An analysis of categorical perception of facial emotion in schizophrenia

Deconstructing Mechanisms of Abnormal Categorical Perception of Emotional Facial Expressions in Schizophrenia Patients

OBJECTIVE

The current study aims to find out the potential reasons why most schizophrenia patients have a relatively low sensitivity to the classification of emotional facial expressions.

METHODS

By using an emotional categorical perception task, eighty-three schizophrenia patients and seventy-one healthy adults are provided with morphed emotional continuums with two emotional facial expressions (a positive emotional valence: happy; a negative emotional valence: sad).

RESULTS

Through comparing the difference between schizophrenia patients and healthy adults in the processes of estimating facial expressions with ambiguous emotions, we find that the pattern of emotional categorical perception for schizophrenia patients is significantly different from that of healthy controls when they process signals on the local facial areas. Compared to healthy people, schizophrenia patients have a significantly separate classification pattern in processing emotional signals between the eyes and mouth regions. It indicates that compared to healthy adults, schizophrenia patients have larger conflicts in integrating emotional signals from different facial areas. To overcome conflicts, more cognitive resources are required. Unfortunately, the lack of cognitive resources leads to the failure of integration, which further increases the difficulty of estimating facial expressions with ambiguous emotions, and finally leads to the relatively low sensitivity of emotional facial expressions classification.

CONCLUSION

To sum up, the deficit of abnormal perceptions of emotional facial expressions in schizophrenia patients results from an integrated deficit of signals on facial areas.

Rhythm perception is shared between audio and haptics

A surface texture is perceived through both the sound and vibrations produced while being explored by our fingers. Because of their common origin, both modalities have a strong influence on each other, particularly at above 60 Hz for which vibrotactile perception and pitch perception share common neural processes. However, whether the sensation of rhythm is shared between audio and haptic perception is still an open question. In this study, we show striking similarities between the audio and haptic perception of rhythmic changes, and demonstrate the interaction of both modalities below 60 Hz. Using a new surface-haptic device to synthesize arbitrary audio-haptic textures, psychophysical experiments demonstrate that the perception threshold curves of audio and haptic rhythmic gradients are the same. Moreover, multimodal integration occurs when audio and haptic rhythmic gradients are congruent. We propose a multimodal model of rhythm perception to explain these observations. These findings suggest that audio and haptic signals are likely to be processed by common neural mechanisms also for the perception of rhythm. They provide a framework for audio-haptic stimulus generation that is beneficial for nonverbal communication or modern human-machine interfaces.

Attention for Emotion-How Young Adults With Neurodevelopmental Disorders Look at Facial Expressions of Affect

While Autism Spectrum Disorder (ASD), Attention-Deficit/Hyperactivity Disorder (ADHD) and Schizophrenia (SCZ) differ in many clinically relevant features such as symptomatology and course, they may also share genetic underpinnings, affective problems, deviancies in social interactions, and are all characterized by some kind of cognitive impairment. This situation calls for a joint investigation of the specifics of cognitive (dys-)functions of the three disorders. Such endeavor should focus, among other domains, on the inter-section of processing cognitive, affective and social information that is crucial in effective real-life interactions and can be accomplished when attentional preferences for human facial expressions of emotions is studied. To that end, attention to facial expressions of basic emotions was examined in young adults with ASD, ADHD, or SCZ in the present study. The three clinical groups were compared with an age-matched group of typically-developing participants (TD) during the free contemplation of five different facial emotions presented simultaneously, by varying identities, through the registration of eye movements. We showed, that dwell times and fixation counts differed for the different emotions in TD and in a highly similar way in ADHD. Patients with ASD differed from TD by showing a stronger differentiation between emotions and partially different attentional preferences. In contrast, the SCZ group showed an overall more restricted scanning behavior and a lack of differentiation between emotions. The ADHD group, showed an emotion-specific gazing pattern that was highly similar to that of controls. Thus, by analyzing eye movements, we were able to differentiate three different viewing patterns that allowed us to distinguish between the three clinical groups. This outcome suggests that attention for emotion may not tap into common pathophysiological processes and argues for a multi-dimensional approach to the grouping of disorders with neurodevelopmental etiology.

Autism, early psychosis, and social anxiety disorder: understanding the role of social cognition and its relationship to disability in young adults with disorders characterized by social impairments

Impairments in social cognition are believed contribute to disability, particularly for disorders characterized by difficulties in social interaction. There has been little transdiagnostic investigation of this across social cognition domains in young adults. A total of 199 young adults diagnosed with autism spectrum disorder (ASD; N = 53), early psychosis (EP; N = 51), and social anxiety disorder (SAD; N = 64) were compared against neurotypical controls (NT; N = 31) on a battery of lower and higher-order and self-report social cognition measures. For both ASD and EP, participants showed impaired performance on all lower-order emotion recognition tasks and one higher-order social cognition test. Self-reports of empathy were reduced in all clinical groups and particularly in ASD. For SAD, despite showing no objective social cognition impairment, self-reported empathy was reduced to the same level as EP. Discriminant analysis revealed that self-reported empathy and lower-order emotion recognition tests provide best capacity to differentiate groups. Regressions predicting disability revealed depression as the strongest predictor across all disability measures. Empathy provided additional predictive value for social disability and social interaction anxiety. Overall, results support a similar social-cognitive development profile across ASD and EP. While self-reported empathy differentiated between groups, discrepancy between objective social cognition test performance and self-reported empathy in the SAD group suggests probable threat-related self-monitoring report biases that likely further influence all group outcomes. As depression and empathy were the most important predictors of disability, regardless of diagnostic group, research is required to explore targeted interventions for difficulties in these domains to reduce disability.

Categorical perception of facial expressions in individuals with non-clinical social anxiety

BACKGROUND AND OBJECTIVES

According to the well-established categorical perception (CP) of facial expressions, we decode complicated expression signals into simplified categories to facilitate expression processing. Expression processing deficits have been widely described in social anxiety (SA), but it remains to be investigated whether CP of expressions are affected by SA. The present study examined whether individuals with SA had an interpretation bias when processing ambiguous expressions and whether the sensitivity of their CP was affected by their SA.

METHODS

Sixty-four participants (high SA, 30; low SA, 34) were selected from 658 undergraduates using the Interaction Anxiousness Scale (IAS). With the CP paradigm, specifically with the analysis method of the logistic function model, we derived the categorical boundaries (reflecting interpretation bias) and slopes (reflecting sensitivity of CP) of both high- and low-SA groups while recognizing angry-fearful, happy-angry, and happy-fearful expression continua.

RESULTS

Based on a comparison of the categorical boundaries and slopes between the high- and low-SA groups, the results showed that the categorical boundaries between the two groups were not different for any of the three continua, which means that the SA does not affect the interpretation bias for any of the three continua. The slopes for the high-SA group were flatter than those for the low-SA group for both the angry-fearful and happy-angry continua, indicating that the high-SA group is insensitive to the subtle changes that occur from angry to fearful faces and from happy to angry faces.

LIMITATIONS

Since participants were selected from a sample of undergraduates based on their IAS scores, the results cannot be directly generalized to individuals with clinical SA disorder.

CONCLUSIONS

The study indicates that SA does not affect interpretation biases in the processing of anger, fear, and happiness, but does modulate the sensitivity of individuals' CP when anger appears. High-SA individuals perceive angry expressions in a less categorical manner than the low-SA group, but no such difference was found in the perception of happy or fearful expressions.

Overview of Human Oxytocin Research

Social dysfunction is a core symptom of many psychiatric disorders and current medications have little or no remedial effects on this. Following on from extensive studies on animal models demonstrating that the neuropeptide oxytocin plays an important role in social recognition and bonding, human-based research has explored its therapeutic potential for social dysfunction in psychiatric disorders. Here we outline the historical background of this human-based research and some of the current methodological challenges it is facing. To date, research has primarily attempted to establish functional effects through measuring altered endogenous concentrations, observing effects of exogenous administration and by investigating the effects of polymorphisms and epigenetic modifications of the oxytocin receptor gene. We summarize some of the key findings on behavioral and neural effects that have been reported in healthy subjects in the context of social cognition which have provided encouragement that oxytocin could represent a promising therapeutic target. At the same time, we have identified a number of key areas where we urgently need further information about optimal dosing strategies and interactions with other peptide and transmitter systems. Finally, we have summarized current translational findings, particularly in the context of therapeutic outcomes of intranasal oxytocin administration in autism and schizophrenia. These clinical findings while somewhat varied in outcome do offer increasing cause for optimism that targeting the oxytocin system may provide a successful therapeutic approach for social dysfunction. However, future research needs to focus on the most effective treatment strategy and which types of individuals are likely to benefit most.

Cognitive bias salience in patients with schizophrenia in relation to social functioning: A four-case observation study

Neurocognition and social cognition are the core deficits influencing social outcomes in patients with schizophrenia. These deficits are present in the prodromal phase, throughout the illness and in first-degree relatives. They are considered in the framework of neurodevelopmental or neurodegenerative models as well as candidates for endophenotypes of schizophrenia. Four clinical cases with patients reflecting different cognitive profiles were chosen to demonstrate heterogeneity of cognitive biases and their influence on social function in vivo. The patients had undergone a number of neurocognitive and social cognitive measures. Better functioning was observed in patients with less affected domains of emotional processing and theory of mind, while neurocognitive statuses were incongruent to levels of social functioning. Further investigation on large samples concerning capacity for empathy and its role in social functioning is needed.

Visual and associated affective processing of face information in schizophrenia: A selective review

Perception of facial features is crucial in social life. In past decades, extensive research showed that the ability to perceive facial emotion expression was compromised in schizophrenia patients. Given that face perception involves visual/cognitive and affective processing, the roles of these two processing domains in the compromised face perception in schizophrenia were studied and discussed, but not clearly defined. One particular issue was whether face-specific processing is implicated in this psychiatric disorder. Recent investigations have probed into the components of face perception processes such as visual detection, identity recognition, emotion expression discrimination and working memory conveyed from faces. Recent investigations have further assessed the associations between face processing and basic visual processing and between face processing and social cognitive processing such as Theory of Mind. In this selective review, we discuss the investigative findings relevant to the issues of cognitive and affective association and face-specific processing. We highlight the implications of multiple processing domains and face-specific processes as potential mechanisms underlying compromised face perception in schizophrenia. These findings suggest a need for a domain-specific therapeutic approach to the improvement of face perception in schizophrenia.

Categorical perception of familiarity: Evidence for a hyper-familiarity in schizophrenia

Familiarity is a crucial aspect of recognition that may be perturbed in schizophrenia patients (SZP) and may lead to delusional disorders. However, there are no existing guidelines on how to assess and treat familiarity disorders in schizophrenia. Some experimental studies have investigated familiarity processing in SZP but have produced inconsistent results, which are likely a result of methodological issues. Moreover, these studies only assessed whether familiarity processing is preserved or impaired in SZP, but not the tendency of SZP to consider unfamiliar stimuli to be familiar. By using a familiarity continuum task based on the existence of the categorical perception effect, the objective of this study was to determine whether SZP present hyper- or hypo-familiarity. To this purpose, 15 SZP and 15 healthy subjects (HS) were presented with facial stimuli, which consisted of picture morphs of unfamiliar faces and faces that were personally familiar to the participants. The percentage of the familiar face contained in the morph ranged from 5 to 95%. The participants were asked to press a button when they felt familiar with the face that was presented. The main results revealed a higher percentage of familiarity responses for SZP compared with HS from the stimuli with low levels of familiarity in the morph and a lower familiarity threshold, suggesting a hyper-familiarity disorder in SZP. Moreover, the intensity of this "hyper-familiarity" was correlated with positive symptoms. This finding clearly suggests the need for a more systematic integration of an assessment of familiarity processing in schizophrenia symptoms assessments.

Categorical perception of emotional facial expressions in alcohol-dependence

BACKGROUND

Emotional deficits have been widely described in alcohol-dependence, but several subtle and critical emotional decoding abilities remain to be investigated. In particular, the ability of alcohol-dependent individuals to process emotionally ambiguous facial stimuli, which are more frequent in everyday life than full emotional facial expressions, remains poorly understood. The present study used a categorical perception paradigm to evaluate the identification of mixed emotional facial expressions among alcohol-dependent participants.

METHOD

Nineteen recently detoxified participants with alcohol-dependence and 19 healthy controls were presented with facial stimuli depicting four emotional facial expressions (happy, angry, sad, and neutral), morphed along continua between each possible pair of emotions. Participants had to indicate the predominant emotion within the randomly presented facial stimuli. For each emotional category, a logistic function that estimated the percentage of identification according to the morph steps was adjusted for each participant's data.

RESULTS

While there was no significant group difference regarding the response slope (p=0.502, ηp(2)=0.014), the identification threshold was significantly increased in alcohol-dependent participants compared to controls (p=0.007, ηp(2)=0.204), independently of the emotional category.

CONCLUSIONS

The categorical perception of emotional facial expression per se appeared preserved in alcohol-dependence, but alcohol-dependent participants exhibited a bias in emotional facial expression decoding characterized by a global under-identification. This study is the first to evidence a deficit of alcohol-dependent individuals in the processing of ambiguous emotional facial expressions by using this emotional continuum paradigm measuring the categorical perception effect.

Impairments in Negative Facial Emotion Recognition in Chinese Schizophrenia Patients Detected With a Newly Designed Task

Facial emotion recognition has been found to be impaired in schizophrenia, although overall results have been inconclusive. A new set of facial emotion stimuli with Chinese faces was developed, using static and dynamic avatars, the identification of which were subsequently validated in 562 healthy control subjects. This test was then used to identify facial emotion recognition accuracy in 44 patients with schizophrenia and 41 healthy controls. Overall, patients identified facial emotions significantly worse than healthy controls (p = 0.018) with a significant main effect for type of emotion (p = 0.016). Patients performed significantly worse in fear (p = 0.029) and sadness (p = 0.037), and marginally worse in anger (p = 0.052). No significant differences were evident in contempt (p = 0.254) or happiness (p = 0.943). Regarding error rates of misattribution, patients overidentified contempt (p = 0.035) and sadness (p = 0.01), but not anger, fear, or happiness. Conclusion, patients of Chinese ethnicity with schizophrenia may have significantly greater difficulties identifying negative, but not positive emotions.

Emotion recognition impairment in traumatic brain injury compared with schizophrenia spectrum: similar deficits with different origins

The aim of our study was to identify the common and separate mechanisms that might underpin emotion recognition impairment in patients with traumatic brain injury (TBI) and schizophrenia (Sz) compared with healthy controls (HCs). We recruited 21 Sz outpatients, 24 severe TBI outpatients, and 38 HCs, and we used eye-tracking to compare facial emotion processing performance. Both Sz and TBI patients were significantly poorer at recognizing facial emotions compared with HC. Sz patients showed a different way of exploring the Pictures of Facial Affects stimuli and were significantly worse in recognition of neutral expressions. Selective or sustained attention deficits in TBI may reduce efficient emotion recognition, whereas in Sz, there is a more strategic deficit underlying the observed problem. There would seem to be scope for adjustment of effective rehabilitative training focused on emotion recognition.

Sensitivity in detecting facial displays of emotion: Impact of maternal depression and oxytocin receptor genotype

The current study examined sensitivity in detecting emotional faces among children of depressed and non-depressed mothers. A second goal was to examine the potential moderating role of the oxytocin receptor gene (OXTR rs53576), which has been linked to emotion recognition in the past. Participants included 247 children (ages 8-14). Children completed a forced choice emotion identification task. Maternal history of major depressive disorder during children's lives was associated with children's sensitivity in detecting emotional faces among children homozygous for the OXTR rs53576 G allele, but not among carriers of the A allele. Among G homozygotes, children of depressed mothers exhibited increased sensitivity in detecting sad faces, and reduced sensitivity in detecting happiness, compared to children of non-depressed mothers.

Working memory dysfunctions predict social problem solving skills in schizophrenia

The current study aimed to examine the contribution of neurocognition and social cognition to components of social problem solving. Sixty-seven inpatients with schizophrenia and 31 healthy controls were administrated batteries of neurocognitive tests, emotion perception tests, and the Chinese Assessment of Interpersonal Problem Solving Skills (CAIPSS). MANOVAs were conducted to investigate the domains in which patients with schizophrenia showed impairments. Correlations were used to determine which impaired domains were associated with social problem solving, and multiple regression analyses were conducted to compare the relative contribution of neurocognitive and social cognitive functioning to components of social problem solving. Compared with healthy controls, patients with schizophrenia performed significantly worse in sustained attention, working memory, negative emotion, intention identification and all components of the CAIPSS. Specifically, sustained attention, working memory and negative emotion identification were found to correlate with social problem solving and 1-back accuracy significantly predicted the poor performance in social problem solving. Among the dysfunctions in schizophrenia, working memory contributed most to deficits in social problem solving in patients with schizophrenia. This finding provides support for targeting working memory in the development of future social problem solving rehabilitation interventions.

Social cognitive performance as a marker of positive psychotic symptoms in young people seeking help for mental health problems

Previous research has suggested that psychotic symptoms are associated with impairments in social cognition. However, there is limited research evaluating this association in the context of younger patients with a broad range of mental health problems. In the present study, we evaluated social cognitive performance in 115 treatment-seeking participants who presented to a youth mental health service with affective or psychotic disturbances. Participants completed symptom severity measures, a social cognition task (the Reading the Mind in the Eyes Test (RMET)), and a standardised battery of neuropsychological tests. Analyses based on diagnostic groups showed that patients with psychotic illnesses (n=23) showed impaired performance on the RMET compared to patients with primarily bipolar (n=40) and depressive illnesses (n=52). Performance on the RMET was negatively correlated with positive and negative psychotic symptoms, but not affective and anxiety symptoms. Performance on the RMET also was the strongest concurrent predictor of positive psychotic symptoms in a regression model that also included predicted intelligence, demographic variables, and neurocognition. RMET performance did not, however, predict negative symptoms above tests of sustained attention and verbal learning, nor was performance associated with any other symptoms of mental illness. Social cognitive impairments may provide a valuable marker for the presence of positive psychotic symptoms in young people with mental illness. Additionally, these impairments may have a role in the aetiology and maintenance of psychotic symptoms. Research is now needed to establish the nature of the relationship between social cognition and psychotic symptoms across different facets of social cognition. Research is also needed to investigate whether targeted social cognition treatments reduce risk for the development of positive psychotic symptoms.

Social cognition deficits and psychopathic traits in young people seeking mental health treatment

Antisocial behaviours and psychopathic traits place an individual at risk for criminality, mental illness, substance dependence, and psychosocial dysfunction. Social cognition deficits appear to be associated with psychopathic traits and are believed to contribute to interpersonal dysfunction. Most research investigating the relationship of these traits with social cognition has been conducted either in children or adult forensic settings. We investigated whether psychopathic traits were associated with social cognition in 91 young people presenting for mental healthcare (aged between 15 and 25 years). Participants completed symptom severity measures, neuropsychological tests, the Reading the Mind in the Eyes Test of social cognition (RMET), and the Antisocial Process Screening Device (APSD) to assess psychopathic personality traits. Correlation analyses showed poorer social cognition was associated with greater psychopathic traits (r = −.36, p = .01). Interestingly, social cognition performance predicted unique variance in concurrent psychopathic personality traits above gender, IQ sustained attention, and working memory performance. These findings suggest that social cognitive impairments are associated with psychopathic tendencies in young people presenting for community mental healthcare. Research is needed to establish the directionality of this relationship and to determine whether social cognition training is an effective treatment amongst young people with psychopathic tendencies.

Happy facial expression processing with different social interaction cues: an fMRI study of individuals with schizotypal personality traits

In daily life facial expressions change rapidly and the direction of change provides important clues about social interaction. The aim of conducting this study was to elucidate the dynamic happy facial expression processing with different social interaction cues in individuals with (n=14) and without (n=14) schizotypal personality disorder (SPD) traits. Using functional magnetic resonance imaging (fMRI), dynamic happy facial expression processing was examined by presenting video clips depicting happiness appearing and disappearing under happiness inducing ('praise') or reducing ('blame') interaction cues. The happiness appearing condition consistently elicited more brain activations than the happiness disappearing condition in the posterior cingulate bilaterally in all participants. Further analyses showed that the SPD group was less deactivated than the non-SPD group in the right anterior cingulate cortex in the happiness appearing-disappearing contrast. The SPD group deactivated more than the non-SPD group in the left posterior cingulate and right superior temporal gyrus in the praise-blame contrast. Moreover, the incongruence of cues and facial expression activated the frontal-thalamus-caudate-parietal network, which is involved in emotion recognition and conflict resolution. These results shed light on the neural basis of social interaction deficits in individuals with schizotypal personality traits.

Facial emotion perception abnormality in patients with early schizophrenia

BACKGROUND

Deficit in facial emotion perception is an important social cognitive impairment in schizophrenic patients, and it is one of the key determinants of functional outcome in schizophrenia. However, the moderating effect of social context and the boundary of perceptual categories of facial emotion perception remain unclear.

METHOD

A total of 36 schizophrenic outpatients in their early stage of illness and 43 healthy controls were recruited for evaluation of social and clinical characteristics, neurocognitive profiles, and facial emotion categorization (FEC) performance. FEC was assessed by a computer-based program with 120 trials, in which social context was presented in the form of a preceding question, in order to simulate the conditions of being praised (positive), blamed (negative), or inquiry (neutral), while the participants were asked to judge a photograph derived from one of the five facial images in a happy-angry emotion continuum. The FEC data was inserted into a logistic function model with subsequent analysis by repeated measures ANOVA and the shift point and slope as outcome measures.

RESULTS

Schizophrenic patients were significantly more likely to perceive ambiguous and subtle facial expressions as happy, rather than angry, in all three social contexts. However, the interaction effects between group and context for FEC performance was not significant.

CONCLUSIONS

Schizophrenic patients, even in their early stage of illness, appear to have abnormal perceptions of facial emotion categories, which may explain some of their abnormal social interactions and disabilities. This study provides additional information in understanding social cognitive deficits among schizophrenic patients.

Emotional context processing in severe mental illness: scale development and preliminary construct validity

There is growing recognition that emotional context may play an important role in emotion perception and severe mental illness (SMI). Limited instruments directly assess and adequately account for emotional context processing. To measure this construct in schizophrenia research, this study aimed to develop and validate the Emotional Context Processing Scale (ECOS) using cartoon portrayals originally developed by Masuda et al. (2008). In Study 1, we piloted the measure with 99 college students and selected 20 cartoon portrayals (4 simple emotions only+16 simple emotions with contextual emotions). In Study 2, we confirmed the emotion-specificity and factor structure of the measure by administering it to 73 individuals with SMI. Item response theory (IRT) modeling confirmed a 4-factor structure of the ECOS, providing evidence that emotional context processing is specific to particular emotions. Internal consistency of the ECOS subscales ranged from 0.61 to 0.83. In Study 3, we examined the convergent and divergent validity of the ECOS in a separate sample of 36 individuals with SMI. Even after controlling for facial affect perception, the ECOS is uniquely related to multi-modal emotion perception and executive functioning measures.

Facial perception bias in patients with major depression

This study used a morphed categorical perception facial expression task to evaluate whether patients with depression demonstrated deficits in distinguishing boundaries between emotions. Forty-one patients with depression and 41 healthy controls took part in this study. They were administered a standardized set of morphed photographs of facial expressions with varying emotional intensities between 0% and 100% of the emotion, in 10% increments to provide a range of intensities from pleasant to unpleasant(e.g. happy to sad, happy to angry) and approach-avoidance (e.g. angry to fearful). Compared with healthy controls, the patients with depression demonstrated a rapid perception of sad expressions in happy-sad emotional continuum and demonstrated a rapid perception of angry expressions in angry-fearful emotional continuum. In addition, when facial expressions shifted from happy to angry, the depressed patients had a clear demarcation for the happy-angry continuum. Depressed patients had a perceptual bias towards unpleasant versus pleasant expressions and the hypersensitivity to angry facial signals might influence the interaction behaviors between depressed patients and others.

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.

Subjective disturbance of perception is related to facial affect recognition in schizophrenia

To examine the relationship between facial affect recognition (FAR) and subjective perceptual disturbances (SPDs), we assessed SPDs in 82 patients with DSM-IV schizophrenia (44 with first-episode psychosis [FEP] and 38 with multiple episodes [ME]) using two subscales of the Frankfurt Complaint Questionnaire (FCQ), WAS (simple perception) and WAK (complex perception). Emotional judgment ability was assessed using Ekman and Friesen's FAR task. Impaired recognition of emotion correlated with scores on the WAS but not on the WAK. The association was significant in the entire group and in the ME group. FAR was more impaired in the ME than in the FEP group. Our findings suggest that there is a relationship between SPDs and FAR impairment in schizophrenia, particularly in multiple-episode patients.

How do schizophrenia patients use visual information to decode facial emotion?

Impairment in recognizing facial emotions is a prominent feature of schizophrenia patients, but the underlying mechanism of this impairment remains unclear. This study investigated the specific aspects of visual information that are critical for schizophrenia patients to recognize emotional expression. Using the Bubbles technique, we probed the use of visual information during a facial emotion discrimination task (fear vs. happy) in 21 schizophrenia patients and 17 healthy controls. Visual information was sampled through randomly located Gaussian apertures (or "bubbles") at 5 spatial frequency scales. Online calibration of the amount of face exposed through bubbles was used to ensure 75% overall accuracy for each subject. Least-square multiple linear regression analyses between sampled information and accuracy were performed to identify critical visual information that was used to identify emotional expression. To accurately identify emotional expression, schizophrenia patients required more exposure of facial areas (i.e., more bubbles) compared with healthy controls. To identify fearful faces, schizophrenia patients relied less on bilateral eye regions at high-spatial frequency compared with healthy controls. For identification of happy faces, schizophrenia patients relied on the mouth and eye regions; healthy controls did not utilize eyes and used the mouth much less than patients did. Schizophrenia patients needed more facial information to recognize emotional expression of faces. In addition, patients differed from controls in their use of high-spatial frequency information from eye regions to identify fearful faces. This study provides direct evidence that schizophrenia patients employ an atypical strategy of using visual information to recognize emotional faces.

Categorization and timbre perception of environmental sounds in schizophrenia

Perception of environmental sounds from impacted materials (Wood, Metal and Glass) was examined by conducting a categorization experiment. Stimuli consisted of sound continua evoking progressive transitions between material categories. Results highlighted shallower response curves in subjects with schizophrenia than healthy participants, and are discussed in the framework of Signal Detection Theory and in terms of impaired perception of specific timbre features in schizophrenia.

Emotion processing in schizophrenia: fMRI study of patients treated with risperidone long-acting injections or conventional depot medication

We employed two event-related functional magnetic resonance imaging tasks using the pictures of mild and intense facial emotions of fear or happiness. The sample comprised 16 chronic schizophrenia patients treated with risperidone long-acting injections (RLAI), 16 patients treated with conventional antipsychotic depots (CONV) and 16 healthy controls (HC). The HC and RLAI groups demonstrated greater activation in the left amygdala in response to intensively fearful faces, and in right cerebellum to intensively happy faces compared with CONV patients. The CONV group demonstrated under-activation in the right temporal pole in response to intensively happy faces (compared with HC) and over-activation in ventro-medial prefrontal cortex (VMPFC) in response to both intensively happy and fearful expressions, compared with HC and RLAI groups. Our results suggest that networks implicated in the allocation of attentional resources (VMPFC) and emotion processing (amygdala, cerebellum) are differentially affected in patients on CONV versus RLAI.

Do patients with schizophrenia have a general or specific deficit in the perception of social threat? A meta-analytic study

This study investigates whether social cognitive deficits found in patients with schizophrenia are specific to social threat stimuli, and whether the deficits increase across the delusion spectrum from a subclinical sample to clinical manifestation. The authors presented the meta-analytic review of the published literature on social threat perception performance in three kinds of group comparisons: a subclinical group and a healthy control group, a schizophrenia group and a healthy control group, and a schizophrenia with delusion symptoms group and a healthy control group. The meta-analysis of 20 studies yielded six weighted effect sizes. The largest differences were found between the schizophrenia with delusion group and the healthy controls in both the threat and non-threat conditions. No differences were found between the effect sizes in the threat-related condition and the non-threat condition in any of the three group comparisons. Age was found to be significantly correlated with the effect sizes. The performance differences in both the threat and non-threat conditions reflect a generalized performance deficit, rather than a specific deficit, in the perception of social threat stimuli among patients with schizophrenia.

Perceptual bias of patients with schizophrenia in morphed facial expression

Limited research has specifically examined the nature of the dysfunction in emotion categorization representation in schizophrenia. The current study aimed to investigate the perception bias of morphed facial expression in subjects with schizophrenia and healthy controls in the emotion continua. Twenty-eight patients with schizophrenia and thirty-one healthy controls took part in this study. They were administered a standardized set of morphed photographs of facial expressions with varying emotional intensities between 0% and 100% of the emotion, in 10% increments to provide a range of intensities from pleasant to unpleasant and approach to withdraw. Shift points, indicating the time point that the subjects' emotion identification begins to change, and response slopes, indicating how rapidly these changes have happened at the shift points in the emotion continuum, were measured. Patients exhibited a significantly greater response slope (i.e., patients' perception changed more rapidly) and greater shift point (i.e., patients still perceived mild expressions of anger as happy faces) with increasing emotion signal compared with healthy controls when the facial expression morphed from happy to angry. Furthermore, patients with schizophrenia still perceived mild expressions of fear as angry faces(a greater shift point) and were less discriminative from angry to fearful emotion(a flatter response slope). They were sensitive to sadness (a smaller shift point) and the perception changed rapidly (a sharper response slope) as compared with healthy controls in the emotion continuum of happy to sad. In conclusion, patients with schizophrenia demonstrated impaired categorical perception of facial expressions, with generally 'rapid' but 'late' discrimination towards social threat-related stimuli such as angry facial expression. Compared with healthy controls, these patients have a sharper discrimination perception pattern in the emotion continua from positive valence to negative valence.

Attributional style of Egyptians with schizophrenia

The attributional style is one domain of social cognition that involves perceiving, interpreting, and generating responses to others' intentions and behaviours in different situations. This study describes the attributional style of Egyptians with schizophrenia. The study took place in a psychiatric hospital in Egypt. Eight psychiatric wards were randomly selected, and all participants (150) with a diagnosis of schizophrenia participated. Data were collected using the Ambiguous Intention Hostility Questionnaire (AIHQ), the attributional style interview schedule, and the sociodemographic/clinical data sheet. Participants' scores on the AIHQ varied significantly between different situations (intentional, accidental, and ambiguous). The attributional style of the studied participants regarding their perceived psychosocial problems tended to be related to specific causes. These causes were mostly externally attributed to other people and to circumstances, and were perceived not to persist in the future. It would seem that Egyptians with schizophrenia tend to blame other people for negative events if these events are perceived to cause intentional harm.

Facial emotion perception in schizophrenia: a meta-analytic review

OBJECTIVES

A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005).

RESULTS

The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race.

CONCLUSION

Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

Vocational, social, and cognitive rehabilitation for individuals diagnosed with schizophrenia: a review of recent research and trends

A growing body of evidence suggests that social and vocational interventions effectively enhance social and vocational functioning for individuals with schizophrenia. In this review, we first consider recent advances in vocational and social rehabilitation, then examine current findings on neurocognition, social cognition, and motivation with regard to the impact these elements have on rehabilitation interventions and outcomes. A critical evaluation of recent studies examining standalone treatment approaches and hybrid approaches that integrate components such as cognitive remediation and skills training reveals several ongoing challenges within the field. Greater understanding of the differential impact of various approaches, methods that may increase the magnitude of treatment effects, and the generalization of treatment effects to community functioning are among crucial areas for future research. Overall, these treatments hold promise in improving psychosocial functioning and helping individuals with schizophrenia acquire important life skills.

Perception bias of disgust in ambiguous facial expressions in obsessive-compulsive disorder

Impaired recognition of facial expressions of disgust has been suggested for patients with obsessive-compulsive disorder (OCD). This study aimed to compare the perception of negative emotions by OCD patients and controls using both non-ambiguous and ambiguous facial expressions. Forty-one OCD patients and thirty-seven controls performed the computerised emotion perception task. There were no differences between OCD patients and controls in the frequency of correct identification of non-ambiguous facial expressions. However, OCD patients were more likely to perceive disgust and less likely to perceive anger in response to ambiguous facial expressions when controlling for covariates. In OCD patients, a higher cleaning dimension was associated with a lower perception of anger and a higher perception of disgust when presented with ambiguous facial expressions. The domains of core disgust and contamination-based disgust domains of disgust sensitivity were positively correlated with the perception of ambiguous facial expressions as disgust, as well as cleaning symptom dimension scores. Our findings suggest that OCD patients, particularly those with higher washing/contamination symptoms, are more likely to perceive disgust in ambiguous facial expressions.

Memory-prediction errors and their consequences in schizophrenia

Cognitive deficits play a central role in the onset of schizophrenia. Cognitive impairment precedes the onset of psychosis in at least a subgroup of patients, and accounts for considerable dysfunction. Yet cognitive deficits as currently measured are not significantly related to hallucinations and delusions. Part of this counterintuitive absence of a relationship may be caused by the lack of an organizing principle of cognitive impairment in schizophrenia research. We review literature suggesting that a system of memory-based prediction is central to human perception, thought and action , and forward the notion that many of the symptoms of schizophrenia are a result of a failure of this system.

The influence of emotion clarity on emotional prosody identification in paranoid schizophrenia

BACKGROUND

Identification of emotional facial expression and emotional prosody (i.e. speech melody) is often impaired in schizophrenia. For facial emotion identification, a recent study suggested that the relative deficit in schizophrenia is enhanced when the presented emotion is easier to recognize. It is unclear whether this effect is specific to face processing or part of a more general emotion recognition deficit.

METHOD

We used clarity-graded emotional prosodic stimuli without semantic content, and tested 25 in-patients with paranoid schizophrenia, 25 healthy control participants and 25 depressive in-patients on emotional prosody identification. Facial expression identification was used as a control task.

RESULTS

Patients with paranoid schizophrenia performed worse than both control groups in identifying emotional prosody, with no specific deficit in any individual emotion category. This deficit was present in high-clarity but not in low-clarity stimuli. Performance in facial control tasks was also impaired, with identification of emotional facial expression being a better predictor of emotional prosody identification than illness-related factors. Of those, negative symptoms emerged as the best predictor for emotional prosody identification.

CONCLUSIONS

This study suggests a general deficit in identifying high-clarity emotional cues. This finding is in line with the hypothesis that schizophrenia is characterized by high noise in internal representations and by increased fluctuations in cerebral networks.

Emotion categorization perception in schizophrenia in conversations with different social contexts

OBJECTIVE

The aim of the present study was to investigate whether the boundaries between the happy and angry emotions of schizophrenia would be influenced by social context and the difference in emotion categorization boundaries between schizophrenia patients and healthy controls.

METHOD

Eighteen patients with schizophrenia and 16 healthy controls were given a forced-choice emotion identification task in which they were required to listen to a series of conversations with different social contexts. The stimuli were linear morphed facial expressions between 'happy' and 'angry' emotions. For each type of social context, the shift point was used as the parameter to estimate when the subjects began to perceive the morphed facial expression as angry. The response slope was used to estimate how abruptly this change in perception occurred.

RESULTS

There was no significant difference in the schizophrenia group in the shift point of emotion categorization perception for four categories of conversations occurring in different social contexts. Compared with the healthy controls, the schizophrenia group demonstrated a steeper response slope at the shift point regardless of the conversation type.

CONCLUSION

The patients with schizophrenia were less discriminative in their categorization of emotion perception in conversations with different social contexts. The schizophrenia patients, however, were more alert to angry facial expressions in the process of facial expressions morphing from happy to angry, independent of the social context.

Facial emotion perception in schizophrenia: a meta-analytic review

OBJECTIVES

A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005).

RESULTS

The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race.

CONCLUSION

Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

CNTRICS final task selection: social cognitive and affective neuroscience-based measures

This article describes the results and recommendations of the third Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia meeting related to measuring treatment effects on social and affective processing. At the first meeting, it was recommended that measurement development focuses on the construct of emotion identification and responding. Five Tasks were nominated as candidate measures for this construct via the premeeting web-based survey. Two of the 5 tasks were recommended for immediate translation, the Penn Emotion Recognition Task and the Facial Affect Recognition and the Effects of Situational Context, which provides a measure of emotion identification and responding as well as a related, higher level construct, context-based modulation of emotional responding. This article summarizes the criteria-based, consensus building analysis of each nominated task that led to these 2 paradigms being recommended as priority tasks for development as measures of treatment effects on negative symptoms in schizophrenia.

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.

Criterion B (social dysfunction) in persons with schizophrenia: the puzzle

PURPOSE OF REVIEW

This review focuses on social dysfunction in persons with schizophrenia and addresses three main questions. What is the core ability that is disordered in social dysfunction according to mainstream paradigms? How is social dysfunction primarily assessed in current research? Which levels of personal experience, and which trans-personal and sub-personal factors, are assessed by mainstream empirical research?

RECENT FINDINGS

Empirical studies on social dysfunction include research on trans-personal factors (stigma, availability of social and psychiatric facilities, and family resources), sub-personal factors (neurocognition) and personal factors (social cognition, coping and noncognitive factors). The main recent findings of these approaches are described and commented upon. Inconsistencies between studies are identified.

SUMMARY

What is it like to be a person with schizophrenia in the social world? Building upon empirical research, we can finally address this question. We argue that more qualitative research is needed into the reasons that persons with schizophrenia have for adopting or embracing their given type of relatedness to the others.