Emotional processing in schizophrenia across cultures: standardized measures of discrimination and experience

Meta-analysis of Face Perception in Schizophrenia Spectrum Disorders: Evidence for Differential Impairment in Emotion Face Perception

BACKGROUND AND HYPOTHESIS

Schizophrenia spectrum disorders (SSD) are associated with face perception impairments. It is unclear whether impairments are equal across aspects of face perception or larger-indicating a differential impairment-for perceiving emotions relative to other characteristics (eg, identity, age). While many studies have attempted to compare emotion and non-emotion face perception in SSD, they have varied in design and produced conflicting findings. Additionally, prior meta-analyses on this topic were not designed to disentangle differential emotion impairments from broader impairments in face perception or cognition. We hypothesize that SSD-related impairments are larger for emotion than non-emotion face perception, but study characteristics moderate this differential impairment.

STUDY DESIGN

We meta-analyzed 313 effect sizes from 104 articles to investigate if SSD-related impairments are significantly greater for emotion than non-emotion face perception. We tested whether key study characteristics moderated these impairments, including SSD severity, sample intelligence matching, task difficulty, and task memory dependency.

STUDY RESULTS

We found significantly greater impairments for emotion (Cohen's d = 0.74) than non-emotion face perception (d = 0.55) in SSD relative to control samples, regardless of SSD severity, intelligence matching, or task difficulty. Importantly, this effect was obscured when non-emotion tasks used a memory-dependent design.

CONCLUSIONS

This is the first meta-analysis to demonstrate a differential emotion impairment in SSD that cannot be explained by broader impairments in face perception or cognition. The findings also underscore the critical role of task matching in studies of face perception impairments; to prevent confounding influences from memory-dependent task designs.

Efficacy of a Culturally Adapted Emotion Recognition Training Program in Improving Facial Emotion Recognition in Persons with Schizophrenia

Background

Facial emotion recognition (FER) deficits are being considered as core features of social cognitive deficits in schizophrenia, associated with socio-occupational dysfunction. Social cognition intervention programs have been shown to improve these deficits; however, there are no such intervention strategies in India. In this study, we aim to examine the efficacy of Training of Affect Recognition - Indian Version (TAR-IV) to enhance the FER abilities of people with schizophrenia.

Methods

In an open-label experimental design, 36 participants with schizophrenia underwent 12 sessions of TAR-IV as an add-on to treatment as usual (TAU), while 29 participants with schizophrenia continued TAU (pharmacological treatment with or without occupational therapy and vocational rehabilitation services). Clinical and functional assessments were done using the positive and negative syndrome scale (PANSS) and socio-occupational functioning scale. Emotion recognition abilities were assessed on the tool for recognition of emotions in neuropsychiatric disorders at baseline, post-intervention, and follow-up (two to three months post-intervention).

Results

The intervention group showed significant improvements in FER (P = .001) and socio-occupational functioning (P = .008) after receiving the TAR-IV, which remained significant at two months follow-up. A lower age of onset and poorer neurocognitive function at baseline predicted greater changes in emotion recognition ability following the intervention.

Conclusions

This study demonstrated the efficacy of TAR-IV, the Indian adaptation of social cognition intervention, in improving emotion recognition abilities and socio-occupational functioning in patients with schizophrenia. These findings need to be replicated in randomized controlled trials.

Emotional Contagion and Emotional Mimicry in Individuals with Schizophrenia: A Systematic Review

Background: Individuals with schizophrenia often exhibit social interaction deficits, which can affect their ability to engage effectively with others. Emotional processes, such as emotional contagion (the transfer of emotion between individuals) and emotional mimicry (the imitation of emotional expressions), are crucial for enhancing the quality of social interactions. Methods: We conducted a PubMed, Web of Science, and PsycInfo database search. The inclusion and exclusion criteria were established based on the definitions of emotional contagion and emotional mimicry, rather than relying on specific terminology from various research fields. Forty-two studies were included in the review, including six emotional mimicry studies and thirty-six emotional contagion studies. Results: The current findings suggest decreased or inappropriate emotional mimicry in individuals with schizophrenia. Relating to emotional contagion, the results showed altered brain and psychophysiological activity in individuals with schizophrenia, whereas the self-reported measures indicated no difference between the groups. The relationships between emotional contagion, emotional mimicry, and psychotic symptom severity showed variability across the studies, whereas no associations between antipsychotic dosage and either emotional mimicry or emotional contagion were found. Discussion: This review highlights the need to further evaluate and train emotional contagion and emotional mimicry in individuals with schizophrenia because these processess influence social interaction quality. Clinical implications and guidelines for future studies are discussed.

Facial expression-based indicators of schizophrenia: Evidence from recent research

Impaired ability to recognize emotion in other's face (decoding) or to express emotion through the face (encoding) are considered critical in schizophrenia. The topic of research draws considerable attention since clinicians rely heavily on the patient's facial expressions for diagnosis and on the patient's ability to understand the clinician's communicative intent. While most researchers argue in favor of a generalized emotion deficit, others indicate an emotion-specific deficit in schizophrenia. An early review (Mandal et al., 1998) indicated a possible breakdown in perception-expression-experience link of emotion; later reviews (Kohler et al., 2010; Chan et al., 2010) pointed to a generalized emotion processing deficit due to perceptual deficits in schizophrenia. The present review (2010-2022) revisits this controversy with 47 published studies (37 decoding, 10 encoding) conducted on 2364 patients in 20 countries. Schizophrenia is characterized by reduced emotion processing ability, especially with negative symptoms and at an acute state of illness. It is however still unclear whether this dysfunction is independent of a generalized face perception deficit or of subjective experience of emotion in schizophrenia.

Cognitive Failures and the Role of Emotion in Dimensional Schizotypy: A Replication and Extension

INTRODUCTION

Cognitive failures are commonplace within the general population but may be particularly heightened in those with higher levels of schizotypy. This is especially salient in the context of enduring trait and momentary state negative emotion which often contributes to increases in daily impairments, leading to a more debilitating and distracted life. Particularly, individuals with elevated levels of schizotypy may be more likely to experience cognitive failures, especially in the presence of negative trait emotion such as depression, anxiety, and stress. However, little is known about the influence of state emotion and the distinct roles that state and trait emotion may have with cognitive failures and schizotypy.

METHODS

To replicate and extend previous findings, 306 (58% males) undergraduate students aged 18-50 years (M = 19.343; SD = 2.493) completed self-report measures of cognitive failures, trait and state emotion, and schizotypy. Mediation and moderation analyses were performed in SPSS to examine the potential effects of trait and state emotion on the relationship between schizotypy and cognitive failures.

RESULTS

Consistent with previous findings, mood symptomology, in addition to negative affect, mediated cognitive failures in those with higher levels of schizotypy. However, in our sample, positive affect did not appear to buffer against cognitive failures.

CONCLUSION

The findings of the present study suggest there may be a nuanced relationship between both negative trait and state emotions on the relationships between cognitive failures and schizotypy. Understanding the interaction of enduring versus momentary emotion on cognition as they relate to an elevated risk for developing schizophrenia-spectrum phenomena may be a point for earlier and more targeted interventions.

Community Psychosis Risk Screening: An Instrument Development Investigation

Schizophrenia and other psychotic disorders are serious psychiatric disorders that are associated with substantial societal, family, and individual costs/distress. Evidence suggests that early intervention can improve prognostic outcomes; therefore, it is essential to accurately identify those at risk for psychosis before full psychotic symptoms emerge. The purpose of our study is to develop a brief, valid screening questionnaire to identify individuals at risk for psychosis in non-clinical populations across 3 large, community catchment areas with diverse populations. This is a needed study, as the current screening tools for at-risk psychotic populations in the US have been validated only in clinical and/or treatment seeking samples, which are not likely to generalize beyond these specialized settings. The specific aims are as follows: (1) to determine norms and prevalence rates of attenuated positive psychotic symptoms across 3 diverse, community catchment areas and (2) to develop a screening questionnaire, inclusive of both symptom-based and risk factor-based questions. Our study will develop an essential screening tool that will identify which individuals have the greatest need of follow-up with structured interviews in both research and clinical settings. Our study has the potential for major contributions to the early detection and prevention of psychotic disorders.

Gender differences in facial emotion recognition in persons with chronic schizophrenia

Background

The aim of the present study was to investigate possible sex differences in the recognition of facial expressions of emotion and to investigate the pattern of classification errors in schizophrenic males and females. Such an approach provides an opportunity to inspect the degree to which males and females differ in perceiving and interpreting the different emotions displayed to them and to analyze which emotions are most susceptible to recognition errors.

Methods

Fifty six chronically hospitalized schizophrenic patients (38 men and 18 women) completed the Penn Emotion Recognition Test (ER40), a computerized emotion discrimination test presenting 40 color photographs of evoked happy, sad, anger, fear expressions and neutral expressions balanced for poser gender and ethnicity.

Results

We found a significant sex difference in the patterns of error rates in the Penn Emotion Recognition Test. Neutral faces were more commonly mistaken as angry in schizophrenic men, whereas schizophrenic women misinterpreted neutral faces more frequently as sad. Moreover, female faces were better recognized overall, but fear was better recognized in same gender photographs, whereas anger was better recognized in different gender photographs.

Conclusions

The findings of the present study lend support to the notion that sex differences in aggressive behavior could be related to a cognitive style characterized by hostile attributions to neutral faces in schizophrenic men.

Do patients from the Democratic Republic of Congo with schizophrenia have facial emotion recognition deficits?

Patients with schizophrenia can have difficulty recognizing emotion, and the impact of this difficulty on social functioning has been widely reported. However, earlier studies did not thoroughly explore how this deficit may vary according to emotion intensity, or how it may differ among individuals and across cultures. In the present study, our aim was to identify possible deficits in facial emotion recognition across a wide range of emotions of different intensities among patients with schizophrenia from the Democratic Republic of Congo (DRC). Thirty stable patients with schizophrenia and 30 healthy controls matched for age and level of education were evaluated using a validated and integrative facial emotion recognition test (TREF). A total recognition score and an intensity threshold were obtained for each emotion. Patients with schizophrenia had emotion recognition deficits, particularly for negative emotions. These deficits were correlated to the severity of negative symptoms. Patients showed no threshold deficit at the group level, but analysis of individual profiles showed marked heterogeneity across patients for the intensity of the emotion decoding deficit. Our study confirms the existence of deficits in emotion recognition for negative emotions in patients with schizophrenia, generalizes it to DRC patients, and underlines considerable heterogeneity among patients.

Reward-related decision-making in schizophrenia: A multimodal neuroimaging study

Schizophrenia is a severe psychiatric disorder characterized by important cognitive deficits, which ultimately compromise the patients' ability to make optimal decisions. Unfortunately, the neurobiological bases of impaired reward-related decision-making in schizophrenia have rarely been studied. The objective of this study is to examine the neural mechanisms involved in reward-related decision-making in schizophrenia, using functional magnetic resonance imaging (fMRI). Forty-seven schizophrenia patients (DSM-IV criteria) and 23 healthy subjects with no psychiatric disorders were scanned using fMRI while performing the Balloon Analogue Risk Task (BART). A rapid event-related fMRI paradigm was used, separating decision and outcome events. Between-group differences in grey matter volumes were assessed with voxel-based morphometry. During the reward outcomes, increased activations were observed in schizophrenia in the left anterior insula, the putamen, and frontal sub-regions. Reduced grey matter volumes were observed in the left anterior insula in schizophrenia which spatially overlapped with functional alterations. Finally, schizophrenia patients made fewer gains on the BART. The fact that schizophrenia patients had increased activations in sub-cortical regions such as the striatum and insula in response to reward events suggests that the impaired decision-making abilities of these patients are mostly driven by an overvaluation of outcome stimuli.

PTSD and the influence of context: The self as a social mirror

The principal accepted models of posttraumatic stress disorder (PTSD) are based on both memory processing and biological/brain changes occurring when one's life or well-being is threatened. It is our thesis that these models would be greatly informed by community studies indicating that PTSD is predicted to a greater extent by earlier life experience and experiences that occur distant from the threatening event. These findings suggest posttraumatic responding is best conceptualized through the lens of the self-in-context, as opposed to imprinting that results from a given event at a given time. Moreover, studies of non-Western populations often do not express trauma as PTSD, or at least not primarily as PTSD, which argues against specific neural or memory encoding processes, but rather for a more plastic neural process that is shaped by experience and how the self develops in its cultural context, as a product of a broad array of experiences. We posit that fear and emotional conditioning as well as the ways traumas are encoded in memory are only partial explanatory mechanisms for trauma responding, and that issues of safety and harm, which are long term and developmental, are the common and principal underpinnings of the occurrence of posttraumatic distress, including PTSD.

Even subtle cultural differences affect face tuning

Culture shapes social cognition in many ways. Yet cultural impact on face tuning remains largely unclear. Here typically developing females and males from the French-speaking part of Switzerland were presented with a set of Arcimboldo-like Face-n-Food images composed of food ingredients and in different degree resembling a face. The outcome had been compared with previous findings obtained in young adults of the South-West Germany. In that study, males exhibit higher thresholds for face tuning on the Face-n-Food task than females. In Swiss participants, no gender differences exist in face tuning. Strikingly, males from the French-speaking part of Switzerland possess higher sensitivity to faces than their German peers, whereas no difference in face tuning occurs between females. The outcome indicates that even relatively subtle cultural differences as well as culture by gender interaction can modulate social cognition. Clarification of the nature of cultural impact on face tuning as well as social cognition at large is of substantial value for understanding a wide range of neuropsychiatric and neurodevelopmental conditions.

Respiratory Variability during Different Auditory Stimulation Periods in Schizophrenia Patients

Background: Schizophrenic patients are known to have difficulty processing emotions and to exhibit impairment in stimuli discrimination. However, there is limited knowledge regarding their physiological responsivity to auditory stimuli.

Objectives: The purpose of this study was to compare the respiratory effects of two types of auditory stimuli with emotional content, classical Turkish music (CTM) and white noise (WN), on schizophrenia patients and healthy control subjects.

Methods: Forty-six individuals participated in the experiment, and respiratory signals derived from a strain-gauge were recorded. Two important respiratory patterns, respiration rate and depth, were analyzed.

Results: The results indicated that the patients presented a significantly higher respiration rate than control subjects during the initial baseline and WN exposure periods. Although CTM evoked an increase in respiration rates and a decrease in respiration depths in the control group, no significant differences were found during the stimulation periods in the patient group. The respiration rate was lower in the post-stimulation period than during the initial baseline period, and no respiration depth differences were found for the WN, music or post-stimulation periods in the schizophrenia group. Patients exhibited a greater respiration depth than the control subjects over all periods; however, a significant difference between the patient and control groups was obtained in the second resting condition and CTM exposure period. Furthermore, to analyze the effect of symptom severity on respiratory patterns, patients were divided into two classes according to their Positive and Negative Syndrome Scale score.

Conclusions: Further studies are needed to correlate respiratory differences with emotionally evocative stimuli and to refine our understanding of the dynamics of these types of stimuli in relation to clinical state and medication effects.

Social cognition intervention in schizophrenia: Description of the training of affect recognition program - Indian version

Social cognition refers to mental operations involved in processing of social cues and includes the domains of emotion processing, Theory of Mind (ToM), social perception, social knowledge and attributional bias. Significant deficits in ToM, emotion perception and social perception have been demonstrated in schizophrenia which can have an impact on socio-occupational functioning. Intervention modules for social cognition have demonstrated moderate effect sizes for improving emotion identification and discrimination. We describe the Indian version of the Training of Affect Recognition (TAR) program and a pilot study to demonstrate the feasibility of administering this intervention program in the Indian population. We also discuss the cultural sensibilities in adopting an intervention program for the Indian setting. To the best of our knowledge this is the first intervention program for social cognition for use in persons with schizophrenia in India.

Development, Administration, and Structural Validity of a Brief, Computerized Neurocognitive Battery: Results From the Army Study to Assess Risk and Resilience in Servicemembers

The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a research project aimed at identifying risk and protective factors for suicide and related mental health outcomes among Army Soldiers. The New Soldier Study component of Army STARRS included the assessment of a range of cognitive- and emotion-processing domains linked to brain systems related to suicidal behavior including posttraumatic stress disorder, mood disorders, substance use disorders, and impulsivity. We describe the design and application of the Army STARRS neurocognitive test battery to a sample of 56,824 soldiers. We investigate its structural and concurrent validity through factor analysis and correlation of scores with demographics. We conclude that, in addition to being composed of previously well-validated measures, the Army STARRS neurocognitive battery as a whole demonstrates good psychometric properties. Correlations of scores with age and sex differences mostly replicate previously published findings, highlighting moderate to large effect sizes even within this restricted age range. Factor structures of scores conform to theoretical expectations. This neurocognitive battery provides a brief, valid measurement of neurocognition that may be helpful in predicting mental health and military performance. These measures can be integrated with neuroimaging to offer a powerful tool for assessing neurocognition in Servicemembers.

How culture shapes social cognition deficits in mental disorders: A review

Social cognitive skills are indispensable for successful communication with others. Substantial research has determined deficits in these abilities in patients with mental disorders. In neurobiological development and continuing into adulthood, cross-cultural differences in social cognition have been demonstrated. Moreover, symptomatic patterns in mental disorders may vary according to the cultural background of an individual. Cross-cultural studies can thus help in understanding underlying (biological) mechanisms and factors that influence behavior in health and disease. In addition, studies that apply novel paradigms assessing the impact of culture on cognition may benefit and advance neuroscience research. In this review, the authors give an overview of cross-cultural research in the field of social cognition in health and in mental disorders and provide an outlook on future research directions, taking a neuroscience perspective.

Common impairments of emotional facial expression recognition in schizophrenia across French and Japanese cultures

To address whether the recognition of emotional facial expressions is impaired in schizophrenia across different cultures, patients with schizophrenia and age-matched normal controls in France and Japan were tested with a labeling task of emotional facial expressions and a matching task of unfamiliar faces. Schizophrenia patients in both France and Japan were less accurate in labeling fearful facial expressions. There was no correlation between the scores of facial emotion labeling and face matching. These results suggest that the impaired recognition of emotional facial expressions in schizophrenia is common across different cultures.

Face recognition in schizophrenia disorder: A comprehensive review of behavioral, neuroimaging and neurophysiological studies

Facial emotion processing has been extensively studied in schizophrenia patients while general face processing has received less attention. The already published reviews do not address the current scientific literature in a complete manner. Therefore, here we tried to answer some questions that remain to be clarified, particularly: are the non-emotional aspects of facial processing in fact impaired in schizophrenia patients? At the behavioral level, our key conclusions are that visual perception deficit in schizophrenia patients: are not specific to faces; are most often present when the cognitive (e.g. attention) and perceptual demands of the tasks are important; and seems to worsen with the illness chronification. Although, currently evidence suggests impaired second order configural processing, more studies are necessary to determine whether or not holistic processing is impaired in schizophrenia patients. Neural and neurophysiological evidence suggests impaired earlier levels of visual processing, which might involve the deficits in interaction of the magnocellular and parvocellular pathways impacting on further processing. These deficits seem to be present even before the disorder out-set. Although evidence suggests that this deficit may be not specific to faces, further evidence on this question is necessary, in particularly more ecological studies including context and body processing.

Neural correlates of explicit social judgments on vocal stimuli

Functional neuroimaging research on the neural basis of social evaluation has traditionally focused on face perception paradigms. Thus, little is known about the neurobiology of social evaluation processes based on auditory cues, such as voices. To investigate the top-down effects of social trait judgments on voices, hemodynamic responses of 44 healthy participants were measured during social trait (trustworthiness [TR] and attractiveness [AT]), emotional (happiness, HA), and cognitive (age, AG) voice judgments. Relative to HA and AG judgments, TR and AT judgments both engaged the bilateral inferior parietal cortex (IPC; area PGa) and the dorsomedial prefrontal cortex (dmPFC) extending into the perigenual anterior cingulate cortex. This dmPFC activation overlapped with previously reported areas specifically involved in social judgments on 'faces.' Moreover, social trait judgments were expected to share neural correlates with emotional HA and cognitive AG judgments. Comparison of effects pertaining to social, social-emotional, and social-cognitive appraisal processes revealed a dissociation of the left IPC into 3 functional subregions assigned to distinct cytoarchitectonic subdivisions. In total, the dmPFC is proposed to assume a central role in social attribution processes across sensory qualities. In social judgments on voices, IPC activity shifts from rostral processing of more emotional judgment facets to caudal processing of more cognitive judgment facets.

Hemispheric interaction, task complexity, and emotional valence: evidence from naturalistic images

Two experiments extend the ecological validity of tests of hemispheric interaction in three novel ways. First, we present a broad class of naturalistic stimuli that have not yet been used in tests of hemispheric interaction. Second, we test whether probable differences in complexity within the class of stimuli are supported by outcomes from measures of hemispheric interaction. Third, we use a procedure that presents target stimuli at fixation rather than at a lateralized location in order to more closely approximate normal viewing behavior. Images of positive or negative valence were presented with a lateralized distractor or no distractor at all. Response time and accuracy to determine whether an image was pleasant or unpleasant was measured. Results found that positive images were more quickly and accurately processed by the left hemisphere alone, while negative images were more quickly processed when the hemispheres interacted, and were more accurately processed when the hemispheres interacted than the left hemisphere alone. The findings support the idea that hemispheric interaction costs the performance of a simple task and benefits the performance of a complex task, and that the respective cost or gain is mediated by the pattern of laterality for emotional processing.

Cognition-emotion dysinteraction in schizophrenia

Evolving theories of schizophrenia emphasize a "disconnection" in distributed fronto-striatal-limbic neural systems, which may give rise to breakdowns in cognition and emotional function. We discuss these diverse domains of function from the perspective of disrupted neural circuits involved in "cold" cognitive vs. "hot" affective operations and the interplay between these processes. We focus on three research areas that highlight cognition-emotion dysinteractions in schizophrenia: First, we discuss the role of cognitive deficits in the "maintenance" of emotional information. We review recent evidence suggesting that motivational abnormalities in schizophrenia may in part arise due to a disrupted ability to "maintain" affective information over time. Here, dysfunction in a prototypical "cold" cognitive operation may result in "affective" deficits in schizophrenia. Second, we discuss abnormalities in the detection and ascription of salience, manifest as excessive processing of non-emotional stimuli and inappropriate distractibility. We review emerging evidence suggesting deficits in some, but not other, specific emotional processes in schizophrenia - namely an intact ability to perceive emotion "in-the-moment" but poor prospective valuation of stimuli and heightened reactivity to stimuli that ought to be filtered. Third, we discuss abnormalities in learning mechanisms that may give rise to delusions, the fixed, false, and often emotionally charged beliefs that accompany psychosis. We highlight the role of affect in aberrant belief formation, mostly ignored by current theoretical models. Together, we attempt to provide a consilient overview for how breakdowns in neural systems underlying affect and cognition in psychosis interact across symptom domains. We conclude with a brief treatment of the neurobiology of schizophrenia and the need to close our explanatory gap between cellular-level hypotheses and complex behavioral symptoms observed in this illness.

Cognition-emotion dysinteraction in schizophrenia

Evolving theories of schizophrenia emphasize a "disconnection" in distributed fronto-striatal-limbic neural systems, which may give rise to breakdowns in cognition and emotional function. We discuss these diverse domains of function from the perspective of disrupted neural circuits involved in "cold" cognitive vs. "hot" affective operations and the interplay between these processes. We focus on three research areas that highlight cognition-emotion dysinteractions in schizophrenia: First, we discuss the role of cognitive deficits in the "maintenance" of emotional information. We review recent evidence suggesting that motivational abnormalities in schizophrenia may in part arise due to a disrupted ability to "maintain" affective information over time. Here, dysfunction in a prototypical "cold" cognitive operation may result in "affective" deficits in schizophrenia. Second, we discuss abnormalities in the detection and ascription of salience, manifest as excessive processing of non-emotional stimuli and inappropriate distractibility. We review emerging evidence suggesting deficits in some, but not other, specific emotional processes in schizophrenia - namely an intact ability to perceive emotion "in-the-moment" but poor prospective valuation of stimuli and heightened reactivity to stimuli that ought to be filtered. Third, we discuss abnormalities in learning mechanisms that may give rise to delusions, the fixed, false, and often emotionally charged beliefs that accompany psychosis. We highlight the role of affect in aberrant belief formation, mostly ignored by current theoretical models. Together, we attempt to provide a consilient overview for how breakdowns in neural systems underlying affect and cognition in psychosis interact across symptom domains. We conclude with a brief treatment of the neurobiology of schizophrenia and the need to close our explanatory gap between cellular-level hypotheses and complex behavioral symptoms observed in this illness.

Emotion effects on attention, amygdala activation, and functional connectivity in schizophrenia

Emotional abnormalities are a critical clinical feature of schizophrenia (SCZ), but complete understanding of their underlying neuropathology is lacking. Numerous studies have examined amygdala activation in response to affective stimuli in SCZ, but no consensus has emerged. However, behavioral studies examining 'in-the-moment' processing of affect have suggested intact emotional processing in SCZ. To examine which aspects of emotional processing may be impaired in SCZ, we combined behavior and neuroimaging to investigate effects of aversive stimuli during minimal cognitive engagement, at the level of behavior, amygdala recruitment, and its whole-brain task-based functional connectivity (tb-fcMRI) because impairments may manifest when examining across-region functional integration. Twenty-eight patients and 24 matched controls underwent rapid event-related fMRI at 3 T while performing a simple perceptual decision task with negative or neutral distraction. We examined perceptual decision slowing, amygdala activation, and whole-brain amygdala tb-fcMRI, while ensuring group signal-to-noise profile matching. Following scanning, subjects rated all images for experienced arousal and valence. No significant group differences emerged for negative vs neutral reaction time, emotional ratings across groups, or amygdala activation. However, even in the absence of behavioral or activation differences, SCZ subjects demonstrated significantly weaker amygdala-prefrontal cortical coupling, specifically during negative distraction. Whereas in-the-moment perception, behavioral response, and amygdala recruitment to negative stimuli during minimal cognitive load seem to be intact, there is evidence of aberrant amygdala-prefrontal integration in SCZ subjects. Such abnormalities may prove critical for understanding disturbances in patients' ability to use affective cues when guiding higher level cognitive processes needed in social interactions.

Trait and state positive emotional experience in schizophrenia: a meta-analysis

BACKGROUND

Prior meta-analyses indicated that people with schizophrenia show impairment in trait hedonic capacity but retain their state hedonic experience (valence) in laboratory-based assessments. Little is known about what is the extent of differences for state positive emotional experience (especially arousal) between people with schizophrenia and healthy controls. It is also not clear whether negative symptoms and gender effect contribute to the variance of positive affect.

METHODS AND FINDINGS

The current meta-analysis examined 21 studies assessing state arousal experience, 40 studies measuring state valence experience, and 47 studies assessing trait hedonic capacity in schizophrenia. Patients with schizophrenia demonstrated significant impairment in trait hedonic capacity (Cohen's d = 0.81). However, patients and controls did not statistically differ in state hedonic (valence) as well as exciting (arousal) experience to positive stimuli (Cohen's d = -0.24 to 0.06). They also reported experiencing relatively robust state aversion and calmness to positive stimuli compared with controls (Cohen's d = 0.75, 0.56, respectively). Negative symptoms and gender contributed to the variance of findings in positive affect, especially trait hedonic capacity in schizophrenia.

CONCLUSIONS

Our findings suggest that schizophrenia patients have no deficit in state positive emotional experience but impairment in "noncurrent" hedonic capacity, which may be mediated by negative symptoms and gender effect.

Amygdala recruitment in schizophrenia in response to aversive emotional material: a meta-analysis of neuroimaging studies

Emotional dysfunction has long been established as a critical clinical feature of schizophrenia. In the past decade, there has been extensive work examining the potential contribution of abnormal amygdala activation to this dysfunction in patients with schizophrenia. A number of studies have demonstrated under-recruitment of the amygdala in response to emotional stimuli, while others have shown intact recruitment of this region. To date, there have been few attempts to synthesize this literature using quantitative criteria or to use a formal meta-analytic approach to examine which variables may moderate the magnitude of between-group differences in amygdala activation in response to aversive emotional stimuli. We conducted a meta-analysis of amygdala activation in patients with schizophrenia, using a bootstrapping approach to investigate: (a) evidence for amygdala under-recruitment in schizophrenia and (b) variables that may moderate the magnitude of between-group differences in amygdala activation. We demonstrate that patients with schizophrenia show statistically significant, but modest, under-recruitment of bilateral amygdala (mean effect size = -0.20 SD). However, present findings indicate that this under-recruitment is dependent on the use of a neutral vs emotion interaction contrast and is not apparent if amygdala activation by patients and controls is evaluated in a negative emotional condition only.

Facial emotion recognition in Chinese with schizophrenia at early and chronic stages of illness

Deficits in facial emotion recognition have been recognised in Chinese patients diagnosed with schizophrenia. This study examined the relationship between chronicity of illness and performance of facial emotion recognition in Chinese with schizophrenia. There were altogether four groups of subjects matched for age and gender composition. The first and second groups comprised medically stable outpatients with first-episode schizophrenia (n=50) and their healthy controls (n=26). The third and fourth groups were patients with chronic schizophrenic illness (n=51) and their controls (n=28). The ability to recognise the six prototypical facial emotions was examined using locally validated coloured photographs from the Japanese and Caucasian Facial Expressions of Emotion. Chinese patients with schizophrenia, in both the first-episode and chronic stages, performed significantly worse than their control counterparts on overall facial emotion recognition, (P<0.001), with specific impairment in identifying surprise, fear and disgust. The level of deficit was similar at the two stages of illness. Findings suggest that impaired recognition of facial emotion did not appear to have worsened over the course of disease progression, suggesting that recognition of facial emotion is a rather stable trait of the illness. The emotion-specific deficit may have implications for understanding the social difficulties in schizophrenia.

Negative and nonemotional interference with visual working memory in schizophrenia

BACKGROUND

Schizophrenia (SCZ) results in abnormalities affecting both working memory (WM) and emotional processing. Prior work suggests that individuals with SCZ exhibit increased effects of distraction on WM-a deficit that might be exacerbated via emotional interference. However, no study characterized effects of negative and nonemotional interference on visual WM in SCZ with functional magnetic resonance imaging. We tested the hypothesis that SCZ is associated with a general inability to filter distraction versus a specific deficit in the ability to filter aversive emotional distraction.

METHODS

Twenty-eight patients with DSM-IV-diagnosed SCZ and 24 matched control subjects underwent blood-oxygen-level-dependent imaging with functional magnetic resonance imaging at 3-T. Subjects performed a modified delayed-response visual WM task faced with affectively negative, neutral, or task-related interference.

RESULTS

Control subjects showed maximal interference after aversive distraction, whereas patients were more distracted irrespective of interference type. Importantly, aversive distraction resulted in similar across-group activation in regions previously showing robust effects of negative interference. Conversely, after any distraction, patients showed reduced blood-oxygen-level-dependent activity in prefrontal regions previously implicated in filtering interference. Particularly when distracted, SCZ subjects exhibited aberrant responses to nonemotional distraction across posterior cortical regions.

CONCLUSIONS

Results suggest that patients fail to deploy activity associated with distracter filtering exhibited by control subjects. Although SCZ subjects show similar responses to aversive interference across certain regions, there is also evidence of enhanced responses to nonemotional inputs. These results are consistent with a general deficit in the ability of patients to filter distraction, which might be in line with aberrant salience processing as a pathophysiological mechanism in SCZ.

Challenges and opportunities for genomic developmental neuropsychology: examples from the Penn-Drexel collaborative battery

Genomics has been revolutionizing medicine over the past decade by offering mechanistic insights into disease processes and engendering the age of "individualized medicine." Because of the sheer number of measures generated by gene sequencing methods, genomics requires "Big Science" where large datasets on genes are analyzed in reference to electronic medical record data. This revolution has largely bypassed the behavioral neurosciences, mainly because of the paucity of behavioral data in medical records and the labor-intensity of available neuropsychological assessment methods. We describe the development and implementation of an efficient neuroscience-based computerized battery, coupled with a computerized clinical assessment procedure. This assessment package has been applied to a genomic study of 10,000 children aged 8-21, of whom 1000 also undergo neuroimaging. Results from the first 3000 participants indicate sensitivity to neurodevelopmental trajectories. Sex differences were evident, with females outperforming males in memory and social cognition domains, while for spatial processing males were more accurate and faster, and they were faster on simple motor tasks. The study illustrates what will hopefully become a major component of the work of clinical and research neuropsychologists as invaluable participants in the dawning age of Big Science neuropsychological genomics.

Self-concept, emotion and memory performance in schizophrenia

The "self-reference effect" describes better memory for material someone has related to one's self previously. Schizophrenia can affect aspects of the inner self such as own thoughts or actions. Schizophrenia symptoms, therefore, might not only have an influence on the self-concept, including the self-attribution of positive or negative personality traits, but also reduce the self-reference effect. 15 schizophrenia patients and 15 matched healthy controls were asked to decide on positive and negative personality traits across three separate conditions: self-evaluation, other evaluation (of an intimate person), and during a lexical control task, respectively. An unannounced recognition task followed. Patients revealed a negative bias in the evaluation of themselves and of the well-known other person. The reference to a person (oneself, close other) increased later recognition performance. However, patients with schizophrenia revealed an overall decreased recognition performance. The amount of patients' passivity symptoms, i.e., an increase in the permeability of their "self-other boundary", correlated negatively with their recognition performance for previously self-referred characteristics and traits referred to the intimate other. This was not the case for lexically processed stimuli or an increase of negative symptoms. Our data underline the necessity of taking into account symptom subgroups when dealing with specific cognitive dysfunctions in schizophrenia.

Deficit in negative emotional information processing in schizophrenia: does it occur in all patients?

The nature of the impairment in the processing of emotional information in schizophrenia is still being debated. Some authors reported that schizophrenia patients would show deficits in the treatment processing of negative emotional information without a negative bias, as observed in controls, when in a combined emotional situation including positive/negative information. Eighteen subjects with paranoid schizophrenia in remission with a low level of negative symptoms and 18 control subjects were exposed to 108 pairs of pictures (International Affective Picture System) depicting different emotions (N = negative, P = positive, n = neutral) from six different combinations: N/N, P/P, n/n, P/N, P/n, and N/n. The subjects responded by clicking on a right or left button in response to a negative or positive feeling toward the stimuli (forced choice task). They were also asked to classify each of the individual pictures as positive, negative, or neutral (emotion-recognition task). In this well-defined group of paranoid schizophrenia patients in remission, we observed the persistence of a negative bias when an ambiguous situation is displayed (P/N) with the absence of an impairment in negative emotional information recognition and the presence of a positive bias in the recognition of neutral stimuli, reflecting a tendency to keep arousal-provoking perceptual cues from entering into subjective awareness.

Deficits in facial emotion recognition in schizophrenia: a replication study with korean subjects

OBJECTIVE

We investigated the deficit in the recognition of facial emotions in a sample of medicated, stable Korean patients with schizophrenia using Korean facial emotion pictures and examined whether the possible impairments would corroborate previous findings.

METHODS

Fifty-five patients with schizophrenia and 62 healthy control subjects completed the Facial Affect Identification Test with a new set of 44 colored photographs of Korean faces including the six universal emotions as well as neutral faces.

RESULTS

Korean patients with schizophrenia showed impairments in the recognition of sad, fearful, and angry faces [F(1,114)=6.26, p=0.014; F(1,114)=6.18, p=0.014; F(1,114)=9.28, p=0.003, respectively], but their accuracy was no different from that of controls in the recognition of happy emotions. Higher total and three subscale scores of the Positive and Negative Syndrome Scale (PANSS) correlated with worse performance on both angry and neutral faces. Correct responses on happy stimuli were negatively correlated with negative symptom scores of the PANSS. Patients with schizophrenia also exhibited different patterns of misidentification relative to normal controls.

CONCLUSION

These findings were consistent with previous studies carried out with different ethnic groups, suggesting cross-cultural similarities in facial recognition impairment in schizophrenia.

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.

Impaired facial emotion perception in schizophrenia: a meta-analysis

Research into facial emotion perception in schizophrenia has burgeoned over the past several decades. The evidence is mixed regarding whether patients with schizophrenia have a general facial emotion perception deficit (a deficit in facial emotion perception plus a more basic deficit in facial processing) or specific facial emotion perception deficits (deficits only in facial emotion perception tasks). A meta-analysis is conducted of 28 facial emotion perception studies that include control tasks. These studies use differential deficit designs to examine whether patients with schizophrenia demonstrate a general deficit or specific deficit in facial emotion perception. A significant mean effect size is found for total facial emotion perception (d=-0.85). Patients with schizophrenia demonstrate impaired ability to perform corresponding control tasks, and the mean effect size is -0.70. The current findings suggest that patients with schizophrenia have moderately to severely impaired perception of facial emotion.

Facial emotion perception in Chinese patients with schizophrenia and non-psychotic first-degree relatives

Although there is a consensus that patients with schizophrenia have certain deficits in perceiving and expressing facial emotions, previous studies of facial emotion perception in schizophrenia do not present consistent results. The objective of this study was to explore facial emotion perception deficits in Chinese patients with schizophrenia and their non-psychotic first-degree relatives. Sixty-nine patients with schizophrenia, 56 of their first-degree relatives (33 parents and 23 siblings), and 92 healthy controls (67 younger healthy controls matched to the patients and siblings, and 25 older healthy controls matched to the parents) completed a set of facial emotion perception tasks, including facial emotion discrimination, identification, intensity, valence, and corresponding face identification tasks. The results demonstrated that patients with schizophrenia performed significantly worse than their siblings and younger healthy controls in accuracy in a variety of facial emotion perception tasks, whereas the siblings of the patients performed as well as the corresponding younger healthy controls in all of the facial emotion perception tasks. Patients with schizophrenia also showed significantly reduced speed than younger healthy controls, while siblings of patients did not demonstrate significant differences with both patients and younger healthy controls in speed. Meanwhile, we also found that parents of the schizophrenia patients performed significantly worse than the corresponding older healthy controls in accuracy in terms of facial emotion identification, valence, and the composite index of the facial discrimination, identification, intensity and valence tasks. Moreover, no significant differences were found between the parents of patients and older healthy controls in speed after controlling the years of education and IQ. Taken together, the results suggest that facial emotion perception deficits may serve as potential endophenotypes for schizophrenia.

Emotional experience in patients with schizophrenia revisited: meta-analysis of laboratory studies

Our understanding of the emotion deficits in schizophrenia is limited. Findings from studies employing trait emotion instruments suggest that patients have attenuated levels of positive emotion (ie, anhedonia) and increased levels of negative emotion. Conversely, patients and controls have not statistically differed in their subjective reactions to positive or negative valenced stimuli in most laboratory studies to date. Further obfuscating this issue is the fact that many of these laboratory studies are underpowered and a handful of emotion induction studies have found evidence of anhedonia. We conducted a meta-analysis of 26 published studies employing laboratory emotion induction procedures in patients with schizophrenia and healthy controls. Patients did not differ from controls when strictly rating their subjective hedonic reactions to the stimuli. However, they reported experiencing relatively strong aversion to both positive and neutral stimuli (Hedges D = .72 and .64, respectively). These findings were not the result of demonstrable sample or methodological differences across studies. Patients' ability to experience hedonic emotion is preserved, although they also show relatively strong, simultaneously occurring aversive emotion when processing laboratory stimuli considered by others to be pleasant or neutral.

[Functional magnetic resonance tomography in patients with schizophrenia: neural correlates of symptoms, cognition and emotion]

In patients with schizophrenia, numerous mental processes are impaired, which can be related to brain systems using functional imaging methods (e.g. functional magnetic resonance imaging; fMRI). In this review the methodological and conceptual background of fMRI will first be discussed. Secondly, the cerebral networks involved in important symptoms of schizophrenia such as hallucinations, delusions and formal thought disorders will be outlined. Furthermore, the pathways of the central nervous system involved in cognitive dysfunction in patients with schizophrenia will be described also in the dependence on genotype and medicinal status. Functional imaging methods provide psychiatry and psychotherapy with the unique opportunity to correlate mental processes and dysfunctions with neural networks.

Reduced neuron density, enlarged minicolumn spacing and altered ageing effects in fusiform cortex in schizophrenia

Structural and functional MRI studies report reduced volume and activation of the fusiform gyrus in schizophrenia. The fusiform cortex is involved in object naming and face recognition. Neuron cell size, shape and density, glial cell density and minicolumn spacing in layers III and V of the fusiform cortex were assessed following systematic random sampling from 13 controls and 11 schizophrenic patients. Pyramidal cell density was reduced in schizophrenia. Non-pyramidal cell density was reduced in layer III of the left hemisphere in schizophrenia, mostly in females. Non-pyramidal cells were larger in schizophrenia. Glial cell density was unaltered. Fusiform minicolumn spacing was asymmetrically wider in the right hemisphere of normal control subjects. Minicolumns were less dense in schizophrenia, particularly in the left hemisphere of females and the right hemisphere of males. Reduced neuron density in the fusiform cortex in schizophrenia contributes to evidence of functional-anatomical abnormalities from neuroimaging and neuropathology studies. Anatomical sex differences in schizophrenia may relate to anatomical and cognitive sex differences associated with fusiform cortex in the normal population. Wider minicolumn spacing is consistent with reduced cell density and is linked to altered ageing in schizophrenia.

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.

Generalized deficit in all core components of empathy in schizophrenia

Empathy is a multidimensional construct composed of several components such as emotion recognition, emotional perspective taking and affective responsiveness. Patients with schizophrenia demonstrate deficits in several domains of emotion processing and perspective taking, thus suggesting a dysfunctional emotional competence. We assessed empathic abilities via three paradigms measuring emotion recognition, perspective taking and affective responsiveness as well as self-report empathy questionnaires in 24 (12 females, 12 males) schizophrenia patients meeting the DSM-IV criteria for schizophrenia and 24 matched healthy volunteers. Patients were recruited from the Department of Psychiatry and Psychotherapy, RWTH Aachen University and healthy volunteers were recruited via advertisement. Groups were matched for age, gender and parental education. Data analysis indicates a significant empathic deficit in patients, reflected in worse performance in all three domains. This deficit was only partly reflected in the self-report empathy questionnaires. Comparing the different tasks, emotional perspective taking was the most difficult task for all subjects and symptomatology worsened affective responsiveness. Schizophrenia patients not only struggle to correctly identify emotions, but also have difficulties in spontaneously simulating another person's subjective world (perspective taking) and might not be able to respond adequately in terms of their own emotional experience (affective responsiveness), which are not caused by emotion perception deficits. The results suggest that all domains of empathy are affected in schizophrenia and have to be addressed independently in behavioral therapies, thereby offering a possibility to improve socio-occupational life.

In support of Bleuler: objective evidence for increased affective ambivalence in schizophrenia based upon evocative testing

BACKGROUND

Ambivalence and anhedonia have long been identified as schizophrenic symptoms. However, ambivalence has rarely been studied, and in most evocative studies, schizophrenia participants are not anhedonic. Affective neurosciences posit two evaluative systems (one for Positivity and one for Negativity), the coactivation of which produces ambivalence, and point to two asymmetries in affective processing: Positivity Offset (which measures our capacity to explore the environment) and Negativity Bias (a measure of reactivity to intense threat). These characteristics have not received much attention in schizophrenia research.

METHODS

Sixty-four individuals with schizophrenia and 32 non-patient control participants completed an evocative emotional task with pictures, sounds and words of various valences and intensities. Following each presentation, participants rated the level of pleasantness, unpleasantness, and arousal elicited by the stimulus. Finally, participants completed questionnaires on anhedonia, and practical life skills were assessed.

RESULTS

Schizophrenia participants showed higher levels of ambivalence, greater arousal, greater Positivity Offset, and non-significantly different hedonic capacities and Negativity Bias. Ambivalence to positive stimuli significantly correlated with duration of illness, current level of psychopathology, anhedonia questionnaires and practical life skills. Schizophrenia patients with negative symptoms did not differ from patients without negative symptoms on computer tasks.

CONCLUSIONS

Ambivalence is greater in schizophrenia, and can be understood as a de-differentiation of the activation of the two evaluative systems. Ambivalence to positive stimuli, which may reflect early-stage affective processing is associated with impairments in higher-level emotional processes and in everyday functioning. Future studies should clarify the status of anhedonia in schizophrenia.

The other-race effect in face processing among African American and Caucasian individuals with schizophrenia

OBJECTIVE

Studies of emotion recognition abilities in schizophrenia show greater impairment for non-Caucasians with schizophrenia compared with Caucasians. These studies, however, included only Caucasian faces as stimuli. There is evidence from healthy individuals for a performance disadvantage on face memory and emotion recognition when processing faces from a different ethnicity. The authors sought to measure the "other-race effect" in schizophrenia, which could account for previous findings and provide information about sensitivity to such social cues in patients.

METHOD

The study included 540 participants from four groups: African Americans with schizophrenia (N=135), Caucasians with schizophrenia (N=135), African American community comparison subjects (N=135), and Caucasian community comparison subjects (N=135). All participants completed face recognition and facial emotion identification tasks that included both Caucasian and African American faces as stimuli.

RESULTS

Although comparison participants performed better than individuals with schizophrenia across all tasks, both comparison participants and participants with schizophrenia exhibited a strong and significant other-race effect for face memory and emotion recognition. The magnitude of the other-race effect did not differ between these two groups.

CONCLUSIONS

These findings reveal an intact other-race effect in patients with schizophrenia and highlight a methodological concern in the measurement of face processing abilities in schizophrenia, namely, that findings of greater impairment in African American patients are spurious when Caucasian faces are used as stimuli. Despite overall impairments in face memory and emotion recognition, the presence of a normative other-race effect in schizophrenia may reflect typical experiences with faces during development.

Basic emotions and psychological distress: association between recognition of facial expressions and Symptom Checklist-90 subscales

OBJECTIVE

Cross-cultural studies have demonstrated universal similarity in the recognition and expression of basic emotions in facial expressions. The so-called mood congruency effect, observed primarily in clinical populations, implies that subjects with depressed mood tend to judge positive emotions as neutral and neutral faces as negative. The objective was to investigate whether a mood congruency effect can be detected in case of mild impairments among healthy subjects. First, it was hypothesized that subjects with mild psychiatric symptom distress have poorer performance in affective facial recognition in general. Second, it was also hypothesized that these subjects have poorer functioning in neutral face recognition and that they are prone to attribute negative emotions, for example, sadness and fear to neutral faces. Third, it was also assumed that people with mild psychiatric symptom distress have poor performance in recognizing positive emotions.

METHODS

Pictures representing the basic emotions were used to examine the recognition of facial emotions; the Symptom Checklist-90 was obtained to quantify overall psychological distress and the severity of psychiatric symptoms on 9 primary symptom dimensions, including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. One hundred seventeen healthy volunteers were recruited for the purpose of the study.

RESULTS

Consistent with the first hypothesis, results indicated a significant negative association between the overall recognition rate of facial expressions and the level of psychiatric symptoms in a healthy population. Consistent with the second hypothesis, the level of psychiatric symptoms was related inversely with the neutral facial expression recognition and directly with the negative bias in neutral facial expressions. However, our data did not support the assumption that people with mild psychiatric symptom distress would have a poorer performance in recognizing positive emotions.

CONCLUSIONS

These findings support the notion that difficulties in emotion processing in general and in neutral face recognition, including a negative bias in particular, are strongly related to psychological distress and the severity of psychiatric symptoms in a healthy population.

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.

Neural substrates of olfactory processing in schizophrenia patients and their healthy relatives

Odorants represent powerful stimuli capable of eliciting various emotional responses. In schizophrenia patients and their non-affected relatives, olfactory and emotional functions are impaired, revealing a familial influence on these deficits. We aimed at determining the neural basis of emotional olfactory dysfunctions using odors of different emotional valence for mood induction and functional magnetic resonance imaging (fMRI) by comparing 13 schizophrenia patients, their non-affected brothers and 26 matched healthy controls. Blood-oxygen-level-dependent (BOLD) effects and subjective mood changes were assessed during negative (rotten yeast), positive (vanilla) and neutral (ambient air) olfactory stimulation. Group comparisons of brain activation were performed in regions of interest. Subjective ratings were comparable between groups and indicated successful mood induction. However, during stimulation with the negative odor, hypofunctional activity emerged in regions of the right frontal and temporal cortex in the patients. A familial influence in the neural substrates of negative olfactory dysfunction was indicated by a similar reduced frontal brain activity in relatives. Dysfunctions therefore appeared to be located in regions involved in higher cognitive processes associated with olfaction. No familial influences were indicated for cerebral dysfunctions during positive olfactory stimulation. Results point to a differentiation between trait and state components in cerebral dysfunctions during emotional olfactory processing in schizophrenia.

Exploring the nature of facial affect processing deficits in schizophrenia

Schizophrenia has been associated with deficits in facial affect processing, especially negative emotions. However, the exact nature of the deficit remains unclear. The aim of the present study was to investigate whether schizophrenia patients have problems in automatic allocation of attention as well as in controlled evaluation of facial affect. Thirty-seven patients with schizophrenia were compared with 41 control subjects on incidental facial affect processing (gender decision of faces with a fearful, angry, happy, disgusted, and neutral expression) and degraded facial affect labeling (labeling of fearful, angry, happy, and neutral faces). The groups were matched on estimates of verbal and performance intelligence (National Adult Reading Test; Raven's Matrices), general face recognition ability (Benton Face Recognition), and other demographic variables. The results showed that patients with schizophrenia as well as control subjects demonstrate the normal threat-related interference during incidental facial affect processing. Conversely, on controlled evaluation patients were specifically worse in the labeling of fearful faces. In particular, patients with high levels of negative symptoms may be characterized by deficits in labeling fear. We suggest that patients with schizophrenia show no evidence of deficits in the automatic allocation of attention resources to fearful (threat-indicating) faces, but have a deficit in the controlled processing of facial emotions that may be specific for fearful faces.

Impaired emotion perception in schizophrenia: a differential deficit

We investigated previously reported contradictory findings regarding the nature of deficits in emotion perception among patients with schizophrenia. Some studies have concluded that such deficits are due to a generalized impairment in visual processing of faces, while others have found it to be restricted to facial emotional expressions. We examined 37 patients and 32 healthy controls, matched on age and education, using three computerized tests: matching facial identity, matching facial emotional expressions, and discrimination of subtle differences in the valence of facial emotional expressions. Our results showed impaired matching of emotions in patients with schizophrenia. This impairment did not manifest on tasks that depended on perceiving the identity of faces or cues of the relative valence of facial emotional expressions. Our findings support the differential deficit hypothesis of emotion perception in schizophrenia.