Inefficient integration during multiple facial processing in pre-morbid and early phases of psychosis

Abstract

Objectives

We used eye-tracking to evaluate multiple facial context processing and event-related potential (ERP) to evaluate multiple facial recognition in individuals at clinical high risk (CHR) for psychosis.

Methods

In total, 173 subjects (83 CHRs and 90 healthy controls [HCs]) were included and their emotion perception performances were accessed. A total of 40 CHRs and 40 well-matched HCs completed an eye-tracking task where they viewed pictures depicting a person in the foreground, presented as context-free, context-compatible, and context-incompatible. During the two-year follow-up, 26 CHRs developed psychosis, including 17 individuals who developed first-episode schizophrenia (FES). Eighteen well-matched HCs were made to complete the face number detection ERP task with image stimuli of one, two, or three faces.

Results

Compared to the HC group, the CHR group showed reduced visual attention to contextual processing when viewing multiple faces. With the increasing complexity of contextual faces, the differences in eye-tracking characteristics also increased. In the ERP task, the N170 amplitude decreased with a higher face number in FES patients, while it increased with a higher face number in HCs.

Conclusions

Individuals in the very early phase of psychosis showed facial processing deficits with supporting evidence of different scan paths during context processing and disruption of N170 during multiple facial recognition.

Keywords:

• Psychosis
• social cognition
• emotional processing biases
• schizophrenia
• eye movement

Disclosure statement

There are no conflicts of interest to report.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China (82171544, 81901832, 62171269), Science and Technology Commission of Shanghai Municipality (19441907800, 19ZR1445200, 17411953100, 21S31903100, 2018SHZDZX01, 19410710800, 19411969100, 19411950800), Shanghai Clinical Research Centre for Mental Health (19MC1911100) and The Clinical Research Centre at Shanghai Mental Health Centre (CRC2018ZD01, CRC2018ZD04), Shanghai Jiao Tong University Foundation (ZH2018ZDB03, ZH2018QNB19, YG2016QN42, YG2014MS40), Project of the Key Discipline Construction, Shanghai 3-Year Public Health Action Plan (GWV-10.1-XK18), Shanghai Municipal Science and Technology Major Project (2018SHZDZX05) and ZJLab.