Emotion Recognition Deficits In Patients Research Articles

Facial emotion-recognition deficits in patients with schizophrenia and unaffected first-degree relatives.

This study aimed to determine trait- and state-dependent markers of schizophrenia by investigating facial emotion-recognition (FER) deficits in remitted patients with schizophrenia and their first-degree relatives (FR). Three groups were included: the Schizophrenia group (n=66), their unaffected FR group (n=40), and healthy controls (n=50) who were matched for age, sex, and years of education. A facial-labeling task was used to examine FER deficits using the following eight standardized expressions: happy, fearful, disgusted, angry, sad, contemptuous, surprised, and neutral. There was a poorer accuracy in the recognition of sadness and anger in the Schizophrenia group as well as in contempt in both the Schizophrenia and FR groups compared with healthy controls. The response times for the recognition of contempt, sadness, and neutral emotion were delayed in the Schizophrenia group and those for fear were delayed in the Schizophrenia and FR groups compared with healthy controls. Concerning the accuracy in FER, sadness and anger can be considered state-dependent markers of remitted schizophrenia, and contempt is a trait-dependent marker of schizophrenia. Similarly, for response times in FER, contempt, sadness, and neutral emotion can be considered state-dependent markers of remitted schizophrenia, while fear is considered a trait-dependent marker of schizophrenia. These findings may contribute to the early diagnosis of schizophrenia and the development of relevant therapeutic interventions.

70 Visual Attention and Emotion Recognition Deficits in Patients with Cerebellar Tumors

Objective:Social cognition refers to processing, analyzing and understanding information about emotions and social situations. Many studies indicate a frequent deficit of these functions in people with tumors of the cerebellum. Visual search is an important attention process prior to information processing. It also mediates the relationship between cognitive function (attention) and social cognition. There are numerous data showing that disorders of various aspects of attention are fairly common in patients with tumors of the cerebellum. The question arises whether there is any relationship between these functions. The purpose of this study was to find out if there is a relationship between visual search performance and the ability to recognize emotions.Participants and Methods:The study included 19 patients with the cerebello-pontine angle (CPA) tumors (mean age = 38.84, SD = 14.27; 10 women and 9 men) and 19 healthy controls (mean age 38.26, SD = 10.40; 10 women and 9 men). The research group consisted of patients from the Department of Neurosurgery, UCK Medical University of Warsaw, the control group was healthy. The groups did not differ demographically. At the beginning, the respondents completed a questionnaire in which they were asked about demographic data and health status. Then, a series of 40 boards presenting the letters T in two colors, blue and orange, scattered in different planes was presented. The letters were right or upside down. The test person’s task was to find and click the correctly positioned orange T letter as quickly as possible. Then, a series of 56 photos of faces representing seven different emotions was presented (happiness, anger, sadness, surprise, disgust, fear and a neutral face). The test person’s task was to decide which of the emotions mentioned under the photo were presented by the presented face.Results:The results indicated that patients with tumors in the CPA area had a longer mean reaction time and lower accuracy when performing visual searches than subjects from the control group. Likewise, there were longer times and lower accuracy in the emotional recognition task. Moreover, in the group of patients with CPA tumor, the response time during visual search was negatively associated with the correctness of the response in visual search (p = -0.57, p <0.05). There were also negative correlations between the reaction time and the correctness of recognizing particular emotional states: anger (p = -0.48, p <0.05), disgust (p = -0.62, p <0.01) and neutral (p = -0.64, p <0.01). The correctness of answers in visual search correlated positively with the accuracy of emotion recognition (p = 0.72, p <0.01). None of the above-mentioned relationships were found in the control group.Conclusions:The obtained results indicate a relationship between the quality of visual attention and the ability to recognize emotions in people with cerebellar lesions. In order to better understand this phenomenon, it is necessary to continue research in this field.

Facial Affect Recognition in Immersive Virtual Reality: Where is the Participant Looking?

The recognition of facial expression of emotions in others is essential in daily social interactions. The different areas of the face play different roles in decoding each emotion. To find out which ones are more important, the traditional approach has been to use eye-tracking devices with static pictures to capture which parts of the face people are looking at when decoding emotions. However, the ecological validity of this approach is limited because, unlike in real life, there is no movement in the face that can be used to identify the emotion. The use of virtual reality technology opens the door to new experiences in which the users perceive that they are in front of dynamic virtual humans. Therefore, our main aim is to investigate whether the user's immersion in a virtual environment influences the way dynamic virtual faces are visually scanned when decoding emotions. An experiment involving 74 healthy participants was carried out. The results obtained are consistent with previous works. Having confirmed the correct functioning of our solution, it is our intention to study whether emotion recognition deficits in patients with neuropsychiatric disorders are related to the way they visually scan faces.

High Schizotypy Predicts Emotion Recognition Independently of Negative Affect.

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.

A new measure of authentic auditory emotion recognition: Application to patients with schizophrenia

BackgroundMany social processes such as emotion recognition are severely impaired in patients with schizophrenia. While basic auditory processing seems to play a key role in identifying emotions, research in this field is limited due to the lack of proper assessment batteries. Many of the widely accepted tests utilize actors to portray certain emotions—these batteries are less ecologically and face valid. MethodsThis study utilized a newly developed auditory emotion recognition test that contained natural stimuli from spontaneous displays of emotions to assess 28 patients with schizophrenia and 16 healthy controls. ResultsThe results indicate that the newly developed test, referred to as the INTONATION Test, is more sensitive to the emotion recognition deficits in patients with schizophrenia than previously used measures. The correlations of the INTONATION Test measures with basic auditory processes were similar to established tests of auditory emotion. Particular emotion sub scores from the INTONTATION test, such as happiness, demonstrated the strongest correlations with specific auditory processing skills, such as formant discrimination and sinusoidal amplitude modulation detection (SAM60). ConclusionsThe results from this study indicate that auditory emotion recognition impairments are more pronounced in patients with schizophrenia when perceiving authentic displays of emotion. Understanding these deficits could help specify the nature of auditory emotion recognition deficits in patients with schizophrenia and those at risk.

Facial emotion recognition deficits in patients with bipolar disorder and their healthy parents

BackgroundThere is evidence on deficits in facial emotion recognition (FER) in patients with bipolar disorder (BD), and these deficits may be present in individuals with genetic risk for BD. This study investigated facial emotion identification and discrimination abilities in patients with BD, their parents, and healthy controls. Materials and methodsThis study included 38 patients with bipolar I disorder and 30 healthy controls for patients as well as 30 healthy mothers and 30 healthy fathers of these patients and 30 healthy controls who matched the mothers and fathers for age, gender, and education (total 188 participants). Facial Emotion Identification and Discrimination Tests were applied to all participants; the Hamilton Depression Rating Scale and Young Mania Rating Scale were applied to patients and their control group. ResultsFacial Emotion Identification and Discrimination Test scores of patients and their parents were reasonably lower than their matching control groups. Moreover, we found that difficulty in FER affected more emotions in mothers than in fathers and mothers performed significantly worse than patients in the identification of angry and embarrassed faces. ConclusionThese findings indicate that parents of patients with BD have impairment with recognizing facial emotions and suggest that there may be an association between FER of patients with BD and that of their mothers.

Altered P3a Modulations to Emotional Faces in Male Patients With Chronic Schizophrenia.

Existing evidence suggests that patients with schizophrenia may have a deficit in processing facial expressions. However, the neural basis of this processing deficit remains unclear. A total of 20 men diagnosed with chronic schizophrenia and 13 age- and sex-matched controls participated in the study. We investigated visual N170 and P3a components evoked in response to fearful, happy, and sad faces during an emotion discrimination task. Compared with control subjects, patients showed significantly smaller N170 amplitudes bilaterally (P = .04). We found no significant main effect of emotion of the presented faces (fearful, happy, or sad) on N170 amplitude. Patients showed significantly smaller P3a amplitudes in response to fearful (P = .01) and happy (P = .02) faces, but no significant between-group differences were observed for sad faces (P = .22). Moreover, we found no significant P3a modulation effect in response to emotional faces in patients with schizophrenia. Our results suggest that altered P3a modulations to emotional faces may be associated with emotion recognition deficits in patients with schizophrenia.

T32. INTACT AUDITORY PERCEPTION IN INDIVIDUALS AT CLINICAL HIGH RISK FOR PSYCHOSIS

Basic perceptual processes are impaired in schizophrenia and may explain key social deficits such as the ability to identify emotions in other people. We recently reported widespread auditory impairments across multiple domains of auditory function in individuals with schizophrenia. Additionally, we found that these auditory impairments are associated with auditory emotion recognition deficits in patients with schizophrenia. These auditory deficits may be closely linked to the neural circuits relevant for the development of psychotic symptoms and thus may be useful predictors of psychosis onset and promising therapeutic targets. However, it is not yet known if basic auditory processing deficits are associated with the impaired emotional processing preceding the illness. We have assessed 25 individuals at clinical high-risk for psychosis and 42 healthy controls between the ages of 12 and 30 on a comprehensive battery of tasks spanning the four empirically derived domains of auditory function. We explored group differences across the battery of basic auditory tasks using between groups t-tests. We also explored the relationship between basic auditory processing and auditory emotion identification within the high-risk group using correlational analysis. We did not observe significant group differences in the ability to identify emotion in vocal samples or in basic auditory skills, with the exception of frequency discrimination, which was significantly better in high-risk subjects (Cohen’s =.67, p<.05). Additionally, none of the basic auditory skills correlated with emotion recognition in the high-risk group. Previous research has indicated widespread impairment of basic auditory skills in schizophrenia that is associated with difficulty understanding emotion from the vocal characteristics of a speaker. We investigated whether these impairments and correlations are present in individuals at high-risk for psychosis. We found no indication of impaired emotion recognition or basic auditory skills in high-risk individuals. Our results suggest that auditory impairment is not a characteristic of high-risk status and thus may emerge after psychosis onset.

Are emotion recognition deficits in patients with schizophrenia states or traits? A 6-month follow-up study.

Background:Patients with schizophrenia were found to be less successful at emotion recognition tasks (ERTs) than healthy individuals. There is a debate surrounding whether this deficit is permanent or temporary. The current study aims to assess how emotion recognition skills are affected by treatment processes and during the course of the disease and also to determine the relation of this change with clinical assessment scales, other cognitive functions, and quantitative electroencephalography (QEEG).Materials and Methods:Twenty-four inpatients with treatment-resistant schizophrenia have been included in the study. Patients were assessed before beginning clozapine and 6 months later. During both assessments, clinical evaluation scales (Positive and Negative Syndrome Scale and Global Assessment of Functioning), Cambridge Neuropsychological Test Automated Battery (CANTAB) for schizophrenia which is used for assessment of cognitive functions were used. Electroencephalography (EEG) monitorings were performed only once before treatment. In this study, CANTAB ERT was used for emotion recognition.Results:There was no statistically significant change in the emotion recognition when the first and final ERTs were compared. There was a moderately positive relationship between emotional recognition and functioning (r = 0.65, P < 0.05). Cognitive functions such as visual memory, attention, flexible thinking, and planning were found to be in correlation with emotion recognition. Furthermore, slow waves such as delta and theta activities obtained from frontal, temporoparietal, and occipital regions were associated with emotion recognition.Conclusion:The current study supports that emotion recognition deficits are long-term stable features of schizophrenia, slow-wave electrical activity in the frontal, temporoparietal, and occipital areas in QEEG, and cognitive functions such as visual memory, attention, flexible thinking, and planning are found to be correlated with emotion recognition.

T79. AFFECTIVE FACE PROCESSING IN SCHIZOPHRENIA: DISORDER-SPECIFIC OR TRANSDIAGNOSTIC DEFICIT?

BackgroundSocial cognitive dysfunction is common in patients with schizophrenia and is associated with marked and persistent functional disability. Facial emotion recognition is a core aspect of social cognition and has been consistently demonstrated to be impaired in this population. However, it remains unclear whether these deficits are unique to patients with schizophrenia. We compared the severity of facial emotion recognition deficits in patients with both sub- and full-threshold psychotic symptoms to those observed across a range of psychiatric, neurological and developmental disorders in order to determine to what extent this represents a disorder-specific or transdiagnostic aspect of cognitive dysfunction.MethodsWe conducted an electronic database search in order to identify published, peer-reviewed meta-analyses that compared facial emotion recognition task performance between individuals meeting clinical criteria for a psychiatric, neurological or developmental condition against healthy controls. Facial emotion recognition standardized mean difference effect size estimates (Cohen’s d or Hedges’ g) were required to have been derived from tasks in which participants had to identify, label or match images of faces consisting of all or any combination of the six basic emotions (happiness, sadness, anger, fear, surprise or disgust). Where possible, a ‘total’ score was used, comprising performance across multiple emotions. Effect size estimates must have been derived from two or more independent studies in order for the meta-analysis to be included. Where there were multiple publications for a given medical condition that met our inclusion criteria, we included the most recently published paper.ResultsWe identified 19 meta-analyses eligible for inclusion that examined performance across relevant tasks among 24 different clinical populations. Though the effect sizes are not directly comparable across clinical conditions (due to methodological differences between studies and in meta-analytic procedures), they demonstrate consistent and statistically significant deficits in facial emotion recognition across almost all of the clinical groups included in this review. Effect size estimates indicated that deficits among patients with schizophrenia were among the largest and most robust. Deficits were also evident even among those individuals with sub-threshold psychotic symptoms who met clinical criteria for being at ultra-high risk of developing a psychotic disorder.DiscussionFacial emotion recognition deficits are a transdiagnostic issue, potentially serving as a biomarker of neurological abnormality. However, these impairments appear to be particularly severe and debilitating among people with schizophrenia. There are currently no recognized treatments for these deficits. This in part is due to a lack of outcome measures suitable for use in clinical trials. Improved characterization and operationalization of social cognition and other ‘hot’ cognitive processes are necessary to facilitate and advance treatment efforts, both in schizophrenia and across other clinical groups. We are currently in the process of developing and acquiring normative data for a series of computerized tasks which can be used to assess these domains. This includes new variants of established tests which have been used to assess facial emotion recognition, as well as novel tasks to detect emotional biases and assess responses to socially-relevant information. These tasks will help to facilitate further research into these complex social processes and potentially assist in the development of interventions for those patients that are adversely affected.

Altered Kinematics of Facial Emotion Expression and Emotion Recognition Deficits Are Unrelated in Parkinson's Disease.

Altered emotional processing, including reduced emotion facial expression and defective emotion recognition, has been reported in patients with Parkinson's disease (PD). However, few studies have objectively investigated facial expression abnormalities in PD using neurophysiological techniques. It is not known whether altered facial expression and recognition in PD are related. To investigate possible deficits in facial emotion expression and emotion recognition and their relationship, if any, in patients with PD. Eighteen patients with PD and 16 healthy controls were enrolled in this study. Facial expressions of emotion were recorded using a 3D optoelectronic system and analyzed using the facial action coding system. Possible deficits in emotion recognition were assessed using the Ekman test. Participants were assessed in one experimental session. Possible relationship between the kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients were evaluated using the Spearman's test and multiple regression analysis. The facial expression of all six basic emotions had slower velocity and lower amplitude in patients in comparison to healthy controls (all Ps < 0.05). Patients also yielded worse Ekman global score and disgust, sadness, and fear sub-scores than healthy controls (all Ps < 0.001). Altered facial expression kinematics and emotion recognition deficits were unrelated in patients (all Ps > 0.05). Finally, no relationship emerged between kinematic variables of facial emotion expression, the Ekman test scores, and clinical and demographic data in patients (all Ps > 0.05). The results in this study provide further evidence of altered emotional processing in PD. The lack of any correlation between altered facial emotion expression kinematics and emotion recognition deficits in patients suggests that these abnormalities are mediated by separate pathophysiological mechanisms.

Virtual Avatar for Emotion Recognition in Patients with Schizophrenia: A Pilot Study

Persons who suffer from schizophrenia have difficulties in recognizing emotions in others’ facial expressions, which affects their capabilities for social interaction and hinders their social integration. Photographic images have traditionally been used to explore emotion recognition impairments in schizophrenia patients, but they lack of the dynamism that is inherent to facial expressiveness. In order to overcome those inconveniences, over the last years different authors have proposed the use of virtual avatars. In this work, we present the results of a pilot study that explored the possibilities of using a realistic-looking avatar for the assessment of emotion recognition deficits in patients who suffer from schizophrenia. In the study, 20 subjects with schizophrenia of long evolution and 20 control subjects were invited to recognize a set of facial expressions of emotions showed by both the said virtual avatar and static images. Our results show that schizophrenic patients exhibit recognition deficits in emotion recognition from facial expressions regardless the type of stimuli (avatar or images), and that those deficits are related with the psychopathology. Finally, some improvements in recognition rates (RRs) for the patient group when using the avatar were observed for sadness or surprise expressions, and they even outperform the control group in the recognition of the happiness expression. This leads to conclude that, apart from the dynamism of the shown expression, the RRs for schizophrenia patients when employing animated avatars may depend on other factors which need to be further explored.

Two systems for empathy in obsessive-compulsive disorder: mentalizing and experience sharing.

Objective:To investigate empathic abilities in patients with obsessive-compulsive disorder (OCD) compared to control subjects. OCD is characterized by persistent obsessions and compulsions. Previous studies have proposed specific emotion recognition deficits in patients with OCD. The ability to recognize emotion is part of the broad construct of empathy that incorporates mentalizing and experience-sharing dimensions.Methods:Twenty-four subjects with a diagnosis of OCD and 23 control subjects underwent empathic measures.Results:Patients with OCD compared to control subjects showed deficits in all mentalizing measures. They were incapable of understanding the mental and emotional states of other people. On the other hand, in the sharing experience measures, the OCD group was able to empathize with the emotional experience of other people when they expressed emotions with positive valence, but were not able to do when the emotional valence was negative.Conclusion:Our results suggest that patients with OCD show a difficulty in mentalizing ability, whereas the deficit in sharing ability is specific for the negative emotional valence.

EPA-1071 – Emotion recognition deficit in patients with single right hemisphere damage

Introduction Research about psychological manifestations in right hemisphere damage (RHD) has increased in recent decades. The most characteristic alterations affect social cognition, which involves skills related to social interaction, as Theory of Mind, use of humor or metaphors comprehension inter alia. One of them is Facial Emotion Recognition (FER), which has been investigated in brain damaged patients, although studies present small samples and other metodological limitations. Objectives Comparing FER skills in a single RHD patients and non-brain damaged control group. Aims Identifying the FER patterns, analyzing differences according to the type of emotion. Method 46 patients with RHD due to stroke (mean age 68.93;SD12.62. 52% males) and 46 control subjects (67.28;SD18.29. 50% males), were assessed in sociodemographic and clinical variables. Mini-mental State Examination and Hamilton Depression Rating Scale were administered. To assess FER, 60 photographs from Pictures of Facial Affect (POFA) collection (Ekman, 1993) were shown to the sample, which identified them according to the type of emotion (i.e. happiness, fear, surprise, sadness, disgust, anger). Results Both samples, despite having similar characteristics, showed significant differences in FER (T=−2.751;p=0.007). In total sample, lowest performance was recorded in identifying fear (mean correct answers 0.45;SD0.252) and anger (0.48;SD0.301). RHD patients presented a deficit in FER skill compared to controls. Significant differences were found in recognizing anger (T=−2.043;p=0.044), disgust (T=−2.059;p=.042), happiness (T=−2.371;p=0.020), and sadness (T=−2.633;p=0.010). Conclusions Results confirm a probable relationship between single RH and FER, suggesting RH involvement in anger, disgust, happiness and sadness processing.

Effect of yoga therapy on plasma oxytocin and facial emotion recognition deficits in patients of schizophrenia

Context:Yoga therapy has been demonstrated to be useful in treatment of negative symptoms and improving the socio-occupational functioning and emotion recognition deficits in antipsychotic-stabilized schizophrenia patients. Oxytocin has been recently implicated in social cognition deficits in schizophrenia. The effect of yoga therapy on oxytocin levels in schizophrenia has not been studied.Aims:This study aimed to assess the effect of yoga therapy on symptoms, socio-occupational functioning, facial emotion recognition deficits and plasma oxytocin levels in antipsychotic stabilized schizophrenia patients.Settings and Design:Randomized controlled study on 43 consenting, medication stabilized patients with schizophrenia in a tertiary psychiatric center using yoga intervention and waitlisted groups.Materials and Methods:A total of 43 schizophrenia patients were randomized to yoga group (n=15) or waitlist group (n=28). Patients in the yoga group received training in a specific yoga therapy module for schizophrenia. Patients in both groups were continued on stable antipsychotic medication. Assessments included scale for assessment of positive symptoms, scale for assessment of negative symptoms, socio-occupational functioning scale and tool for recognition of emotions in neuropsychiatric disorders (TRENDS) and plasma oxytocin levels; performed at baseline and at the end of 1 month.Results:A total of 15 patients in the yoga group and 12 in waitlist group completed the study. The yoga therapy group showed a significant improvement in socio-occupational functioning, performance on TRENDS (P<0.001) and plasma increase in oxytocin levels (P=0.01) as compared with the waitlist group.Conclusion:The study supported the role of add-on yoga therapy in management of schizophrenia and demonstrated an improvement in endogenous plasma oxytocin levels in schizophrenia patients receiving yoga therapy.

Emotion recognition and oxytocin in patients with schizophrenia

BackgroundStudies have suggested that patients with schizophrenia are impaired at recognizing emotions. Recently, it has been shown that the neuropeptide oxytocin can have beneficial effects on social behaviors.MethodTo examine emotion recognition deficits in patients and see whether oxytocin could improve these deficits, we carried out two experiments. In the first experiment we recruited 30 patients with schizophrenia and 29 age- and IQ-matched control subjects, and gave them an emotion recognition task. Following this, we carried out a second experiment in which we recruited 21 patients with schizophrenia for a double-blind, placebo-controlled cross-over study of the effects of oxytocin on the same emotion recognition task.ResultsIn the first experiment we found that patients with schizophrenia had a deficit relative to controls in recognizing emotions. In the second experiment we found that administration of oxytocin improved the ability of patients to recognize emotions. The improvement was consistent and occurred for most emotions, and was present whether patients were identifying morphed or non-morphed faces.ConclusionsThese data add to a growing literature showing beneficial effects of oxytocin on social–behavioral tasks, as well as clinical symptoms.