Facial Emotion Perception in Schizophrenia: A Meta-analytic Review

Schizophrenia Research Center, Department of Psychiatry, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Schizophrenia Bulletin (Impact Factor: 8.45). 04/2009; 36(5):1009-19. DOI: 10.1093/schbul/sbn192
Source: PubMed


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).
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.
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.

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    • "We have also shown that the cognitive impairments characterising ASz children extend to social cognition. Consistent with the impaired ability to recognise facial emotions reported among individuals with schizophrenia [45] and CHR youth [46], ASz children (aged 9-15 years) showed moderate deficits in the ability to recognise facial emotions, in particular, sad and angry expressions [47]. Future analyses will need to examine whether these facial emotional processing deficits also characterise FHx children, as previous investigations of older youth (13-25 years) indicate that such impairments are more prominent among CHR individuals than those with family history of schizophrenia [48]. "

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    • "A very large body of work has examined face emotion perception in schizophrenia (e.g., for a meta-analysis, see Kohler et al., 2010), but the perception of face identity has receivedFigure 5. SDMs in the controls and schizophrenics using the upright and inverted face-matching tasks. Error bars represent SE. less attention (e.g., for reviews see Bortolon et al., 2015; Darke et al., 2013). "
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    ABSTRACT: Introduction: Patients with schizophrenia have a large-scaled and severe cognitive impairment. This study examines whether a well-established deficit in face recognition in schizophrenia is a part of this general cognitive impairment or is specific to faces per se. Method: The differential deficit in matching upright faces as compared with two psychometrically matched control tasks (matching inverted faces and matching none-face objects) was assessed in two well-matched samples of schizophrenics (n = 40) and controls (n = 40). Results: Indicating a generalised cognitive deficit, schizophrenics were impaired in all tasks. Importantly, however, the deficit in matching upright faces was stronger in magnitude (15.6%) than the deficits in matching inverted faces (10.1%) and non-face objects (10.2%). Consistently, schizophrenics showed weaker face inversion effects, indicating a configural processing dysfunction. Conclusion: These results provide compelling evidence for a face-specific deficit in schizophrenia that may be associated with, but separable from, a generalised cognitive impairment.
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    • "Competence in perceiving facial emotions is essential for pro-social behaviour and effective social interactions. A recent meta-analysis (Kohler et al., 2010) pooled data from 86 studies and concluded that patients with schizophrenia tend to misperceive facial emotions with negative valences, including " fear " , " sadness " , and " disgust " . Patients with schizophrenia also tend to over-attribute the negative emotion of " disgust " to neutral facial expressions (Edwards et al., 2001; Kohler et al., 2003; Monkul et al., 2007). "
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