The Schizophrenia Research Center, Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
Schizophr Res. 2010 Sep;122(1-3):144-50. doi: 10.1016/j.schres.2010.04.004. Epub 2010 May 21.
Impaired facial emotion expression is central to schizophrenia. Extensive work has quantified these differences, but it remains unclear how patient expressions are perceived by their healthy peers and other non-trained individuals. This study examined how static facial expressions of posed and evoked emotions of patients and controls are recognized by naïve observers.
Facial photographs of 6 persons with stable schizophrenia and 6 matched healthy controls expressing five universal emotions (happy, sad, anger, fear, and disgust) and neutral were selected from a previous data set. Untrained raters (N=420) viewed each photo and identified the expressed emotion. Repeated measures ANOVAs were used to assess differences in accuracy and error patterns between patient and control expressions.
Expressions from healthy individuals were more accurately identified than those from schizophrenia patients across all conditions, except for posed sadness and evoked neutral faces, in which groups did not differ, and posed fear, in which patient expressions were more accurately identified than control expressions. Analysis of incorrect responses revealed misidentifications as neutral were most common across both groups but significantly more likely among patients.
Present findings demonstrate that patient expressions of emotion are poorly perceived by naïve observers and support the concept of affective flattening in schizophrenia. These results highlight the real world implications of impairments in emotion expression and may shed light on potential mechanisms of impaired social functioning in schizophrenia.
面部情绪表达障碍是精神分裂症的核心症状。大量研究已经对这些差异进行了量化，但目前尚不清楚患者的表情如何被他们的健康同龄人或其他未经训练的个体所感知。本研究旨在考察患者和对照组的静态表情和诱发表情是如何被未经训练的观察者识别的。
从先前的数据集选择了 6 名稳定型精神分裂症患者和 6 名匹配的健康对照者的面部照片，这些照片表达了五种通用情绪（快乐、悲伤、愤怒、恐惧和厌恶）和中性。未受过训练的评判者（N=420）观看每张照片并识别所表达的情绪。使用重复测量方差分析来评估患者和对照组表情的准确性和错误模式差异。
除了在呈现悲伤和诱发中性表情时，健康个体的表情比精神分裂症患者的表情识别更为准确，而在呈现恐惧表情时，患者的表情比对照组的表情识别更为准确。对错误反应的分析表明，两组中最常见的错误识别是中性，但患者的错误识别更为常见。
目前的研究结果表明，未经训练的观察者对患者的情绪表达识别较差，支持了精神分裂症中情感迟钝的概念。这些结果强调了情绪表达障碍在现实世界中的影响，可能为精神分裂症患者社交功能障碍的潜在机制提供线索。
