Bottom-up processing of fearful and angry facial expressions is intact in schizophrenia

ABSTRACT

Introduction

Judgments of emotion from faces are reportedly impaired in schizophrenia. However, it is unclear whether this is due to a top-down cognitive deficit in evaluating sensory information or a fundamental bottom-up perturbation in the early stages of face encoding. This study examined whether deficits in emotion processing reflect imprecision in the initial preconscious registration of emotional face expressions within the visual system.

Methods

Using continuous flash suppression (CFS), we presented participants (18 patients with schizophrenia, 8M/10F; 20 healthy controls, 13M/7F) with fearful and angry faces. Previous CFS research on healthy participants reveals that fearful facial expressions gain privileged access to awareness over angry faces—demonstrating the visual system’s ability to discriminate these emotions at a preconscious level. We used this same approach to probe the integrity of early emotion encoding whilst minimising the potential contribution of any top-down cognitive biases on perceptual judgments.

Results

In both groups, fearful faces were perceived faster than angry faces, with no differences observed between patients and controls.

Conclusions

Emotion processing difficulties in schizophrenia are unlikely to reflect an early sensory deficit, but rather a deficit in social cognition that has a top-down impact on the conscious evaluation of facial expressions.

KEYWORDS:

• Face processing
• emotion
• social perception
• schizophrenia
• continuous flash suppression

Acknowledgements

Thank you to Dr Marwa El Zein for kindly sharing the face stimuli that were used in this study. Thanks also goes to Christine Inkley who assisted with data collection and Dr Kelsie Boulton who assisted with clinical interviews. NC and KS designed the experiment. NC coordinated data collection. NC and KS analysed the data and wrote the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 The current sample of healthy controls were taken from a sample of 24 healthy adults used in a previous study (Caruana, Inkley, et al., 2019). However, four healthy participants under the age of 30 were not included in the current study to provide a better match between groups on age.

2 ToM data was not available for one control participant.

Additional information

Funding

This work was supported by the Australian Research Council (ARC) and the ARC Centre of Excellence for Cognition and its Disorders (CCD; www.ccd.edu.au) [grant number CE110001021]. Drs Caruana and Seymour were recipients of two ARC CCD Cross Program Support Scheme grants which directly supported this work. Dr Caruana was the recipient of a Macquarie University Research Fellowship. Dr Seymour also received financial support from the Society for Mental Health Research.

Notes on contributors

Nathan Caruana

Nathan Caruana is a social neuroscientist interested in understanding the neurocognitive mechanisms that underpin social perception, cognition and interaction across our neurodiverse population.

Kiley Seymour

Kiley Seymour is a cognitive neuroscientist investigating the neural basis of conscious visual perception and the brain mechanisms underlying altered states of consciousness, such as those experienced in psychosis (e.g., hallucinations and delusions).