Increased face detection responses on the mooney faces test in people at clinical high risk for psychosis

Steven M Silverstein,Jason A Levin,Richard E Zinbarg,Judy L Thompson,Scott W Woods,Joshua Kenney,Philip R Corlett,Trevor F Williams,Eren Kafadar,Albert R Powers,Lauren M Ellman,James M Gold,James A Waltz,Vijay A Mittal,Dillon Smith,Elaine F Walker,Gregory P Strauss,Jason Schiffman

doi:10.1038/s41537-021-00156-1

Abstract

Identifying state-sensitive measures of perceptual and cognitive processes implicated in psychosis may allow for objective, earlier, and better monitoring of changes in mental status that are predictive of an impending psychotic episode, relative to traditional self-report-based clinical measures. To determine whether a measure of visual perception that has demonstrated sensitivity to the clinical state of schizophrenia in multiple prior studies is sensitive to features of the at-risk mental state, we examined differences between young people identified as being at clinical high risk for psychosis (CHR; n = 37) and non-psychiatric matched controls (n = 29) on the Mooney Faces Test (MFT). On each trial of the MFT, participants report whether they perceive a face in a degraded face image. The CHR group reported perceiving a greater number of faces in both upright and inverted MFT stimuli. Consistent with prior work, males reported more faces on the MFT than females in both conditions. However, the finding of greater reported face perception among CHR subjects was robustly observed in the female CHR group relative to the female control group. Among male CHR participants, greater reported face perception was related to increased perceptual abnormalities. These preliminary results are consistent with a small but growing literature suggesting that heightened perceptual sensitivity may characterize individuals at increased clinical risk for psychosis. Further studies are needed to determine the contributions of specific perceptual, cognitive, and motivational mechanisms to the findings.

Highlights

The clinical high risk (CHR) approach to studying psychosis has led to advances in the ability to reliably identify and effectively treat those most likely to develop a psychotic disorder[1,2]
To inform the identification of measures that are sensitive to processes underlying symptom development and expression in the at-risk mental state, we investigated the performance of individuals at CHR on a well-validated assessment of visual perception, the Mooney Faces Test (MFT19)
Due to the small numbers in some of the race categories, the CHR and Healthy control (HC) groups were compared on the proportion of Caucasian vs. non-Caucasian participants

Summary

INTRODUCTION

The clinical high risk (CHR) approach to studying psychosis has led to advances in the ability to reliably identify and effectively treat those most likely to develop a psychotic disorder[1,2]. The incorporation of state-sensitive performance-based measures with established links to the pathophysiological mechanisms implicated in symptom genesis may allow for more objective and effective monitoring of changes in mental status that are predictive of an impending psychotic episode or a positive response to treatment[4,5] While this approach to psychosis risk assessment is just emerging, there are already multiple studies of schizophrenia documenting that relatively brief and non-invasive behavioral and electrophysiological measures can tap into mechanisms thought to be involved in positive[6,7,8], negative[9,10,11,12], disorganized[13,14,15] or motor[16] symptoms, and that these measures are sensitive to changes in the severity level of the symptom cluster with which they are correlated[14,17,18]. Unlike in the Teufel et al study described above, we did not provide subjects with prior exposure to the unaltered face images, as we sought to determine the ‘naïve’ MFT performance of subjects, unaffected by prior exposure to any form of the images

RESULTS

DISCUSSION

CODE AVAILABILITY