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.