Emotional Processing in Schizophrenia

What is emotional processing?

The term emotional processing refers to the individual’s ability to perceive and use different emotions in an adaptive way (Green and Horan, 2010).

Emotional intelligence, defined as a set of four components (emotional identification, emotional facilitation, emotional knowledge and emotional management) (Mayer and Salovey, 1997) has become a reference model for the study of emotional processing.

Evaluation of emotional processing

Currently there are several measures that are commonly used to evaluate some areas of emotional processing, the most relevant are the following:

• Pictures of Facial Affect (POFA) (Ekman, 1976): This collection consists of a total of 110 photographs of faces showing one of the six basic emotions. The task is to identify the emotion expressed by each of the faces.
• Facial Emotion Identification Task (FEIT) (Kerr y Neale, 1993): Uses 19 photographs of faces that show one of the six basic emotions. After the presentation of each, the emotion presented by the face that has been taught must be identified.
• Prueba de Evaluación del Reconocimiento de Emociones (Emotion Recognition Evaluation Test) (PERE) (Gil-Sanz y cols, 2017) : Composed of 56 photographs showing the different basic emotions. It consists of identifying the emotion in each of the photographs presented.
• Facial Emotion Discrimination Test, (FEDT) (Kerr y Neale, 1993): includes 30 pairs of photographs of faces of people of the same sex. The photographs are presented in pairs and it must be decided whether both faces are expressing the same emotion.
• Vocal Emotion Identification Test (Kerr y Neale, 1993): Consists of 21 phrases of neutral content pronounced by male and female voices with an intonation that tries to show one of the six basic emotions. After presenting each phrase, the subject is asked to identify the emotion with which it has been pronounced.
• The Bell- Lysaker Emotion Recognition Task (BLERT) (Bell, Bryson y Lysaker, 1997). It consists of 21 videos in which an actor intones, with one of the six basic emotions, three monologues of neutral content. After showing each video, the subject is asked about the emotion with which he believes the actor has pronounced the monologue.

 

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• Facial Expression of Emotion: Stimuli and Test (FEEST) (Young, Perrett, Calder, Sprengelmeyer y Ekman, 2002). The task is to identify the emotions that show 60 photographs of faces. After each photograph, which shows one of the basic emotions, one has to choose which of these six emotions is represented.
• Prosody Task (Pijnenborg, Whitaar, Van den Bosch y Brower, 2007). It consists of 16 phrases of neutral content recorded together with eight syllable structures pronounced, on the one hand, neutrally and, on the other hand, using five of the six basic emotions, namely anguish, fear, sadness, joy and surprise. The subjects have to identify the emotion with which these phrases and syllabic structures are pronounced.
• Mayer- Salovey -Caruso Emotional Intelligence Test (MSCEIT) (Mayer, Salovey y Caruso, 2002). Designed to evaluate emotional intelligence understood as a capacity. It is a test of ability whose answers represent real attitudes to solve emotional problems.

The test is composed of 141 items divided into eight tasks (faces, drawings, facilitation, sensations, changes, combinations, emotional management, emotional relationships) that provide scores in each of the four main areas of emotional intelligence according to the model of Mayer and Salovey (1997) (emotional perception, emotional facilitation, emotional understanding, emotional management).

It also allows to obtain a total score of emotional intelligence, as well as scores in the two areas (experiential and strategic) that integrate this quotient. Kee et al (2009) verified the good psychometric characteristics of the test in a sample of patients diagnosed with schizophrenia.

Deficits in schizophrenia

The most important deficits in schizophrenia have to do with the perception of negative emotions. For example, Kohler et al (2003) find it difficult for patients diagnosed with schizophrenia to recognize fear and disgust; they also find it difficult to recognize faces that might be categorized as neutral, since they generally tend to identify such expressions with negative emotions.

Deficits in emotional processing are present throughout the different phases of the disease, and are found to be more severe in patients in acute phases of the disease. Thus, Comparelli et al (2013) find these deficits in patients with a high risk of developing schizophrenia, in those who are in a first episode and, finally, in those who show a chronic profile.

In some studies (Green and Phillips, 2004; Russell, Green, Simpson and Coltheart, 2008; Williams, Loughland, Gordon and Davidson, 1999) it has been found that the majority of individuals diagnosed with schizophrenia spend less time than subjects without the pathology in the analysis of facial features in the tasks of emotional recognition.

Finally, neuroimaging studies have found structural abnormalities in several brain areas that have generally been associated with emotional processing. These anomalies are located in the fusiform gyrus, the temporo-medial sulcus, the amygdala and the prefrontal cortex (Marwick and Hall, 2008).

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References

• Bell, M. D., Bryson, G., y Lysaker, P. (1997). Positive and negative affect recognition in schizophrenia: a comparison with substance abuse and normal control subjects. Psychiatry Research, 73(1), 73-82.
• Comparelli, A., De Carolis, A., Corigliano, V., Di Pietro, S., Trovini, G., Granese, C.,…y Girardi, P. (2013). Symptom correlates of facial emotion recognition impairment in schizophrenia. Psychopathology, 47(1), 65-70.
• Ekman, P. (1976). Pictures of facial affect. Palo Alto, CA: Consulting Psychologists Press.
• Gil-Sanz, D., Fernández-Modamio, M., Bengochea-Seco, R., Arrieta-Rodríguez, M., González-Fraile, E., Pérez-Fuentes, G., … y Santos-Zorrozúa, B. (2017). PERE: Una nueva herramienta para valorar el reconocimiento de las emociones básicas y su aplicación en la esquizofrenia. Revista de Psicopatología y Psicología Clínica, 22(2), 85-93.
• Green, M. F., y Horan, W. P. (2010). Social cognition in schizophrenia. Current Directions in Psychological Science, 19(4), 243-248.
• Green, M. F., y Phillips, M. L. (2004). Social threat perception and the evolution of paranoia. Neuroscience Biobehavioral Reviews, 28(3), 333-342
• Kee, K. S., Horan, W. P., Salovey, P., Kern, R. S., Sergi, M. J., Fiske, A. P.,… y Green, M. F. (2009). Emotional intelligence in schizophrenia. Schizophrenia Research, 107(1), 61-68
• Kerr, S. L., y Neale, J. M. (1993). Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance? Journal of Abnormal Psychology, 102(2), 312-318
• Kohler, C. G., Turner, T. H., Bilker, W. B., Brensinger, C., Siegel, S. J., Kanes, S. J.,… y Gur, R. C. (2003). Facial emotion recognition in schizophrenia: intensity effects and error pattern. American Journal of Psychiatry, 160(10), 1768-1774.
• Marwick, K., y Hall, J. (2008). Social cognition in schizophrenia: a review of face processing. British Medical Bulletin, 88(1), 43-58.
• Mayer, J. D., y Salovey, P. (1997). What is emotional intelligence? En P. Salovey y D. Sluyter (Eds). Emotional development and emotional intelligence: implications for educators (pp 3-31). New York, NY: Basic Books
• Mayer, J. D., Salovey, P., y Caruso, D. R. (2002). Mayer- Salovey- Caruso Emotional Intelligence Test (MSCEIT): USER´s Manual. Toronto, ON: Multi- Health Systems Inc
• Pijnenborg, G. H. M., Withaar, F. K., Van den Bosch, R. J., y Brouwer, W. H. (2007). Impaired perception of negative emotional prosody in schizophrenia. The Clinical Neuropsychologist, 21(5), 762-775.
• Russell, T. A., Green, M. J., Simpson, I., y Coltheart, M. (2008). Remediation of facial emotion perception in schizophrenia: concomitant changes in visual attention. Schizophrenia Research, 103(1-3), 248-253
• Williams, L. M., Loughland, C. M., Gordon, E., y Davidson, D. (1999). Visual scanpaths in schizophrenia. Is there a deficit in face recognition? Schizophrenia Research, 40(3),189-199
• Young, A. W., Perrett, D., Calder, A., Sprengelmeyer, R., y Ekman, P. (2002). The facial expressions of emotion: stimuli and test, manual. Bury St. Edmunds, UK: Thames Valley Test Company

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