Facial affect recognition and schizotypal personality characteristics

Aim: Deficits in facial affect recognition are well established in schizophrenia, yet relatively little research has examined facial affect recognition in hypothetically psychosis‐prone or ‘schizotypal’ individuals. Those studies that have examined social cognition in psychosis‐prone individuals have paid little attention to the association between facial emotion recognition and particular schizotypal personality features. The present study therefore sought to investigate relationships between facial emotion recognition and the different aspects of schizotypy. Methods: Facial affect recognition accuracy was examined in 50 psychiatrically healthy individuals assessed for level of schizotypy using the Schizotypal Personality Questionnaire. This instrument provides a multidimensional measure of schizophrenia proneness, encompassing ‘cognitive‐perceptual’, ‘interpersonal’ and ‘disorganized’ features of schizotypy. It was hypothesized that the cognitive‐perceptual and interpersonal aspects of schizotypy would be associated with difficulties identifying facial expressions of emotion during a forced‐choice recognition task using a standardized series of colour photographs. Results: As predicted, interpersonal aspects of schizotypy (particularly social anxiety) were associated with reduced accuracy on the facial affect recognition task, but there was no association between affect recognition accuracy and cognitive‐perceptual features of schizotypy. Conclusions: These results suggest that subtle deficits in facial affect recognition in otherwise psychiatrically healthy individuals may be related to the vulnerability for interpersonal communication difficulties, as seen in schizophrenia.     

Sensory contributions to impaired prosodic processing in schizophrenia.

BACKGROUND: Deficits in affect recognition are prominent features of schizophrenia. Within the auditory domain, patients show difficulty in interpreting vocal emotional cues based on intonation (prosody). The relationship of these symptoms to deficits in basic sensory processing has not been previously evaluated. METHODS: Forty-three patients and 34 healthy comparison subjects were tested on two affective prosody measures: voice emotion identification and voice emotion discrimination. Basic auditory sensory processing was measured using a tone-matching paradigm and the Distorted Tunes Test (DTT). A subset of subjects was also tested on facial affect identification and discrimination tasks. RESULTS: Patients showed significantly impaired performance on all emotion processing tasks. Within the patient group, a principal components analysis demonstrated significant intercorrelations between basic pitch perception and affective prosodic performance. In contrast, facial affect recognition deficits represented a distinct second component. Prosodic affect measures correlated significantly with severity of negative symptoms and impaired global outcome. CONCLUSIONS: These results demonstrate significant relationships between basic auditory processing deficits and impaired receptive prosody in schizophrenia. The separate loading of auditory and visual affective recognition measures suggests that within-modality factors may be more significant than cross-modality factors in the etiology of affect recognition deficits in schizophrenia.     

Emotional information processing in violent patients with schizophrenia: association with psychopathy and symptomatology

Schizophrenia and psychopathy have been independently shown to be associated with deficits in the recognition of facial expressions. These disorders are highly co-morbid in forensic settings, and both are associated with aggressive behaviour. This study examines the relative contribution of psychopathic traits and psychotic symptoms to reported deficits in facial affect recognition in forensic patients with schizophrenia. Fifty-four male patients with schizophrenia were recruited from medium and high security hospitals. Participants were categorised into groups with high (HP), medium (MP) and low (LP) scores on the Psychopathy Checklist: Screening Version and based on symptomatology assessed using the Positive and Negative Syndrome Scale. Participants completed an animated facial affect recognition task assessing accuracy across the six basic emotions over high and low intensities. The HP group was found to have impaired recognition of sadness at low intensity compared with the LP group. In the overall sample, facial affect recognition for negatively valenced emotions was not related to positive or negative symptom scores. However, recognition accuracy for disgust was found to be negatively related to the severity of cognitive symptoms. Patients with high psychopathy scores and schizophrenia showed similar deficits in emotional information processing to those reported in the literature in non-psychotic psychopathic samples.     

The McCollough effect and facial emotion discrimination in patients with schizophrenia and their unaffected relatives

Abnormalities in visual processing have been found consistently in schizophrenia patients, including deficits in early visual processing, perceptual organization, and facial emotion recognition. There is however no consensus as to whether these abnormalities represent heritable illness traits and what their contribution is to psychopathology. Fifty patients with schizophrenia, 61 of their first-degree healthy relatives, and 50 psychiatrically healthy volunteers were tested with regard to facial affect (FA) discrimination and susceptibility to develop the color-contingent illusion [the McCollough Effect (ME)]. Both patients and relatives demonstrated significantly lower accuracy in FA discrimination compared with controls. There was also a significant effect of familiality: Participants from the same families had more similar accuracy scores than those who belonged to different families. Experiments with the ME showed that schizophrenia patients required longer time to develop the illusion than relatives and controls, which indicated poor visual adaptation in schizophrenia. Relatives were marginally slower than controls. There was no significant association between the measures of FA discrimination accuracy and ME in any of the participant groups. Facial emotion discrimination was associated with the degree of interpersonal problems, as measured by the Schizotypal Personality Questionnaire in relatives and healthy volunteers, whereas the ME was associated with the perceptual-cognitive symptoms of schizotypy and positive symptoms of schizophrenia. Our results support the heritability of FA discrimination deficits as a trait and indicate visual adaptation abnormalities in schizophrenia, which are symptom related.     

Facial recognition deficits and cognition in schizophrenia

Previous investigations have found impaired recognition of facial affect and cognition in schizophrenia. We compared patients with schizophrenia and healthy control volunteers on computerized tasks of emotion recognition, to determine whether emotion processing deficits were correlated with neurocognitive performance. A Computerized Neuropsychological Test Battery (CNP) was administered to 40 patients (25 male, 15 female, mean age+/-S.D. 30.4+/-8.1) with schizophrenia (DSM-IV, 15 first episode and 25 chronically ill patients) treated with atypical neuroleptics and 43 healthy volunteers. A German version of the PENN Facial Discrimination, Differentiation and Memory Test, including happy, sad and neutral faces was used. Additionally, all patients were tested with a standard neuropsychological battery and rated for positive and negative symptoms. Patients with schizophrenia performed worse than control subjects on all emotion recognition tasks (p<0.01). We found higher error rates for discrimination of emotion in happy (p<0.02) and happy female faces (p<0.01), for differentiation of sad versus happy faces (p<0.001) and for facial memory (p<0.04). Poorer performance in emotion discrimination and facial memory correlated with severity of negative symptoms, abstraction-flexibility (p<0.001), verbal memory (p<0.01) and language processing (p<0.001). The study did not reveal a specific deficit for emotion recognition in schizophrenia. These findings lend support to the notion that difficulties in emotion recognition are associated in schizophrenia with key cognitive deficits.     

Facial and vocal affect perception in people at ultra‐high risk of psychosis,first‐episode schizophrenia and healthy controls

Aim: The study aims to investigate affect recognition in young people at different stages of psychotic illness. Methods: Seventy‐nine ultra‐high risk patients, 30 first‐episode schizophrenia patients and 30 healthy control subjects completed a facial affect labelling test and an affective prosody recognition test. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). Results: We observed significant impairments in facial and vocal emotion recognition in both of the clinical groups compared with the control group. These group differences remained significant when age, sex and education were taken into account. Conclusions: The findings suggest that emotion recognition impairments may be independent of the stage of illness in schizophrenia. Deficits in emotion recognition may be present before the full expression of psychotic illness, and may contribute to the social cognition and social functioning deficits apparent in emerging psychotic disorders.     

Fearful faces in schizophrenia: the relationship between patient characteristics and facial affect recognition

Although schizophrenia has often been associated with deficits in facial affect recognition, it is debated whether the recognition of specific emotions is affected and if these facial affect-processing deficits are related to symptomatology or other patient characteristics. The purpose of the present study was to explore whether particular patient characteristics are associated with the recognition of specific facial expressions in patients with schizophrenia. Sixty-four patients with a DSM-IV diagnosis of schizophrenia were assessed with a computerized test of degraded facial affect recognition. Linear regression analysis showed that, in particular, negative symptoms and male sex were associated with worse recognition of fearful faces. Furthermore, diagnosis of nonparanoid schizophrenia and later age of onset were associated with worse recognition of neutral faces. Findings are explained in the light of a neuroanatomical dysfunction accounting for both negative symptoms, such as reduced emotional expression and social-emotional dysfunction, for which men seem more vulnerable than women.     

Facial fear processing and psychotic symptoms in schizophrenia: functional magnetic resonance imaging study

BACKGROUND: The recognition of negative facial affect is impaired in people with schizophrenia. The neural underpinnings of this deficit and its relationship to the symptoms of psychosis are still unclear. AIMS: To examine the association between positive and negative psychotic symptoms and activation within the amygdala and extrastriate visual regions of patients with schizophrenia during fearful and neutral facial expression processing. METHOD: Functional magnetic resonance imaging was used to measure neural responses to neutral and fearful facial expressions in 11 patients with schizophrenia and 9 healthy volunteers during an implicit emotional task. RESULTS: No association between amygdala activation and positive symptoms was found; the activation within the left superior temporal gyrus was negatively associated with the negative symptoms of the patients. CONCLUSIONS: Our results indicate an association between impaired extrastriate visual processing of facial fear and negative symptoms, which may underlie the previously reported difficulties of patients with negative symptoms in the recognition of facial fear.     

Right lateral fusiform gyrus dysfunction during facial information processing in schizophrenia.

BACKGROUND: Patients with schizophrenia exhibit facial information processing deficits that likely contribute to their social dysfunction. Whether the deficits involve facial affect and/or identity processing or result from other cognitive abnormalities in schizophrenia remains controversial, and a brain dysfunction specifically related to them has never been reported. If such dysfunction existed, it should be consistently observed across groups of patients and during performance of different facial information processing tasks, independently of whether such tasks demand working memory (WM), semantic, or other cognitive processes. We hypothesized that the right lateral fusiform gyrus (rLFG), one of several human brain areas involved in facial information processing, would consistently show activation abnormalities during both facial affect and identity discrimination in schizophrenia. METHODS: We used functional magnetic resonance imaging to measure brain activation in two groups of six chronic, stable schizophrenic outpatients and two of six age- and gender-matched healthy controls. One group of patients and one of controls performed facial affect-with or without semantic processing-and identity discrimination tasks, and the other two groups WM tasks with facial expression cues and varying attentional demands. RESULTS: Patients from either group failed to activate the rLFG when compared to controls in any task. Other activation abnormalities were task-specific (i.e., seen only during performance of one set of tasks) and not consistently observed in both groups of patients, and thus could not be directly and solely linked to facial information discrimination. CONCLUSIONS: These results indicate a specific rLFG dysfunction during early facial information--identity or affect--processing, independent from other cognitive deficits, in schizophrenia.     

Training of affect recognition (TAR) in schizophrenia--impact on functional outcome

Deficits in facial affect recognition as one aspect of social cognitive deficits are treatment targets to improve functional outcome in schizophrenia. According to preliminary results antipsychotics alone show little effects on affect recognition. A few randomized intervention studies have evaluated special psychosocial treatment programs on social cognition. In this study, the effects of a computer-based training of affect recognition were investigated as well as its impact on facial affect recognition and functional outcome, particularly on patients' quality of life. Forty clinically stabilized schizophrenic patients were randomized to a six-week training on affect recognition (TAR) or treatment as usual including occupational therapy (TAU) and completed pre- and post-treatment assessments of emotion recognition, cognition, quality of life and clinical symptoms. Between pre- and post treatment, the TAR group achieved significant improvements in facial affect recognition, in particular in recognizing sad faces and, in addition, in the quality of life domain social relationship. These changes were not found in the TAU group. Furthermore, the TAR training contributes to enhancing some aspects of cognitive functioning and negative symptoms. These improvements in facial affect recognition and quality of life were independent of changes in clinical symptoms and general cognitive functions. The findings support the efficacy of an affect recognition training for patients with schizophrenia and the generalization to social relationship. Further development is needed in the impact of a psychosocial intervention in other aspects of social cognition and functional outcome.     

Symptom Correlates of Static and Dynamic Facial Affect Processing in Schizophrenia: Evidence of a Double Dissociation?

Schizophrenia patients have been shown to be compromised in their ability to recognize facial emotion. This deficit has been shown to be related to negative symptoms severity. However, to date, most studies have used static rather than dynamic depictions of faces. Nineteen patients with schizophrenia were compared with seventeen controls on 2 tasks; the first involving the discrimination of facial identity, emotion, and butterfly wings; the second testing emotion recognition using both static and dynamic stimuli. In the first task, the patients performed more poorly than controls for emotion discrimination only, confirming a specific deficit in facial emotion recognition. In the second task, patients performed more poorly in both static and dynamic facial emotion processing. An interesting pattern of associations suggestive of a possible double dissociation emerged in relation to correlations with symptom ratings: high negative symptom ratings were associated with poorer recognition of static displays of emotion, whereas high positive symptom ratings were associated with poorer recognition of dynamic displays of emotion. However, while the strength of associations between negative symptom ratings and accuracy during static and dynamic facial emotion processing was significantly different, those between positive symptom ratings and task performance were not. The results confirm a facial emotion-processing deficit in schizophrenia using more ecologically valid dynamic expressions of emotion. The pattern of findings may reflect differential patterns of cortical dysfunction associated with negative and positive symptoms of schizophrenia in the context of differential neural mechanisms for the processing of static and dynamic displays of facial emotion.     

Deficits in facial affect recognition in unaffected siblings of Xhosa schizophrenia patients: evidence for a neurocognitive endophenotype

The present study in an African Xhosa sample examined whether familial vulnerability to schizophrenia is associated with deficits in facial affect recognition. Healthy comparison subjects, unaffected siblings of schizophrenia patients, and schizophrenia patients were tested with a task requiring rapid recognition of matched positive (happy), negative (angry), and neutral facial expressions. Siblings and patients demonstrated impaired recognition of negative relative to positive facial expressions whereas comparison subjects recognized negative and positive expressions at an equal level of accuracy. These results suggest that deficits in the processing negative affect from social cues are transmitted in families and may represent a heritable endophenotype of schizophrenia.     

Facial emotion recognition in patients with schizophrenia and their siblings

Background: Deficits in recognition of facial emotions have been widely reported in patients with schizophrenia. Previous studies that examined recognition of facial emotions in relatives of patients with schizophrenia brought out inconsistent results. Aims: In this study, we aimed to examine facial emotion identification and discrimination abilities in patients with schizophrenia and their healthy siblings to find out whether familial vulnerability to schizophrenia is associated with deficits in facial emotion recognition. Methods: Patients with schizophrenia (n=57), their unaffected biological siblings (n=58) and healthy controls (n=58) were included in the study. The three groups did not differ significantly for gender, age and education level. All the participants were evaluated with the Facial Emotion Identification Test (FEIT) and Facial Emotion Discrimination Test (FEDT). Results: Patients with schizophrenia performed significantly worse than controls on FEIT and FEDT. Siblings performed significantly better than patients and significantly worse than controls on FEIT and FEDT. Conclusions: Impaired performance of siblings on facial emotion identification and discrimination tasks provides evidence for the hypothesis that facial emotion recognition deficits are transmitted in families and may represent a heritable endophenotype of schizophrenia.     

Facial emotion recognition in schizophrenia: when and why does it go awry?

OBJECTIVE: Schizophrenia patients demonstrate impaired emotional processing that may be due, in part, to impaired facial emotion recognition. This study examined event-related potential (ERP) responses to emotional faces in schizophrenia patients and controls to determine when, in the temporal processing stream, patient abnormalities occur. METHOD: 16 patients and 16 healthy control participants performed a facial emotion recognition task. Very sad, somewhat sad, neutral, somewhat happy, and very happy faces were each presented for 100 ms. Subjects indicated whether each face was "Happy", "Neutral", or "Sad". Evoked potential data were obtained using a 32-channel EEG system. RESULTS: Controls performed better than patients in recognizing facial emotions. In patients, better recognition of happy faces correlated with less severe negative symptoms. Four ERP components corresponding to the P100, N170, N250, and P300 were identified. Group differences were noted for the N170 "face processing" component that underlies the structural encoding of facial features, but not for the subsequent N250 "affect modulation" component. Higher amplitude of the N170 response to sad faces was correlated with less severe delusional symptoms. Although P300 abnormalities were found, the variance of this component was explained by the earlier N170 response. CONCLUSION: Patients with schizophrenia demonstrate abnormalities in early visual encoding of facial features that precedes the ERP response typically associated with facial affect recognition. This suggests that affect recognition deficits, at least for happy and sad discrimination, are secondary to faulty structural encoding of faces. The association of abnormal face encoding with delusions may denote the physiological basis for clinical misidentification syndromes.     

A multidimensional assessment of social cognition in psychometrically defined schizotypy

Individuals with schizophrenia exhibit impairments in multiple social cognitive domains. There is evidence that these impairments may be trait-related vulnerability markers for schizophrenia. However, the literature focusing on individuals vulnerable to developing schizophrenia-spectrum disorders, referred to as schizotypy, has produced inconsistent findings. This study's primary aim was to provide a more comprehensive understanding of social cognitive functioning within schizotypy than previous studies by employing a broad array of measures to assess multiple social cognitive domains, and examine how these domains relate to specific schizotypy traits (i.e., positive, negative, and disorganized) and Quality of Life (QOL). Facial emotion recognition, Theory of Mind (ToM), and aspects of emotional intelligence related to regulating one's own emotions (emotion management) and other's emotions (social management) were measured. Individuals with psychometrically defined schizotypy (n=36) and controls (n=26) were examined. The schizotypy group performed significantly worse than controls on facial emotion recognition, ToM, and emotion management, but not social management. Generally speaking, poorer social cognition performance was not a function of specific schizotypy traits. However, negative traits were associated with poorer facial emotion recognition, and disorganized traits were associated with better social management. Facial emotion recognition was associated with QOL in the schizotypy group.     

Affect processing and positive syndrome schizotypy in cannabis users

While cannabis is associated with positive syndrome schizophrenia (SZ), it is unclear whether cannabinoids are also related to negative symptoms such as affective blunting. We examined whether cannabis use is associated with schizotypy and utilized event-related potentials (ERPs) to assess affect processing. Cannabis users demonstrated increased P300 amplitudes for unpleasant trait words, and demonstrated higher positive syndrome schizotypy which correlated with levels of cannabis use. The cannabis group also exhibited lower negative syndrome schizotypy. The lack of blunted responses during the affect ERP and decreased negative subscale schizotypy scores provide evidence that the endocannabinoid theory of schizophrenia may be primarily relevant in relation to positive syndrome SZ.     

Emotion recognition in Chinese people with schizophrenia

This study examined whether people with paranoid or nonparanoid schizophrenia would show emotion-recognition deficits, both facial and prosodic. Furthermore, this study examined the neuropsychological predictors of emotion-recognition ability in people with schizophrenia. Participants comprised 86 people, of whom: 43 were people diagnosed with schizophrenia and 43 were controls. The 43 clinical participants were placed in either the paranoid group (n=19) or the nonparanoid group (n=24). Each participant was administered the Facial Emotion Recognition task and the Prosodic Recognition task, together with other neuropsychological measures of attention and visual perception. People suffering from nonparanoid schizophrenia were found to have deficits in both facial and prosodic emotion recognition, after correction for the differences in the intelligence and depression scores between the two groups. Furthermore, spatial perception was observed to be the best predictor of facial emotion identification in individuals with nonparanoid schizophrenia, whereas attentional processing control predicted both prosodic emotion identification and discrimination in nonparanoid schizophrenia patients. Our findings suggest that patients with schizophrenia in remission may still suffer from impairment of certain aspects of emotion recognition.     

Empathy, social functioning and schizotypy

Whilst affective empathy is concerned with one's emotional response to the affective state of another, cognitive empathy refers to one's understanding of another's mental state, and deficits in both are believed to contribute to the social behavioral abnormalities associated with schizophrenia. The present study aimed to test whether individual differences in normally distributed schizotypal personality traits are related to cognitive and affective empathy, and whether any observed association between schizotypy and empathy mediates the relationship between schizotypy and (reduced) social functioning. Non-clinical volunteers (N=223) completed measures of schizotypal personality, cognitive and affective empathy, social functioning and negative affect. The results indicated that higher schizotypy was associated with reduced empathy, poorer social functioning and increased negative affect. Of the specific schizotypal dimensions (positive, negative and disorganized), only negative schizotypy was significantly associated with social functioning, and this relationship persisted even after controlling for negative affect. Further, affective empathy functioned as a partial mediator in this relationship. These data show that the relationship between negative schizotypy and social functioning is at least partially attributable to deficits in affective empathy.     

Dimensional approaches to experimental psychopathology of schizophrenia: shift learning and report of psychotic-like experiences in college students

Adopting a dimensional approach to experimental psychopathology, and taking into account inconsistencies in the previous literature, we examined whether reports of psychotic-like experiences in undergraduate students were associated with shift-learning deficits, akin to those seen in schizophrenia. The participants (N=72) were tested on a new compound stimulus discrimination task before and after a target shift, and were administered a multi-dimensional schizotypy inventory (O-LIFE). Performance impairment following a target shift was associated with the negative (introvertive anhedonia) and the impulsive (impulsive non-conformity) dimension of schizotypy, but not with the positive (unusual experiences), nor the disorganised (cognitive disorganisation) dimension. None of the schizotypy measures were associated with performance on discrimination learning before the target shift. The obtained results are in line with past evidence that shift learning is associated with the severity of the negative symptomatology of schizophrenia. The possibility that psychotic-like features may contribute differentially to performance deficits across successive stages of learning is considered.     

Semantic associations, lateralized frontal function, and context maintenance in schizotypy

Symptom heterogeneity within conventional diagnostic groups is fostering a growing focus on narrower symptom profiles to identify psychological and biological mechanisms in psychopathology. Positive symptoms of schizophrenia are associated with context maintenance deficits, which in turn have been linked to frontal-lobe function. Frontal- and temporal-lobe brain dysfunction is also well documented in schizophrenia. The present study (N=36) examined how context and memory deficits are associated with subclinical symptoms in schizotypy by investigating the relationship between symptom reports, neuropsychological performance, and several facets of recognition memory. Context maintenance was probed via lures suggested by presented verbal material. Frontal brain function and positive symptom schizotypy predicted accuracy for lures, whereas posterior brain function and low positive affect predicted accuracy for distracters. This pattern of findings establishes continuity in disruption of context maintenance in clinical and subclinical populations.