Elsevier

Neuroscience Letters

Volume 633, 28 October 2016, Pages 47-54
Neuroscience Letters

Research article
Detecting facial emotion recognition deficits in schizophrenia using dynamic stimuli of varying intensities

https://doi.org/10.1016/j.neulet.2016.09.017Get rights and content

Highlights

  • Dynamic and static stimuli are comparable for emotion recognition in schizophrenia.

  • Emotion intensity may not be a necessary variable to include in this research.

  • Emotion recognition correlates significantly with general cognition in schizophrenia

Abstract

Background

Deficits in facial emotion recognition have been associated with functional impairments in patients with Schizophrenia (SZ). Whilst a strong ecological argument has been made for the use of both dynamic facial expressions and varied emotion intensities in research, SZ emotion recognition studies to date have primarily used static stimuli of a singular, 100%, intensity of emotion. To address this issue, the present study aimed to investigate accuracy of emotion recognition amongst patients with SZ and healthy subjects using dynamic facial emotion stimuli of varying intensities. To this end an emotion recognition task (ERT) designed by Montagne (2007) was adapted and employed.

Methods

47 patients with a DSM-IV diagnosis of SZ and 51 healthy participants were assessed for emotion recognition. Results of the ERT were tested for correlation with performance in areas of cognitive ability typically found to be impaired in psychosis, including IQ, memory, attention and social cognition.

Results

Patients were found to perform less well than healthy participants at recognising each of the 6 emotions analysed. Surprisingly, however, groups did not differ in terms of impact of emotion intensity on recognition accuracy; for both groups higher intensity levels predicted greater accuracy, but no significant interaction between diagnosis and emotional intensity was found for any of the 6 emotions. Accuracy of emotion recognition was, however, more strongly correlated with cognition in the patient cohort.

Discussion

Whilst this study demonstrates the feasibility of using ecologically valid dynamic stimuli in the study of emotion recognition accuracy, varying the intensity of the emotion displayed was not demonstrated to impact patients and healthy participants differentially, and thus may not be a necessary variable to include in emotion recognition research.

Introduction

Deficits in social cognition, including facial emotion recognition, are evident in schizophrenia (SZ) and impact functional prognosis differentially to neurocognitive measures such as memory and intelligence quotient (IQ) [24]. Decades of research have established that individuals with SZ have difficulty in reading and interpreting facial emotion when compared with control subjects (e.g., [17], [65], [10], [43]; impairments which have been demonstrated to be moderately stable over time [32], [2]. Impairments in facial emotion recognition have been linked to social and occupational outcomes such as unemployment, need for assisted living [58], [29], decreased social competence, conversational skills and social interest [49], [30], and inappropriate personal appearance [23]. This impact of facial emotion recognition deficits is perhaps not surprising when one considers that facial emotional expressions are the building blocks of social interaction, conveying vital non-verbal cues for inferences about the motivation and intentions of others [14].

Of interest is how recognition of these emotions relates to performance on neurocognitive measures such as IQ and memory, particularly as people with deficits in emotion recognition often suffer deficits in neurocognition also [16], [42]. There have been surprisingly few studies in this field to date, although the consensus between those that exist is strong. Among healthy participants, neurocognition might be said to have a minimal impact on expression recognition [33], [28]. However, among patients with SZ, research has demonstrated correlations between neurocognitive and social cognitive performance. For example, [44] showed that deficits in executive function in SZ are associated with poorer performance on facial emotion recognition tasks; [38] found that emotion recognition correlated with attention, verbal and spatial memory, and language abilities; whereas [54] found that poorer performance in emotion discrimination correlated with abstraction-flexibility, verbal memory and language processing. Indeed a study by [7] found that when examining patients with SZ, their siblings, and healthy controls, emotion recognition performance was distributed along a continuum between the control group and the schizophrenia group, with the siblings group midway between. This continuum parallels the one observed in cognition [11], [56], [60]. This same study by Bediou et al. also demonstrates that, much like cognition, emotion recognition deficits are apparent prior to illness onset and before treatment and that performance remained impaired after 1 month of low-dose haloperidol treatment despite symptom stabilisation, suggesting trait-like features. For this reason, taking a closer look at the relationship between emotion recognition and cognitive deficits is of great importance.

Many neuropsychological tests have been developed to assess facial emotion recognition. The majority of these use still photographs displaying full intensity emotions [25], [63], [52], [18]. It has been argued that such tasks are not ecologically valid [4]; in everyday society the faces encountered are (1) dynamic and (2) display emotions of varying levels of intensity.

In the last decade, research has begun to focus on the dynamic aspect of face recognition with some interesting results. It was demonstrated that dynamic displays of emotion are recognized more accurately [68], and lead to greater levels of arousal [55], than static displays. Moreover, there is growing evidence of specialized brain systems being preferentially activated by moving faces [50], [62]. A study by [34], for example, showed that during facial emotion processing, static stimuli invoke a greater response than dynamic stimuli in regions of the frontal cortex, whilst dynamic stimuli were associated with greater temporal lobe activation than static stimuli. A further paper by [26] suggests a model whereby the representation of static aspects of faces is mediated more by the face-responsive region in the fusiform gyrus, whereas the representation of dynamic aspects is mediated more by the face-responsive region in the superior temporal sulcus. As such, the processing of static and dynamic facial emotion may well rely upon separable brain systems. This differential biology, coupled with the differing impact of static and dynamic stimuli on functional outcome provide good arguments for the use of dynamic emotion stimuli in research.

Despite this, only a handful of behavioural studies have been conducted to date involving patients with SZ, in which facial emotion-processing accuracy to dynamic facial emotion stimuli was assessed [3], [6], [53], [31], [46], [8], [61]. The validity of both the Archer and Russell studies as measurements of patient accuracy during dynamic face emotion recognition tasks has been questioned [31]. Notwithstanding this however, all studies found that patients had a decreased ability to correctly identify the emotion expressed in dynamic faces compared to controls. This deficit in emotion recognition was also apparent in relatives of patients [61], and in healthy individuals possessing schizotypal traits [1]. In addition, functional neuroimaging research from our lab has shown that patients with schizophrenia show altered activity of brain regions involved in emotion processing while viewing dynamic facial expressions compared to healthy controls, which may contribute towards some of these deficits [48].

A majority of the dynamic stimuli research in SZ to date has employed facial expressions of saturated intensity. Only four studies [6], [46], [61] implemented a multi-intensity dynamic model, with only one of these [6] reporting on the effects of intensity on emotion recognition accuracy. In this study, it was found that emotion recognition is impaired at moderate and high intensities, but not at low intensities, when compared to healthy controls. A few studies have used static stimuli to assess the relationship between emotion intensity and recognition. In the only case/control study conducted to date, [39] found that all emotions, except disgust, were better recognized in the extreme than mild intensity. However, patients with schizophrenia did not benefit from greater emotional intensity to the extent that healthy subjects benefited. As such Kohler concluded (much like [6] that patients with SZ were more impaired than healthy comparison subjects in identifying high-intensity expressions than identifying low intensity expressions, even though the former was an easier task. In patient only studies, [22] reported that patients who scored high for psychopathy were found to have impaired recognition of sadness at low intensity compared to those with low psychopathy, whilst [59] found that violent schizophrenia patients were less able to assess the intensity of emotions than non-violent patients. As such, research investigating emotion intensity using static stimuli suggests that the intensity at which an emotion is expressed may influence a patient’s ability to correctly identify that emotion [57].

The aims of the present study were to examine the effect of emotion intensity on recognition performance using the more ecologically valid stimulus of dynamic emotion, and to look for correlations between emotion recognition and cognition in both patients and healthy controls. To do this, the current study used an adaptation of an innovative dynamic Emotion Recognition Task (ERT) [47], to measure differing intensities of 6 emotion expressions ranging from 20% to 100%. We hypothesised that (1) patients will show poorer performance on the ERT than healthy participants across all six basic emotions; (2) the intensity of the emotion displayed will impact recognition accuracy in both patients and healthy participants, with lower intensity levels leading to poorer recognition accuracy; (3) amongst patients, performance on the ERT will correlate with other social cognitive variables involving face or emotion recognition, as well as with the more traditional cognitive variables of IQ, memory and attention (as it has done in previous research [38], [54]).

Section snippets

Clinical sample

The clinical sample consisted of 47 cases, aged 18–65 years, recruited from two sites in Dublin, Ireland with a DSM-IV diagnosis of SZ (see Table 1 for participant demographics). Inclusion criteria required that participants were clinically stable in the opinion of the treating team (as indicated by having no significant psychotropic medication changes in the past 2 months and none anticipated for the next month; showing evidence of stable symptomatology for at least 3 months, and no recent

Demographics and clinical sample characteristics

Demographic and clinical characteristics for patients and healthy participants, expressed in terms of means and standard deviations appear in Table 1. Comparing patients with healthy subjects, there was a significant difference in mean scores for age, years of education, IQ and gender between groups, such that patients were older (F = 8.28, p = 0.004), had less years of education (F = 13.91, p = < 0.001), had a lower full scale IQ (F = 16.65, p = < 0.001), and comprised significantly more males (F = 6.42, p = 

Discussion

The purpose of the present study was to investigate whether patients with SZ (n = 47) were impaired relative to their healthy counterparts (n = 50) at accurately identifying emotions of varying intensities in a dynamic emotion recognition task developed by [47], and whether an interaction between group by intensity was apparent. We further sought to ascertain whether any correlation existed between performance on the dynamic ERT and performance on other cognitive variables, both social and

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