Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany.
Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany.
Psychiatry Res. 2018 Nov;269:430-436. doi: 10.1016/j.psychres.2018.08.052. Epub 2018 Aug 16.
The vigilance-avoidance hypothesis of paranoia states that in paranoia visual attention is shifted away from threat-related stimuli. This may be an explanation for reduced scanning of salient facial features in psychosis and subsequently impaired emotion recognition. Here, we explored whether higher levels of paranoia would predict reduced visual attention to salient facial features and impaired emotion recognition and whether reduced visual attention to salient facial features mediates the association between paranoia and errors in emotion recognition. Participants with schizophrenia (SZ, n = 22) and healthy controls (HC, n = 19) completed questionnaire assessments of paranoia and negative symptoms and conducted an emotion recognition task comprised of dynamic facial stimuli. Additionally, visual attention (number of fixations) to salient facial features was assessed using eye-tracking. SZ made more errors in affect recognition than HC. Visual attention to salient facial features did not differ between SZ and HC but significantly mediated the significant association between paranoia and errors in the emotion recognition task in the complete sample. Negative symptoms also predicted errors in emotion recognition but this association was not mediated by visual attention. Our findings are in line with the avoidance-assumption of a vigilance-avoidance hypothesis of paranoia, in which correct facial emotion recognition is prevented due to an avoidance of salient facial features.
偏执狂的警惕回避假说认为，在偏执狂中，视觉注意力从与威胁相关的刺激上转移开。这可能解释了精神分裂症患者对面部特征的扫视减少，以及随后的情绪识别受损。在这里，我们探讨了较高水平的偏执是否会预测对显著面部特征的视觉注意力减少和情绪识别受损，以及对显著面部特征的视觉注意力减少是否会在偏执和情绪识别错误之间的关联中起中介作用。22 名精神分裂症患者（SZ）和 19 名健康对照者（HC）完成了偏执和阴性症状的问卷调查，并进行了包含动态面部刺激的情绪识别任务。此外，使用眼动追踪评估了对显著面部特征的视觉注意力（注视次数）。SZ 在情感识别上的错误比 HC 多。SZ 和 HC 之间对显著面部特征的视觉注意力没有差异，但在全样本中，偏执与情绪识别任务中的错误之间的显著关联显著中介了视觉注意力。阴性症状也预测了情绪识别错误，但这种关联不受视觉注意力的影响。我们的发现与偏执的警惕回避假说的回避假设一致，在该假说中，由于对显著面部特征的回避，正确的面部情绪识别受到阻碍。
