Facial emotion perception in schizophrenia: a meta-analytic review.

OBJECTIVES A considerable body of literature has reported on emotion perception deficits and the relevance to clinical symptoms and social functioning in schizophrenia. Studies published between 1970-2007 were examined regarding emotion perception abilities between patient and control groups and potential methodological, demographic, and clinical moderators. DATA SOURCES AND REVIEW: Eighty-six studies were identified through a computerized literature search of the MEDLINE, PsychINFO, and PubMed databases. A quality of reporting of meta-analysis standard was followed in the extraction of relevant studies and data. Data on emotion perception, methodology, demographic and clinical characteristics, and antipsychotic medication status were compiled and analyzed using Comprehensive Meta-analysis Version 2.0 (Borenstein M, Hedges L, Higgins J and Rothstein H. Comprehensive Meta-analysis. 2. Englewood, NJ: Biostat; 2005). RESULTS The meta-analysis revealed a large deficit in emotion perception in schizophrenia, irrespective of task type, and several factors that moderated the observed impairment. Illness-related factors included current hospitalization and--in part--clinical symptoms and antipsychotic treatment. Demographic factors included patient age and gender in controls but not race. CONCLUSION Emotion perception impairment in schizophrenia represents a robust finding in schizophrenia that appears to be moderated by certain clinical and demographic factors. Future directions for research on emotion perception are discussed.

[1]  Xiao-Hua Zhou,et al.  Statistical Methods for Meta‐Analysis , 2008 .

[2]  R. Gur,et al.  The other-race effect in face processing among African American and Caucasian individuals with schizophrenia. , 2008, The American journal of psychiatry.

[3]  D. Penn,et al.  Facial affect recognition in individuals at clinical high risk for psychosis , 2008, British Journal of Psychiatry.

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

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

[6]  B. Turetsky,et al.  Facial emotion recognition in schizophrenia:When and why does it go awry? , 2007, Schizophrenia Research.

[7]  J. Piven,et al.  Orienting to social stimuli differentiates social cognitive impairment in autism and schizophrenia , 2007, Neuropsychologia.

[8]  D. Penn,et al.  Emotion perception and social skill over the course of psychosis: A comparison of individuals “at-risk” for psychosis and individuals with early and chronic schizophrenia spectrum illness , 2007, Cognitive neuropsychiatry.

[9]  R. Kahn,et al.  Exploring the nature of facial affect processing deficits in schizophrenia , 2007, Psychiatry Research.

[10]  Margarete Delazer,et al.  Gender differences in facial emotion recognition in persons with chronic schizophrenia , 2007, European Psychiatry.

[11]  M. Bell,et al.  A comparison of basic and social cognition between schizophrenia and schizoaffective disorder , 2007, Schizophrenia Research.

[12]  M. Kosmidis,et al.  Impaired emotion perception in schizophrenia: A differential deficit , 2007, Psychiatry Research.

[13]  N. Franck,et al.  The role of configural information in facial emotion recognition in schizophrenia , 2006, Neuropsychologia.

[14]  U. Habel,et al.  A special role of negative emotion in children and adolescents with schizophrenia and other psychoses , 2006, Psychiatry Research.

[15]  Philip D. Harvey,et al.  Improvement in social competence with short-term atypical antipsychotic treatment: a randomized, double-blind comparison of quetiapine versus risperidone for social competence, social cognition, and neuropsychological functioning. , 2006, The American journal of psychiatry.

[16]  David L. Roberts,et al.  The functional significance of social cognition in schizophrenia: a review. , 2006, Schizophrenia bulletin.

[17]  Michael F. Green,et al.  An analysis of categorical perception of facial emotion in schizophrenia , 2006, Schizophrenia Research.

[18]  Michael F. Green,et al.  Baseline Neurocognitive Deficits in the CATIE Schizophrenia Trial , 2006, Neuropsychopharmacology.

[19]  A. Cohen,et al.  Attentional dysfunction, social perception, and social competence: what is the nature of the relationship? , 2006, Journal of abnormal psychology.

[20]  Robert A. Johnston,et al.  Facial emotion recognition from moving and static point-light images in schizophrenia , 2006, Schizophrenia Research.

[21]  J. Addington,et al.  Facial affect recognition: A mediator between cognitive and social functioning in psychosis? , 2006, Schizophrenia Research.

[22]  F. Karayanidis,et al.  Facial emotion processing in schizophrenia: No evidence for a deficit specific to negative emotions in a differential deficit design , 2006, Psychiatry Research.

[23]  R. Emsley,et al.  Emotional face processing deficit in schizophrenia: A replication study in a South African Xhosa population , 2006, Schizophrenia Research.

[24]  R. Adolphs,et al.  Perception of socially relevant stimuli in schizophrenia , 2006, Schizophrenia Research.

[25]  M. Herrmann,et al.  Facial affect decoding in schizophrenic disorders: A study using event-related potentials , 2006, Psychiatry Research.

[26]  K. Amunts,et al.  Impairment in the specificity of emotion processing in schizophrenia. , 2006, The American journal of psychiatry.

[27]  M. Dolan,et al.  Emotional information processing in violent patients with schizophrenia: Association with psychopathy and symptomatology , 2006, Psychiatry Research.

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

[29]  W. Gaebel,et al.  Remediation of impairments in facial affect recognition in schizophrenia: Efficacy and specificity of a new training program , 2005, Schizophrenia Research.

[30]  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.

[31]  B. Fredrickson,et al.  “We All Look the Same to Me” , 2005, Psychological science.

[32]  R. Kahn,et al.  Schizophrenia and processing of facial emotions: Sex matters , 2005, Schizophrenia Research.

[33]  Michael F. Green,et al.  Cross-ethnic differences in perception of emotion in schizophrenia , 2005, Schizophrenia Research.

[34]  Ulrich Schall,et al.  Functional MRI of facial emotion recognition deficits in schizophrenia and their electrophysiological correlates , 2005, The European journal of neuroscience.

[35]  J. Sweeney,et al.  Effects of antipsychotic treatment on emotion perception deficits in first-episode schizophrenia. , 2005, The American journal of psychiatry.

[36]  John J. Foxe,et al.  Sensory Contributions to Impaired Prosodic Processing in Schizophrenia , 2005, Biological Psychiatry.

[37]  G. Tiberghien,et al.  Processing emotional expression and facial identity in schizophrenia , 2005, Psychiatry Research.

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

[39]  Thierry d'Amato,et al.  Effects of emotion and identity on facial affect processing in schizophrenia , 2005, Psychiatry Research.

[40]  N. Rüsch,et al.  Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? , 2004, Psychiatry Research.

[41]  G. Weniger,et al.  Differential impairments of facial affect recognition in schizophrenia subtypes and major depression , 2004, Psychiatry Research.

[42]  A. Young,et al.  Social cognition and face processing in schizophrenia , 2004, British Journal of Psychiatry.

[43]  M. Kosmidis,et al.  Relationship of affect recognition with psychopathology and cognitive performance in schizophrenia , 2004, Journal of the International Neuropsychological Society.

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

[45]  P. Lysaker,et al.  Neurocognitive deficits and history of childhood abuse in schizophrenia spectrum disorders: associations with Cluster B personality traits , 2004, Schizophrenia Research.

[46]  L. Williams,et al.  Visual scanpath dysfunction in first-degree relatives of schizophrenia probands: evidence for a vulnerability marker? , 2004, Schizophrenia Research.

[47]  R. Gur,et al.  Facial emotion recognition in schizophrenia: intensity effects and error pattern. , 2003, The American journal of psychiatry.

[48]  Melissa J. Green,et al.  Emotion perception in schizophrenia: an eye movement study comparing the effectiveness of risperidone vs. haloperidol , 2003, Psychiatry Research.

[49]  Hillary Anger Elfenbein,et al.  When familiarity breeds accuracy: cultural exposure and facial emotion recognition. , 2003, Journal of personality and social psychology.

[50]  S. Bölte,et al.  The recognition of facial affect in autistic and schizophrenic subjects and their first-degree relatives , 2003, Psychological Medicine.

[51]  S. Yoshikawa,et al.  Facial affect recognition in pre-lingually deaf people with schizophrenia , 2003, Schizophrenia Research.

[52]  P. Johnston,et al.  Differential susceptibility to performance degradation across categories of facial emotion—a model confirmation , 2003, Biological Psychology.

[53]  W. Wölwer,et al.  Remediation of facial affect recognition impairments in patients with schizophrenia: a new training program , 2003, Psychiatry Research.

[54]  Nicolas Franck,et al.  Selective attention to facial emotion and identity in schizophrenia , 2002, Neuropsychologia.

[55]  Sohee Park,et al.  Emotion processing and its relationship to social functioning in schizophrenia patients , 2002, Psychiatry Research.

[56]  E. Gordon,et al.  Schizophrenia and affective disorder show different visual scanning behavior for faces: a trait versus state-based distinction? , 2002, Biological Psychiatry.

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

[58]  R. Gur,et al.  Perception of happy and sad facial expressions in chronic schizophrenia: Evidence for two evaluative systems , 2002, Schizophrenia Research.

[59]  Leanne M Williams,et al.  Visual scanpaths to positive and negative facial emotions in an outpatient schizophrenia sample , 2002, Schizophrenia Research.

[60]  R. Bajcsy,et al.  A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies , 2002, Journal of Neuroscience Methods.

[61]  Hillary Anger Elfenbein,et al.  On the universality and cultural specificity of emotion recognition: a meta-analysis. , 2002, Psychological bulletin.

[62]  P. Johnston,et al.  A generalised deficit can account for problems in facial emotion recognition in schizophrenia , 2001, Biological Psychology.

[63]  D. Combs,et al.  The role of attention in affect perception: an examination of Mirsky's four factor model of attention in chronic schizophrenia. , 2001, Schizophrenia bulletin.

[64]  W Gaebel,et al.  Disturbed facial affect recognition in patients with schizophrenia associated with hypoactivity in distributed brain regions: a magnetoencephalographic study. , 2001, The American journal of psychiatry.

[65]  B. Wexler,et al.  Neurocognitive enhancement therapy with work therapy: effects on neuropsychological test performance. , 2001, Archives of general psychiatry.

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

[67]  I. Olkin,et al.  Improving the quality of reports of meta‐analyses of randomised controlled trials: the QUOROM statement , 2000, Revista espanola de salud publica.

[68]  Dennis R. Combs,et al.  Emotion recognition in schizophrenia: further investigation of generalized versus specific deficit models. , 2000, Journal of abnormal psychology.

[69]  P. Davis,et al.  Recognition of posed and genuine facial expressions of emotion in paranoid and nonparanoid schizophrenia. , 2000, Journal of abnormal psychology.

[70]  R. Gur,et al.  Emotion recognition deficit in schizophrenia: association with symptomatology and cognition , 2000, Biological Psychiatry.

[71]  U. Habel,et al.  Emotional processing in schizophrenia across cultures: standardized measures of discrimination and experience , 2000, Schizophrenia Research.

[72]  I. Olkin,et al.  Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement , 1999, The Lancet.

[73]  M. Mandal,et al.  Generality and specificity of emotion-recognition deficit in schizophrenic patients with positive and negative symptoms , 1999, Psychiatry Research.

[74]  Murray Alpert,et al.  The relationship between affect expression and affect recognition in schizophrenia , 1999, Schizophrenia Research.

[75]  Michael F. Green,et al.  Perception of emotion and neurocognitive functioning in schizophrenia: what's the link? , 1998, Psychiatry Research.

[76]  D. Penn,et al.  Social perception and social skill in schizophrenia , 1998, Psychiatry Research.

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

[78]  A. Leentjens,et al.  Disturbances of affective prosody in patients with schizophrenia; a cross sectional study , 1998, Journal of neurology, neurosurgery, and psychiatry.

[79]  M. Bell,et al.  Affect recognition in deficit syndrome schizophrenia , 1998, Psychiatry Research.

[80]  M. Bell,et al.  Positive and negative affect recognition in schizophrenia: a comparison with substance abuse and normal control subjects , 1997, Psychiatry Research.

[81]  G. Smith,et al.  Bias in meta-analysis detected by a simple, graphical test , 1997, BMJ.

[82]  M. Bell,et al.  Affect recognition in schizophrenia: a function of global impairment or a specific cognitive deficit , 1997, Psychiatry Research.

[83]  W. Gaebel,et al.  Facial-affect recognition and visual scanning behaviour in the course of schizophrenia , 1997, Schizophrenia Research.

[84]  E. Mikhailova,et al.  Abnormal recognition of facial expression of emotions in depressed patients with major depression disorder and schizotypal personality disorder , 1996, Biological Psychiatry.

[85]  A. Kring,et al.  More evidence for generalized poor performance in facial emotion perception in schizophrenia. , 1996, Journal of abnormal psychology.

[86]  D. Penn,et al.  The relationship of social cognition to ward behavior in chronic schizophrenia , 1996, Schizophrenia Research.

[87]  D. Penn,et al.  Emotion recognition and social competence in chronic schizophrenia. , 1996, Journal of abnormal psychology.

[88]  Ruben C. Gur,et al.  Emotional processing in schizophrenia: Neurobehavioral probes in relation to psychopathology , 1995, Schizophrenia Research.

[89]  J. W. Burch.  Typicality range deficit in schizophrenics' recognition of emotion in faces. , 1995, Journal of clinical psychology.

[90]  C. Begg,et al.  Operating characteristics of a rank correlation test for publication bias. , 1994, Biometrics.

[91]  D C Hay,et al.  Movement, face processing and schizophrenia: evidence of a differential deficit in expression analysis. , 1994, The British journal of clinical psychology.

[92]  J. Borod,et al.  Perception of Facial Emotion in Schizophrenic and Right Brain-Damaged Patients , 1993, The Journal of nervous and mental disease.

[93]  J. Neale,et al.  Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance? , 1993, Journal of abnormal psychology.

[94]  J. Leff,et al.  The Perception of Emotion by Schizophrenic Patients , 1992, British Journal of Psychiatry.

[95]  H. Ellis,et al.  Paranoid and nonparanoid schizophrenic processing of facially displayed affect. , 1992, Journal of psychiatric research.

[96]  R. Gur,et al.  Facial emotion discrimination: III. Behavioral findings in schizophrenia , 1992, Psychiatry Research.

[97]  K. Mueser,et al.  The ability of schizophrenics to perceive and cope with negative affect , 1991, Schizophrenia Research.

[98]  N. Mimica,et al.  Scale for the Assessment of Negative Symptoms (SANS)* , 1989, British Journal of Psychiatry.

[99]  M. O'Neill,et al.  Schizophrenia and the Perception of Emotions , 1989, British Journal of Psychiatry.

[100]  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.

[101]  C. Frith,et al.  Schizophrenic inability to judge facial emotion: a controlled study. , 1989, The British journal of clinical psychology.

[102]  T. Bashore,et al.  Perception of emotion among schizophrenic patients , 1988 .

[103]  M K Mandal,et al.  Decoding of facial emotions, in terms of expressiveness, by schizophrenics and depressives. , 1987, Psychiatry.

[104]  D. Zuroff,et al.  Emotion recognition in schizophrenic and depressed inpatients. , 1986, Journal of clinical psychology.

[105]  E. Walker,et al.  Facial discrimination and emotional recognition in schizophrenia and affective disorders. , 1986, Archives of general psychiatry.

[106]  D. Luchins,et al.  Facial Affect Recognition in Schizophrenia is there a Differential Deficit? , 1984, British Journal of Psychiatry.

[107]  E. Walker,et al.  Recognition and identification of facial stimuli by schizophrenics and patients with affective disorders. , 1984, The British journal of clinical psychology.

[108]  J. Cutting.  Judgement of Emotional Expression in Schizophrenics , 1981, British Journal of Psychiatry.

[109]  E. Emory,et al.  A cross-sectional study of emotion recognition in schizophrenics. , 1980, Journal of abnormal psychology.

[110]  M. Bates,et al.  Judgment of emotion among chronic schizophrenics. , 1977, Journal of clinical psychology.

[111]  J. Overall,et al.  The Brief Psychiatric Rating Scale , 1962 .

[112]  W. Gaebel,et al.  Facial expression and emotional face recognition in schizophrenia and depression , 2005, European Archives of Psychiatry and Clinical Neuroscience.

[113]  W. Gaebel,et al.  Facial affect recognition in the course of schizophrenia , 2005, European Archives of Psychiatry and Clinical Neuroscience.

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

[115]  Juan Carlos Espinosa,et al.  Comprehensive Meta-Analysis , 2004 .

[116]  Michael F. Green,et al.  Is emotion processing a predictor of functional outcome in schizophrenia? , 2003, Schizophrenia bulletin.

[117]  M. Mandal,et al.  Facial expressions of emotions and schizophrenia: a review. , 1998, Schizophrenia bulletin.

[118]  K. Mueser,et al.  Cue availability and affect perception in schizophrenia. , 1996, Schizophrenia bulletin.

[119]  D. Garver,et al.  Treatment and diagnostic subtype in facial affect recognition in schizophrenia. , 1995, Journal of psychiatric research.

[120]  D W Harrison,et al.  Is right hemisphere decline in the perception of emotion a function of aging? , 1994, The International journal of neuroscience.

[121]  M. K. Mandal,et al.  Identification of brief presentations of facial expressions of affects in schizophrenics. , 1989, International journal of psychology : Journal international de psychologie.

[122]  M. Mandal,et al.  Identifying the components of facial emotion and schizophrenia. , 1989, Psychopathology.

[123]  S. Kay,et al.  The positive and negative syndrome scale (PANSS) for schizophrenia. , 1987, Schizophrenia bulletin.

[124]  L. J. Chapman,et al.  The measurement of differential deficit. , 1978, Journal of psychiatric research.