Dynamic evoked facial expressions of emotions in schizophrenia.
OBJECTIVE
Impaired facial expressions of emotions have been described as characteristic symptoms of schizophrenia. Previous investigations of dynamic facial expressions have reported on global assessment of positive and negative emotion expressions. In this study, we examined facial expression differences based on duration and frequencies of emotion expressions.


METHODS
12 persons with stable schizophrenia and matched healthy controls underwent a standardized procedure for evoked facial expressions of five universal emotions, including happy, sad, anger, fear, and disgust expressions. Subjects completed self-ratings of their emotion experience. Reliable raters coded evoked facial expressions according to the Facial Expression Coding System. For each emotion, facial expressions were coded as target, non-target or neutral expressions. Logistic regression analyses examined group differences in duration and frequencies of facial expressions.


RESULTS
Comparing overall duration of and frequencies of emotion expressions revealed affective flattening and inappropriate affect in patients, as evidenced by neutral and non-target expressions. Separated by emotion, impaired emotion expression was found in happy, sad and anger expression, but not for fear and disgust in which expressions were not well recognized.


CONCLUSIONS
In matched groups of participants, we found evidence for altered expressions in schizophrenia but equal subjective experience. Both affective flattening and inappropriate affect comprise abnormal facial expressions but may differ with respect to interpersonal communication and engagement. Future directions may include automated measurement, remediation of expressions and early detection of schizophrenia.
Kohler
Christian G
CG
Neuropsychiatry Division, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States. kohler@upenn.edu
Martin
Elizabeth A
EA
Milonova
Marina
M
Wang
Peng
P
Verma
Ragini
R
Brensinger
Colleen M
CM
Bilker
Warren
W
Gur
Raquel E
RE
Gur
Ruben C
RC
D000328:Adult; D000339:Affect; D000342:Affective Symptoms / Q000175:diagnosis / Q000503:physiopathology; D000553:Ambulatory Care; D035061:Control Groups; D004644:Emotions / Q000502:physiology; D005145:Face / Q000502:physiology*; D005149:Facial Expression; D005152:Facial Muscles / Q000502:physiology; D005239:Fear; D005260:Female; D006240:Happiness; D006801:Humans; D008297:Male; D033262:Narration; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000503:physiopathology; D012565:Schizophrenic Psychology; D014705:Verbal Behavior / Q000502:physiology; D014743:Videotape Recording
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