Social cognition training improves recognition of individual emotions in schizophrenia disorder

Abstract

Impaired recognition of angry, fearful, and emotionless (i.e., neutral) faces is associated with poor social functioning among individuals with schizophrenia disorder (SZ). Limited research evaluates how interventions impact these impairments. Computerized social cognition training can improve overall facial emotion recognition in SZ, but it is unclear whether it improves the aforementioned impairments. We report results from a randomized controlled trial (Trial Registration: NCT02246426) evaluating how computerized social cognition training (SCT) impacts recognition of individual emotions in SZ. Ninety-eight individuals with SZ were randomly assigned to one of two internet-based interventions: SCT or a control condition (computer games without social content) (CON). Participants completed 40 sessions of training over 8-12 weeks. Facial emotion recognition was measured with the Penn ER-40 before training, after 20 sessions, and within 8 weeks of completing 40 sessions. Accuracy and reaction times for each emotion (i.e., anger, fear, happy, neutral, and sad) were analyzed. Linear mixed model analyses and t-tests elucidated intervention effects. A significant Group x Time interaction on accuracy was found favoring the SCT group. Only the SCT group improved recognizing fearful and sad faces; the CON group did not. The SCT group had higher accuracy for neutral recognition than the CON group after training. There was no Group x Time interaction on reaction times. We conclude that, because SCT training improves fear and neutral recognition, it has the potential to improve social functioning in SZ. However, interventions need to be further refined to improve anger recognition and emotion recognition reaction times.

Keywords: Cognitive remediation; Facial emotion recognition; Schizophrenia; Social cognition.