The processing of emotional prosody and semantics in schizophrenia: relationship to gender and IQ

Syntactic and affective prosody recognition: Schizophrenia vs. Autism spectrum disorders

Patients with a recent diagnosis of schizophrenia and individuals receiving a diagnosis of autism spectrum disorder without accompanying intellectual impairment (ASD w/o intellectual impairment) during their adulthood share several clinical characteristics. Exploring under-investigated aspects of these two clinical conditions may shed light on their possible connection and facilitate differential diagnosis at very early stages. To this end, we explored the ability of 15 adults with a recent diagnosis of schizophrenia, 15 individuals diagnosed with ASD w/o intellectual impairment as adults, and 15 healthy adults to resolve sentence ambiguities with the use of syntactic prosody, and to decode happiness, anger, sadness, surprise, fear, and neutrality based on affective prosody. Results revealed intact perception of syntactic prosody in adults with schizophrenia, but impaired affective prosody recognition, which could be attributed, however, to emotion processing difficulties overall. On the other hand, individuals with ASD w/o intellectual impairment were impaired on prosody comprehension per se, as evidenced in the most challenging conditions, namely the subject-reading condition and the emotion of surprise. The differences in prosody comprehension ability between the two clinical conditions may serve as an indicator, among other signs, during the diagnostic evaluation.

Negative-emotion-induced reduction in speech-in-noise recognition is associated with source-monitoring deficits and psychiatric symptoms in mandarin-speaking patients with schizophrenia

BACKGROUND

Patients with schizophrenia (SCH) have deficits in source monitoring (SM), speech-in-noise recognition (SR), and auditory prosody recognition. This study aimed to test the covariation between SM and SR alteration induced by negative prosodies and their association with psychiatric symptoms in SCH.

METHODS

Fifty-four SCH patients and 59 healthy controls (HCs) underwent a speech SM task, an SR task, and the assessment of positive and negative syndrome scale (PANSS). We used the multivariate analyses of partial least squares (PLS) regression to explore the associations among SM (external/internal/new attribution error [AE] and response bias [RB]), SR alteration/release induced by four negative-emotion (sad, angry, fear, and disgust) prosodies of target speech, and psychiatric symptoms.

RESULTS

In SCH, but not HCs, a profile (linear combination) of SM (especially the external-source RB) was positively associated with a profile of SR reductions (induced especially by the angry prosody). Moreover, two SR reduction profiles (especially in the anger and sadness conditions) were related to two profiles of psychiatric symptoms (negative symptoms, lack of insight, and emotional disturbances). The two PLS components explained 50.4% of the total variances of the release-symptom association.

CONCLUSION

Compared to HCs, SCH is more likely to perceive the external-source speech as internal/new source speech. The SM-related SR reduction induced by the angry prosody was mainly associated with negative symptoms. These findings help understand the psychopathology of SCH and may provide a potential direction to improve negative symptoms via minimizing emotional SR reduction in schizophrenia.

Impaired emotion perception in schizophrenia shows sex differences with channel- and category-specific effects: A pilot study

Individuals with schizophrenia reportedly demonstrate deficits in emotion perception. Relevant studies on the effects of decoder's sex, communication channels and emotion categories have produced mixed findings and seldom explored the interactions among these three key factors. The present pilot study examined how male and female individuals with schizophrenia and healthy controls perceived emotional (e.g., angry, happy, and sad) and neutral expressions from verbal semantic and nonverbal prosodic and facial channels. Twenty-eight (11 females) individuals with schizophrenia and 30 healthy controls (13 females) were asked to recognize emotional facial expressions, emotional prosody, and emotional semantics. Both accuracy and response time showed subpar performance for all communication channels and emotional categories in the schizophrenia group. More severe emotion perception deficits were found with the nonverbal (not the verbal) materials. There was also a reduced level of impairment with anger perception, especially in the female individuals with schizophrenia while biased perception towards emotional semantics was more pronounced in male individuals with schizophrenia. These findings, although preliminary, indicate the channel- and category-specific nature of emotion perception with potential sex differences among people with schizophrenia, which has important theoretical and practical implications.

Processing of Spoken Emotions in Schizophrenia: Forensic and Non-forensic Patients Differ in Emotional Identification and Integration but Not in Selective Attention

Patients with schizophrenia (PwS) typically demonstrate deficits in visual processing of emotions. Less is known about auditory processing of spoken-emotions, as conveyed by the prosodic (tone) and semantics (words) channels. In a previous study, forensic PwS (who committed violent offenses) identified spoken-emotions and integrated the emotional information from both channels similarly to controls. However, their performance indicated larger failures of selective-attention, and lower discrimination between spoken-emotions, than controls. Given that forensic schizophrenia represents a special subgroup, the current study compared forensic and non-forensic PwS. Forty-five PwS listened to sentences conveying four basic emotions presented in semantic or prosodic channels, in different combinations. They were asked to rate how much they agreed that the sentences conveyed a predefined emotion, focusing on one channel or on the sentence as a whole. Their performance was compared to that of 21 forensic PwS (previous study). The two groups did not differ in selective-attention. However, better emotional identification and discrimination, as well as better channel integration were found for the forensic PwS. Results have several clinical implications: difficulties in spoken-emotions processing might not necessarily relate to schizophrenia; attentional deficits might not be a risk factor for aggression in schizophrenia; and forensic schizophrenia might have unique characteristics as related to spoken-emotions processing (motivation, stimulation).

Unisensory and Multisensory Stroop Effects Modulate Gender Differences in Verbal and Nonverbal Emotion Perception

Purpose This study aimed to examine the Stroop effects of verbal and nonverbal cues and their relative impacts on gender differences in unisensory and multisensory emotion perception. Method Experiment 1 investigated how well 88 normal Chinese adults (43 women and 45 men) could identify emotions conveyed through face, prosody and semantics as three independent channels. Experiments 2 and 3 further explored gender differences during multisensory integration of emotion through a cross-channel (prosody-semantics) and a cross-modal (face-prosody-semantics) Stroop task, respectively, in which 78 participants (41 women and 37 men) were asked to selectively attend to one of the two or three communication channels. Results The integration of accuracy and reaction time data indicated that paralinguistic cues (i.e., face and prosody) of emotions were consistently more salient than linguistic ones (i.e., semantics) throughout the study. Additionally, women demonstrated advantages in processing all three types of emotional signals in the unisensory task, but only preserved their strengths in paralinguistic processing and showed greater Stroop effects of nonverbal cues on verbal ones during multisensory perception. Conclusions These findings demonstrate clear gender differences in verbal and nonverbal emotion perception that are modulated by sensory channels, which have important theoretical and practical implications. Supplemental Material https://doi.org/10.23641/asha.16435599.

Processing of Emotions in Speech in Forensic Patients With Schizophrenia: Impairments in Identification, Selective Attention, and Integration of Speech Channels

Individuals with schizophrenia show deficits in recognition of emotions which may increase the risk of violence. This study explored how forensic patients with schizophrenia process spoken emotion by: (a) identifying emotions expressed in prosodic and semantic content separately, (b) selectively attending to one speech channel while ignoring the other, and (c) integrating the prosodic and the semantic channels, compared to non-clinical controls. Twenty-one forensic patients with schizophrenia and 21 matched controls listened to sentences conveying four emotions (anger, happiness, sadness, and neutrality) presented in semantic or prosodic channels, in different combinations. They were asked to rate how much they agreed that the sentences conveyed a predefined emotion, focusing on one channel or on the sentence as a whole. Forensic patients with schizophrenia performed with intact identification and integration of spoken emotions, but their ratings indicated reduced discrimination, larger failures of selective attention, and under-ratings of negative emotions, compared to controls. This finding doesn't support previous reports of an inclination to interpret social situations in a negative way among individuals with schizophrenia. Finally, current results may guide rehabilitation approaches matched to the pattern of auditory emotional processing presented by forensic patients with schizophrenia, improving social interactions and quality of life.

Improving emotion recognition in schizophrenia with "VOICES": An on-line prosodic self-training

Introduction

Emotion recognition (ER) deficits have been extensively demonstrated in schizophrenia. These deficiencies are not only restricted to facial emotion recognition but also include emotional prosody (tone of the voice) recognition deficits. They have been significantly associated with symptom severity and poor social functioning. The aim of this study was to test the efficacy, in real clinical conditions, of an online self-training prosodic game included in the Social Cognition rehabilitation program e-Motional Training.

Method

A randomized, single-blind multicenter clinical trial was conducted with 50 outpatients with schizophrenia or schizoaffective disorder. The control group was treated with Treatment-as-usual (TAU), based on drug therapy, case management and individual and group psychotherapy (not focused on Social Cognition). The intervention group was treated with TAU plus the employment of Voices, an online self-training program devised for prosodic rehabilitation.

Statistical analysis

Linear regression was used to evaluate the effectiveness of the intervention in emotion recognition measured with the Reading the Mind in the Voice–Spanish Version (RMV-SV).

Results

There were statistically significant differences between the intervention and control group measured with RMV-SV (β = 3,6[IC 95%], p<0.001), with a response variable in RMV post R² = 0,617.

Discussion

Voices, a prosodic rehabilitation game included in e-Motional Training, seems to be a promising tool for improving emotional voice recognition deficits in schizophrenia, filling the need for such interventions.

Emotional Prosody Processing in Schizophrenic Patients: A Selective Review and Meta-Analysis

Emotional prosody (EP) has been increasingly recognized as an important area of schizophrenic patients’ dysfunctions in their language use and social communication. The present review aims to provide an updated synopsis on emotional prosody processing (EPP) in schizophrenic disorders, with a specific focus on performance characteristics, the influential factors and underlying neural mechanisms. A literature search up to 2018 was conducted with online databases, and final selections were limited to empirical studies which investigated the prosodic processing of at least one of the six basic emotions in patients with a clear diagnosis of schizophrenia without co-morbid diseases. A narrative synthesis was performed, covering the range of research topics, task paradigms, stimulus presentation, study populations and statistical power with a quantitative meta-analytic approach in Comprehensive Meta-Analysis Version 2.0. Study outcomes indicated that schizophrenic patients’ EPP deficits were consistently observed across studies (d = −0.92, 95% CI = −1.06 < δ < −0.78), with identification tasks (d = −0.95, 95% CI = −1.11 < δ < −0.80) being more difficult to process than discrimination tasks (d = −0.74, 95% CI = −1.03 < δ < −0.44) and emotional stimuli being more difficult than neutral stimuli. Patients’ performance was influenced by both participant- and experiment-related factors. Their social cognitive deficits in EP could be further explained by right-lateralized impairments and abnormalities in primary auditory cortex, medial prefrontal cortex and auditory-insula connectivity. The data pointed to impaired pre-attentive and attentive processes, both of which played important roles in the abnormal EPP in the schizophrenic population. The current selective review and meta-analysis support the clinical advocacy of including EP in early diagnosis and rehabilitation in the general framework of social cognition and neurocognition deficits in schizophrenic disorders. Future cross-sectional and longitudinal studies are further suggested to investigate schizophrenic patients’ perception and production of EP in different languages and cultures, modality forms and neuro-cognitive domains.

What does the Managing Emotions branch of the MSCEIT add to the MATRICS consensus cognitive battery?

The Managing Emotions branch of the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT-ME) was included within the MATRICS Consensus Cognitive Battery (MCCB) as the measure of social cognition, although limited research has examined its associations with psychosocial functioning in people with schizophrenia or other severe mental illnesses. This secondary analysis with 107 participants examined what the MSCEIT-ME contributes to our understanding of functioning in this population, and whether it uniquely predicts psychosocial functioning after controlling for performance on the other MCCB tests and negative symptoms. Performance on the MSCEIT-ME was significantly correlated with all three MCCP factors (processing speed, attention/working memory, learning) within schizophrenia-schizoaffective disorder, bipolar disorder, and other mixed diagnoses groups. Better performance on MSCEIT-ME was associated with better psychosocial functioning on the Quality of Life Scale (QLS) in the schizophrenia-schizoaffective disorder group, but not in the bipolar or other mixed diagnoses groups. In addition, in the schizophrenia-schizoaffective disorder group, after controlling for demographic characteristics in stepwise multiple regression analyses, MSCEIT-ME was the only significant predictor of the QLS total score and the QLS interpersonal relations and intrapsychic foundations subscales, with none of the MCCB factors entering any of the regression models. The MSCEIT-ME may reflect a unique aspect of social cognition that is related to impaired psychosocial functioning in schizophrenia and is not tapped by the other cognitive tests on the MCCB. Further research on the MSCEIT-ME could provide unique insights into the social functioning problems in schizophrenia.

Listening to a patient: An exploratory experimental investigation into the effects of vocalization and therapist gender on interpreting clinical material

Carefully listening to the patient is of paramount importance for psychoanalysis and psychoanalytic psychotherapy. The present study explored whether patient vocalization as well as the gender of the analyst play significant roles in clinical listening. Fifty-one psychoanalysts and psychoanalytic therapists were randomly assigned to listen to one of two dramatized psychoanalytic sessions. The content of the sessions was the same for both versions, but the sessions were dramatized differently. Some differences emerged between the versions, especially on ratings of reality testing, impulse control, pressured speech, patient was confusing, and awareness of imagery. Furthermore, differences emerged between male and female analysts in terms of ratings of intervention strategies and countertransference reactions to the patient material. Session version and gender affect different ratings. Implications of the findings are discussed as is the utility of using more ecologically valid material in conducting empirical research into clinical judgment.

Emotion recognition deficits among persons with schizophrenia: Beyond stimulus complexity level and presentation modality

Studies have shown that persons with schizophrenia have lower accuracy in emotion recognition compared to persons without schizophrenia. However, the impact of the complexity level of the stimuli or the modality of presentation has not been extensively addressed. Forty three persons with a diagnosis of schizophrenia and 43 healthy controls, matched for age and gender, were administered tests assessing emotion recognition from stimuli with low and high levels of complexity presented via visual, auditory and semantic channels. For both groups, recognition rates were higher for high-complexity stimuli compared to low-complexity stimuli. Additionally, both groups obtained higher recognition rates for visual and semantic stimuli than for auditory stimuli, but persons with schizophrenia obtained lower accuracy than persons in the control group for all presentation modalities. Persons diagnosed with schizophrenia did not present a level of complexity specific deficit or modality-specific deficit compared to healthy controls. Results suggest that emotion recognition deficits in schizophrenia are beyond level of complexity of stimuli and modality, and present a global difficulty in cognitive functioning.

Theory of mind in schizophrenia: error types and associations with symptoms

INTRODUCTION

Social cognition is an important determinant of functioning in schizophrenia. However, how social cognition relates to the clinical symptoms of schizophrenia is still unclear. The aim of this study was to explore the relationship between a social cognition domain, Theory of Mind (ToM), and the clinical symptoms of schizophrenia. Specifically, we investigated the associations between three ToM error types; 1) "overmentalizing" 2) "reduced ToM and 3) "no ToM", and positive, negative and disorganized symptoms.

METHODS

Fifty-two participants with a diagnosis of schizophrenia or schizoaffective disorder were assessed with the Movie for the Assessment of Social Cognition (MASC), a video-based ToM measure. An empirically validated five-factor model of the Positive and Negative Syndrome Scale (PANSS) was used to assess clinical symptoms.

RESULTS

There was a significant, small-moderate association between overmentalizing and positive symptoms (rho=.28, p=.04). Disorganized symptoms correlated at a trend level with "reduced ToM" (rho=.27, p=.05). There were no other significant correlations between ToM impairments and symptom levels. Positive/disorganized symptoms did not contribute significantly in explaining total ToM performance, whereas IQ did (B=.37, p=.01). Within the undermentalizing domain, participants performed more "reduced ToM" errors than "no ToM" errors.

CONCLUSION

Overmentalizing was associated with positive symptoms. The undermentalizing error types were unrelated to symptoms, but "reduced ToM" was somewhat associated to disorganization. The higher number of "reduced ToM" responses suggests that schizophrenia is characterized by accuracy problems rather than a fundamental lack of mental state concept. The findings call for the use of more sensitive measures when investigating ToM in schizophrenia to avoid the "right/wrong ToM"-dichotomy.

Perception of emotion-related conflict in human communications: what are the effects of schizophrenia?

Our ability to make sense of emotional cues is of paramount importance for understanding state of mind and communicative intent. However, emotional cues often conflict with each other; this presents a significant challenge for people with schizophrenia. We conducted a theoretical review to determine the extent and types of impaired processing of emotion-related conflict in schizophrenia; we evaluated the relationship with medication and symptoms, and considered possible mediatory mechanisms. The literature established that people with schizophrenia demonstrated impaired function: (i) when passively exposed to emotion cues whilst performing an unrelated task, (ii) when selectively attending to one source of emotion cues whilst trying to ignore interference from another source, and (iii) when trying to resolve conflicting emotion cues and judge meta-communicative intent. These deficits showed associations with both negative and positive symptoms. There was limited evidence for antipsychotic medications attenuating impaired emotion perception when there are conflicting cues, with further direct research needed. Impaired attentional control and context processing may underlie some of the observed impairments. Neuroanatomical correlates are likely to involve interhemispheric transfer via the corpus callosum, limbic regions such as the amygdala, and possibly dorsolateral prefrontal and anterior cingulate cortex through their role in conflict processing.

Theory of mind impairments in patients with deficit schizophrenia

The deficit syndrome, a subgroup within schizophrenia, is characterized by enduring, idiopathic negative symptoms. Theory of mind (ToM), a domain of social cognition, is the ability of attributing mental states to ourselves and other people. ToM impairments have not been investigated earlier in deficit schizophrenia. The aim of the present study was to examine ToM differences between patients with deficit (SZ-D) and non-deficit schizophrenia (SZ-ND). Gender differences were also investigated, and based on the literature a better ToM performance was expected in female patients. The participants were 28 patients with SZ-ND, 30 patients with SZ-D, and 29 healthy control volunteers. The "Reading the Mind in the Eyes Test" was used to asses ToM deficits. Control subjects outperformed both patient groups, while there were no significant differences between the two schizophrenia subgroups. In female subjects, both controls and patients with SZ-ND performed significantly better than the SZ-D subgroup. In male subjects, controls performed significantly better than both patient groups. The "diminished emotional range" and the "curbing of interest" items of the Schedule for the Deficit Syndrome showed significant negative relationship with the ToM score. Our main finding is that female subjects with SZ-ND performed significantly better than female subjects with SZ-D.

Social cognition in schizophrenic patients: the effect of semantic content and emotional prosody in the comprehension of emotional discourse

BACKGROUND

The recognition of the emotion expressed during conversation relies on the integration of both semantic processing and decoding of emotional prosody. The integration of both types of elements is necessary for social interaction. No study has investigated how these processes are impaired in patients with schizophrenia during the comprehension of an emotional speech. Since patients with schizophrenia have difficulty in daily interactions, it would be of great interest to investigate how these processes are impaired. We tested the hypothesis that patients present lesser performances regarding both semantic and emotional prosodic processes during emotional speech comprehension compared with healthy participants.

METHODS

The paradigm is based on sentences built with emotional (anger, happiness, or sadness) semantic content uttered with or without congruent emotional prosody. The study participants had to decide with which of the emotional categories each sentence corresponded.

RESULTS

Patients performed significantly worse than their matched controls, even in the presence of emotional prosody, showing that their ability to understand emotional semantic content was impaired. Although prosody improved performances in both groups, it benefited the patients more than the controls.

CONCLUSION

Patients exhibited both impaired semantic and emotional prosodic comprehensions. However, they took greater advantage of emotional prosody adjunction than healthy participants. Consequently, focusing on emotional prosody during carrying may improve social communication.

Abnormalities in the processing of emotional prosody from single words in schizophrenia

BACKGROUND

Abnormalities in emotional prosody processing have been consistently reported in schizophrenia and are related to poor social outcomes. However, the role of stimulus complexity in abnormal emotional prosody processing is still unclear.

METHOD

We recorded event-related potentials in 16 patients with chronic schizophrenia and 16 healthy controls to investigate: 1) the temporal course of emotional prosody processing; and 2) the relative contribution of prosodic and semantic cues in emotional prosody processing. Stimuli were prosodic single words presented in two conditions: with intelligible (semantic content condition-SCC) and unintelligible semantic content (pure prosody condition-PPC).

RESULTS

Relative to healthy controls, schizophrenia patients showed reduced P50 for happy PPC words, and reduced N100 for both neutral and emotional SCC words and for neutral PPC stimuli. Also, increased P200 was observed in schizophrenia for happy prosody in SCC only. Behavioral results revealed higher error rates in schizophrenia for angry prosody in SCC and for happy prosody in PPC.

CONCLUSIONS

Together, these data further demonstrate the interactions between abnormal sensory processes and higher-order processes in bringing about emotional prosody processing dysfunction in schizophrenia. They further suggest that impaired emotional prosody processing is dependent on stimulus complexity.

Is the non-verbal behavioural emotion-processing profile of bipolar disorder impaired? A critical review

OBJECTIVE

Growing evidence suggests that patients with bipolar disorder (BD) are impaired in their ability to process non-verbal emotion, although few comprehensive reviews of the behavioural literature exist, and there has been little consideration of methodological issues that may account for discrepant empirical findings. This review examines the behavioural facial, prosodic and multimodal processing literature in BD and discusses methodological issues in the context of this evidence.

METHOD

Major computer databases including Google Scholar and PsychINFO were consulted to conduct a comprehensive review of quantitative behavioural differences in the emotion-processing literature in BD. Articles were accepted only if the target population sample met criteria for a DSM-III, DSM-IV or ICD-10 diagnosis, and they contained a healthy control group.

RESULTS

The current literature suggests that facial emotion processing is impaired, and there is preliminary evidence for some behavioural impairment in the processing of emotional prosody.

CONCLUSION

The specificity or generalisability of impairments in facial emotion processing and the effects of mood state are unclear. Similarly, the lack of clarity around the impact of auditory processes on emotional prosody processing warrants a comprehensive examination of the auditory profile in BD.

Sensory-based and higher-order operations contribute to abnormal emotional prosody processing in schizophrenia: an electrophysiological investigation

BACKGROUND

Schizophrenia is characterized by deficits in emotional prosody (EP) perception. However, it is not clear which stages of processing prosody are abnormal and whether the presence of semantic content contributes to the abnormality. This study aimed to examine event-related potential (ERP) correlates of EP processing in 15 chronic schizophrenia individuals and 15 healthy controls.

METHOD

A total of 114 sentences with neutral semantic content [sentences with semantic content (SSC) condition] were generated by a female speaker (38 with happy, 38 with angry, and 38 with neutral intonation). The same sentences were synthesized and presented in the 'pure prosody' sentences (PPS) condition where semantic content was unintelligible.

RESULTS

Group differences were observed for N100 and P200 amplitude: patients were characterized by more negative N100 for SSC, and more positive P200 for angry and happy SSC and happy PPS. Correlations were found between delusions and P200 amplitude for happy SSC and PPS. Higher error rates in the recognition of EP were also observed in schizophrenia: higher error rates in neutral SSC were associated with reduced N100, and higher error rates in angry SSC were associated with reduced P200.

CONCLUSIONS

These results indicate that abnormalities in prosody processing occur at the three stages of EP processing, and are enhanced in SSC. Correlations between P200 amplitude for happy prosody and delusions suggest a role that abnormalities in the processing of emotionally salient acoustic cues may play in schizophrenia symptomatology. Correlations between ERP and behavioral data point to a relationship between early sensory abnormalities and prosody recognition in schizophrenia.

Prosody recognition and audiovisual emotion matching in schizophrenia: the contribution of cognition and psychopathology

This study aimed to evaluate the ability to decode emotion in the auditory and audiovisual modality in a group of patients with schizophrenia, and to explore the role of cognition and psychopathology in affecting these emotion recognition abilities. Ninety-four outpatients in a stable phase and 51 healthy subjects were recruited. Patients were assessed through a psychiatric evaluation and a wide neuropsychological battery. All subjects completed the comprehensive affect testing system (CATS), a group of computerized tests designed to evaluate emotion perception abilities. With respect to the controls, patients were not impaired in the CATS tasks involving discrimination of nonemotional prosody, naming of emotional stimuli expressed by voice and judging the emotional content of a sentence, whereas they showed a specific impairment in decoding emotion in a conflicting auditory condition and in the multichannel modality. Prosody impairment was affected by executive functions, attention and negative symptoms, while deficit in multisensory emotion recognition was affected by executive functions and negative symptoms. These emotion recognition deficits, rather than being associated purely with emotion perception disturbances in schizophrenia, are affected by core symptoms of the illness.

Sex differences in facial, prosodic, and social context emotional recognition in early-onset schizophrenia

The purpose of the present study was to determine sex differences in facial, prosodic, and social context emotional recognition in schizophrenia (SCH). Thirty-eight patients (SCH, 20 females) and 38 healthy controls (CON, 20 females) participated in the study. Clinical scales (BPRS and PANSS) and an Affective States Scale were applied, as well as tasks to evaluate facial, prosodic, and within a social context emotional recognition. SCH showed lower accuracy and longer response times than CON, but no significant sex differences were observed in either facial or prosody recognition. In social context emotions, however, females showed higher empathy than males with respect to happiness in both groups. SCH reported being more identified with sad films than CON and females more with fear than males. The results of this study confirm the deficits of emotional recognition in male and female patients with schizophrenia compared to healthy subjects. Sex differences were detected in relation to social context emotions and facial and prosodic recognition depending on age.

Complex interaction between symptoms, social factors, and gender in social functioning in a community-dwelling sample of schizophrenia

Social functioning (SF) is the ultimate target aimed in treatment plans in schizophrenia, thus it is critical to know what are the factors that determine SF. Gender is a well-established variable influencing SF, yet it is not known how social variables and symptoms interact in schizophrenia patients. Furthermore, it remains unclear whether the interaction between social variables and symptoms is different in men compared to women. Our aim is to test whether social variables are better predictors of SF in community-dwelled individuals with schizophrenia, and whether men and women differ in how symptoms and social variables interact to impact SF. Community-dwelling individuals with schizophrenia (N = 231) were randomly selected from a register. Participants were assessed with symptom measures (PANSS), performance-based social scale (LSP), objective social and demographic variables. Stratification by gender and stepwise multivariate regression analyses by gender were used to find the best-fitting models that predict SF in both gender. Men had poorer SF than women in spite of showing similar symptom scores. On stepwise regression analyses, gender was the main variable explaining SF, with a significant contribution by disorganized and excitatory symptoms. Age of onset made a less marked, yet significant, contribution to explain SF. When the sample was stratified by gender, disorganized symptoms and 'Income' variable entered the model and accounted for a 30.8% of the SF variance in women. On the other hand, positive and disorganized symptoms entered the model and accounted for a 36.1% of the SF variance in men. Community-dwelling men and women with schizophrenia differ in the constellation of variables associated with SF. Symptom scores still account for most of the variance in SF in both genders.

Translating mouse vocalizations: prosody and frequency modulation

Mental illness can include impaired abilities to express emotions or respond to the emotions of others. Speech provides a mechanism for expressing emotions, by both what words are spoken and by the melody or intonation of speech (prosody). Through the perception of variations in prosody, an individual can detect changes in another's emotional state. Prosodic features of mouse ultrasonic vocalizations (USVs), indicated by changes in frequency and amplitude, also convey information. Dams retrieve pups that emit separation calls, females approach males emitting solicitous calls, and mice can become fearful of a cue associated with the vocalizations of a distressed conspecific. Because acoustic features of mouse USVs respond to drugs and genetic manipulations that influence reward circuits, USV analysis can be employed to examine how genes influence social motivation, affect regulation, and communication. The purpose of this review is to discuss how genetic and developmental factors influence aspects of the mouse vocal repertoire and how mice respond to the vocalizations of their conspecifics. To generate falsifiable hypotheses about the emotional content of particular calls, this review addresses USV analysis within the framework of affective neuroscience (e.g. measures of motivated behavior such as conditioned place preference tests, brain activity and systemic physiology). Suggested future studies include employment of an expanded array of physiological and statistical approaches to identify the salient acoustic features of mouse vocalizations. We are particularly interested in rearing environments that incorporate sufficient spatial and temporal complexity to familiarize developing mice with a broader array of affective states.

Factors in sensory processing of prosody in schizotypal personality disorder: an fMRI experiment

INTRODUCTION

Persons diagnosed with schizophrenia demonstrate deficits in prosody recognition. To examine prosody along the schizophrenia spectrum, antipsychotic-naïve schizotypal personality disorder (SPD) subjects and healthy control subjects were compared. It was hypothesized that SPD subjects would perform more poorly; with cognitive and demographic factors contributing to the poor performance. The superior temporal gyrus (STG) was selected as the region-of-interest (ROI) given its known abnormalities in SPD and its important role in the processing of prosody.

METHODS

SPD and healthy comparison (HC) subjects were matched on age, IQ, and parental social-economic status (PSES). Cognitive measures included the Speech Sound Perception Test (SSPT) to examine phonological processing (SPD=68, HC=74) and the Verbal Fluency task to examine executive functioning (SPD=129, HC=138). The main experiment was a novel fMRI task of prosody identification using semantically neutral sentences spoken with emotional prosody (SPD=16, HC=13). Finally, volumetric measurement of the superior temporal sulcus (STS), a key region for processing prosody, and partially overlapping with the STG, was performed (SPD=30, HC=30).

RESULTS

Phonological processing and executive functioning were both impaired in SPD subjects compared with HC subjects. Contrary to the prediction, SPD subjects, as a group, were similar to HC subjects in terms of correctly indentifying the emotion conveyed and reaction time. Within the SPD group, prosody identification accuracy was influenced by executive functioning, IQ and perhaps PSES, relationships not found with HC subjects. Phonological perception aided prosody identification in both diagnostic groups. As expected, both groups activated the STG while performing the prosody identification task. However, SPD subjects may have been less "efficient" in their recruitment of STG neurons. Finally, SPD subjects demonstrated a trend toward smaller STS volumes on the left, particularly the lower bank.

CONCLUSIONS

These data suggest that subtle differences between SPD and controls in phonological processing, executive functioning, IQ, and possibly PSES, contributed to difficulty in processing prosody for some SPD subjects.

Neurocognition and social skill in older persons with schizophrenia and major mood disorders: An analysis of gender and diagnosis effects

Effective social interactions necessary for getting affiliative and instrumental needs met require the smooth integration of social skills, including verbal, non-verbal, and paralinguistic behaviors. Schizophrenia is characterized by prominent impairments in social and role functioning, and research on younger individuals with the illness has shown that social skills deficits are both common and distinguish the disease from other psychiatric disorders. However, less research has focused on diagnostic differences and correlates of social skills in older persons with schizophrenia. To address this question, we examined diagnostic and gender differences in social skills in a community-dwelling sample of 183 people older than age 50 with severe mental illness, and the relationships between social skills and neurocognitive functioning, symptoms, and social contact.Individuals with schizophrenia had worse social skills than those with bipolar disorder or major depression, with people with schizoaffective disorder in between. Social contact and cognitive functioning, especially executive functions and verbal fluency, were strongly predictive of social skills in people with schizophrenia and schizoaffective disorder, but not those with mood disorder. Other than blunted affect, symptoms were not predictive of social skills in either the schizophrenia spectrum or the mood disorder group. Older age was associated with worse social skills in both groups, whereas female gender was related to better skills in the mood disorder group, but not the schizophrenia group. The findings suggest that poor social skills, which are related to the cognitive impairment associated with the illness, are a fundamental feature of schizophrenia that persists from the onset of the illness into older age.

Dealing with feelings: characterization of trait alexithymia on emotion regulation strategies and cognitive-emotional processing

BACKGROUND

Alexithymia, or "no words for feelings", is a personality trait which is associated with difficulties in emotion recognition and regulation. It is unknown whether this deficit is due primarily to regulation, perception, or mentalizing of emotions. In order to shed light on the core deficit, we tested our subjects on a wide range of emotional tasks. We expected the high alexithymics to underperform on all tasks.

METHOD

Two groups of healthy individuals, high and low scoring on the cognitive component of the Bermond-Vorst Alexithymia Questionnaire, completed questionnaires of emotion regulation and performed several emotion processing tasks including a micro expression recognition task, recognition of emotional prosody and semantics in spoken sentences, an emotional and identity learning task and a conflicting beliefs and emotions task (emotional mentalizing).

RESULTS

The two groups differed on the Emotion Regulation Questionnaire, Berkeley Expressivity Questionnaire and Empathy Quotient. Specifically, the Emotion Regulation Quotient showed that alexithymic individuals used more suppressive and less reappraisal strategies. On the behavioral tasks, as expected, alexithymics performed worse on recognition of micro expressions and emotional mentalizing. Surprisingly, groups did not differ on tasks of emotional semantics and prosody and associative emotional-learning.

CONCLUSION

Individuals scoring high on the cognitive component of alexithymia are more prone to suppressive emotion regulation strategies rather than reappraisal strategies. Regarding emotional information processing, alexithymia is associated with reduced performance on measures of early processing as well as higher order mentalizing. However, difficulties in the processing of emotional language were not a core deficit in our alexithymic group.

Generalized deficit in all core components of empathy in schizophrenia

Empathy is a multidimensional construct composed of several components such as emotion recognition, emotional perspective taking and affective responsiveness. Patients with schizophrenia demonstrate deficits in several domains of emotion processing and perspective taking, thus suggesting a dysfunctional emotional competence. We assessed empathic abilities via three paradigms measuring emotion recognition, perspective taking and affective responsiveness as well as self-report empathy questionnaires in 24 (12 females, 12 males) schizophrenia patients meeting the DSM-IV criteria for schizophrenia and 24 matched healthy volunteers. Patients were recruited from the Department of Psychiatry and Psychotherapy, RWTH Aachen University and healthy volunteers were recruited via advertisement. Groups were matched for age, gender and parental education. Data analysis indicates a significant empathic deficit in patients, reflected in worse performance in all three domains. This deficit was only partly reflected in the self-report empathy questionnaires. Comparing the different tasks, emotional perspective taking was the most difficult task for all subjects and symptomatology worsened affective responsiveness. Schizophrenia patients not only struggle to correctly identify emotions, but also have difficulties in spontaneously simulating another person's subjective world (perspective taking) and might not be able to respond adequately in terms of their own emotional experience (affective responsiveness), which are not caused by emotion perception deficits. The results suggest that all domains of empathy are affected in schizophrenia and have to be addressed independently in behavioral therapies, thereby offering a possibility to improve socio-occupational life.

Lateralization of the serotonin-1A receptor distribution in language areas revealed by PET

Lateralization is a well described aspect of the human brain. A plethora of morphological, cytological and functional studies describes hemispheric asymmetry in auditory and language areas. However, no study has reported cortical lateralization in the healthy human brain in vivo on the level of neurotransmitter receptors and in relation to functional organization so far. In this study, we assessed the distribution of the main inhibitory serotonergic receptor (the 5-HT1A receptor) and analyzed its regional binding with regard to hemisphere, sex and plasma levels of sex steroid hormones (testosterone, estradiol, progesterone). We quantified the 5-HT1A receptor binding potential by positron emission tomography (PET) using the highly selective and specific radioligand [carbonyl-11C]WAY-100635 and measured hormone levels in thirty-four (16 females, 18 males) healthy right-handed subjects. The obtained data were analyzed in an automated region of interest (ROI) based approach investigating 14 auditory, language and limbic areas. We found significantly higher 5-HT1A receptor binding in the superior and middle frontal gyri of the right hemisphere, the triangular and orbital parts of the inferior frontal gyrus, the supramarginal gyrus, the superior gyrus of the temporal pole and the middle temporal gyrus. Regions of the primary and secondary auditory cortex (Heschl's gyrus and superior temporal gyrus) and the Rolandic operculum displayed significantly higher receptor binding in the left hemisphere. 5-HT1A receptor binding was 1.8-2.9% higher in right frontal ROIs and 2-3.6% higher in left primary and secondary auditory regions. There was no hemispheric difference in 5-HT(1A) receptor binding in the hippocampus, amygdala, and insula. Post-hoc testing suggested that lateralization of 5-HT1A receptor binding differed between the sexes in the triangular part of the inferior frontal gyrus. For the first time, this PET study shows lateralization of the main inhibitory receptor of the serotonergic system in functionally asymmetric organized regions of the healthy human brain in vivo.