Static posed and evoked facial expressions of emotions in schizophrenia

Abstract

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.

Self-reported empathy and neural activity during action imitation and observation in schizophrenia

“…The patients' poorer imitation for faces is consistent with prior studies showing impaired voluntary imitation of face and complex hand gesture movements in schizophrenia (e.g., Kohler et al, 2008, Lee et al, 2014, Matthews et al, 2013, Park et al, 2008). Despite these differences, the patient group showed comparable activation to controls during the finger and face imitation and execution tasks.…”

“…While behavioral studies show impaired imitation of complex hand movements and facial emotional expressions in schizophrenia (e.g., Kohler et al, 2008, Lee et al, 2014, Matthews et al, 2013, Park et al, 2008, Varcin et al, 2010), the few studies of MNS activity have been inconsistent. Three electrophysiological studies examined Mu suppression, a hypothesized biomarker of MNS activity.…”

Facial expression of positive emotions in individuals with eating disorders

“…For example, individuals suffering from depression have been found to produce fewer DS when exposed to positive stimuli and to show smiles that were followed by negative affect-related expressions in response to amusing film clips (Reed et al, 2007). Participants with schizophrenia display fewer DS when induced to feel positive emotions through remembering biographic emotional situations (Kohler et al, 2008). Similar results have been found for participants with post-traumatic stress disorder during a psychodynamic interview (Kirsch and Brunnhuber, 2007).…”

Some markers of mirroring appear intact in schizophrenia: evidence from mu suppression

“…Second, studies using other methods have suggested that mirroring-related processes are not fully intact in schizophrenia. As was mentioned above, patients have shown impaired voluntary imitation of facial expressions and complex gestures, as well as diminished spontaneous mimicking of others' behaviors (e.g., yawning, face expressions; Kohler et al, 2008;Matthews et al, 2013;Park et al, 2008;Varcin et al, 2010). The apparent discrepancy between intact mirroring, as indexed by mu suppression, versus overt mirroring-related impairments requires further research attention.…”

“…Relatively little research has examined whether schizophrenia is also associated with impairments in mirroring. Although behavioral studies have shown impaired imitation of complex hand movements and facial emotional expressions in schizophrenia (e.g., Kohler et al, 2008;Matthews, Gold, Sekuler, & Park, 2013;Park, Matthews, & Gibson, 2008;Varcin, Bailey, & Henry, 2010), the two prior EEG studies of MNS activity, as indexed by mu suppression, have provided mixed results. One study focused on observation/execution of hand movements, and found no overall group differences between patients with schizophrenia spectrum disorders and healthy controls (McCormick et al, 2012).…”