Affective prosody and facial emotion recognition in first-episode schizophrenia: Associations with functioning & symptoms

Impact of psychosocial stress on facial emotion recognition in schizophrenia and controls: an experimental study in a forensic sample

Introduction

Psychotic disorders have been associated with dysregulated stress reactions and adaptation. Little is known about the neuroendocrine responses to psychosocial stress in justice-involved individuals with schizophrenia.

Methods

Using an experimental research design, the present study aims to examine differences in the subjective and neuroendocrine responses to psychosocial stress and its impact on facial emotion recognition (FER) and performance on an arithmetic task in chronically ill justice-involved individuals with schizophrenia (PAT) and a healthy control group. PAT undergoing treatment in forensic psychiatric inpatient wards (n = 17) and a healthy control group (n = 17) were assessed regarding sociodemographic and clinical characteristics. Additionally, salivary cortisol levels, measured before and after performing a psychosocial stress task [Montreal Imaging Stress Task (MIST)], and performance on an arithmetic problem-solving task and two FER tasks were recorded. Two participants dropped out, one from each group. Therefore, the final sample consisted of 32 individuals.

Results

Significant group differences in FER were recorded. There was a significant rise in subjective perception of momentary strain relating to the induction of psychosocial stress in both groups. Notably, the pre-stress level of subjective strain was higher in the PAT group than controls. Acute psychosocial stress induced an increase in FER performance in a sub-task related to naming emotions in individuals with schizophrenia spectrum disorder.

Discussion

The results underline the importance of psychosocial and therapeutic interventions aimed at strengthening stress resilience in individuals with schizophrenia spectrum disorders.

The social cognitive and neural mechanisms that underlie social functioning in individuals with schizophrenia - a review

In many individuals with a diagnosis of schizophrenia social functioning is impaired across the lifespan. Social cognition has emerged as one of the possible factors that may contribute to these challenges. Neuroimaging research can give further insights into the underlying mechanisms of social (cognitive) difficulties. This review summarises the evidence on the associations between social cognition in the domains of theory of mind and emotion perception and processing, and individuals' social functioning and social skills, as well as associated neural mechanisms. Eighteen behavioural studies were conducted since the last major review and meta-analysis in the field (inclusion between 7/2017 and 1/2022). No major review has investigated the link between the neural mechanisms of social cognition and their association with social functioning in schizophrenia. Fourteen relevant studies were included (from 1/2000 to 1/2022). The findings of the behavioural studies showed that associations with social outcomes were slightly stronger for theory of mind than for emotion perception and processing. Moreover, performance in both social cognitive domains was more strongly associated with performance on social skill measures than questionnaire-based assessment of social functioning in the community. Studies on the underlying neural substrate of these associations presented mixed findings. In general, higher activation in various regions of the social brain was associated with better social functioning. The available evidence suggests some shared regions that might underlie the social cognition-social outcome link between different domains. However, due to the heterogeneity in approaches and findings, the current knowledge base will need to be expanded before firm conclusions can be drawn.

Association between fractional amplitude of low-frequency fluctuation (fALFF) and facial emotion recognition ability in first-episode schizophrenia patients: a fMRI study

It was still unclear that the correlation between the resting-state intrinsic activity in brain regions and facial emotion recognition (FER) ability in patients with first-episode schizophrenia (FSZ). Our aim was to analyse the correlation between the fractional amplitude of low-frequency fluctuation (fALFF) and FER ability in FSZ patients. A total of 28 patients with FSZ and 33 healthy controls (HCs) completed visual search tasks for FER ability. Regions of interest (ROIs) related to facial emotion were obtained from a previous meta-analysis. Pearson correlation analysis was performed to understand the correlation between fALFF and FER ability. Our results indicated that the patients performed worse than the HCs in the accuracy performances of happy FER and fearful FER. The previous meta-analysis results showed that the brain regions related to FER included the bilateral amygdala (AMY)/hippocampus (HIP), right fusiform gyrus (FFG), and right supplementary motor area (SMA). Partial correlation analysis showed that the fALFF of the right FFG was associated with high-load fearful FER accuracy (r = - 0.60, p = 0.004). Our study indicated that FER ability is correlated with resting-state intrinsic activity in brain regions related to facial emotion, which may provide a reference for the study of FER deficiency in schizophrenia.

Facial affect recognition in first-episode psychosis is impaired but not associated with psychotic symptoms

Introduction

Aims

Method

Results

Discussion

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Impaired affect recognition (FAR) present already in first episode psychosis (FEP).

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Preserved FAR of happiness found in individuals with FEP.

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Individuals with FEP mainly have impaired FAR of negative affects.

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Both FEP and controls mainly mistook negative affects for other negative affects.

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Psychotic symptoms are not associated with FAR in individuals with FEP.

Emotion recognition through Spanish prosody in people with schizophrenia

People with schizophrenia have deficits in the ability to identify emotions. An area of important dysfunction is the understanding of affective prosody, which can limit communication and social functionality. The objective of this study is to compare emotional recognition through prosody between a group of people with schizophrenia versus a control group without pathology, through the Reading the Mind in the Voice - Spanish Version scale (RMV-SV).

Impact of self adaptive-elephant herding optimization towards neural network for facial emotion recognition

FACIAL expression is one of the most efficient, universal and fundamental indicators to identify their emotions and intentions in humans. Various experiments have already been performed on automatic Facial Emotion Recognition (FER) owing to useful significance in medical diagnosis, stress monitoring for drivers, sociable robots, and other human-computer interface devices. Here, this proposed framework consists of two processes namely; “(i) proposed feature extraction and (ii) classification”. Here, a major novelty relies in the initial phase (i.e. feature extraction phase), where the Proposed Local Vector Pattern (Proposed- LVP) based features are extracted. In addition to the proposed-LVP, the other Discrete Wavelet Transform (DWT) and Gray Level Co-occurrence Matrix (GLCM) based features are also extracted. Besides, the Principal Component Analysis (PCA) method is used for reducing the dimension of the features. Further, they are subjected to classification process, where Optimized Neural Network (NN) is used. More particularly, a new Improved Elephant Herding Optimization (EHO) model termed as Self Adaptive-EHO (SA-EHO) is used to train the NN model via selecting the optimal weights. At last, the proposed work performance is computed over the other traditional systems with respect to the positive measures like “accuracy, sensitivity, specificity and precision”; negative measures like “False Positive Rate (FPR), False Negative Rate (FNR) and False Discovery Rate (FDR)”; other measures like “Negative Predictive Value (NPV), F1-score and Matthew’s Correlation Coefficient (MCC)”, respectively.

Prediction of Facial Emotion Recognition Ability in Patients With First-Episode Schizophrenia Using Amplitude of Low-Frequency Fluctuation-Based Support Vector Regression Model

OBJECTIVE

There were few studies that had attempted to predict facial emotion recognition (FER) ability at the individual level in schizophrenia patients. In this study, we developed a model for the prediction of FER ability in Chinese Han patients with the first-episode schizophrenia (FSZ).

MATERIALS AND METHODS

A total of 28 patients with FSZ and 33 healthy controls (HCs) were recruited. All subjects underwent resting-state fMRI (rs-fMRI). The amplitude of low-frequency fluctuation (ALFF) method was selected to analyze voxel-level spontaneous neuronal activity. The visual search experiments were selected to evaluate the FER, while the support vector regression (SVR) model was selected to develop a model based on individual rs-fMRI brain scan.

RESULTS

Group difference in FER ability showed statistical significance (P < 0.05). In FSZ patients, increased mALFF value were observed in the limbic lobe and frontal lobe, while decreased mALFF value were observed in the frontal lobe, parietal lobe, and occipital lobe (P < 0.05, AlphaSim correction). SVR analysis showed that abnormal spontaneous activity in multiple brain regions, especially in the right posterior cingulate, right precuneus, and left calcarine could effectively predict fearful FER accuracy (r = 0.64, P = 0.011) in patients.

CONCLUSION

Our study provides an evidence that abnormal spontaneous activity in specific brain regions may serve as a predictive biomarker for fearful FER ability in schizophrenia.

Social Dysfunction in Psychosis Is More Than a Matter of Misperception: Advances From the Study of Metacognition

Many with psychosis experience substantial difficulties forming and maintaining social bonds leading to persistent social alienation and a lack of a sense of membership in a larger community. While it is clear that social impairments in psychosis cannot be fully explained by symptoms or other traditional features of psychosis, the antecedents of disturbances in social function remain poorly understood. One recent model has proposed that deficits in social cognition may be a root cause of social dysfunction. In this model social relationships become untenable among persons diagnosed with psychosis when deficits in social cognition result in inaccurate ideas of what others feel, think or desire. While there is evidence to support the influence of social cognition upon social function, there are substantial limitations to this point of view. Many with psychosis have social impairments but not significant deficits in social cognition. First person and clinical accounts of the phenomenology of psychosis also do not suggest that persons with psychosis commonly experience making mistakes when trying to understand others. They report instead that intersubjectivity, or the formation of an intimate shared understanding of thoughts and emotions with others, has become extraordinarily difficult. In this paper we explore how research in metacognition in psychosis can transcend these limitations and address some of the ways in which intersubjectivity and more broadly social function is compromised in psychosis. Specifically, research will be reviewed on the relationship between social cognitive abilities and social function in psychosis, including measurement strategies and limits to its explanatory power, in particular with regard to challenges to intersubjectivity. Next, we present research on the integrated model of metacognition in psychosis and its relation to social function. We then discuss how this model might go beyond social cognitive models of social dysfunction in psychosis by describing how compromises in intersubjectivity occur as metacognitive deficits leave persons without an integrated sense of others' purposes, relative positions in the world, possibilities and personal complexities. We suggest that while social cognitive deficits may leave persons with inaccurate ideas about others, metacognitive deficits leave persons ill equipped to make broader sense of the situations in which people interact and this is what leaves them without a holistic sense of the other and what makes it difficult to know others, share experiences, and sustain relationships. The potential of developing clinical interventions focused on metacognition for promoting social recovery will finally be explored.

Metacognition, social cognition, and mentalizing in psychosis: are these distinct constructs when it comes to subjective experience or are we just splitting hairs?

Research using the integrated model of metacognition has suggested that the construct of metacognition could quantify the spectrum of activities that, if impaired, might cause many of the subjective disturbances found in psychosis. Research on social cognition and mentalizing in psychosis, however, has also pointed to underlying deficits in how persons make sense of their experience of themselves and others. To explore the question of whether metacognitive research in psychosis offers unique insight in the midst of these other two emerging fields, we have offered a review of the constructs and research from each field. Following that summary, we discuss ways in which research on metacognition may be distinguished from research on social cognition and mentalizing in three broad categories: (1) experimental procedures, (2) theoretical advances, and (3) clinical applications or indicated interventions. In terms of its research methods, we will describe how metacognition makes a unique contribution to understanding disturbances in how persons make sense of and interpret their own experiences within the flow of life. We will next discuss how metacognitive research in psychosis uniquely describes an architecture which when compromised - as often occurs in psychosis - results in the loss of persons' sense of purpose, possibilities, place in the world and cohesiveness of self. Turning to clinical issues, we explore how metacognitive research offers an operational model of the architecture which if repaired or restored should promote the recovery of a coherent sense of self and others in psychosis. Finally, we discuss the concrete implications of this for recovery-oriented treatment for psychosis as well as the need for further research on the commonalities of these approaches.

Corpus callosum morphology in major mental disorders: a magnetic resonance imaging study

Mental disorders diagnosis is based on specific clinical criteria. However, clinical studies found similarities and overlapping phenomenology across a variety of disorders, which suggests a common neurobiological substrate. Thus, there is a need to measure disease-related neuroanatomical similarities and differences across conditions. While structural alterations of the corpus callosum have been investigated in obsessive-compulsive disorder, schizophrenia, major depressive disorder and bipolar disorder, no study has addressed callosal aberrations in all diseases in a single study. Moreover, results from pairwise comparisons (patients vs. controls) show some inconsistencies, possibly related to the parcellation methods to divide the corpus callosum into subregions. The main aim of the present paper was to uncover highly localized callosal characteristics for each condition (i.e. obsessive-compulsive disorder, schizophrenia, major depressive disorder and bipolar disorder) as compared either to healthy control subjects or to each other. For this purpose, we did not rely on any sub-callosal parcellation method, but applied a well-validated approach measuring callosal thickness at 100 equidistant locations along the whole midline of the corpus callosum. One hundred and twenty patients (30 in each disorder) as well as 30 controls were recruited for the study. All groups were closely matched for age and gender, and the analyses were performed controlling for the impact of antipsychotic treatment and illness duration. There was a significant main effect of group along the whole callosal surface. Pairwise post hoc comparisons revealed that, compared to controls, patients with obsessive-compulsive disorder had the thinnest corpora callosa with significant effects almost on the entire callosal structure. Patients with schizophrenia also showed thinner corpora callosa than controls but effects were confined to the isthmus and the anterior part of the splenium. No significant differences were found in both major depressive disorder and bipolar disorder patients compared to controls. When comparing the disease groups to each other, the corpus callosum was thinner in obsessive-compulsive disorder patients than in any other group. The effect was evident across the entire corpus callosum, with the exception of the posterior body. Altogether, our study suggests that the corpus callosum is highly changed in obsessive-compulsive disorder, selectively changed in schizophrenia and not changed in bipolar disorder and major depressive disorder. These results shed light on callosal similarities and differences among mental disorders providing valuable insights regarding the involvement of the major brain commissural fibre tract in the pathophysiology of each specific mental illness.

The Deficit of Multimodal Perception of Congruent and Non-Congruent Fearful Expressions in Patients with Schizophrenia: The ERP Study

Emotional dysfunction, including flat affect and emotional perception deficits, is a specific symptom of schizophrenia disorder. We used a modified multimodal odd-ball paradigm with fearful facial expressions accompanied by congruent and non-congruent emotional vocalizations (sounds of women screaming and laughing) to investigate the impairment of emotional perception and reactions to other people's emotions in schizophrenia. We compared subjective ratings of emotional state and event-related potentials (EPPs) in response to congruent and non-congruent stimuli in patients with schizophrenia and healthy controls. The results showed the altered multimodal perception of fearful stimuli in patients with schizophrenia. The amplitude of N50 was significantly higher for non-congruent stimuli than congruent ones in the control group and did not differ in patients. The P100 and N200 amplitudes were higher in response to non-congruent stimuli in patients than in controls, implying impaired sensory gating in schizophrenia. The observed decrease of P3a and P3b amplitudes in patients could be associated with less attention, less emotional arousal, or incorrect interpretation of emotional valence, as patients differed from healthy controls in the emotion scores of non-congruent stimuli. The difficulties in identifying the incoherence of facial and audial components of emotional expression could be significant in understanding the psychopathology of schizophrenia.

Emotion-specific performance across empathy tasks in schizophrenia: Influence of metacognitive capacity

People with schizophrenia exhibit deficits in emotion recognition that are associated with community and social functioning. Emotion-specific performance within emotion recognition tasks has been investigated, suggesting differential patterns of recognition for positive and negative emotions. However, no study has yet examined emotion-specific performance for a higher-order social cognitive construct such as empathy. This study aimed to: 1) examine emotion-specific performance on an empathy task, and 2) elucidate associations with four metacognitive domains: self-reflectivity, understanding of others' minds, decentration, and mastery. Fifty-seven people with schizophrenia or schizoaffective disorder participated. All were administered a computerized, performance-based measure of empathy and an interview-based measure of metacognitive capacity. Results revealed that, consistent with research on facial affect recognition, participants performed significantly better when recognizing happiness in empathic stimuli than all other emotions. Results also revealed positive associations between empathic performance and metacognitive self-reflectivity, across types of emotions. Other metacognitive domains were also associated with performance, but in a less consistent manner. Together, results indicate that not all emotions are created equal - happiness is easier to recognize for those with schizophrenia, suggesting that social cognitive interventions may be more helpful if focused on recognizing negative emotions. Results also emphasize the importance of metacognitive capacity for basic and higher-order social cognitive skills.