)
- Lucas J Drucaroff
- FLENI-CONICET, Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Paraguay 2155, C1121ABG, Buenos Aires, Argentina; Department of Psychiatry, FLENI, Montañeses 2325, C1428AQK, Buenos Aires, Argentina.
| | - Maria Lucia Fazzito
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Paraguay 2155, C1121ABG, Buenos Aires, Argentina; Department of Psychiatry, FLENI, Montañeses 2325, C1428AQK, Buenos Aires, Argentina.
| | - Mariana N Castro
- FLENI-CONICET, Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Paraguay 2155, C1121ABG, Buenos Aires, Argentina.
| | - Charles B Nemeroff
- Department of Psychiatry, Dell Medical School, University of Texas at Austin, 1601 Trinity St, Austin, TX, 78712, USA.
| | - Salvador M Guinjoan
- FLENI-CONICET, Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Paraguay 2155, C1121ABG, Buenos Aires, Argentina; Department of Psychiatry, FLENI, Montañeses 2325, C1428AQK, Buenos Aires, Argentina.
| | - Mirta F Villarreal
- FLENI-CONICET, Montañeses 2325, C1428AQK, Buenos Aires, Argentina; Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Pabellón I, Ciudad Universitaria, 1428, Buenos Aires, Argentina.
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41
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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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Bulgari V, Bava M, Gamba G, Bartoli F, Ornaghi A, Candini V, Ferla MT, Cricelli M, Bianconi G, Cavalera C, Conte G, Stefana A, Picchioni M, Iozzino L, Crocamo C, Carrà G. Facial emotion recognition in people with schizophrenia and a history of violence: a mediation analysis. Eur Arch Psychiatry Clin Neurosci 2020; 270:761-769. [PMID: 31106387 DOI: 10.1007/s00406-019-01027-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 05/15/2019] [Indexed: 11/26/2022]
Abstract
Evidence for an association between impaired facial emotion recognition and violence in people with schizophrenia is inconclusive. In particular, the role of misidentification patterns involving specific emotions such as anger and the influence of clinical characteristics on this association remain unclear. In this study, we compared facial emotion recognition performance in age- and gender-matched schizophrenia spectrum disorders subjects with (N = 52) and without (N = 52) a history of violence. Data on current symptom severity, Cluster B personality status, past victimization, and alcohol and substance misuse were also collected. Compared to those without, subjects with a history of violence showed worse facial emotion recognition performances, involving anger, fear, disgust, sadness, and happiness. When formally testing the reporting of angry faces, evidence of enhanced sensitivity to anger was not supported. Finally, when the impact of current symptoms was assessed, higher severity of activation symptoms, including motor hyperactivity, elevated mood, excitement and distractibility, mediated the relationship between history of violence and poor facial emotion recognition performance. As a whole, our findings seem to support the role of perceptual deficits involving different emotions as well as of a mediation played by activation symptoms. Facial emotion recognition deficits associated with the propensity to violence, as well certain symptoms mediating their relationship, should be targeted by specific treatment approaches.
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Affiliation(s)
- Viola Bulgari
- Psychiatric and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Mattia Bava
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giulia Gamba
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Alessandra Ornaghi
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Valentina Candini
- Psychiatric and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Maria Teresa Ferla
- Department of Mental Health, ASST-Rhodense G.Salvini di Garbagnate, Milan, Italy
| | - Marta Cricelli
- Department of Mental Health, ASST-Rhodense G.Salvini di Garbagnate, Milan, Italy
| | | | - Cesare Cavalera
- Psychiatric and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milan, Italy
| | - Giovanni Conte
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Alberto Stefana
- Department of Mental Health, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Marco Picchioni
- St Magnus Hospital, Marley Lane, Haslemere, Surrey, UK
- GU and Department of Forensic and Neurodevelopmental Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Laura Iozzino
- Psychiatric and Evaluation Unit, IRCCS Istituto Centro San Giovanni di Dio, Fatebenefratelli, Brescia, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
- Division of Psychiatry, University College of London, London, UK.
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Caruana N, Inkley C, El Zein M. Gaze direction biases emotion categorisation in schizophrenia. Schizophr Res Cogn 2020; 21:100181. [PMID: 32477892 PMCID: PMC7248285 DOI: 10.1016/j.scog.2020.100181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/04/2020] [Accepted: 05/13/2020] [Indexed: 12/13/2022]
Abstract
The successful integration of eye gaze direction and emotion cues from faces is important not only for co-ordinated interactions, but also for the detection of social signals alerting us to threat posed by a conspecific, or elsewhere in our immediate environment. It is now well-established that people with schizophrenia experience aberrant eye gaze and facial emotion processing. These social-cognitive differences might contribute to the maintenance of socially-themed delusions which are characterised by the hyper-attribution of threatening intentions to others. However, no study has directly examined whether the mechanisms which govern the integration of eye gaze and emotion information diverge in schizophrenia, and more importantly, whether this reflects a fundamental 'bottom-up' perceptual deficit or a 'top-down' cognitive bias. Fifteen outpatients diagnosed with schizophrenia and 21 healthy age- and IQ-matched controls performed an emotion categorisation task (anger/fear) on morphed facial expressions of anger or fear, displaying either direct or averted gaze. Results in both controls and patients replicated the previous finding that combinations of anger with direct gaze, and fear with averted gaze - which signal a relevant threat to the observer - benefited from more accurate emotion recognition than alternate gaze-emotion combinations. Bayesian model selection revealed that for patients this effect was mediated by a shift in decision bias towards emotions which signal self-relevant threat, rather than a change in sensitivity as observed in controls. These results critically highlight a different cognitive mechanism governing gaze and face-cued emotion integration in schizophrenia, which has a top-down influence on the evaluation of perceptual input.
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Affiliation(s)
- Nathan Caruana
- Perception in Action Research Centre, Macquarie University, Sydney, Australia
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Christine Inkley
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Marwa El Zein
- Institute of Cognitive Neuroscience, University College London, United Kingdom
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McDonald S, Wilson E, Wearne T, Darke L, Cassel A, Rosenberg H. The complex audio visual emotion assessment task (CAVEAT): development of a shorter version for clinical use. Disabil Rehabil 2020; 44:1498-1507. [PMID: 32787689 DOI: 10.1080/09638288.2020.1803425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The Complex Audio Visual Emotion Assessment Task (CAVEAT) is a measure of emotion recognition using dynamic, naturalistic videos to assess recognition of 22 different emotional states (11 positive, 11 negative). It has established construct validity and demonstrated sensitivity to emotion perception impairments in those with moderate-severe traumatic brain injury (TBI). Despite this, its lengthy administration has limited its use in clinical practice and rehabilitation. The current paper aimed to develop shortened versions of the CAVEAT and examine their psychometric properties. METHODS The CAVEAT-S A and CAVEAT-S B (22 items each) and the CAVEAT-S AB (44 items) were developed using the original data. Comparability, reliability, construct and predictive validity were examined in the original sample (Study 1: 32 people with TBI and 32 demographically matched control participants) and a replication sample (Study 2: 18 adults with TBI and 21 demographically matched controls). RESULTS All short forms produced comparable accuracy ratings to the full measure, as well as discriminating between people with or without a TBI. Shortened forms all correlated with other measures of emotion perception and social cognition and also predicted psychosocial outcomes in terms of self-reported interpersonal relationships. Internal reliability of the short forms was low relative to the longer forms, especially for the two very short measures. CONCLUSIONS The new shortened forms of the CAVEAT are promising tools that are sensitive and valid for assessing emotion perception in people with TBI for clinical purposes. Their application in other clinical disorders is yet to be examined.Implications for rehabilitationEmotion perception deficits are present in many clinical populations and an important target for rehabilitation.CAVEAT Short provides ecologically valid emotional stimuli. Such stimuli are important for assessing real world function and to set rehabilitation targets.By having parallel versions of CAVEAT, there is the opportunity to test pre and post intervention while minimising practice effects.Alternatively, one version of CAVEAT-S can be used for assessment, while the other is used for training purposes during remediation.
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Affiliation(s)
- Skye McDonald
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Emily Wilson
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Travis Wearne
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Lillian Darke
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Anneli Cassel
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Hannah Rosenberg
- School of Psychology, University of New South Wales, Sydney, Australia
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45
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Sandsten KE, Nordgaard J, Kjaer TW, Gallese V, Ardizzi M, Ferroni F, Petersen J, Parnas J. Altered self-recognition in patients with schizophrenia. Schizophr Res 2020; 218:116-123. [PMID: 32007345 DOI: 10.1016/j.schres.2020.01.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/12/2020] [Accepted: 01/19/2020] [Indexed: 10/25/2022]
Abstract
Self-alienation is a common characterization of various disturbing experiences in patients with schizophrenia. A vivid example comes from patient reports of not recognizing themselves when inspecting their specular image in the mirror. By applying the multisensory paradigm of the Enfacement Illusion, this study empirically addresses the specular Self-Other discrimination in patients with schizophrenia. 35 patients diagnosed with schizophrenia and 35 healthy matched controls were enrolled in the study. Results found that the group of patients with schizophrenia had a significant skewed self-other discrimination towards the other at baseline. Furthermore, the effect of visuo-tactile stimulation on self-recognition in the schizophrenia patients was significantly altered after both synchronous and asynchronous stimulation compared to baseline. This contrasted with healthy controls which in line with earlier studies only had significantly different self-recognition after synchronous stimulation. The study thus suggests that patients with schizophrenia have deviations in their specular self-recognition compared to healthy controls. Moreover, that temporal factors in multisensory integration may contribute to alterations of self-related stimuli in patients with schizophrenia.
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Affiliation(s)
- Karl Erik Sandsten
- Early Psychosis Intervention Center, Region Zealand Psychiatry, Roskilde, Denmark.
| | | | | | - Vittorio Gallese
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Institute of Philosophy, School of Advanced Study, University of London, London, UK
| | - Martina Ardizzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Ferroni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Janne Petersen
- Center for Clinical Research and Prevention, Frederiksberg Hospital, Copenhagen, Denmark
| | - Josef Parnas
- Center for Subjectivity Research, Copenhagen University, Denmark; Mental Health Center Glostrup, Brondby, Denmark
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46
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Mehl S, Hesse K, Schmidt AC, Landsberg MW, Soll D, Bechdolf A, Herrlich J, Kircher T, Klingberg S, Müller BW, Wiedemann G, Wittorf A, Wölwer W, Wagner M. Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis - a secondary analysis of a randomized-controlled therapy trial. BMC Psychiatry 2020; 20:59. [PMID: 32041577 PMCID: PMC7011563 DOI: 10.1186/s12888-020-2482-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/04/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cognitive models of psychosis postulate an important role of Theory of mind (ToM) in the formation and maintenance of delusions, but research on this plausible conjecture has gathered conflicting findings. In addition, it is still an open question whether problems in emotion recognition (ER) are associated with delusions. We examined the association of problems in ToM and ER with different aspects of delusions in a large sample of patients with psychosis enrolled in a therapy trial. This also enabled us to explore the possible impact of ToM and ER on one part of patients' social life: the quality of their therapeutic relationship. METHODS Patients with psychotic disorders and delusions and/or hallucinations (n = 185) and healthy controls (n = 48) completed a ToM picture sequencing task and an ER task. Subsequently, patients were enrolled in a randomized-controlled Cognitive Behavior Therapy (CBT) trial (ISRCTN29242879). Patients and therapists rated the quality of the therapeutic relationship during the first five sessions of therapy. RESULTS In comparison to controls, patients were impaired in both ToM and ER. Patients with deficits in ER experienced more severe delusional distress, whereas ToM problems were not related to delusions. In addition, deficits in ER predicted a less favorable therapeutic relationship and interactional problems viewed by the therapist. Impaired ER also moderated (increased) the negative influence of delusions on the therapeutic relationship and interactional difficulties viewed by the therapist. CONCLUSIONS Cognitive models on the formation and maintenance of delusions should consider ER as a potential candidate that might be related to the formation and maintenance of delusional distress, whereas problems in ToM might not be directly related to delusions and secondary dimensions of delusions. In addition, problems in ER in patients with psychosis might have an impact on the quality of the therapeutic relationship and patients with problems in ER are more likely to be viewed as problematic by their therapists. Nevertheless, training ER might be a way to improve the quality of the therapeutic relationship and potentially the effectiveness of CBT or other interventions for patients with psychosis.
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Affiliation(s)
- Stephanie Mehl
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039 Marburg, Germany
| | - Klaus Hesse
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Anna-Christine Schmidt
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Martin W. Landsberg
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
| | - Daniel Soll
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039 Marburg, Germany
| | - Andreas Bechdolf
- Department of Psychiatry and Psychotherapy, University of Cologne, Gleuler Straße, 50931 Köln, Germany
- Department of Psychiatry and Psychotherapy, Vivantes Hospital Berlin, Dieffenbachstraße 1, 10967 Berlin, Germany
| | - Jutta Herrlich
- Department of Psychiatry, Psychosomatic and Psychotherapy, University of Frankfurt, Heinrich-Hoffmann-Straße 10, 60528 Frankfurt am Main, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University of Marburg, Rudolf-Bultmann-Straße 8, 35039 Marburg, Germany
| | - Stefan Klingberg
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Bernhard W. Müller
- Department of Psychiatry and Psychotherapy, University of Duisburg- Essen, Virchowstraße 147, 45147 Essen, Germany
| | - Georg Wiedemann
- Department of Psychiatry and Psychotherapy, Hospital Fulda, Pacelliallee 4, 36043 Fulda, Germany
| | - Andreas Wittorf
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076 Tübingen, Germany
| | - Wolfgang Wölwer
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University of Düsseldorf, Bergische Landstraße 2, 40629 Düsseldorf, Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Sigmund-Freud-Straße 25, 53105 Bonn, Germany
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Modinos G, Kempton MJ, Tognin S, Calem M, Porffy L, Antoniades M, Mason A, Azis M, Allen P, Nelson B, McGorry P, Pantelis C, Riecher-Rössler A, Borgwardt S, Bressan R, Barrantes-Vidal N, Krebs MO, Nordentoft M, Glenthøj B, Ruhrmann S, Sachs G, Rutten B, van Os J, de Haan L, Velthorst E, van der Gaag M, Valmaggia LR, McGuire P. Association of Adverse Outcomes With Emotion Processing and Its Neural Substrate in Individuals at Clinical High Risk for Psychosis. JAMA Psychiatry 2020; 77:190-200. [PMID: 31722018 PMCID: PMC6865249 DOI: 10.1001/jamapsychiatry.2019.3501] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. OBJECTIVE To examine the association between alterations in emotion processing and regional gray matter volumes in individuals at clinical high risk (CHR) for psychosis, and the association with subsequent clinical outcomes. DESIGN, SETTING, AND PARTICIPANTS This naturalistic case-control study with clinical follow-up at 12 months was conducted from July 1, 2010, to August 31, 2016, and collected data from 9 psychosis early detection centers (Amsterdam, Basel, Cologne, Copenhagen, London, Melbourne, Paris, The Hague, and Vienna). Participants (213 individuals at CHR and 52 healthy controls) were enrolled in the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) project. Data were analyzed from October 1, 2018, to April 24, 2019. MAIN MEASURES AND OUTCOMES Emotion recognition was assessed with the Degraded Facial Affect Recognition Task. Three-Tesla magnetic resonance imaging scans were acquired from all participants, and gray matter volume was measured in regions of interest (medial prefrontal cortex, amygdala, hippocampus, and insula). Clinical outcomes at 12 months were evaluated for transition to psychosis using the Comprehensive Assessment of At-Risk Mental States criteria, and the level of overall functioning was measured through the Global Assessment of Functioning [GAF] scale. RESULTS A total of 213 individuals at CHR (105 women [49.3%]; mean [SD] age, 22.9 [4.7] years) and 52 healthy controls (25 women [48.1%]; mean [SD] age, 23.3 [4.0] years) were included in the study at baseline. At the follow-up within 2 years of baseline, 44 individuals at CHR (20.7%) had developed psychosis and 169 (79.3%) had not. Of the individuals at CHR reinterviewed with the GAF, 39 (30.0%) showed good overall functioning (GAF score, ≥65), whereas 91 (70.0%) had poor overall functioning (GAF score, <65). Within the CHR sample, better anger recognition at baseline was associated with worse functional outcome (odds ratio [OR], 0.88; 95% CI, 0.78-0.99; P = .03). In individuals at CHR with a good functional outcome, positive associations were found between anger recognition and hippocampal volume (ze = 3.91; familywise error [FWE] P = .02) and between fear recognition and medial prefrontal cortex volume (z = 3.60; FWE P = .02), compared with participants with a poor outcome. The onset of psychosis was not associated with baseline emotion recognition performance (neutral OR, 0.93; 95% CI, 0.79-1.09; P = .37; happy OR, 1.03; 95% CI, 0.84-1.25; P = .81; fear OR, 0.98; 95% CI, 0.85-1.13; P = .77; anger OR, 1.00; 95% CI, 0.89-1.12; P = .96). No difference was observed in the association between performance and regional gray matter volumes in individuals at CHR who developed or did not develop psychosis (FWE P < .05). CONCLUSIONS AND RELEVANCE In this study, poor functional outcome in individuals at CHR was found to be associated with baseline abnormalities in recognizing negative emotion. This finding has potential implications for the stratification of individuals at CHR and suggests that interventions that target socioemotional processing may improve functional outcomes.
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Affiliation(s)
- Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matthew J. Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,National Institute for Health Research, Biomedical Research Centre, London, United Kingdom
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Maria Calem
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Lilla Porffy
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Ava Mason
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,Department of Psychology, University of Roehampton, London, United Kingdom
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Christos Pantelis
- Center for Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Rodrigo Bressan
- LiNC—Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo—UNIFESP, São Paulo, Brazil
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Barcelona, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C’JAAD, Hospitalo-Universitaire Department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark,Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, University of Copenhagen, Mental Health Centre Glostrup, Copenhagen, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart Rutten
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,University Medical Centre Utrecht Brain Center, Department of Psychiatry, Utrecht University Medical Centre, Utrecht, the Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, the Netherlands
| | - Eva Velthorst
- Early Psychosis Department, Amsterdam UMC, Amsterdam, the Netherlands,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mark van der Gaag
- Amsterdam Public Mental Health Research Institute, Department of Clinical Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands,Parnassia Psychiatric Institute, Department of Psychosis Research, The Hague, the Netherlands
| | - Lucia R. Valmaggia
- Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom,National Institute for Health Research, Biomedical Research Centre, London, United Kingdom,South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
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48
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Vakhrusheva J, Khan S, Chang R, Hansen M, Ayanruoh L, Gross J, Kimhy D. Lexical analysis of emotional responses to "real-world" experiences in individuals with schizophrenia. Schizophr Res 2020; 216:272-278. [PMID: 31839556 PMCID: PMC7239730 DOI: 10.1016/j.schres.2019.11.045] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 08/30/2019] [Accepted: 11/24/2019] [Indexed: 01/22/2023]
Abstract
Abnormalities in emotion perception, expression, and experience are considered a core component of schizophrenia. Previous laboratory studies have demonstrated that while individuals with schizophrenia report levels of positive emotions comparable to healthy individuals in response to positive stimuli, they also report co-occurring negative emotions in response to such stimuli. However, it is unknown whether this response pattern extends to "real world" naturalistic environments. To examine this question, we employed an experience sampling method (ESM) approach using mobile electronic devices to collect information up to 10 times/day over a two-day period from 53 individuals with schizophrenia and 19 non-clinical controls. As part of each experience sample, participants completed brief open-ended responses and answered questions about their emotional responses to three recent events (neutral, positive, and negative). Additionally, participants completed diagnostic and clinical measures. Lexical analyses were used to analyze ESM-based word production and characterize emotion word use. Compared to non-clinical controls, individuals with schizophrenia reported similar levels of positive emotion, but significantly higher negative emotion, which was associated with increased negative symptoms. The schizophrenia group used more anxiety words in response to negative and neutral events, and more anger words in response to positive events. Increased use of anger words was linked with elevations in positive symptoms as well as symptoms of depression, while use of sadness words was linked with anhedonia. Our findings support the co-activation of negative emotion hypothesis documented in laboratory settings and provide evidence of its ecological validity. Implications for functioning and future directions are discussed.
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Affiliation(s)
- J. Vakhrusheva
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - S. Khan
- New York State Psychiatric Institute, New York, NY
| | - R. Chang
- New York State Psychiatric Institute, New York, NY
| | - M. Hansen
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - L. Ayanruoh
- New York State Psychiatric Institute, New York, NY
| | - J.J. Gross
- Department of Psychiatry & Behavioral Science, Stanford University, Stanford, CA
| | - D. Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
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49
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Peveretou F, Radke S, Derntl B, Habel U. A Short Empathy Paradigm to Assess Empathic Deficits in Schizophrenia. Behav Sci (Basel) 2020; 10:bs10020041. [PMID: 31991547 PMCID: PMC7071360 DOI: 10.3390/bs10020041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 12/30/2022] Open
Abstract
Empathy is important for successful social interaction and maintaining relationships. Several studies detected impairments in empathic abilities in schizophrenia, with some even indicating a broader deficit in several components, including emotion recognition, perspective taking, and affective responsiveness. The aim of our study was to validate a short version of the previous empathy paradigm as a reliable and easily applicable method to assess empathic deficits in patients with schizophrenia potentially within clinical routine. To do so, we applied the short version to 30 patients (14 females) diagnosed with schizophrenia meeting the DSM-5 criteria and 30 well-matched healthy controls (14 females). The data analysis indicates a significant empathic deficit in patients due to worse performance in all three domains. We managed to replicate most of the findings of our previous study. In contrary to the previous study, significant correlations between performance in the empathy tasks and psychopathology occurred: the severity of negative symptoms was negatively associated with performance in the emotion recognition task and the affective responsiveness task. Gender did not significantly affect performance in the empathy tasks. Regarding the results, our short empathy paradigm appears to be a valid method in assessing empathic impairments in schizophrenia that may be useful in clinical routine.
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Affiliation(s)
- Foteini Peveretou
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Correspondence: ; Tel.: +49-241-80-80368; Fax: +49-241-80-82401
| | - Sina Radke
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Jülich Aachen Research Alliance—BRAIN Institute I: Brain Structure–Function Relationships: Decoding the Human Brain at Systemic Levels, Research Center Jülich GmbH and RWTH Aachen University, Wilhelm-Johnen-Strasse, 52425 Jülich, Germany
| | - Birgit Derntl
- Department of Psychiatry and Psychotherapy, Medical School, University of Tübingen, Calwerstrasse 14, 72076 Tübingen, Germany;
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Pauwelsstrasse 30, 52074 Aachen, Germany; (S.R.); (U.H.)
- Jülich Aachen Research Alliance—BRAIN Institute I: Brain Structure–Function Relationships: Decoding the Human Brain at Systemic Levels, Research Center Jülich GmbH and RWTH Aachen University, Wilhelm-Johnen-Strasse, 52425 Jülich, Germany
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50
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Seo E, Park HY, Park K, Koo SJ, Lee SY, Min JE, Lee E, An SK. Impaired Facial Emotion Recognition in Individuals at Ultra-High Risk for Psychosis and Associations With Schizotypy and Paranoia Level. Front Psychiatry 2020; 11:577. [PMID: 32676040 PMCID: PMC7333645 DOI: 10.3389/fpsyt.2020.00577] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 06/05/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with schizophrenia and individuals at ultra-high risk for psychosis (UHR) have been reported to exhibit impaired recognition of facial emotion expressions. This impairment has involved both inaccuracy and negative bias of facial emotion recognition. The present study aimed to investigate whether UHR individuals display both types of impaired facial emotion recognition and to explore correlations between these impairments and schizotypy, as well as paranoia levels, in these individuals. METHODS A total of 43 UHR individuals and 57 healthy controls (HC) completed a facial emotion recognition task consisting of 60 standardized facial photographs. To explore correlations, we assessed schizotypy using the Revised Physical Anhedonia Scale and Magical Ideation Scale and paranoia level using the Paranoia Scale and persecution/suspicious item of the Positive and Negative Syndrome Scale in UHR individuals. RESULTS Compared with HC, UHR individuals exhibited less accuracy for facial emotion recognition (70.6% vs. 75.6%, p=0.010) and a higher rate of "fear" responses for neutral faces (14.5% vs. 6.0%, p=0.003). In UHR individuals, inaccuracy was significantly correlated with schizotypy scores, but not with paranoia level. Conversely, "disgust" response for neutral faces was the only fear response correlated with paranoia level, and no threat-related emotion response correlated with schizotypy scores. DISCUSSION UHR individuals exhibited inaccuracy and negative bias of facial emotion recognition. Furthermore, schizotypy scores were associated with inaccuracy but not with negative bias of facial emotion recognition. Paranoia level was correlated with "disgust" responses for neutral faces but not with inaccuracy. These findings suggest that inaccuracy and negative bias of facial emotion recognition reflect different underlying processes, and that inaccuracy may be a vulnerability marker for schizophrenia.
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Affiliation(s)
- Eunchong Seo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Hye Yoon Park
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Kyungmee Park
- Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Department of Hospital Medicine, Yonsei University College of Medicine, Yongin Severance Hospital, Gyeonggi-do, South Korea
| | - Se Jun Koo
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Su Young Lee
- Department of Psychiatry, Myongji Hospital, Gyeonggi-do, South Korea
| | - Jee Eun Min
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea
| | - Suk Kyoon An
- Section of Self, Affect and Neuroscience, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Severance Hospital, Seoul, South Korea.,Graduate Program in Cognitive Science, Yonsei University, Seoul, South Korea
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