title: Effects of Training of Affect Recognition on the recognition and visual exploration of emotional faces in schizophrenia.
abstract: BACKGROUND
  Schizophrenia patients have impairments in facial affect recognition and display scanpath abnormalities during the visual exploration of faces. These abnormalities are characterized by fewer fixations on salient feature areas and longer fixation durations. The present study investigated whether social-cognitive remediation not only improves performance in facial affect recognition but also normalizes patients' gaze behavior while looking at faces.
  
  
  METHODS
  Within a 2 × 2-design (group × time), 16 schizophrenia patients and 16 healthy controls performed a facial affect recognition task with concomitant infrared oculography at baseline (T0) and after six weeks (T1). Between the measurements, patients completed the Training of Affect Recognition (TAR) program. The influence of the training on facial affect recognition (percent of correct answers) and gaze behavior (number and mean duration of fixations into salient or non-salient facial areas) was assessed.
  
  
  RESULTS
  In line with former studies, at baseline patients showed poorer facial affect recognition than controls and aberrant scanpaths, and after TAR facial affect recognition was improved. Concomitant with improvements in performance, the number of fixations in feature areas ('mouth') increased while fixations in non-feature areas ('white space') decreased. However, the change in fixation behavior did not correlate with the improvement in performance.
  
  
  CONCLUSIONS
  After TAR, patients pay more attention to facial areas that contain information about a displayed emotion. Although this may contribute to the improved performance, the lack of a statistical correlation implies that this factor is not sufficient to explain the underlying mechanism of the treatment effect.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany. Electronic address: katharina.drusch@uni-duesseldorf.de.
authors.forename: Katharina
authors.initials: K
authors.lastname: Drusch
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Sanna
authors.initials: S
authors.lastname: Stroth
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kamp
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Frommann
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich Heine University Düsseldorf, Bergische Landstrasse 2, 40629 Düsseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005133:Eye Movements / Q000502:physiology; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010364:Pattern Recognition, Visual / Q000502:physiology*; D012559:Schizophrenia / Q000503:physiopathology* / Q000534:rehabilitation*; D012938:Social Perception; D016896:Treatment Outcome
keywords: Cognitive remediation; Facial affect recognition; Schizophrenia; Social cognition; Visual scanpath