Facial Affect Recognition by Patients with Schizophrenia Using Human Avatars

Abstract

People with schizophrenia have difficulty recognizing the emotions in the facial expressions of others, which affects their social interaction and functioning in the community. Static stimuli such as photographs have been used traditionally to examine deficiencies in the recognition of emotions in patients with schizophrenia, which has been criticized by some authors for lacking the dynamism that real facial stimuli have. With the aim of overcoming these drawbacks, in recent years, the creation and validation of virtual humans has been developed. This work presents the results of a study that evaluated facial recognition of emotions through a new set of dynamic virtual humans previously designed by the research team, in patients diagnosed of schizophrenia. The study included 56 stable patients, compared with 56 healthy controls. Our results showed that patients with schizophrenia present a deficit in facial affect recognition, compared to healthy controls (average hit rate 71.6% for patients vs 90.0% for controls). Facial expressions with greater dynamism (compared to less dynamic ones), as well as those presented from frontal view (compared to profile view) were better recognized in both groups. Regarding clinical and sociodemographic variables, the number of hospitalizations throughout life did not correlate with recognition rates. There was also no correlation between functioning or quality of life and recognition. A trend showed a reduction in the emotional recognition rate as a result of increases in Positive and Negative Syndrome Scale (PANSS), being statistically significant for negative PANSS. Patients presented a learning effect during the progression of the task, slightly greater in comparison to the control group. This finding is relevant when designing training interventions for people with schizophrenia. Maintaining the attention of patients and getting them to improve in the proposed tasks is a challenge for today’s psychiatry.

Facial emotion recognition deficits in schizophrenia - a review of research and a model of pathogenesis

“…Virtual reality may turn out to be the future direction of the development of programs aimed at training the recognition of the expression of Archives of Psychiatry and Psychotherapy, 2023; 1: 24-32 facial emotions. The results confirm that deficits in recognizing emotions also occur when reading them from the dynamic faces of avatars [71]. Virtual reality allows you to create situations in which the subject will have to recognize emotions in everyday life.…”

Facial emotion identification impairments in Chinese persons living with schizophrenia: A meta-analysis

“…Findings from empirical studies have shown that PLwS present more severe impairments in recognizing negative and neutral emotions, such as anger, fear, and calmness, while they do not present difficulties in recognizing positive emotions, such as happiness ( 1 , 57 , 58 ). Similarly, the meta-analysis found the greatest levels of impairments in identifying fear, disgust, anger, and sadness emotions in Chinese PLwS.…”

Could Avatar Therapy Enhance Mental Health in Chronic Patients? A Systematic Review

“…The use of avatars in treating illnesses has advanced in recent years, offering many possibilities in terms of the pathologies they are geared towards. Although not all the benefits of this kind of intervention are currently known, good results have been obtained in the treatment of anxiety in disorders such as agoraphobia [20] and social phobia [17][18][19], as well as in treating eating disorders [13,14], addictions [15,16], weight control [9][10][11], facial pattern recognition [26][27][28][29][30], and ASD [31][32][33]. Education is another area in which they have been used.…”

“…The results found in the scientific literature suggest that immersive virtual reality, through the use of avatars, can be used as a tool for training patients in recognizing emotions [26]. This finding is particularly useful for people with schizophrenia, as they find it difficult to recognize facial emotions, causing alterations in their interpersonal relationships [27,28]. Its usefulness has also been established for people with autism, given their deficiency in social cognition and communication [29], and for major depressive disorders in which patients have a negative response bias towards sadness, tending to assess positive, neutral, and ambiguous facial expressions as being sadder [30].…”