Past Issues

Facial Emotion Processing in Patients with Schizophrenia: Study Results from Psychological Measurement to Brain Imaging?

Pei-Chi Tu

A prominent characteristic of patients with
schizophrenia is impaired social functioning ability.
Positive symptoms, negative symptoms, and
neurocognitive defi cits can impair their ability to
function and interact in normal social environments.
Patients’ inability to identify facial emotions
is a major contributing factor to this dysfunction.
Identifying and interpreting facial
emotions are critical to social cognition, and previous
behavioral studies have shown a signifi cant
defi cit in facial emotion processing for them. The
defi cit is category-specifi c and more substantially
related to negative emotions. When studying facial
emotion processing in Taiwanese patients
with schizophrenia, previous studies faced two issues.
First, the investigators found that Taiwanese
patients cannot process facial emotions in non-
Taiwanese faces as accurately as in Taiwanese
faces. And second, cultural bias in assessment
methods may compromise their validity. In the
study, “Dissimilar Defi cits of Facial and Prosodic
Emotion Recognition in Patients with Schizophrenia
in Taiwan” in this issue of the Taiwanese Journal
of Psychiatry (Taipei) [1], Tseng, Chen and Huang
established a new data set of emotional stimuli for
assessing facial emotion processing in Taiwan to
address those concerns. This article provides evidence
that the defi cit in facial emotion recognition
in patients with schizophrenia is cross-cultural.
In this study [1], the authors created a
Taiwanese version of the Diagnostic Analysis of
Nonverbal Accuracy Scale (DANVA2-TW), and
established a data set of emotional stimuli based
on Han Chinese facial features. With the culturally
modifi ed instrument, the investigators assessed
nonverbal emotion recognition accuracy in 26 patients
with chronically medicated schizophrenia
and 39 normal controls. They found that Taiwanese
patients with schizophrenia display less accuracy
in negative emotion recognition than in positive
emotion recognition. This study fi nding suggests
that defi cits in facial emotion processing might
exist for patients with schizophrenia across different
cultures. Inability to process facial emotions,
especially negative emotions, may be a universal
feature of schizophrenia according to the authors.
Along with a previous behavioral study on facial
emotion recognition in major depressive and anxiety
disorder patients [2], this study is one of few
key studies on facial emotion processing in
Taiwan. In particular, the data set of emotional
stimuli based on ethnic Han Chinese facial features
may be useful for facial emotion-related
studies in the future. Using these materials to assess
facial emotion processing in a high-risk group
may especially help determine whether the behavioral
defi cit is a valid endophenotype of
Key Word
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