Perception of facial emotion in schizophrenic and right brain-damaged patients.

Deficits in the perception of facial emotion have been demonstrated in patients with right-sided brain damage (RBD) and schizophrenia (SZ). Furthermore, recent speculations have implicated right-hemisphere dysfunction in Type II schizophrenics, especially those with a preponderance of "negative symptoms" and flat affect. The performance of SZ, RBD, and normal control subjects was compared on measures assessing facial emotional perception. Both identification and discrimination paradigms were used, with positive/pleasant and negative/unpleasant emotions. To examine the effects of visuospatial and facial processing on facial emotion tasks, the Visual Matrices Test and the Benton Facial Recognition Test were administered. On both facial emotion tests, SZ and RBD patients were significantly impaired relative to normal subjects, but not different from each other. The SZ and RBD patients were also impaired on the matrices and facial recognition tests. When the effects of the matrices and neutral face recognition tests were statistically controlled, significant group differences remained for the identification task but not for the discrimination task. Thus, methodologies are presented for the neuropsychological study of facial emotional perception, and some support is provided for the notion that negative-symptom schizophrenia is associated with right hemisphere dysfunction.