Background: Deficit in facial emotion perception is an important social cognitive impairment in schizophrenic patients, and it is one of the key determinants of functional outcome in schizophrenia. However, the moderating effect of social context and the boundary of perceptual categories of facial emotion perception remain unclear.
Method: A total of 36 schizophrenic outpatients in their early stage of illness and 43 healthy controls were recruited for evaluation of social and clinical characteristics, neurocognitive profiles, and facial emotion categorization (FEC) performance. FEC was assessed by a computer-based program with 120 trials, in which social context was presented in the form of a preceding question, in order to simulate the conditions of being praised (positive), blamed (negative), or inquiry (neutral), while the participants were asked to judge a photograph derived from one of the five facial images in a happy-angry emotion continuum. The FEC data was inserted into a logistic function model with subsequent analysis by repeated measures ANOVA and the shift point and slope as outcome measures.
Results: Schizophrenic patients were significantly more likely to perceive ambiguous and subtle facial expressions as happy, rather than angry, in all three social contexts. However, the interaction effects between group and context for FEC performance was not significant.
Conclusions: Schizophrenic patients, even in their early stage of illness, appear to have abnormal perceptions of facial emotion categories, which may explain some of their abnormal social interactions and disabilities. This study provides additional information in understanding social cognitive deficits among schizophrenic patients.
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