Identifying the components of facial emotion and schizophrenia

Usability of a Psychotherapeutic Interactive Gaming Tool Used in Facial Emotion Recognition for People with Schizophrenia

The objective of the study was to test the usability of ‘Feeling Master’ as a psychotherapeutic interactive gaming tool with LEGO cartoon faces showing the five basic emotions, for the assessment of emotional recognition in people with schizophrenia in comparison with healthy controls, and the relationship between face affect recognition (FER), attributional style, and theory of mind (ToM), which is the ability to understand the potential mental states and intentions of others. Nineteen individuals with schizophrenia (SZ) and 17 healthy control (HC) subjects completed the ‘Feeling Master’ that includes five basic emotions. To assess social cognition, the group with schizophrenia was evaluated with the Personal and Situational Attribution Questionnaire (IPSAQ) for the assessment of attributional style and the Hinting Task (ToM). Patients with SZ showed significant impairments in emotion recognition and their response time appeared to be slower than the HC in the recognition of each emotion. Taking into account the impairment in the recognition of each emotion, we only found a trend toward significance in error rates on fear recognition. The correlations between correct response on the ‘Feeling Master’ and the hinting task appeared to be significant in the correlation of surprise and theory of mind. In conclusion, this study demonstrated that the ‘Feeling Master’ could be useful for the evaluation of FER in people with schizophrenia. These results sustain the notion that impairments in emotion recognition are more prevalent in people with schizophrenia and that these are related with impairment in ToM.

Interpretation biases in paranoia

Information in the environment is frequently ambiguous in meaning. Emotional ambiguity, such as the stare of a stranger, or the scream of a child, encompasses possible good or bad emotional consequences. Those with elevated vulnerability to affective disorders tend to interpret such material more negatively than those without, a phenomenon known as "negative interpretation bias." In this study we examined the relationship between vulnerability to psychosis, measured by trait paranoia, and interpretation bias. One set of material permitted broadly positive/negative (valenced) interpretations, while another allowed more or less paranoid interpretations, allowing us to also investigate the content specificity of interpretation biases associated with paranoia. Regression analyses (n=70) revealed that trait paranoia, trait anxiety, and cognitive inflexibility predicted paranoid interpretation bias, whereas trait anxiety and cognitive inflexibility predicted negative interpretation bias. In a group comparison those with high levels of trait paranoia were negatively biased in their interpretations of ambiguous information relative to those with low trait paranoia, and this effect was most pronounced for material directly related to paranoid concerns. Together these data suggest that a negative interpretation bias occurs in those with elevated vulnerability to paranoia, and that this bias may be strongest for material matching paranoid beliefs. We conclude that content-specific biases may be important in the cause and maintenance of paranoid symptoms.

Self-face recognition in schizophrenia is related to insight

A core feature of schizophrenia is the breakdown of the sense of self. A widespread clinical consequence of impaired self-awareness is a lack of insight. Self-face recognition is regarded as one aspect of self-awareness; how this relates to other self-referential processes such as insight into the disorder is as yet unknown. Nineteen patients with schizophrenia performed a facial recognition task using video morphings during which an average face gradually transformed into one's own, a famous or an unfamiliar face (and vice versa). Reaction times to detect faces during the transitions were compared between patients and a matched control group. In the patient group, we also examined correlations between face recognition and insight, psychopathology, and self-evaluation. Both patients with schizophrenia and controls recognised their own faces faster than unfamiliar faces. Whereas healthy subjects recognised a famous face at an intermediate speed that did not differ significantly from the recognition of one's own and unfamiliar faces, schizophrenia patients recognised the famous face, similar to their own face, significantly faster than an unfamiliar face. Moreover, in the patient group, higher insight correlated with faster reaction times in distinguishing one's own from famous faces. Patients with schizophrenia seem to distinguish less than controls between their own and a famous face relative to an unfamiliar face. Patients with good insight into the disorder, however, were better able to differentiate between their own and a famous face. This study supports the view that self-face recognition is an indicator for higher-order self-awareness.

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.

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.

Using the MATRICS to guide development of a preclinical cognitive test battery for research in schizophrenia

Cognitive deficits in schizophrenia are among the core symptoms of the disease, correlate with functional outcome, and are not well treated with current antipsychotic therapies. In order to bring together academic, industrial, and governmental bodies to address this great 'unmet therapeutic need', the NIMH sponsored the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative. Through careful factor analysis and consensus of expert opinion, MATRICS identified seven domains of cognition that are deficient in schizophrenia (attention/vigilance, working memory, reasoning and problem solving, processing speed, visual learning and memory, verbal learning and memory, and social cognition) and recommended a specific neuropsychological test battery to probe these domains. In order to move the field forward and outline an approach for translational research, there is a need for a "preclinical MATRICS" to develop a rodent test battery that is appropriate for drug development. In this review, we outline such an approach and review current rodent tasks that target these seven domains of cognition. The rodent tasks are discussed in terms of their validity for probing each cognitive domain as well as a brief overview of the pharmacology and manipulations relevant to schizophrenia for each task.

Neural bases of different cognitive strategies for facial affect processing in schizophrenia

OBJECTIVE

To examine the neural basis and dynamics of facial affect processing in schizophrenic patients as compared to healthy controls.

METHOD

Fourteen schizophrenic patients and fourteen matched controls performed a facial affect identification task during fMRI acquisition. The emotional task included an intuitive emotional condition (matching emotional faces) and a more cognitively demanding condition (labeling emotional faces). Individual analysis for each emotional condition, and second-level t-tests examining both within-, and between-group differences, were carried out using a random effects approach. Psychophysiological interactions (PPI) were tested for variations in functional connectivity between amygdala and other brain regions as a function of changes in experimental conditions (labeling versus matching).

RESULTS

During the labeling condition, both groups engaged similar networks. During the matching condition, schizophrenics failed to activate regions of the limbic system implicated in the automatic processing of emotions. PPI revealed an inverse functional connectivity between prefrontal regions and the left amygdala in healthy volunteers but there was no such change in patients. Furthermore, during the matching condition, and compared to controls, patients showed decreased activation of regions involved in holistic face processing (fusiform gyrus) and increased activation of regions associated with feature analysis (inferior parietal cortex, left middle temporal lobe, right precuneus).

CONCLUSIONS

Our findings suggest that schizophrenic patients invariably adopt a cognitive approach when identifying facial affect. The distributed neocortical network observed during the intuitive condition indicates that patients may resort to feature-based, rather than configuration-based, processing and may constitute a compensatory strategy for limbic dysfunction.

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.

Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review

Disturbances in affect recognition may be one of the most pervasive and serious aspects of the schizophrenic patient's interpersonal problems. Interest in the decoding of emotional information in schizophrenia has focused on facial affect recognition with 29 experimental papers on that topic published since 1987. A smaller literature exists on the topic of recognition of affect in speech and there are at least seven studies, which have examined both face and voice perception in the same individuals with schizophrenia. This paper includes a comprehensive analysis of the schizophrenia facial affect recognition research over the past decade and the schizophrenia literature on affective prosody, and provides the first review of the schizophrenia literature on multichannel emotion recognition research. The weight of evidence would suggest that individuals with schizophrenia experience problems in the perception of emotional material; however, the specificity, extent, and nature of the deficits are unclear. Emotion recognition research in schizophrenia should be informed by the general literature on emotion recognition with serious attention paid to methodological issues.

On the universality and cultural specificity of emotion recognition: a meta-analysis

A meta-analysis examined emotion recognition within and across cultures. Emotions were universally recognized at better-than-chance levels. Accuracy was higher when emotions were both expressed and recognized by members of the same national, ethnic, or regional group, suggesting an in-group advantage. This advantage was smaller for cultural groups with greater exposure to one another, measured in terms of living in the same nation, physical proximity, and telephone communication. Majority group members were poorer at judging minority group members than the reverse. Cross-cultural accuracy was lower in studies that used a balanced research design, and higher in studies that used imitation rather than posed or spontaneous emotional expressions. Attributes of study design appeared not to moderate the size of the in-group advantage.

Configural processing in face recognition in schizophrenia

INTRODUCTION

There is currently substantial literature to suggest that patients with schizophrenia are impaired on many face-processing tasks. This study investigated the specific effects of configural changes on face recognition in groups of schizophrenia patients.

METHODS

In Experiment 1, participants identified facial expressions in upright faces and in faces inverted from their upright orientation. Experiments 2 and 3 examined recognition memory for faces and other non-face objects presented in upright and inverted orientations. Experiment 4 explored recognition of facial identity in composite images where the top half of one face was fused to the bottom half of another face to form a new face configuration.

RESULTS

In each experiment, the configural change had the same effect on face recognition for the schizophenia patients as it did for control participants. Recognising inverted faces was more difficult than recognising upright faces, with a disproportionate effect of inversion on faces relative to other objects. Recognition of facial identity in face-halves was interfered with by the formation of a new face configuration.

CONCLUSION

Collectively, these results suggest that people with schizophrenia rely on configural information to recognise photographs of faces.

Visual scanning of faces correlates with schizophrenia symptomatology

1. The purpose of this study was to examine whether quantitative measures of visual scanning of faces correlated with the severity of symptoms in patients with schizophrenia. 2. Preattentive visual fixations (fixations less than or equal to 50.1 ms in duration) were measured while 16 subjects with chronic schizophrenia and 38 comparison subjects scanned slides of human faces. 3. A significant inverse correlation was found between the number of preattentive fixations exhibited during 10 seconds of facial scanning and total Brief Psychiatric Rating Scale (BPRS) scores. 4. This study suggests that measures that probe preattentive processing during scanning of faces could represent a novel paradigm for studying the symptoms of schizophrenia.

Facial affect recognition in the course of schizophrenia

Deficits in facial affect recognition have been shown repeatedly in schizophrenia. However, the stability of this deficit over time remains to be clarified. A total of 36 remitted, 32 acutely ill schizophrenic patients and 21 healthy volunteers participated in a cross-sectional and longitudinal study. All subjects were assessed twice within 4 weeks (acute schizophrenics and normal controls), or 12 weeks, respectively (remitted schizophrenics). Subjects had to identify six basic emotions from corresponding facial expressions shown as photographs on a video screen. Both acute and remitted schizophrenics demonstrated a stable deficit over time in facial affect recognition unrelated to psychopathology and medication. This suggests that deficits in facial affect recognition in schizophrenia reflect a trait-like, rather than a state-dependent, characteristic.

Exposed eye area (EEA) in the expression of various emotions

Exposed eye area (EEA) was measured in photographs of Indian adults who modeled six emotions--happiness, sadness, fear, anger, surprise, and disgust--as well as a neutral expression. The data were analyzed with a 2 x 6 (Eyes x Emotions) factorial analysis of covariance (ANCOVA). EEA for neutral expression was used as the covariate measure. The EEAs of the two eyes did not differ significantly during the expression of emotion. The EEAs for fear and surprise were significantly larger, and the EEA for disgust was significantly smaller than those for either other emotions or neutral expression.

Role of cerebral hemispheres and regions in processing hemifacial expression of emotion: evidence from brain-damage

Patients with focal brain-damage, right or left hemisphere-damage (RHD/LHD) and anterior or posterior region-damage (ARD/PRD), and normal controls (NC) were asked to match the photographs of (left-right) hemifacial expressions of emotions, positive (happy-surprise), negative-aroused (fear-anger), negative-nonaroused (sad-disgust). Findings indicated that (a) NC subjects were significantly superior to brain-damaged patients; the difference between RHD and LHD patients was nonsignificant, and (b) ARD patients were significantly inferior to PRD patients who, in turn, were significantly inferior to NC subjects, in the perceptual matching task with hemifacial affective stimuli.