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Impairments in facial affect recognition have been linked to schizophrenia. Recent studies suggest that the degree of impairment varies as a function of clinical subtype. Paranoid patients have been found to be more accurate than nonparanoid patients at recognizing posed and spontaneous facial expressions of negative emotion, and more accurate even than nonpsychiatric controls at identifying spontaneous expressions of negative emotions. This is noteworthy given that spontaneous expressions are generally less intense and more ambiguous than posed expressions of emotion. No studies, however, have attempted to explicate this finding. The main objectives of the present investigation, therefore, were to replicate this finding and test the hypothesis that cognitive biases associated with psychosis cause paranoid patients to interpret ambiguous expressions of emotion as more negative than others. To do so, 24 paranoid schizophrenia patients, 26 nonparanoid schizophrenia patients, and 29 control participants completed an emotion recognition task as well as measures of attentional and referential biases consisting of a probabilistic reasoning task, an attribution style questionnaire, a theory of mind task, and an emotional Stroop task. Contrary to expectations, impairments in the recognition of posed and spontaneous expressions of emotion were found in both the paranoid and nonparanoid schizophrenia groups. Furthermore, although paranoid patients' performance on some of the cognitive measures was suggestive of biased processing of ambiguous information, thinking errors did not predict accurate recognition of spontaneous expressions of negative emotions. IQ was the only significant predictor of performance on the recognition of spontaneous expressions of negative emotion. Results therefore suggest that, regardless of subtype, stable schizophrenia outpatients have more difficulty recognizing facial expressions of negative emotion in others than nonpsychiatric controls. Emotion recognition deficits may be better explained by impairments in general cognitive abilities than specific biased processing of ambiguous and threatening information. |
