Abstract
Introduction: Deficits in Emotion Recognition (ER) contribute significantly to poorer functional outcomes in people with schizophrenia. However, rather than reflecting a core symptom of schizophrenia, reduced ER has been suggested to reflect increased mood disorder co-morbidity and confounds of patient status such as medication. We investigated whether ER deficits are replicable in psychometrically defined schizotypy, and whether this putative association is mediated by increased negative affect.Methods: Two hundred and nine participants between the ages of 18 and 69 (66% female) were recruited from online platforms: 80% held an undergraduate qualification or higher, 44% were current students, and 46% were in current employment. Participants were assessed on psychometric schizotypy using the O-LIFE which maps onto the same symptoms structure (positive, negative, and disorganised) as schizophrenia. Negative affect was assessed using the Depression Anxiety and Stress Scale (DASS-21). Emotion Recognition of both positive and negative emotions was assessed using the short version of the Geneva Emotion Recognition Task (GERT-S).Results: Negative schizotypy traits predicted poorer ER accuracy to negative emotions (β = −0.192, p = 0.002) as predicted. Unexpectedly, disorganised schizotypy traits predicted improved performance to negative emotions (β = 0.256, p = 0.007) (primarily disgust). Negative affect was found to be unrelated to ER performance of either valence (both p > 0.591). No measure predicted ER accuracy of positive emotions. Positive schizotypy traits were not found to predict either positive or negative ER accuracy. However, positive schizotypy predicted increased confidence in decisions and disorganised schizotypy predicted reduced confidence in decisions.Discussion: The replication of ER deficits in non-clinical negative schizotypy suggests that the association between negative symptoms and ER deficits in clinical samples may be independent of confounds of patient status (i.e., anti-psychotic medication). The finding that this association was independent of negative affect further suggests ER deficits in patients may also be independent of mood disorder co-morbidity. This association was not demonstrated for the positive symptom dimension of the O-LIFE, which may be due to low levels of this trait in the current sample.
Highlights
Deficits in Emotion Recognition (ER) contribute significantly to poorer functional outcomes in people with schizophrenia
Positive schizotypy was lower in the current sample (p = 0.004, rrb = −0.27), negative schizotypy (p < 0.001, rrb = 0.76), DASS-21 (p < 0.001, rrb = 0.80), and total GERT-S were higher (p < 0.001, d = 1.09), but disorganised schizotypy did not differ (p = 0.536, rrb = 0.04)
This study demonstrated Emotion Recognition deficits were associated with negative schizotypy, suggesting an association between negative clinical symptoms and emotion recognition deficits may be independent of confounds of patient status
Summary
Deficits in Emotion Recognition (ER) contribute significantly to poorer functional outcomes in people with schizophrenia. The symptoms of schizophrenia can be categorised as positive negative or cognitive [2]. Negative symptoms in particular are associated with poorer functional outcomes [4, 5], including lower employment rates [6], smaller social networks [7], and poorer quality of life [8,9,10]. It is the negative symptoms and disorganised symptoms that are most consistently associated with poorer social cognition in schizophrenia [11]
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