Childhood precursors of schizophrenia: facial expressions of emotion

Walker, Elaine F.; Grimes, Kathleen; Davis, Dana; Smith, Adina J.

doi:10.1176/ajp.150.11.1654

Cited by 184 publications

(29 citation statements)

References 21 publications

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“…As noted above, the psychosis prodrome is characterized by deterioration in functioning and increasing symptoms that precede the onset of psychosis (Yung and McGorry, 1996). The duration of the prodromal phase can vary from months to years, with the characteristic signs including attenuated positive symptoms (e.g., unusual sensory experiences and ideations, suspiciousness, and disorganized thought), negative symptoms (e.g., social withdrawal, anhedonia, and decreased emotional experience and expression), and a range of “nonspecific” symptoms (e.g., anxiety, depression, and impaired attention) (Walker et al, 1993; Fuller et al, 2002; Lencz et al, 2004; Yung et al, 2004). Because many view the prodromal phase as affording the greatest opportunities for preventive intervention, structured interview measures for prospective assessment of prodromal features have been developed (Correll et al, 2010; Addington and Heinssen, 2012).…”

Section: The Prodromal Stage Of Psychosismentioning

confidence: 99%

Stress and neurodevelopmental processes in the emergence of psychosis

et al. 2013

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The notion that stress plays a role in the etiology of psychotic disorders, especially schizophrenia, is longstanding. However, it is only in recent years that the potential neural mechanisms mediating this effect have come into sharper focus. The introduction of more sophisticated models of the interplay between psychosocial factors and brain function has expanded our opportunities for conceptualizing more detailed psychobiological models of stress in psychosis. Further, scientific advances in our understanding of adolescent brain development have shed light on a pivotal question that has challenged researchers; namely, why the first episode of psychosis typically occurs in late adolescence/young adulthood. In this paper, we begin by reviewing the evidence supporting associations between psychosocial stress and psychosis in diagnosed patients as well as individuals at clinical high risk for psychosis. We then discuss biological stress systems and examine changes that precede and follow psychosis onset. Next, research findings on structural and functional brain characteristics associated with psychosis are presented; these findings suggest that normal adolescent neuromaturational processes may go awry, thereby setting the stage for the emergence of psychotic syndromes. Finally, a model of neural mechanisms underlying the pathogenesis of psychosis is presented and directions for future research strategies are explored.

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Section: The Prodromal Stage Of Psychosismentioning

confidence: 99%

Stress and neurodevelopmental processes in the emergence of psychosis

et al. 2013

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“…This is the strategy employed here to investigate whether altered emotional facial expression [8] is present in people with a past history of AN. Studies of facial expression in other clinical groups [schizophrenia and post traumatic stress disorder (PTSD)] of people who are in remission [14,15] or who are at risk of mental illness [16] provide tentative support for alterations in emotion expressivity serving as a trait vulnerability factor for these disorders.…”

Section: Introductionmentioning

confidence: 99%

Emotional facial expression in women recovered from anorexia nervosa

2013

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BackgroundRecent models of anorexia nervosa (AN) have emphasised the importance of social and emotional difficulties as maintenance factors of the disorder, however, empirical data are limited. The aim of this study was to examine whether altered emotional facial expression, previously observed in people currently ill with anorexia nervosa, is limited to the ill state or present in people recovered from the illness.MethodsThe sample consisted of 123 participants [49 AN, 21 recovered AN (RecAN) and 53 healthy controls (HC)]. Participants watched three films clips (amusing, neutral, sad) whilst their facial expressions were recorded and completed the positive and negative affect scale (PANAS) to record subjective experience. Facial expressions were subsequently coded for frequency of positive and negative expression and frequency of looking away.ResultsIn response to the amusing clip, AN participants showed significantly less positive expression than both HC and RecAN groups and both AN and RecAN showed more negative expression than HC with no difference between groups in looking away.In response to the sad clip there was no difference between groups in positive expression, but current AN participants showed significantly less negative expression than HC and looked away from the stimuli more than RecAN or HC.In terms of their subjective emotional experience, patients with current AN reported less positive emotion in response to both the amusing and the sad film clip. There was no difference between groups in subjective negative experience.ConclusionsAlterations in facial expression are present in people currently ill with AN contributing to the social difficulties found in AN and potentially exacerbating resistance to treatment. Some alterations in facial expression are found in women with a past history of AN but not to the same extent as those shown in the currently ill group. Future studies need to use a wider range of stimuli involving different emotions to corroborate findings.

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“…Abnormal expressions of emotions have been described as characteristic symptoms of schizophrenia (Andreasen, 1984a; Bleuler, 1911) and may precede the onset of illness by many years (Walker et al, 1993). Affective flattening and other negative symptoms are present at onset of illness (Gelber et al, 2004; Shtasel et al, 1992) more common in males, increase with illness duration (Shtasel et al, 1992) and appear distinct from depression (Kohler et al, 1998).…”

Section: Introductionmentioning

confidence: 99%

Static posed and evoked facial expressions of emotions in schizophrenia

Kohler

Martin

Stolar

et al. 2008

Schizophrenia Research

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Objective Impaired facial expressions of emotions have been described as characteristic symptoms of schizophrenia. Differences regarding individual facial muscle changes associated with specific emotions in posed and evoked expressions remain unclear. This study examined static facial expressions of emotions for evidence of flattened and inappropriate affect in persons with stable schizophrenia. Methods 12 persons with stable schizophrenia and matched healthy controls underwent a standardized procedure for posed and evoked facial expressions of five universal emotions, including happy, sad, anger, fear, and disgust expressions, at three intensity levels. Subjects completed self-ratings of their emotion experience. Certified raters coded images of facial expressions for presence of action units (AUs) according to the Facial Action Coding System. Logistic regression analyses were used to examine differences in the presence of AUs and emotion experience ratings by diagnosis, condition and intensity of expression. Results Patient and control groups experienced similar intensities of emotions, however, the difference between posed and evoked emotions was less pronounced in patients. Differences in expression of frequent and infrequent AUs support clinical observations of flattened and inappropriate affect in schizophrenia. Specific differences involve the Duchenne smile for happy expressions and decreased furrowed brows in all negative emotion expressions in schizophrenia. Conclusion While patterns of facial expressions were similar between groups, general and emotion specific differences support the concept of impaired facial expressions in schizophrenia. Expression of emotions in schizophrenia could not be explained by impaired experience. Future directions may include automated measurement, remediation of expressions and early detection of schizophrenia.

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Childhood precursors of schizophrenia: facial expressions of emotion

Abstract: These findings lend support to the assumption that vulnerability to schizophrenia may be subtly manifested in emotional behavior long before the onset of clinical symptoms.

Cited by 184 publications

References 21 publications

Stress and neurodevelopmental processes in the emergence of psychosis

Stress and neurodevelopmental processes in the emergence of psychosis

Emotional facial expression in women recovered from anorexia nervosa

Static posed and evoked facial expressions of emotions in schizophrenia

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