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Alexithymia and the Recognition of Facial Emotion in Schizophrenic Patients  

Noh, Jin-Chan (Department of Psychiatry, Gongju National Hospital)
Park, Sung-Hyouk (Department of Psychiatry, Chookryoung Evangelical Hospital)
Kim, Kyung-Hee (Department of Psychiatry, Gongju National Hospital)
Kim, So-Yul (Department of Psychiatry, Gongju National Hospital)
Shin, Sung-Woong (Department of Psychiatry, Chookryoung Evangelical Hospital)
Lee, Koun-Seok (Department of Psychiatry, Gongju National Hospital)
Publication Information
Korean Journal of Biological Psychiatry / v.18, no.4, 2011 , pp. 239-244 More about this Journal
Abstract
Objectives Schizophrenic patients have been shown to be impaired in both emotional self-awareness and recognition of others' facial emotions. Alexithymia refers to the deficits in emotional self-awareness. The relationship between alexithymia and recognition of others' facial emotions needs to be explored to better understand the characteristics of emotional deficits in schizophrenic patients. Methods Thirty control subjects and 31 schizophrenic patients completed the Toronto Alexithymia Scale-20-Korean version (TAS-20K) and facial emotion recognition task. The stimuli in facial emotion recognition task consist of 6 emotions (happiness, sadness, anger, fear, disgust, and neutral). Recognition accuracy was calculated within each emotion category. Correlations between TAS-20K and recognition accuracy were analyzed. Results The schizophrenic patients showed higher TAS-20K scores and lower recognition accuracy compared with the control subjects. The schizophrenic patients did not demonstrate any significant correlations between TAS-20K and recognition accuracy, unlike the control subjects. Conclusions The data suggest that, although schizophrenia may impair both emotional self-awareness and recognition of others' facial emotions, the degrees of deficit can be different between emotional self-awareness and recognition of others' facial emotions. This indicates that the emotional deficits in schizophrenia may assume more complex features.
Keywords
Alexithymia; Facial emotion; Emotion recognition; Schizophrenia;
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1 Mueser KT, Doonan R, Penn DL, Blanchard JJ, Bellack AS, Nishith P, et al. Emotion recognition and social competence in chronic schizophrenia. J Abnorm Psychol 1996;105:271-275.
2 Kerr SL, Neale JM. Emotion perception in schizophrenia: specific deficit or further evidence of generalized poor performance? J Abnorm Psychol 1993;102:312-318.
3 Kohler CG, Bilker W, Hagendoorn M, Gur RE, Gur RC. Emotion recognition deficit in schizophrenia: association with symptomatology and cognition. Biol Psychiatry 2000;48:127-136.   DOI   ScienceOn
4 Edwards J, Jackson HJ, Pattison PE. Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review. Clin Psychol Rev 2002;22:789-832.   DOI   ScienceOn
5 Kring AM, Moran EK. Emotional response deficits in schizophrenia: insights from affective science. Schizophr Bull 2008;34:819- 834.   DOI   ScienceOn
6 Edwards J, Pattison PE, Jackson HJ, Wales RJ. Facial affect and affective prosody recognition in first-episode schizophrenia. Schizophr Res 2001;48:235-253.   DOI   ScienceOn
7 Addington J, Addington D. Facial affect recognition and information processing in schizophrenia and bipolar disorder. Schizophr Res 1998;32:171-181.   DOI   ScienceOn
8 Kohler CG, Turner TH, Bilker WB, Brensinger CM, Siegel SJ, Kanes SJ, et al. Facial emotion recognition in schizophrenia: intensity effects and error pattern. Am J Psychiatry 2003;160:1768-1774.   DOI   ScienceOn
9 Turetsky BI, Kohler CG, Indersmitten T, Bhati MT, Charbonnier D, Gur RC. Facial emotion recognition in schizophrenia: when and why does it go awry? Schizophr Res 2007;94:253-263.   DOI   ScienceOn
10 Aleman A, Kahn RS. Strange feelings: do amygdala abnormalities dysregulate the emotional brain in schizophrenia? Prog Neurobiol 2005;77:283-298.
11 Kucharska-Pietura K, David AS, Masiak M, Phillips ML. Perception of facial and vocal affect by people with schizophrenia in early and late stages of illness. Br J Psychiatry 2005;187:523-528.   DOI   ScienceOn
12 Pinkham AE, Penn DL, Perkins DO, Graham KA, Siegel M. Emotion perception and social skill over the course of psychosis: a comparison of individuals "at-risk" for psychosis and individuals with early and chronic schizophrenia spectrum illness. Cogn Neuropsychiatry 2007;12:198-212.   DOI   ScienceOn
13 Weniger G, Lange C, RÜther E, Irle E. Differential impairments of facial affect recognition in schizophrenia subtypes and major depression. Psychiatry Res 2004;128:135-146.   DOI   ScienceOn
14 Hall J, Harris JM, Sprengelmeyer R, Sprengelmeyer A, Young AW, Santos IM, et al. Social cognition and face processing in schizophrenia. Br J Psychiatry 2004;185:169-170.   DOI   ScienceOn
15 Martin F, Baudouin JY, Tiberghien G, Franck N. Processing emotional expression and facial identity in schizophrenia. Psychiatry Res 2005;134:43-53.   DOI   ScienceOn
16 Sachs G, Steger-Wuchse D, Kryspin-Exner I, Gur RC, Katschnig H. Facial recognition deficits and cognition in schizophrenia. Schizophr Res 2004;68:27-35.   DOI   ScienceOn
17 Lee SJ, Lee HK, Kweon YS, Lee CT, Lee KU. Deficits in facial emotion recognition in schizophrenia: a replication study with korean subjects. Psychiatry Investig 2010;7:291-297.   DOI   ScienceOn
18 Schneider F, Gur RC, Koch K, Backes V, Amunts K, Shah NJ, et al. Impairment in the specificity of emotion processing in schizophrenia. Am J Psychiatry 2006;163:442-447.   DOI   ScienceOn
19 Archer J, Hay DC, Young AW. Movement, face processing and schizophrenia: evidence of a differential deficit in expression analysis. Br J Clin Psychol 1994;33:517-528.   DOI   ScienceOn
20 Bellack AS, Blanchard JJ, Mueser KT. Cue availability and affect perception in schizophrenia. Schizophr Bull 1996;22:535-544.   DOI   ScienceOn
21 Gaebel W, Wolwer W. Facial expression and emotional face recognition in schizophrenia and depression. Eur Arch Psychiatry Clin Neurosci 1992;242:46-52.   DOI   ScienceOn
22 van't Wout M, Aleman A, Kessels RP, Cahn W, de Haan EH, Kahn RS. Exploring the nature of facial affect processing deficits in schizophrenia. Psychiatry Res 2007;150:227-235.   DOI   ScienceOn
23 Tsoi DT, Lee KH, Khokhar WA, Mir NU, Swalli JS, Gee KA, et al. Is facial emotion recognition impairment in schizophrenia identical for different emotions? A signal detection analysis. Schizophr Res 2008;99:263-269.   DOI
24 Bediou B, Franck N, Saoud M, Baudouin JY, Tiberghien G, Dalery J, et al. Effects of emotion and identity on facial affect processing in schizophrenia. Psychiatry Res 2005;133:149-157.   DOI
25 An SK, Lee SJ, Lee CH, Cho HS, Lee PG, Lee CI, et al. Reduced P3 amplitudes by negative facial emotional photographs in schizophrenia. Schizophr Res 2003;64:125-135.   DOI
26 Im WY, Oh SH, Lee SH, Park YM, Bae SM. Ability of facial affect perception in patients with schizophrenia. Korean J Biol Psychiatry 2008;15:211-218.
27 Sifneos PE, Apfel-Savitz R, Frankel FH. The phenomenon of 'alexithymia'. Observations in neurotic and psychosomatic patients. Psychother Psychosom 1977;28:47-57.   DOI
28 Sifneos PE. The prevalence of 'alexithymic' characteristics in psychosomatic patients. Psychother Psychosom 1973;22:255-262.   DOI   ScienceOn
29 Lane RD, Sechrest L, Riedel R, Shapiro DE, Kaszniak AW. Pervasive emotion recognition deficit common to alexithymia and the repressive coping style. Psychosom Med 2000;62:492-501.
30 Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res 1994;38:33-40.   DOI   ScienceOn
31 Bagby RM, Parker JD, Taylor GJ. The twenty-item Toronto Alexithymia Scale--I. Item selection and cross-validation of the factor structure. J Psychosom Res 1994;38:23-32.   DOI   ScienceOn
32 Cedro A, Kokoszka A, Popiel A, Narkiewicz-Jodko W. Alexithymia in schizophrenia: an exploratory study. Psychol Rep 2001;89:95-98.
33 Heshmati R, Jafari E, Hoseinifar J, Ahmadi M. Comparative study of alexithymia in patients with schizophrenia spectrum disorders, non-psychotic disorders and normal people. Procedia - Social and Behavioral Sciences 2010;5:1084-1089.   DOI
34 Serper M, Berenbaum H. The relation between emotional awareness and hallucinations and delusions in acute psychiatric inpatients. Schizophr Res 2008;101:195-200.   DOI
35 Stanghellini G, Ricca V. Alexithymia and schizophrenias. Psychopathology 1995;28:263-272.   DOI   ScienceOn
36 Kubota M, Miyata J, Hirao K, Fujiwara H, Kawada R, Fujimoto S, et al. Alexithymia and regional gray matter alterations in schizophrenia. Neurosci Res 2011;70:206-213.   DOI   ScienceOn
37 Henry JD, Bailey PE, von Hippel C, Rendell PG, Lane A. Alexithymia in schizophrenia. J Clin Exp Neuropsychol 2010;32:890- 897.   DOI   ScienceOn
38 Maggini C, Raballo A. Alexithymia and schizophrenic psychopathology. Acta Biomed 2004;75:40-49.
39 Todarello O, Porcelli P, Grilletti F, Bellomo A. Is alexithymia related to negative symptoms of schizophrenia? A preliminary longitudinal study. Psychopathology 2005;38:310-314.   DOI
40 Parker JD, Taylor GJ, Bagby RM. Alexithymia and the recognition of facial expressions of emotion. Psychother Psychosom 1993;59:197- 202.   DOI   ScienceOn
41 McDonald PW, Prkachin KM. The expression and perception of facial emotion in alexithymia: a pilot study. Psychosom Med 1990;52:199-210.
42 Mann LS, Wise TN, Trinidad A, Kohanski R. Alexithymia, affect recognition, and the five-factor model of personality in normal subjects. Psychol Rep 1994;74:563-567.   DOI   ScienceOn
43 First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV Axis I Disorders: Patient Edition (SCIDI/ P). Version 2. New York: New York State Psychiatric Institute Biometric Research;1996.
44 Andreasen NC. Scale for the Assessment of Negative Symptoms (SANS). Iowa city: University of Iowa;1984.
45 Andreasen NC. Scale for the Assessment of Positive Symptoms (SAPS). Iowa city: University of Iowa;1984.
46 Lane RD, Sechrest L, Reidel R, Weldon V, Kaszniak A, Schwartz GE. Impaired verbal and nonverbal emotion recognition in alexithymia. Psychosom Med 1996;58:203-210.
47 Subic-Wrana C, Bruder S, Thomas W, Lane RD, Kohle K. Emotional awareness deficits in inpatients of a psychosomatic ward: a comparison of two different measures of alexithymia. Psychosom Med 2005;67:483-489.   DOI   ScienceOn
48 Lee YH, Rim HD, Lee JY. Development and Validation of a Korean Version of the 20-Item Toronto Alexithymia Scale (TAS-20K). J Korean Neuropsychiatr Assoc 1996;35:888-899.
49 Ekman P, Friesen WV. Pictures of Facial Affect. Palo Alto, CA: Consulting Psychologists Press;1976.
50 Guttman H, Laporte L. Alexithymia, empathy, and psychological symptoms in a family context. Compr Psychiatry 2002;43:448-455.   DOI   ScienceOn
51 Pinkham AE, Sasson NJ, Calkins ME, Richard J, Hughett P, Gur RE, et al. The other-race effect in face processing among African American and Caucasian individuals with schizophrenia. Am J Psychiatry 2008;165:639-645.   DOI   ScienceOn
52 Kee KS, Green MF, Mintz J, Brekke JS. Is emotion processing a predictor of functional outcome in schizophrenia? Schizophr Bull 2003;29:487-497.   DOI   ScienceOn
53 Addington J, Saeedi H, Addington D. Facial affect recognition: a mediator between cognitive and social functioning in psychosis? Schizophr Res 2006;85:142-150.   DOI
54 Hooker C, Park S. Emotion processing and its relationship to social functioning in schizophrenia patients. Psychiatry Res 2002;112:41- 50.   DOI   ScienceOn