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Schizophrenia Patients Often Mistake Angry Expression for Fear
The problem appears to be specific to emotion recognition, say the researchers, because schizophrenia patients performed as well as bipolar disorder patients and mentally healthy controls when asked to figure out the age of people with angry facial expressions.
The study included 27 patients with schizophrenia, 16 with bipolar I disorder, and 30 mentally healthy controls.
“A better understanding of facial emotional recognition deficits in the two severe mental disorders might assist with diagnostic clarification, as well as inform treatment development and selection,” according to the researchers, psychologists Drs. Vina Goghari of the University of Calgary and Scott Sponheim of the University of Minnesota.
During the study, schizophrenia patients correctly identified angry facial expressions just 60 percent of the time, most often mistaking these faces as frightened, followed by happy, sad, and then neutral.
Similarly, the patients with bipolar disorder tended to mistake anger as fear, significantly more so than the controls.
However, they were more accurate overall than schizophrenia patients, correctly labeling 75 percent of the angry faces, which was not very different from the controls, who got 78 percent correct.
“Greater facial emotion recognition deficits in schizophrenia patients compared to bipolar patients found in this study may be a reflection of greater degree of brain abnormalities in regions associated with facial emotion recognition, such as in the amygdala and hippocampus, in schizophrenia patients,” said the researchers.
While trying to identify the other facial expressions — fear, sad, happy, and neutral — both the schizophrenia and bipolar groups were as accurate as the controls. The three groups also had similar ability in identifying the age of the faces.
The only other difference found was that bipolar disorder patients took much longer to figure out emotional expressions than they did to determine age. Schizophrenia patients and controls took a similar length of time to complete both tasks.
“This finding may have clinical implications for treatment development in schizophrenia as it suggests that schizophrenia patients may have a different strategy when viewing faces compared to bipolar patients, which may result in lower accuracy,” said the researchers.
Source: Comprehensive Psychiatry
Man with angry expression photo by shutterstock.
Psychopaths Not Hardwired to be Concerned for Others
“A marked lack of empathy is a hallmark characteristic of individuals with psychopathy,” said Jean Decety, Ph.D., a professor of psychology and psychiatry at the University of Chicago, who led the study.
Psychopathy affects approximately 1 percent of the general population in the U.S., but 20 percent to 30 percent of the prison population, according to the researcher.
For the study, the research team tested 80 prisoners between the ages of 18 and 50 who volunteered for the series of tests.
They were first tested for levels of psychopathy using standard measures. They were then studied with functional MRI technology, to determine their responses to a series of scenarios depicting people being intentionally hurt. They were also tested on their responses to seeing short videos of facial expressions showing pain.
“This is the first time that neural processes associated with empathic processing have been directly examined in individuals with psychopathy, especially in response to the perception of other people in pain or distress,” Decety said.
The prisoners in the high psychopathy group exhibited significantly less activation in the ventromedial prefrontal cortex, lateral orbitofrontal cortex, amygdala and periaqueductal gray parts of the brain, but more activity in the striatum and the insula when compared to control participants, the study found.
According to the researchers, the high response in the insula in psychopaths was unexpected, as this region is involved in emotion.
Conversely, the diminished response in the ventromedial prefrontal cortex and amygdala is consistent with what is already known about psychopathy, according to the researchers. This region is important for monitoring ongoing behavior, estimating consequences and incorporating emotional learning into moral decision-making. It also plays a role in empathic concern and valuing the well-being of others, they said.
“The neural response to distress of others, such as pain, is thought to reflect an aversive response in the observer that may act as a trigger to inhibit aggression or prompt motivation to help,” the researchers write in the paper. “Hence, examining the neural response of individuals with psychopathy as they view others being harmed or expressing pain is an effective probe into the neural processes underlying affective and empathy deficits in psychopathy.”
The study, supported with a $1.6 million grant from the National Institute of Mental Health, appears in the journal JAMA Psychiatry.
Source: University of Chicago
Young person’s brain abstract photo by shutterstock.
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