Computer-based analysis of facial action in schizophrenic and depressed patients

Summary With a newly developed computer analysis the space coordinates of light-reflecting points, attached to a subjects' face, were recorded across time with high temporal and spatial resolution. Under different experimental conditions the facial actions of 20 schizophrenics, 20 depressives and 20 normal controls were analysed. Furthermore, raters watched the synchronously recorded video versions of the subject's face and rated them as to expressivity. The findings indicate that depressive and schizophrenic patients exhibited reduced facial activity in the upper part of their face in social interaction conditions. Schizophrenic patients showed reduced facial action responsivity across different conditions and emotions. All patients were judged to be less expressive than normal controls by raters, suggesting apparent disintegrated elements in facial activity, although when computer-analysed they exhibited the same amount of facial activity.     

Facial affect recognition in the course of schizophrenia

Deficits in facial affect recognition have been shown repeatedly in schizophrenia. However, the stability of this deficit over time remains to be clarified. A total of 36 remitted, 32 acutely ill schizophrenic patients and 21 healthy volunteers participated in a cross-sectional and longitudinal study. All subjects were assessed twice within 4 weeks (acute schizophrenics and normal controls), or 12 weeks, respectively (remitted schizophrenics). Subjects had to identify six basic emotions from corresponding facial expressions shown as photographs on a video screen. Both acute and remitted schizophrenics demonstrated a stable deficit over time in facial affect recognition unrelated to psychopathology and medication. This suggests that deficits in facial affect recognition in schizophrenia reflect a trait-like, rather than a state-dependent, characteristic.     

The nature of the abnormal perceptual experiences at the onset of schizophrenia

Sixty schizophrenics and 40 depressives in remission from the floridly psychotic phase were given a semi-structured interview concerning their abnormal perceptual experiences at the onset of their illness. About 50% of each set of subjects had experienced an alteration in the quality of their perception. However, there was a fairly characteristic pattern in each case: emotional tainting of the world around, a sense of unreality and noise sensitivity in depression; and an indefinable, qualitative change in visual perception, particularly affecting the way colours, people, space and facial expression were viewed, in schizophrenia. Of the various theories which have been put forward to explain perceptual change in schizophrenia, a breakdown in gestalt appeared to explain these findings best.     

Visual scanpaths to positive and negative facial emotions in an outpatient schizophrenia sample

We used a psychophysiological marker of visual attention (visual scanpath) to investigate facial emotion processing in schizophrenia (n= 65) and healthy control (n = 61) groups. Visual scanpaths to 'happy', *sad' and 'neutral' faces (two exposures each) were recorded using video-oculography. Emotion recognition accuracy was assessed under both 'difficult' (exposure 1) and 'limited choice' (exposure 2) conditions. Compared to controls, schizophrenia subjects showed 'restricted' scanning and reduced attention to salient facial features (eyes, nose, mouth), that was particularly apparent for happy and neutral faces: accuracy was correspondingly reduced for the 'difficult' condition. The schizophrenia deficit in positive emotion perception may reflect a failure to integrate salient features due to dysfunctions in local processing of detailed, relevant information (fewer fixations, less attention to facial features), and in the networks that synchronise local and global processing of biologically-relevant face stimuli (generally restricted scanning style).     

Anhedonia in the deficit syndrome of schizophrenia.

Previous studies have shown that anhedonia characterizes the deficit syndrome of schizophrenia. Anhedonia is also one of the main symptoms of the depressive state. The purpose of this study was to examine the relationships between anhedonia and depression in the deficit syndrome of schizophrenia. Self-evaluations of anhedonia and depression were performed by three groups of subjects (32 deficit schizophrenics, 32 major depressives, 35 healthy subjects) matched for sociodemographic variables. Deficit schizophrenics and major depressives are more anhedonic than controls, but there is no difference between the two study groups. Contrarily to what is evidenced for major depressives and for healthy subjects, the depressive symptomatology correlates with anhedonia in deficit schizophrenics. When deficit schizophrenics are dichotomized into depressed versus non-depressed patients, no difference is observed concerning anhedonia. These results suggest that anhedonia in the deficit syndrome of schizophrenia has no specificity but appears independent of coexisting depression and covaries with several characteristics of depression (retardation, cognitive distortions). Our results support the hypothesis that the deficit syndrome of schizophrenia could constitute a non-depressive mood disorder.     

Paranoid and nonparanoid schizophrenic processing of facially displayed affect.

It was proposed that differences between paranoid and nonparanoid schizophrenics in the processing of affective information may reflect underlying differences in their schema for emotion-laden information. Performances of 14 paranoid schizophrenics, 13 nonparanoid schizophrenics, and 15 matched controls were compared on a facial affect judgment task, and a matched control task comprising geometric figures largely devoid of emotional information. Subjects were required to rate friendliness, select an emotion label, and subsequently to remember the stimuli. Nonparanoids were deficient in overall labeling of facial affect, suggesting a weak cognitive schema for emotional information. The paranoids were particularly more accurate than the nonparanoids at labeling the negative facial affects, suggesting well-developed negative emotional aspects in their cognitive schema. Unexpectedly, nonparanoids relative to paranoids displayed a greater memory deficit in the recognition of geometric figures than in the recognition of faces. The nonparanoid deficit suggests these subjects may have poorly organized schema for remembering less structured nonverbal information. The findings support the idea of fundamental cognitive processing differences between paranoid and nonparanoid schizophrenia.     

Altered face inversion effect and association between face N170 reduction and social dysfunction in patients with schizophrenia

ObjectiveThere is accumulating evidence that schizophrenics may have deficits in facial recognition, which has been related to disease-specific disturbances in normal social interaction. Neurophysiologically, face inversion results in an amplitude increase of the event-related potential (ERP) component N170. This face inversion effect (FIE) presumably reflects a disruption of face-specific configuration processing. The present study investigated FIE and the associations between social functioning and N170 in patients with schizophrenia.MethodsThe subjects consisted of 15 schizophrenics and 15 controls. Event-related potentials (ERPs) to upright and inverted neutral faces and cars were recorded. The relationships between the Social Functioning Scale (SFS) scores and N170 amplitude to upright faces or cars were also evaluated.ResultsNormal controls exhibited a significant FIE of the N170 amplitude, while schizophrenics showed no FIE. In both normal controls and schizophrenics, no inversion effect was observed for car stimuli. For face stimuli, schizophrenics showed significant bilateral N170 reduction; additionally, in schizophrenics, but not in controls, the SFS was significantly correlated with N170 amplitudes to upright faces.ConclusionsThese results indicate face-specific configuration processing deficits and significant associations between face-N170 reduction and social dysfunction in schizophrenia.SignificanceAbnormal face-specific configuration processing may underlie some of the social dysfunctions in schizophrenia.     

Memory scanning and retrieval in affective disorders

Previous studies have consistently demonstrated unimpaired memory scanning and retrieval in schizophrenic patients. Using the choice-reaction time paradigm, this study assessed the speed of short-term memory processing for pictorial information in both unipolar and bipolar depressives by comparing it with that of schizophrenics. It was found that the processing rate is comparable between depressives and schizophrenics, between unipolar and bipolar depressives, and between depressives on medication and those not on medication. It was concluded, therefore, that the short-term memory scanning and retrieval processes are not impaired in depressive patients. The results further suggested that the depressives' slowness often found in simple reaction time tasks may result from a dysfunction in their stimulus encoding and/or response execution rather than in the central information-identification process.     

Facial expression and sex recognition in schizophrenia and depression.

BACKGROUND: Impaired facial expression recognition in schizophrenia patients contributes to abnormal social functioning and may predict functional outcome in these patients. Facial expression processing involves individual neural networks that have been shown to malfunction in schizophrenia. Whether these patients have a selective deficit in facial expression recognition or a more global impairment in face processing remains controversial. OBJECTIVE: To investigate whether patients with schizophrenia exhibit a selective impairment in facial emotional expression recognition, compared with patients with major depression and healthy control subjects. METHODS: We studied performance in facial expression recognition and facial sex recognition paradigms, using original morphed faces, in a population with schizophrenia (n=29) and compared their scores with those of depression patients (n=20) and control subjects (n=20). RESULTS: Schizophrenia patients achieved lower scores than both other groups in the expression recognition task, particularly in fear and disgust recognition. Sex recognition was unimpaired. CONCLUSION: Facial expression recognition is impaired in schizophrenia, whereas sex recognition is preserved, which highly suggests an abnormal processing of changeable facial features in this disease. A dysfunction of the top-down retrograde modulation coming from limbic and paralimbic structures on visual areas is hypothesized.     

Voluntary and involuntary attention affect face discrimination differently

Do voluntary (endogenous) and involuntary (exogenous) attention have the same perceptual consequences? Here we used fMRI to examine activity in the fusiform face area (FFA--a region in ventral visual cortex responsive to faces) and frontal-parietal areas (dorsal regions involved in spatial attention) under voluntary and involuntary spatial cueing conditions. The trial and stimulus parameters were identical for both cueing conditions. However, the cue predicted the location of an upcoming target face in the voluntary condition but was nonpredictive in the involuntary condition. The predictable cue condition led to increased activity in the FFA compared to the nonpredictable cue condition. These results show that voluntary attention leads to more activity in areas of the brain associated with face processing than involuntary attention, and they are consistent with differential behavioral effects of attention on recognition-related processes.     

Hippocampal underactivation in an fMRI study of word and face memory recognition in schizophrenia

Schizophrenia is a major mental disorder which is characterized by several cognitive deficits. Investigations of the neural basis of memory dysfunctions using neuroimaging techniques suggest that the hippocampus plays an important role in declarative memory impairment. The goal of this study was to investigate possible dysfunctions in cerebral activation in schizophrenic patients during both word and face recognition memory tasks. We tested 22 schizophrenics and 24 controls matched by gender, age, handedness and parental socioeconomic status. Compared to healthy volunteers, patients with schizophrenia showed decreased bilateral hippocampal activation during word and face recognition tasks. The whole brain analysis also showed a pattern of cortical and subcortical hypoactivation for both verbal and non-verbal recognition. This study provides further evidence of hippocampal involvement in declarative memory impairments of schizophrenia.     

Automatic-voluntary dissociation: An unusual facial paresis in a patient with probable multiple sclerosis

Summary A patient with multiple sclerosis is described who presented with a unilateral loss of voluntary function of his lower face muscles. However, in an emotional situation, there was strong involuntary innervation of these muscles: automatic-voluntary dissociation. The subcortical afferents to the facial motor nucleus are discussed. It is hypothesized that cortical disinhibition of midbrain nuclei underlies the accentuated involuntary innervation.     

The assessment of thought deficit in psychotic unipolar depression and chronic paranoid schizophrenia

In order to evaluate thought disorder in a nonschizophrenic psychotic group, psychotic depressives were compared with chronic paranoid schizophrenics and normal control subjects on two assessments of thought pathology. The data indicate that: a) psychotic depressives show thought deficits in the same areas as chronic paranoid schizophrenics, and b) idiosyncratic thinking is the single most prominent thought disorder in both psychotic groups. Certain subtypes of thought disorder may be characteristic of psychosis in general rather than of any specific diagnostic category. A psychoticism profile would include idiosyncratic thinking, restricted abstracting ability, linguistic errors, content deficit, intermixing, and loss of goal.     

Voluntary and involuntary schizophrenic patient admissions on the same general hospital psychiatric unit

The authors compare a group of voluntary schizophrenics to another group of involuntary schizophrenic patients with regard to their various clinical and management aspects. Both groups had been treated on the same unit, by the same staff, and within the same approximate time period. The involuntary group needed a slightly longer stay, a significantly higher dosage of neuroleptics, and more staff supervision and intervention. The involuntary schizophrenic patients were more likely to be violent, with agitation and destructive behavior, and to require restraints or seclusion.     

Effects of emotion and identity on facial affect processing in schizophrenia

We used facial affect labeling and matching tasks to study effects of (1) emotion and (2) identity on facial affect processing in patients with remitted schizophrenia (n=30) compared with healthy controls (n=30). The patients (1) had a specific deficit for labeling facial affects of sadness and anger but not happiness, disgust and fear; they (2) performed as well as controls in matching facial affects in one face but were impaired in matching facial affects in two different faces. The patients' impairment in facial affect processing may be emotion-specific. The effects of identity on facial affect processing are discussed in the light of several hypotheses (a deficit of context processing, a global-local processing impairment or a selective attention deficit), and may be related to frontal, prefrontal or amygdala dysfunctions.     

Assessing the Utility of a Virtual Environment for Enhancing Facial Affect Recognition in Adolescents with Autism

Teenagers with autism spectrum disorder (ASD) and age-matched controls participated in a dynamic facial affect recognition task within a virtual reality (VR) environment. Participants identified the emotion of a facial expression displayed at varied levels of intensity by a computer generated avatar. The system assessed performance (i.e., accuracy, confidence ratings, response latency, and stimulus discrimination) as well as how participants used their gaze to process facial information using an eye tracker. Participants in both groups were similarly accurate at basic facial affect recognition at varied levels of intensity. Despite similar performance characteristics, ASD participants endorsed lower confidence in their responses and substantial variation in gaze patterns in absence of perceptual discrimination deficits. These results add support to the hypothesis that deficits in emotion and face recognition for individuals with ASD are related to fundamental differences in information processing. We discuss implications of this finding in a VR environment with regards to potential future applications and paradigms targeting not just enhanced performance, but enhanced social information processing within intelligent systems capable of adaptation to individual processing differences.     

Facial emotion recognition from moving and static point-light images in schizophrenia

It is well established that schizophrenia is associated with difficulties recognising facial expressions of emotion. It has been suggested that this impairment could be specific to moving faces [Archer, J., Hay, D., Young, A., 1994. Movement, face processing and schizophrenia: evidence of a differential deficit in expression analysis. British Journal of Clinical Psychology, 33, 517-528]. The current study used point-light images to assess whether people with schizophrenia can interpret emotions from isolated patterns of facial movement in the absence of featural cues. Emotion recognition from moving and static images was assessed using a forced choice design with two sets of three emotions (anger, sadness and surprise; disgust, fear and happiness). The schizophrenia group was significantly better at recognising the emotions from moving images than static images. Although the control group was more accurate overall than the schizophrenia group, both groups presented the same characteristic patterns of performance across tasks. For example, in terms of which emotions were better recognised than others and the types of misidentifications that were made. Hence, it is concluded that people with schizophrenia are sensitive to the motion patterns which underlie individual expressions of emotion and can use this information to accurately recognise emotions.     

Social adjustment by self-report in a community sample and in psychiatric outpatients

Data are presented on social functioning derived from a self-report social adjustment scale (SAS-SR) administered to 774 subjects including a community sample and three psychiatric outpatient populations: acute depressives, alcoholics, and schizophrenics. This self-report scale derives from an interview form and was developed and tested on depressed outpatients. Since its publication, it has been used in populations other than depressives including other psychiatric patients, nonpsychiatric patients, and nonpatients. The purpose of this paper is to make data available to other investigators on results of this self-report social adjustment scale in a broad range of subjects and to describe further the psychometric properties, limitations, and utility of the scale. Findings show that the scale has wide applicability in a range of subjects but that certain cautions should be followed in using it with chronically impaired psychiatric populations who may not be involved in the major roles assessed by the scale.     

Recognition of emotions in facial expression of visual half-field images by schizophrenic and depressed patients]

Twenty schizophrenics, 20 depressives, and 20 normal controls were asked to identify positive and negative emotional expressions of faces tachistoscopically presented to the left and/or right visual hemifields. Results replicated the frequently cited recognition advantage for emotional stimuli presented in the left visual hemifield (right hemispheric processing). A significant reduction in decoding advantage was observed in both patient groups, which could be explained in terms of an interhemispheric disconnection syndrome in schizophrenics and depressives. Bilateral findings in particular tend to support this hypothesis, since they revealed that both cerebral hemispheres processed contrary information simultaneously.