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

Abstract

Introduction. Deficits in emotion perception and social skill have been well established in schizophrenia; however, little is known about the extent of these deficits across the course of the illness; that is, prior to illness onset and as the duration of the illness increases.

Method. We compared emotion perception (i.e., the Face Emotion Identification Task [FEIT] and Face Emotion Discrimination Task [FEDT]; Kerr & Neale, 1993) and social skill (Conversation Probe role-play test) performance in four groups: individuals “at risk” for psychosis who met criteria for a prodromal state, individuals early in the course of a schizophrenia spectrum illness (SSI), individuals with a chronic SSI, and healthy control individuals.

Results. At-risk individuals did not significantly differ from control participants on emotion perception measures; however, early and chronic SSI groups performed significantly worse than controls, although not different from one another. Conversely, there was evidence that deficits in social skill are present prior to illness onset. Consistent with the findings for the emotion perception tasks, early and chronic SSI groups showed comparable levels of social skill impairment.

Conclusion. Social skill deficits may be a vulnerability marker for schizophrenia, and it appears that the initial psychotic episode represents a critical point for the emergence of emotion perception deficits in schizophrenia spectrum illnesses.

Acknowledgments

The authors would like to thank Jeffrey Lieberman, MD, an anonymous donor (administered through the San Francisco Research Foundation), and The Stanley Foundation (D. Perkins) for their support. Supported in part by studies F1D-MC-HGDH and F1D-MC-HGGF funded by Eli Lilly Pharmaceuticals. Support for this project also came from NIMH projects P50-MH064065 and MH01905 (D. Perkins), and the Foundation of Hope and Eli Lilly Corporation (D. Penn).