Impaired perception of affective prosody in schizophrenia

The authors aimed to explore schizophrenia patients' ability to perceive affective prosody. Specifically, certain emotions that may be more troublesome for patients and possible gender differences in prosody perception were assessed. Thirty six schizophrenia patients and 32 age-, education-, and gender-matched healthy comparison subjects assessed on an affective prosody test were examined. Patients were impaired on recognition of affective prosody overall, and their difficulties with prosody perception may be attributed to those emotions with negative valence, specifically anger and sadness. Findings revealed that only male patients were impaired on prosody perception. Deficits in the perception of affective prosody were principally evident in emotions with negative valence and male patients with schizophrenia. Future studies should explore the influence of these deficits on social and interpersonal functioning more directly.     

Facial affect and affective prosody recognition in first-episode schizophrenia

Individuals with schizophrenia experience problems in the perception of emotional material; however, the specificity, extent, and nature of the deficits are unclear. Facial affect and affective prosody recognition were examined in representative samples of individuals with first-episode psychosis, assessed as outpatients during the early recovery phase of illness, and non-patients. Perception tasks were selected to allow examination of emotion category results across face and voice modalities. Facial tasks were computerised modifications of the Feinberg et al. procedure (Feinberg, T.E., Rifkin, A., Schaffer, C., Walker, E., 1986. Arch. Gen. Psychiatry 43, 276--279). Prosody tasks were developed using four professional actors, and item selections were based on responses of undergraduates. Participant groups did not differ in their understanding of the words used to describe emotions. Findings supported small but consistent deficits in recognition of fear and sadness across both communication channels for the combined schizophrenia (n=29) and other psychotic disorders (n=28) groups as compared to the affective psychoses (n=23) and non-patients (n=24). A diagnostic effect was evident that was independent of the contribution of intelligence. The detection of emotion recognition impairments in first-episode schizophrenia suggests a trait deficit. The pattern of results is consistent with amygdala dysfunction in schizophrenia and related psychoses.     

Disturbances of affective prosody in patients with schizophrenia; a cross sectional study

The objective was to determine whether disturbances ofaffective prosody constitute part of the symptomatology ofschizophrenia. Affective prosody is defined here as aneuropsychological function that encompasses all non-verbal aspects oflanguage that are necessary for recognising and conveying emotions incommunication. Twenty six schizophrenic out-patients and twenty fournormal controls underwent a standardised prosody test, assessing fourdifferent aspects of affective prosody: spontaneous prosody, prosodicrecognition, prosodic repetition, and facial affect recognition. Patients scored significantly worse than controls on three of thefour subtests: spontaneous prosody, prosodic recognition, and prosodic repetition. There were no significant differences on a subtest forfacial affect recognition. Differences in educational level betweenpatients and controls could not account for these differences.

     

Comprehension of affective and nonaffective prosody

We studied patients with damage of either the right (RHD) or left hemisphere (LHD) and control subjects to determine whether the RHD patients had a global or limited prosodic defect. Compared with LHD patients and controls, RHD subjects had decreased comprehension of emotional prosody. Both LHD and RHD groups had more impaired comprehension of propositional prosody than controls, but the RHD and LHD groups did not differ. The right hemisphere, therefore, seems to be dominant for comprehending emotional prosody but not propositional prosody.     

Comprehension of affective prosody in multiple sclerosis

Deficits in cognition have been repeatedly documented in patients with multiple sclerosis (MS), but their ability to comprehend emotional information has received little study. Forty-seven patients with MS and 19 demographic controls received the comprehension portion of the Aprosodia Battery, which is known to be sensitive to the impairments of patients with strokes and other neurological conditions. Patients also received tests of hearing, verbal comprehension and naming, a short cognitive battery, and the Beck Depression Inventory. Patients with MS were impaired in identifying emotional states from prosodic cues. The magnitude of the deficits was greatest for patients with severe physical disability and under test conditions of limited prosodic information. Correlational analyses suggested that the patients' difficulties in comprehending affective prosodic information were not secondary to hearing loss, aphasic deficits, cognitive impairment, or depression. For some patients with MS, deficits in comprehending emotional information may contribute to their difficulties in maintaining effective social interactions.     

Impaired processing of affective prosody in Korsakoff's syndrome

In order to further characterize reported deficits in affect perception in alcoholic Korsakoff patients, selected prosody subtests from the Tübingen Affect Battery were administered to seven Korsakoff patients and seven normal control participants. Results indicated that both linguistic and affective prosody discrimination were intact in Korsakoff patients. As well, affective prosody identification was unimpaired when the semantic content of the sentence was emotionally congruent with affective prosody. In contrast, affective prosody identification was significantly impaired when the semantic content was either neutral or incongruent with prosody. These results suggest that Korsakoff patients are impaired in interpreting the meaning of affective prosody in the absence of semantic cues as to the emotional content of sentences.     

Repetition of affective prosody in mixed transcortical aphasia

Two patients with mixed transcortical aphasia could repeat propositional speech but not affective prosody. These findings suggest that the intact perisylvian region responsible for propositional speech does not mediate effective prosody. We propose that affective prosody is incorporated into propositional speech by means of an interhemispheric mechanism and that the failure of these patients to repeat affective prosody was caused by a disconnection of the left perisylvian structures from the right hemisphere structures thought to mediate affective prosody.     

Neuropsychological function and dysfunction in schizophrenia and psychotic affective disorders

Background: Mounting evidence suggests that compromised neurocognitive function is a central feature of schizophrenia. There are, however, schizophrenia patients with a normal neuropsychological (NP) performance, but estimates of the proportion of NP normal patients vary considerably between studies. Neurocognitive dysfunction is also a characteristic of other psychotic disorders, yet there are inconsistencies in the literature regarding the similarity to impairments in schizophrenia. NP normality in psychotic affective disorders has not been systematically studied.Methods: Data came from the Suffolk County Mental Health Project, an epidemiological study of first-admission patients with psychotic disorders. Respondents with a diagnosis of schizophrenia (N = 94) or schizoaffective disorder (N = 15), bipolar disorder (N = 78), and major depressive disorder (N = 48) were administered a battery of NP tests assessing 8 cognitive domains 2 years after index admission. Patients’ performance profile was compared, and their NP status was classified based on 3 previously published criteria that vary in their stringency.Results: The 4 diagnostic groups had comparable NP performance profile patterns. All groups demonstrated impairments in memory, executive functions, and attention and processing speed. However, schizophrenia patients were more impaired than the other groups on all cognitive domains. Results were not attenuated when IQ was controlled. Prevalence of NP normality ranged between 16% and 45% in schizophrenia, 20% and 33% in schizoaffective disorder, 42% and 64% in bipolar disorder, and 42% and 77% in depression, depending on the criterion employed.Conclusions: Evidence suggests that differences in NP performance between schizophrenia and psychotic affective disorders are largely quantitative. NP impairment is also common in psychotic affective disorders. A significant minority of schizophrenia patients are NP normal.     

Adult outcome of social function in adolescent-onset schizophrenia and affective psychosis

OBJECTIVE: To examine and compare the adult outcome in a representative sample of hospitalized adolescent-onset psychoses including occupational and social aspects. METHOD: A total of 81 patients with a first episode of early-onset psychosis (before age 19 years) presenting to the University Hospital of Lund, Sweden, between 1982 and 1993 were followed up an average of 10.5 years (range 5.1-18.2) after admission. Initial diagnosis was assessed from records and consisted of DSM-IV schizophrenia (n = 32), schizoaffective disorder (n = 7), bipolar disorder (n = 25), and major depressive disorder with psychotic features (n = 17). All could be traced and assigned a major outcome group. RESULTS: Early-onset schizophrenia spectrum disorder suffered a chronic course with a poor outcome in 79% of the cases, while early-onset affective psychosis in 74% showed a good or intermediate outcome. The poor outcome (26%) in the affective group was connected to mental retardation in 7% and to progression to a schizoaffective disorder in 12%. A particularly severe outcome was seen for schizophrenia spectrum patients with a family history of nonaffective psychosis. CONCLUSIONS: Early-onset schizophrenia spectrum disorder showed a severe course while affective psychoses had a much more benign functional outcome.     

Age-at-first-registration for affective psychosis and schizophrenia

We compared the age-at-first-registration for patients with schizophrenia and affective psychosis in a statewide mental health register. After excluding those receiving (1) a diagnosis of both schizophrenia (ICD-9 295.x) and affective psychosis (ICD-9 296.x), or (2) a diagnosis of ICD-9 296.1 (which can cover "major depressive episode"), we adjusted the distributions for the age structure of the background general population. We found that all distributions showed a wide age range of onset, with a similar male modal age group of 20-24 for schizophrenia and 25-29 for affective psychosis. The female modal age group was 50-54 for both diagnoses. Although more individuals were diagnosed with schizophrenia (males = 2,434, females = 1,609) than with affective psychosis (males = 670, females = 913), the shape of the two distributions was similar. This finding suggests that factors influencing age-at-first-registration for schizophrenia and affective psychosis may be similar, especially for females.     

Perceptual and acoustic correlates of affective prosody repetition in transcortical aphasias

Abstract

Perceptual judgements and acoustic analyses of affective prosody during sentence repetition were examined in four patients with transcortical aphasias and in two normal controls. Although all aphasic patients had a relative preservation of sentence repetition, perceptual ratings revealed that they repeated using correct affective intonation significantly less frequently than normal control subjects. Acoustic analysis revealed that patients with transcortical aphasias were unable to impart angry and happy intonation during repetition, producing flat intonation contours in most sentences. Restricted modulation of F0 and flat declinations of repeated utterances were found in patients with transcortical aphasias caused by lesions within the left perisylvian language area as well as outside this area. These findings suggest that repetition of affective prosody in transcortical aphasias is usually disrupted regardless of the intrahemispheric location (perisylvian or extraperisylvian) of the lesion, and that an adequate repetition of affective prosody may require bilateral, simultaneous hemispheric processing.     

Altered lateralisation of emotional prosody processing in schizophrenia

Alterations of cerebral lateralisation in schizophrenia have been reported consistently, and a reduced left-lateralisation has been suggested for language functions. Speech contains non-verbal information, e.g. prosody, and on a behavioural level, the extraction of emotional information from prosody is often impaired in schizophrenia. A previous functional magnetic resonance imaging study suggests increased left-lateralisation in schizophrenia during prosody processing, but did not disentangle effects of speech processing as such and emotional prosody processing. Here, we used meaningless syllables spoken with neutral, angry or fearful speech melody and measured blood oxygen level-dependent (BOLD) responses in 15 in-patients with schizophrenia and 15 healthy control participants matched for age and gender. Lateralisation indices were calculated for responses to emotional versus neutral prosody, and for all types of prosody versus baseline. Compared to control participants, patients with schizophrenia showed an increased right-lateralisation of emotional and non-emotional prosody processing in the temporal and parietal cortex. This right-lateralisation was increased in patients with reduced right-handedness and decreased in patients with stronger negative symptoms, particularly affective blunting, and with longer hospitalisation. Although patients with schizophrenia performed worse in emotion identification, this deficit was not related to lateralisation indices. Enhanced right-lateralisation to prosody resembles previous findings on laterality changes in speech processing and might suggest a common underlying cause in the organization of language functions.     

Impaired perception of negative emotional prosody in schizophrenia

This paper aims to report on the perception of emotional prosody in schizophrenia and to discuss its relationship with performance on neurocognitive measures. It consists of a comparison of 20 clinically stable schizophrenia patients with 20 healthy controls. Schizophrenia patients were impaired in emotional prosody perception, in particular in the perception of negative emotions. This impairment could not be explained on the basis of task difficulty or a general impairment in the decoding of speech intonation. Emotional prosody perception correlated moderately strongly with neurocognitive measures. We did not find a negative bias in the perception of emotional prosody.     

Auditory hallucinations and schizophrenia

Forty-five patients with auditory hallucinations were studied. Sixty per cent proved to be excellent hypnotic subjects with multiple personalities. These latter patients received 11 different diagnoses by clinicians, predominantly those related to schizophrenia or an affective illness. Because patients with multiple personalities frequently have hallucinations, delusions, paranoid ideas and bizarre behaviors, they may be misdiagnosed as some form of schizophrenia.     

Quantitative assessment of smooth pursuit gain and catch-up saccades in schizophrenia and affective disorders

The smooth pursuit responses to 5 degrees and 20 degrees/sec constant-velocity stimuli were recorded from 23 patients with schizophrenia, 16 affective disorder patients, and 21 normals using low-noise infrared oculography. Pursuit gain, catch-up saccade (CUS) rate and amplitude, and their interrelationships were examined. Gain in the schizophrenic patients was reduced only at 20 degrees/sec, but for both patient groups, CUS rate at 5 degrees/sec was significantly lower than in normals. Using CUS rate at 20 degrees/sec, the patient groups could be distinguished from each other (the rate for schizophrenic patients being highest, and the rate for affectives the lowest) but neither differed significantly from normals. The diagnostic groups did not differ significantly in mean CUS amplitude, although there was a trend for patients to have larger saccades. Gain-CUS rate correlation was strong in normals but reduced or absent in both patient groups. These results indicate that the ocular motor systems of patients with schizophrenia and affective disorders process eye position error abnormally.     

Impaired perception of affective prosody in remitted patients with bipolar disorder

Patients with bipolar disorder present deficits in facial emotion perception, both during a manic episode as well as upon recovery. Our goal in the present study was to investigate the ability of remitted patients with bipolar disorder to perceive affective prosody and to explore potential differences in the specific emotions that are troublesome for them. Participants included 19 patients with bipolar disorder I, currently in remission, and 22 healthy comparison subjects, matched on age, education, and gender. An affective prosody test (APT) was administered to all participants. Bipolar patients had significantly lower overall scores on the APT than healthy individuals. This impairment was specific to female patients and certain emotions (e.g., fear and surprise).     

Intervention for increasing the comprehension of affective prosody in children with autism spectrum disorders

Deficits in comprehension of others’ emotions have been well documented in children with autism spectrum disorders (ASDs). As to variety of methodological procedures, many of them can be analyzed by matching-to-sample (MTS) procedures. When using affective prosody as a sample stimulus, children with ASD have been found to have difficulties with cross-modal MTS, including understanding the relationship between affective prosody (auditory stimulus) and affective illustrations or texts (visual stimulus). Furthermore, several studies have attempted to train the perception of cross-modal processing relationships in older children with high functioning ASD or Asperger's syndrome. The purpose of the present study was to examine whether four young children with ASD (mean age, 5 years 6 months) could be taught the relationships between affective prosody and facial expression via cross-modal MTS training and, if so, whether or not this skills generalized to novel stimuli. A multiple baseline design across participants was implemented. Results showed that all four of the children acquired the cross-modal emotion relationships and generalized this learned relationship to the perception of untrained stimuli. These findings are discussed in terms of the procedures to increase the understanding of the richness of other's emotions at an early developmental stage.     

Auditory affective agnosia. Disturbed comprehension of affective speech.

Hughlings Jackson noted that, although some aphasic patients were unable to use propositional speech, affective speech appeared to be spared. The purpose of this experiment was to study patients with unilateral hemispheric disease in order to ascertain if there are hemispheric asymmetries in the comprehension of affective speech. Six subjects had right temporoparietal lesions (left unilateral neglect) and six subjects had left temporoparietal lesions (fluent aphasias). These subjects were presented with 32 tape recorded sentences. In 16 trials the patients were asked to judge the emotional mood of the speaker (happy, sad, angry, indifferent) and in 16 trials the patients were asked to judge the content. Line drawings containing facial expressions of the four emotions or line drawings corresponding with the four basic contents were displayed with each sentence and the patient responded by pointing. All 12 subjects made perfect scores on the content portion of the test. On the emotional portion the right hemispheric patients scored a mean of 4-17 and the left hemispheric group scored a mean 10-17. The difference between these means is significantly (P less than 0-01) and suggests that patients with right hemispheric dysfunction and neglect have a defect in the comprehension of affective speech.     

Concurrent functional magnetic resonance imaging and electroencephalography assessment of sensory gating in schizophrenia

Schizophrenia is frequently accompanied by deficits in basic information processing, such as sensory gating. The sources behind deficient sensory gating in schizophrenia patients are, however, still largely unclear. The aim of the current study was to identify the brain structures involved in deficient sensory gating in schizophrenia patients. Twenty healthy male volunteers and 23 male schizophrenia patients were initially assessed in a somatosensory P50 suppression paradigm using concurrent electroencephalography (EEG)/functional magnetic resonance imaging (fMRI) methodology. The trials consisted of single stimuli or pairs of identical stimuli with either 500 ms or 1,000 ms interstimulus intervals. Not all subjects showed a P50 waveform as a result of the somatosensory stimuli: It was detected in 13 schizophrenia patients and 15 control subjects. Significant P50 suppression was found in the 500 ms trials in controls only. Region of interest analyses were performed for a priori chosen regions. Significant negative correlations between P50 ratios and the BOLD response were found bilaterally in the hippocampus, thalamus, anterior and posterior superior temporal gyrus (STG), and in the left inferior frontal gyrus pars opercularis. However, significant group differences were found in the hippocampus and the thalamus only. This is the first study in which P50 suppression was assessed in schizophrenia patients with concurrent fMRI/EEG methodology. The data support that the STG, thalamus, inferior frontal gyrus, and the hippocampus are involved in P50 suppression. However, of these structures only the hippocampus and thalamus appeared involved in the altered sensory processing found in schizophrenia. Hum Brain Mapp 35:3578–3587, 2014. © 2013 Wiley Periodicals, Inc .