Facial emotion recognition in schizophrenia:When and why does it go awry?

Neurophysiology and Brain Imaging Laboratory, Department of Psychiatry 10th Floor, Gates Building, University of Pennsylvania School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.
Schizophrenia Research (Impact Factor: 3.92). 09/2007; 94(1-3):253-63. DOI: 10.1016/j.schres.2007.05.001
Source: PubMed


Schizophrenia patients demonstrate impaired emotional processing that may be due, in part, to impaired facial emotion recognition. This study examined event-related potential (ERP) responses to emotional faces in schizophrenia patients and controls to determine when, in the temporal processing stream, patient abnormalities occur.
16 patients and 16 healthy control participants performed a facial emotion recognition task. Very sad, somewhat sad, neutral, somewhat happy, and very happy faces were each presented for 100 ms. Subjects indicated whether each face was "Happy", "Neutral", or "Sad". Evoked potential data were obtained using a 32-channel EEG system.
Controls performed better than patients in recognizing facial emotions. In patients, better recognition of happy faces correlated with less severe negative symptoms. Four ERP components corresponding to the P100, N170, N250, and P300 were identified. Group differences were noted for the N170 "face processing" component that underlies the structural encoding of facial features, but not for the subsequent N250 "affect modulation" component. Higher amplitude of the N170 response to sad faces was correlated with less severe delusional symptoms. Although P300 abnormalities were found, the variance of this component was explained by the earlier N170 response.
Patients with schizophrenia demonstrate abnormalities in early visual encoding of facial features that precedes the ERP response typically associated with facial affect recognition. This suggests that affect recognition deficits, at least for happy and sad discrimination, are secondary to faulty structural encoding of faces. The association of abnormal face encoding with delusions may denote the physiological basis for clinical misidentification syndromes.

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Available from: Ruben Gur, Jan 27, 2014
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    • "In particular, impairments in facial emotion recognition have been repeatedly demonstrated in patients with schizophrenia (Kohler et al., 2010; Mandal et al., 1998; Marwick and Hall, 2008). Problems with facial emotion recognition have been found to be more severe in patients with schizophrenia compared with both healthy control subjects (Kohler et al., 2000; Turetsky et al., 2007; van't Wout et al., 2007) and patients with other psychiatric disorders (Addington and Addington, 1998). This has serious implications because several studies have demonstrated that deficits in facial emotion recognition are related to poorer social functioning (Couture et al., 2006; Fett et al., 2011; Hooker and Park, 2002). "
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    ABSTRACT: Patients with schizophrenia show impairments in social cognitive abilities, such as recognizing facial emotions. However, the relation to symptoms remains unclear. The goal of this study was to explore whether facial emotion recognition and face identity recognition are associated with severity of symptoms and to which extent associations with symptoms differ for processing of social versus nonsocial information. Facial emotion recognition, face recognition, and abstract pattern recognition were evaluated in 98 patients with multiepisode schizophrenia. Severity of symptoms was measured using a five-factor model of the Positive and Negative Syndrome Scale. Results show that facial emotion recognition and, to a lesser extent, face recognition were predominantly associated with severity of disorganization symptoms. In contrast, recognition of nonsocial patterns was associated with negative symptoms, excitement, and emotional distress. Reaction time rather than accuracy of social cognition explained variance in symptomatology. These results lead to the conclusion that facial emotion processing in schizophrenia appears to be associated with severity of symptoms, especially disorganization.
    Full-text · Article · Jan 2015 · Journal of Nervous & Mental Disease
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    • "Understanding brain processes contributing to social cognition deficits should facilitate the development and evaluation of tailored remediation strategies. Numerous studies have studied cortical and subcortical correlates of emotion processing in SZ including FAR (for hemodynamic imaging evidence, see Pinkham et al., 2007; Seiferth et al., 2009; Habel et al., 2010; Li et al., 2010; for event-related brain potential evidence, Turetsky et al., 2007; Wölwer et al., 2012; Wynn et al., 2013; for oscillatory activity, Singh et al., 2011; Popov et al., 2013, 2014). These studies provide substantial evidence of deviant brain activity related to social cognition, including FAR. "
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    ABSTRACT: Deficits in social cognition including facial affect recognition and their detrimental effects on functional outcome are well established in schizophrenia. Structured training can have substantial effects on social cognitive measures including facial affect recognition. Elucidating training effects on cortical mechanisms involved in facial affect recognition may identify causes of dysfunctional facial affect recognition in schizophrenia and foster remediation strategies. In the present study, 57 schizophrenia patients were randomly assigned to (a) computer-based facial affect training that focused on affect discrimination and working memory in 20 daily 1-hour sessions, (b) similarly intense, targeted cognitive training on auditory-verbal discrimination and working memory, or (c) treatment as usual. Neuromagnetic activity was measured before and after training during a dynamic facial affect recognition task (5 s videos showing human faces gradually changing from neutral to fear or to happy expressions). Effects on 10–13 Hz (alpha) power during the transition from neutral to emotional expressions were assessed via MEG based on previous findings that alpha power increase is related to facial affect recognition and is smaller in schizophrenia than in healthy subjects. Targeted affect training improved overt performance on the training tasks. Moreover, alpha power increase during the dynamic facial affect recognition task was larger after affect training than after treatment-as-usual, though similar to that after targeted perceptual–cognitive training, indicating somewhat nonspecific benefits. Alpha power modulation was unrelated to general neuropsychological test performance, which improved in all groups. Results suggest that specific neural processes supporting facial affect recognition, evident in oscillatory phenomena, are modifiable. This should be considered when developing remediation strategies targeting social cognition in schizophrenia.
    Full-text · Article · Sep 2014 · Clinical neuroimaging
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    • "The first explanation refers to the sensory deficit in schizophrenia. Several studies have reported a basic sensory disturbance in the processing of emotion in the facial (Turetsky et al., 2007; Wynn et al., 2008; Norton et al., 2009; Laprevote et al., 2010; McBain et al., 2010; Bedwell et al., 2013; Jahshan et al., 2013) and vocal (Leitman et al., 2005, 2007, 2010, 2011a; Gold et al., 2012; Kantrowitz et al., 2013) modalities. This is unlikely to be the case in our study since patients with basic sensory disturbances, as assessed with the Benton test and the PEGA, were excluded from our sample. "
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    ABSTRACT: There has been extensive research on impaired emotion recognition in schizophrenia in the facial and vocal modalities. The literature points to biases toward non-relevant emotions for emotional faces but few studies have examined biases in emotional recognition across different modalities (facial and vocal). In order to test emotion recognition biases, we exposed 23 patients with stabilized chronic schizophrenia and 23 healthy controls (HCs) to emotional facial and vocal tasks asking them to rate emotional intensity on visual analog scales. We showed that patients with schizophrenia provided higher intensity ratings on the non-target scales (e.g., surprise scale for fear stimuli) than HCs for the both tasks. Furthermore, with the exception of neutral vocal stimuli, they provided the same intensity ratings on the target scales as the HCs. These findings suggest that patients with chronic schizophrenia have emotional biases when judging emotional stimuli in the visual and vocal modalities. These biases may stem from a basic sensorial deficit, a high-order cognitive dysfunction, or both. The respective roles of prefrontal-subcortical circuitry and the basal ganglia are discussed.
    Full-text · Article · Aug 2014 · Frontiers in Psychology
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