Posed facial expressions of emotion in schizophrenia and depression.

The goals of the present study were to explore: (1) whether schizophrenics, depressives, and normals differ in their likelihood of expressing different emotions; and (2) whether the types of expressions subjects exhibit are associated with their level of reported depressive symptomatology. Subjects were asked to imagine: seeing, smelling, or tasting something disgusting; and having something wonderful happen to them. Subjects were asked to show the experimenter what their face would look like if these things happened. The groups differed in how frequently they exhibited anger or contempt in the first condition and happiness in the second condition. The depressives were most likely to exhibit anger/contempt and least likely to exhibit happiness. Using Beck Depression Inventory scores as dependent variables, there were significant interactions between diagnostic group and the type of facial expressions exhibited. The associations between facial expressions and BDI scores were in the opposite directions for depressives and schizophrenics.     

Typicality range deficit in schizophrenics' recognition of emotion in faces

Severity of thought disorder in schizophrenics was assessed by a task that involved recognition of joy and shame expressions, with the expressions varied for typicality of the emotion category. Accuracy, typicality rating, and reaction time were measured in schizophrenic patients who were high or low on Whitaker's Index of Schizophrenic Thinking (WIST) and in depressive and normal controls. All groups had significant variation of typicality ratings for joy (normal typicality range), but the clinical groups had smaller typicality ranges for shame recognition and higher mean typicality ratings than did normals. High WIST schizophrenics were least accurate on low typical shame expressions. Results imply that, for shame recognition, schizophrenic and depressive groups used common categorization (no typicality variation in category members) rather than resemblance categorization.     

Time course of regional brain activations during facial emotion recognition in humans

Recognition of facial expressions of emotions is very important for communication and social cognition. Neuroimaging studies showed that numerous brain regions participate in this complex function. To study spatiotemporal aspects of the neural representation of facial emotion recognition we recorded neuromagnetic activity in 12 healthy individuals by means of a whole head magnetoencephalography system. Source reconstructions revealed that several cortical and subcortical brain regions produced strong neural activity in response to emotional faces at latencies between 100 and 360 ms that were much stronger than those to neutral as well as to blurred faces. Orbitofrontal cortex and amygdala showed affect-related activity at short latencies already within 180 ms after stimulus onset. Some of the emotion-responsive regions were repeatedly activated during the stimulus presentation period pointing to the assumption that these reactivations represent indicators of a distributed interacting circuitry.     

Pervasive emotion recognition deficit common to alexithymia and the repressive coping style

OBJECTIVE: Previous research has demonstrated a deficit in the ability to recognize emotions in alexithymic individuals. The repressive coping style is thought to preferentially impair the detection of unpleasant compared with pleasant emotions, and the degree of deficit is typically thought to be less severe than in alexithymia. We compared emotion recognition ability in both individuals with alexithymia and those with the repressive coping style. METHODS: Three hundred seventy-nine subjects completed the 20-item Toronto Alexithymia Scale, the Levels of Emotional Awareness Scale, the Marlowe-Crowne Scale (a measure of repressive defensiveness), the Bendig Short Form of the Taylor Manifest Anxiety Scale, and the Perception of Affect Task. The Perception of Affect Task consists of four 35-item emotion recognition subtasks: matching sentences and words, faces and words, sentences and faces, and faces and photographs of scenes. The stimuli in each subtask consist of seven emotions (happiness, sadness, anger, fear, disgust, surprise, and neutral) depicted five times each. Recognition accuracy results were collapsed across subtasks within each emotion category. RESULTS: Highly alexithymic subjects (for all, p<.01) and those with low emotional awareness (for all, p<.001) were consistently less accurate in emotion recognition in all seven categories. Highly defensive subjects (including repressors) were less accurate in the detection of anger, sadness, fear, and happiness (for all, p<.05). Furthermore, scores on the Levels of Emotional Awareness Scale accounted for significantly more variance in performance on the Perception of Affect Task than scores on the Marlowe-Crowne Scale (p<.01). CONCLUSIONS: The results indicate that alexithymia and the repressive coping style are each associated with impairments in the recognition of both pleasant and unpleasant emotions and that the two styles of emotional self-regulation differ more in the magnitude than in the quality of these impairments.     

Automatic processing of facial emotion in schizophrenia with and without affective negative symptoms

Introduction. It is assumed that people spontaneously evaluate any incoming stimulus as pleasant or unpleasant. The evaluative response appears to structure perception and to have direct links to emotional states.Methods. To investigate the automatic processing of face valence a sequential priming task based on emotional face stimuli was administered to schizophrenia patients with a flat affect expression, schizophrenia patients suffering from anhedonia, schizophrenia patients not suffering from anhedonia or flat affect, and healthy controls. The Scale for the Assessment of Negative Symptoms (Andreasen, 1989) was applied to evaluate affective symptoms and categorise patients into groups.Results. Schizophrenia patients without affective negative symptoms exhibited reversed priming effects similar to that of healthy subjects. In contrast, flat affect patients and anhedonic patients showed only a prime effect due to negative facial valence. In the flat affect patient group, negative prime faces facilitated the evaluation of target faces, whereas in the anhedonic patient group negative prime faces tended to inhibit the evaluation of subsequent target faces.Conclusions. The present findings support the idea that chronic schizophrenia patients extract automatically the valence of emotional facial expression but they also suggest processing differences between schizophrenia patients as a function of affective symptoms.     

The role of attention processes in facial affect recognition in schizophrenia

Introduction: Studies investigating the involvement of attention processes in facial affect recognition (FAR) have been contradictory, with some suggesting a generalised cognitive deficit, whereas others a specialised deficit in affect recognition. Given the ubiquity of both attention and emotion perception deficits in schizophrenia, we examined whether specific attentional processes, in fact, mediate FAR.

Methods: Patients with schizophrenia (n?=?38) and healthy controls (n?=?24) performed tests assessing FAR and attention processes, specifically, visual attention (Trail Making Test A), sustained attention/inhibition (Rapid Visual Processing subtest; Cambridge Automated Neuropsychological Test Battery), and attention to details in facial features (AFF). AFF and FAR were assessed with newly devised experimental procedures.

Results: Hierarchical multiple regression analyses showed a similar pattern of association between attention processes and FAR in both participant groups with respect to all attention processes investigated, predicting FAR accuracy. Additionally, visual attention predicted accuracy in happiness, disgust and surprise, whereas AFF predicted accuracy in anger and fear. Regarding FAR processing speed, no attention process predicted participants' performance on correct responses; AFF response speed predicted participants' FAR response speed, but only on incorrect responses.

Discussion: The present findings highlight the role of attentional processes in emotion recognition, as deficits in the former were predictive of impairments in the latter. Furthermore, AFF appears to be involved in the discrimination of negatively valenced facial expressions. The lack of association between attentional processes and FAR processing speed, particularly regarding correct responses, might reflect the differential pattern of activation of cortical and subcortical structures involved in these cognitive processes.     

A comprehensive analysis of verbal fluency deficit in geriatric schizophrenia.

Deficits in verbal fluency are common in schizophrenia and may provide keys to some of the abnormalities in the semantic system in schizophrenia. While a number of studies have outlined the severity and implications of verbal fluency deficits in younger schizophrenia patients, these findings have not yet been extended to older patients with schizophrenia. In this study, 392 older (age >/= 50) patients with schizophrenia were administered phonological and semantic (i.e., category) fluency examinations, as well as tests of learning, memory, language, and praxic skills, and rated for clinical symptoms and functional status. When compared to normative standards, 82% of the patients were impaired in semantic fluency and 83% were impaired in phonological fluency. Both semantic and phonological fluency impairment were significantly correlated with other cognitive variables, total scores on the functional status measure, and with the social and self-care subscales. Scores were uncorrelated with the severity of psychosis, but were correlated with the severity of negative symptoms. Furthermore, the severity of poverty of speech (a clinical measure of verbal underproductivity) was moderate in magnitude and failed to enter as a predictor of verbal fluency, indicating that impaired fluency scores are not simply an artifact of general underproductivity or mutism. The findings support conclusions from studies with younger schizophrenia patients that suggest that verbal fluency impairment is a consequence of a disorganized semantic system. Verbal fluency impairment remains common and functionally relevant in schizophrenia patients in late life.     

Impaired facial and vocal emotion decoding in schizophrenia is underpinned by basic perceptivo-motor deficits*

Introduction: Emotional decoding impairments have been largely demonstrated in schizophrenia for facial and prosodic stimuli, when presented separately. Nevertheless, the exploration of crossmodal integration has been far less considered, despite its omnipresence in daily social interactions. Moreover, the role played by basic visuo-motor impairments in unimodal and crossmodal decoding remains unexplored.

Methods: Thirty-two patients were compared with 32 matched controls in an emotional decoding task including unimodal (visual and auditory) and crossmodal (congruent and incongruent) conditions. A control perceptive task was also conducted to take potential low-level perceptual deficits into account.

Results: Schizoprenic patients presented lower performance and higher reaction times for both unimodal tasks (visual and auditory) and crossmodal conditions. Moreover, reaction times for the visuo-perceptive task were also significantly longer for patients compared to controls.

Conclusions: The consistency of the results across unimodal and crossmodal tasks suggests a globalised emotional impairment in schizophrenia, independent of the sensorial modality and crossmodal nature of the stimuli. Centrally, given the results in the visuo-perceptive task, the impairments observed for emotional recognition appears at least partly explained by primary cognitive deficits, namely reduced processing speed.     

A specific test of hippocampal deficit in schizophrenia

Despite numerous studies in which hippocampal abnormalities were found, schizophrenia patients' hippocampal neural activity has not been systematically evaluated on a specific hippocampal-dependent task. The transverse-patterning task (TP) is sensitive to the relational mnemonic capabilities of the hippocampus. Ten schizophrenia patients and 10 controls performed TP and control tasks that are not hippocampal dependent. As predicted, patients displayed a behavioral impairment in TP and not in control tasks. Magnetoencephalography showed controls activating right hippocampus during TP performance. Patients showed more bilateral or left hippocampal activation during TP, and greater left lateralization was associated with better performance on TP. Patients' abnormal hippocampal lateralization may play a role in the hippocampal-dependent behavioral deficit.     

Facial emotion space in schizophrenia

Introduction. Previous studies show that patients with schizophrenia have a deficit in facial emotion recognition. In the framework of emotion categorisation theories, the purpose of the present study was to test if this impairment could result from abnormal boundaries between emotions (whether these boundaries are shifted along continuums or are less sharpened).

Method. Twenty-six schizophrenic patients and the same number of healthy participants were required to perform a facial emotion recognition task and an emotion categorisation task with different emotion intensities obtained using morphing techniques.

Results. The main results indicate that schizophrenic patients exhibited an emotion space with less sharpened categories which favoured confusion between different emotions and intrusions of other emotions. Moreover, correlations between different indices showed that the less sharpened the categories, the more frequent the intrusions and the less discriminable the facial emotions.

Conclusion. We conclude that patients with schizophrenia process facial expressions in a less categorical way which involves impaired recognition of facial expressions. Such a specific impairment may favour false perceptions and lead to the settlement of delusional ideas.     

A GABAergic cortical deficit dominates schizophrenia pathophysiology

Several lines of evidence support the role of an epigenetic-induced GABAergic cortical dysfunction in schizophrenia psychopathology, which is probably dependent on an increase in the expression of DNA-methyltransferase-1 occurring selectively in GABAergic neurons. The key enzyme regulating GABA synthesis, termed glutamic acid decarboxylase 67 (GAD67) and the important neurodevelopmental protein called reelin are coexpressed in GABAergic neurons. Upon release, GABA and reelin bind to postsynaptic receptors located in dendrites, somata, or the axon initial segment of pyramidal neurons. Because GAD67 and reelin are downregulated in schizophrenia, it is suggested that schizophrenics may express GABAergic deficit-related alterations of pyramidal neuron function. A reduction of dendritic spines is a finding reported in the prefrontal cortex of schizophrenia patients. Because dendritic spines are innervated by glutamatergic axon terminals, very probably this reduction of dendritic spine expression is translated into a functional deficit of glutamatergic transmission. Plastic modifications of neuronal circuits are probably dependent on GABAergic transmitter tone, and it is likely that GABAergic dysfunction is at the root of synaptic plasticity deficits in schizophrenia. Thus, a possible avenue for the treatment of schizophrenia would be to address this GABAergic functional deficit using positive allosteric modulators of the action of GABA at GABAA receptors. Benzodiazepines (BZ) such as diazepam are effective in treating positive and negative symptoms of schizophrenia, but because they positively modulate GABAA receptors expressing alpha1 subunits, these BZs cause sedation and tolerance. In contrast, imidazenil, a full allosteric modulator of GABAA receptors expressing alpha5 subunits may reduce psychotic symptomatology without producing sedation. Hence, imidazenil should be appropriately studied as a prospective candidate for a pharmacological intervention in schizophrenia.     

Differentiating attention deficit in adult ADHD and schizophrenia.

Most previous studies of attention deficit in ADHD and schizophrenia have used overall measures of inattention that may disguise differences in underlying mechanisms. The present study investigated types of inattentive errors and applied a process view of attention in analyses of Conners' Continuous Performance Test protocols from subjects with ADHD-combined (51), inattentive type (19) and schizophrenia (26). Subjects with ADHD-I had more omission errors and became more inattentive as a function of time on task. Subjects with ADHD-C made more errors of commissions as time passed. In contrast, the performance of the subjects with schizophrenia improved, indicating a training effect. There were no differences in overall attentiveness between the groups. Although all groups were impaired on an overall level, they displayed three distinct patterns of inattention. The ADHD-I group displayed a lethargic inattention characterized by high fatigue. The ADHD-C group showed a hyperactive-impulsive pattern, while the schizophrenia group showed an inability to initially focus attention.