Emotion Perception of Schizophrenia:Differential Deficits in Emotion Categories and Moderation by Sustained Attention Deficit

Objectives:
Patients with schizophrenia often display impaired emotion perception, yet it remains little known whether the impairment varies across emotion categories and perceiving modalities and whether sustained attention deficit moderates such impairment. This study aimed to examine the perception accuracy of individual emotion categories for both facial and prosodic expressions among patients with schizophrenia in Taiwan. The influence of sustained attention on these emotion perception tasks was evaluated by stratifying patients with schizophrenia into those with attention deficit and those without.
Methods:
In a sample of 127 healthy controls and 213 patients with schizophrenia, the perception of both facial and prosodic affect was measured using a locally standardized version of the Diagnostic Analysis of Nonverbal Accuracy 2, including happiness, sadness, anger, and fear. Each subject’s sustained attention was assessed using the Continuous Performance Test, which was used to divide schizophrenia patients into those without attention deficit (n = 126) versus those with attention deficit (n = 87). The mixed-effect models were used to adjust for repeated measures in terms of two emotion perception tasks and four emotional categories.
Results:
Compared with healthy controls, schizophrenia patients without attention deficit still exhibited impairment in the perception of facial affect in fear as well as of prosodic affect in happiness, sadness, and fear. Meanwhile, schizophrenia patients with attention deficit showed across-the-board impairment in emotion perception, regardless of facial or prosodic affect, as compared with healthy controls. Their accuracy rates were also worse than those of patients without attention deficit in three out of four categories of emotion, in both facial and prosodic affect.
Conclusions:
The emotion perception of schizophrenia is impaired differentially in terms of emotional categories, and is moderated by sustained attention deficit. These findings have implications for the underlying pathophysiology and intervention for schizophrenia.