Facial Action Coding System (FACS): uno strumento di valutazione obiettiva dell’espressività mimica facciale e le sue potenziali applicazioni allo studio della schizofrenia

INTRODUCTION Affective flattening and the consequent anomalous expression of emotions are considered as key elements of the negative symptoms of schizophrenia. The purpose of this work is to assess how a survey instrument based on objective evaluation of emotional facial expressiveness (FACS) and a method of elicitation of emotions (film clips) can provide psychopathological manifestations about schizophrenia. METHODS Relevant literature was identified through a search of Medline, PsychInfo and PubMed. Search terms included: "elicitation of emotions", "facial action coding system" and "schizophrenia". The research was limited to English-language publications and studies conducted exclusively in humans. RESULTS The overall evaluation of the studies analyzed in this work show that the FACS is a useful tool to highlight specific clinical characteristics of schizophrenic patients with significant deficits in the expression and recognition of emotions, such as the status of hospitalization, the age of onset, the treatment with antipsychotic drugs, the SANS, SAPS and BPRS scores. CONCLUSIONS Even if we have preliminary and incomplete data, the FACS and the elicitation of emotions through film clips can give an original contribution to the development of knowledge on pathophysiological events and interpretive models of schizophrenia.

[1]  Dennis R. Combs,et al.  Subtypes of social perception deficits in schizophrenia , 2007, Schizophrenia Research.

[2]  Christina Reuterskiöld The Effects of Emotionality on Auditory Comprehension in Aphasia , 1991, Cortex.

[3]  Ragini Verma,et al.  Static posed and evoked facial expressions of emotions in schizophrenia , 2008, Schizophrenia Research.

[4]  Jeffrey A. Lieberman,et al.  Long-Term Neurocognitive Effects of Olanzapine or Low-Dose Haloperidol in First-Episode Psychosis , 2006, Biological Psychiatry.

[5]  W. Cannon The James-Lange theory of emotions: a critical examination and an alternative theory. By Walter B. Cannon, 1927. , 1927, The American journal of psychology.

[6]  L. Obler,et al.  Right hemisphere emotional perception: evidence across multiple channels. , 1998, Neuropsychology.

[7]  Barbara Shapiro,et al.  The role of the right hemisphere in the control of speech prosody in propositional and affective contexts , 1985, Brain and Language.

[8]  Differences between Self‐Reported and Observed Pleasure in Depression and Schizophrenia , 1979, The Journal of nervous and mental disease.

[9]  Wolfgang Gaebel,et al.  Facial expression in male and female schizophrenia patients , 2010, European Archives of Psychiatry and Clinical Neuroscience.

[10]  Leslie S. Greenberg,et al.  Emotion in psychotherapy: Affect, cognition, and the process of change. , 1987 .

[11]  H. Berenbaum,et al.  Emotional experience and expression in schizophrenia and depression. , 1992, Journal of abnormal psychology.

[12]  J. Merten CULTURE, GENDER AND THE RECOGNITION OF THE BASIC EMOTIONS , 2005 .

[13]  R. Töpper,et al.  Volitional type of facial palsy associated with pontine ischaemia. , 1995, Journal of neurology, neurosurgery, and psychiatry.

[14]  A Reichenberg,et al.  Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. , 1999, The American journal of psychiatry.

[15]  J. Gross,et al.  Emotion elicitation using films , 1995 .

[16]  Georg Juckel,et al.  Kinematic analysis of facial behaviour in patients with schizophrenia under emotional stimulation by films with “Mr. Bean” , 2008, European Archives of Psychiatry and Clinical Neuroscience.

[17]  N. Birbaumer,et al.  Reduced emotional response of schizophrenic patients in remission during social interaction , 1995, Schizophrenia Research.

[18]  A. Kring,et al.  Stability of emotional responding in schizophrenia , 1999 .

[19]  J. Deakin,et al.  Face processing in schizophrenia: defining the deficit , 2001, Psychological Medicine.

[20]  M. Phillips,et al.  Perception of facial and vocal affect by people with schizophrenia in early and late stages of illness , 2005, British Journal of Psychiatry.

[21]  G. Bower Mood and memory. , 1981, The American psychologist.

[22]  H. Hopf,et al.  Localization of emotional and volitional facial paresis , 1992, Neurology.

[23]  A. Kring,et al.  Flat affect and social skills in schizophrenia: evidence for their independence , 1999, Psychiatry Research.

[24]  P. Pattison,et al.  Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review. , 2002, Clinical psychology review.

[25]  C. Kohler,et al.  Facial emotion perception in schizophrenia: a meta-analytic review. , 2010, Schizophrenia bulletin.

[26]  A. Young,et al.  Disgust implicated in obsessive–compulsive disorder , 1997, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[27]  W. Gaebel,et al.  Facial expressivity in the course of schizophrenia and depression , 2004, European Archives of Psychiatry and Clinical Neuroscience.

[28]  Flat affect in schizophrenia does not reflect diminished subjective experience of emotion. , 1993 .

[29]  Ruben C. Gur,et al.  Facial recognition deficits and cognition in schizophrenia , 2004, Schizophrenia Research.

[30]  N C Andreasen,et al.  Negative symptoms in schizophrenia , 1982 .

[31]  David J McGonigle,et al.  Elsevier Editorial System(tm) for Biological Psychiatry Manuscript Draft Title: Overactivation of Fear Systems to Neutral Faces in Schizophrenia Fear of Faces in Schizophrenia in This Issue Statement Overactivation of Fear Systems to Neutral Faces in Schizophrenia , 2022 .

[32]  Melissa J. Green,et al.  Social cognition, empathy and functional outcome in schizophrenia , 2010, Schizophrenia Research.

[33]  P. Ekman,et al.  Constants across cultures in the face and emotion. , 1971, Journal of personality and social psychology.

[34]  J. Macher,et al.  Facial expressiveness in patients with schizophrenia compared to depressed patients and nonpatient comparison subjects. , 2005, The American journal of psychiatry.

[35]  S. Sayers,et al.  Affectivity in the problem-solving interactions of schizophrenia patients and their family members , 2004, Schizophrenia Research.

[36]  P. Johnson-Laird,et al.  Towards a Cognitive Theory of Emotions , 1987 .

[37]  A. Kring,et al.  Do schizophrenic patients show a disjunctive relationship among expressive, experiential, and psychophysiological components of emotion? , 1996, Journal of abnormal psychology.

[38]  E. Walker,et al.  Childhood precursors of schizophrenia: facial expressions of emotion. , 1993, The American journal of psychiatry.

[39]  Mohamed Saoud,et al.  Emotion recognition and genetic vulnerability to schizophrenia. , 2007, The British journal of psychiatry : the journal of mental science.

[40]  E. Moran,et al.  Emotional response deficits in schizophrenia: insights from affective science. , 2008, Schizophrenia bulletin.

[41]  J. Borod,et al.  A preliminary comparison of flat affect schizophrenics and brain-damaged patients on measures of affective processing. , 1989, Journal of communication disorders.

[42]  G. Boulogne,et al.  The Mechanism of Human Facial Expression , 1990 .

[43]  H. Schlosberg Three dimensions of emotion. , 1954, Psychological review.

[44]  M. Brüne Emotion recognition, ‘theory of mind,’ and social behavior in schizophrenia , 2005, Psychiatry Research.

[45]  François Mauguière,et al.  Early Amygdala Reaction to Fear Spreading in Occipital, Temporal, and Frontal Cortex A Depth Electrode ERP Study in Human , 2004, Neuron.

[46]  J. Singer,et al.  Cognitive, social, and physiological determinants of emotional state. , 1962 .

[47]  R. Adolphs Neural systems for recognizing emotion , 2002, Current Opinion in Neurobiology.

[48]  R. Zajonc,et al.  Facial efference and the experience of emotion. , 1989, Annual review of psychology.

[49]  R. Adolphs The neurobiology of social cognition , 2001, Current Opinion in Neurobiology.

[50]  S. Hans,et al.  Social adjustment of adolescents at risk for schizophrenia: the Jerusalem Infant Development Study. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[51]  K. Heilman,et al.  Understanding emotional prosody activates right hemisphere regions. , 1996, Archives of neurology.

[52]  P. Philippot Inducing and assessing differentiated emotion-feeling states in the laboratory. , 1993, Cognition & emotion.

[53]  P. Ekman,et al.  Facial action coding system: a technique for the measurement of facial movement , 1978 .

[54]  M. Taylor,et al.  A rating scale for emotional blunting. , 1978, The American journal of psychiatry.

[55]  David Rudrauf,et al.  Damage to Association Fiber Tracts Impairs Recognition of the Facial Expression of Emotion , 2009, The Journal of Neuroscience.

[56]  W. Horan,et al.  The expression and experience of emotion in schizophrenia: a study of social interactions , 2003, Psychiatry Research.

[57]  Daniel Tranel,et al.  Preferences for Visual Stimuli Following Amygdala Damage , 1999, Journal of Cognitive Neuroscience.

[58]  P. Pattison,et al.  Facial affect and affective prosody recognition in first-episode schizophrenia , 2001, Schizophrenia Research.

[59]  T. Crow,et al.  The two-syndrome concept: origins and current status. , 1985, Schizophrenia bulletin.

[60]  J. Addington,et al.  Facial affect recognition and information processing in schizophrenia and bipolar disorder , 1998, Schizophrenia Research.

[61]  R. Adolphs,et al.  Cortical Systems for the Recognition of Emotion in Facial Expressions , 1996, The Journal of Neuroscience.

[62]  R. Gur,et al.  Emotion Processing in Chimeric Faces: Hemispheric Asymmetries in Expression and Recognition of Emotions , 2003, The Journal of Neuroscience.

[63]  R. Dworkin,et al.  Affective deficits and social deficits in schizophrenia: what's what? , 1992, Schizophrenia bulletin.

[64]  Matthew L. Davidson,et al.  The neuroimaging of emotion. , 2008 .

[65]  ChrisD . Frith The Cognitive Neuropsychology of Schizophrenia , 1992 .

[66]  K M Heilman,et al.  [Right hemisphere dominance for attention]. , 1983, Revue neurologique.

[67]  Melissa J. Green,et al.  Emotion dysregulation in schizophrenia: Reduced amplification of emotional expression is associated with emotional blunting , 2007, Schizophrenia Research.

[68]  F. Schneider,et al.  The effects of neuroleptics on facial action in schizophrenic patients. , 1992, Pharmacopsychiatry.

[69]  Jean Addington,et al.  Neurocognitive and social functioning in schizophrenia: a 2.5 year follow-up study , 2000, Schizophrenia Research.

[70]  M. Obermeier The positive and negative syndrome scale for schizophrenia , 2012 .

[71]  P. J. Leite,et al.  The intracarotid amobarbital procedure (Wada test) with two protocols combined, Montreal and Seattle. , 1997, Arquivos de neuro-psiquiatria.