Misattribution bias of threat-related facial expressions is related to a longer duration of illness and poor executive function in schizophrenia and schizoaffective disorder

Eur Psychiatry. 2008 Jan;23(1):14-9. doi: 10.1016/j.eurpsy.2007.10.004. Epub 2008 Jan 16.


Background: While it is known that patients with schizophrenia recognize facial emotions, specifically negative emotions, less accurately, little is known about how they misattribute these emotions to other emotions and whether such misattribution biases are associated with symptoms, course of the disorder, or certain cognitive functions.

Method: Outpatients with schizophrenia or schizoaffective disorder (n=73) and healthy controls (n=30) performed a computerised Facial Emotion Attribution Test and Wisconsin Card Sorting Test (WCST). Patients were also rated on the Positive and Negative Syndrome Scale (PANSS).

Results: Patients were poor at recognizing fearful and angry emotions and attributed fear to angry and angry to neutral expressions. Fear-as-anger misattributions were predicted independently by a longer duration of illness and WCST perseverative errors.

Conclusion: The findings show a bias towards misattributing fearful and angry facial emotions. The propensity for fear-as-anger misattribution biases increases as the length of time that the disorder is experienced increases and a more rigid style of information processing is used. This, at least in part, may be perpetuated by subtle fearfulness expressed by others while interacting with people with schizophrenia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Ambulatory Care
  • Anger*
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Confusion / diagnosis
  • Confusion / psychology
  • Diagnosis, Computer-Assisted
  • Emotions
  • Facial Expression*
  • Fear*
  • Female
  • Humans
  • Interpersonal Relations
  • Male
  • Neuropsychological Tests / statistics & numerical data*
  • Psychotic Disorders / diagnosis*
  • Psychotic Disorders / psychology
  • Schizophrenia / diagnosis*
  • Schizophrenic Psychology
  • Social Perception*
  • Time Factors
  • Visual Perception