Academic journal article Iranian Journal of Psychiatry

Visual Attention to Emotional Face in Schizophrenia: An Eye Tracking Study

Academic journal article Iranian Journal of Psychiatry

Visual Attention to Emotional Face in Schizophrenia: An Eye Tracking Study

Article excerpt

Patients with schizophrenia have disturbed social functioning that remains constant over time and across the acute and partially remitted phases of the illness (1). Recognizing the social-emotional cues like face and its expressions is essential for social communication (2).

A general deficit in the processing of faces has been shown in schizophrenic patients, which is associated with worsening of their symptoms and reduced social functioning (3). Some studies have also found that people with schizophrenia show reduced facial expressiveness in response to emotional stimuli (4). An initial question is whether this deficit pertains to facial emotion recognition or to a more generalized facial information processing deficit. Some studies have shown that these patients have impairments on numerous and varied tasks involving the analysis of faces, including recognizing familiar and unfamiliar faces and tasks concerning with identity matching (3, 5). Individuals with schizophrenia also have difficulties in emotion recognition tasks even in positive emotions such as happiness (6). Results of some studies support deficits in recognizing negative emotions in these patients (7), while others emphasize the impaired recognition of specific emotional faces such as fearful (8), disgusted (9, 8), angry and/or sad (10). Several researches have shown that face recognition and facial emotion processing are independent and have parallel processes (11). This view comes from both neuropsychological studies indicating dissociated face recognition and facial emotion processing abilities (12), and human fMRI studies that have shown different parts of the brain process of these two kinds of information (13).

It is unclear whether deficit in recognition and identification of facial emotional expressions in schizophrenia is a result of abnormal emotion processing or an impairment in processing complex visual stimuli such as face (14). In a recent ERP study, it has been suggested that the impaired facial expression perception in schizophrenia is related to delayed responses in face perception (15). Another potential cause of this deficit might be restricted attention in these patients. Attention has a critical role for almost all cognitive functions and recognizing face feature. It seems that reduced attention to face impairs the face processing ability (16). Patients with schizophrenia typically use a "restricted" strategy in their visual attention allocation, by making fewer and longer fixations (17). This restricted strategy is more obvious when looking at faces compared to other complex stimuli such as geometric figures, indicating the face-specific nature of this disturbance (18). Given the increased processing load associated with emotion processing, this abnormality would even become more obvious when looking at facial emotions (19). Commonly used behavioral tasks have not been able to answer the fundamental questions about the nature and scope of these impairments (5). Assessing visual attention would provide a direct way to test the hypothesis that impaired emotion recognition pertains to basic perceptual processing in schizophrenia. We tracked eye-movements of patients with schizophrenia while viewing facial pictures with different emotional and neutral contents passively. Initial orientation of visual attention of these patients for neutral, negative and positive facial expressions was assessed to examine the possible mechanism that may underlie face and emotion perception deficits in these patients. Furthermore, we also explored any potential correlation between symptom severity and pattern of visual attention for different facial expressions in our patient group. The aim of this study was to extend previous findings of facial processing deficits of schizophrenia in relation to visual attention using eye tracking technique, avoiding language or memory demands which may require an additional cognitive load. We hypothesized that individuals with schizophrenia will show impairment on visual attention to emotional faces compared to healthy individuals. …

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