Implicit and explicit processing of bodily emotions in schizophrenia.

INTRODUCTION: Disturbed emotion processing is well documented in schizophrenia, but the majority of studies evaluate processing of emotion only from facial expressions. Social cues are also communicated via body posture, and they are similarly relevant for successful social interactions. The aim of the current study was to thoroughly examine body perception abilities in individuals with schizophrenia. METHODS: Fifty-nine patients with schizophrenia and 37 healthy controls completed two tasks of body processing. The first, which was based on the Affect Misattribution Procedure, evaluated implicit processing of bodily emotions, and the second utilised a traditional emotion identification paradigm to assess explicit emotion recognition. RESULTS: Results revealed aberrant implicit processing, but more normative explicit processing, in individuals with schizophrenia. Moderate associations were found between processing of bodies and symptoms of paranoia. Performance on the tasks was not related to cognitive functioning but was associated with clinician-rated social functioning. CONCLUSIONS: Collectively, these results provide information about disturbed processing of bodily emotions in schizophrenia and suggest that these disturbances are associated with the severity of positive symptoms and predict difficulties in everyday social activities and interpersonal relationships.

Paranoia and interpersonal functioning across the continuum from healthy to pathological - Network analysis.

OBJECTIVE: Previous research has suggested that paranoia is associated with impaired social functioning in patients with schizophrenia and healthy individuals with high levels of paranoid ideation. This study analysed the relationship between paranoia and interpersonal functioning across the paranoia continuum using network analysis. METHOD: Levels of paranoid ideation and interpersonal functioning were measured in a non-clinical sample (N = 853) and in patients with schizophrenia spectrum disorders (N = 226). Network analyses were used to examine the nature of paranoia's relation to interpersonal functioning in both populations. RESULTS: Although the most central characteristic of paranoia in both samples was the feeling of being talked about behind one's back, across samples, individual characteristics were differentially related to various aspects of interpersonal functioning. Among clinical individuals, difficulties in interpersonal functioning were related to perceived previous experiences of being treated poorly by others, whereas among the non-clinical sample, interpersonal functioning was related to negative beliefs about others. CONCLUSIONS: The current results support previous findings linking paranoid ideation to interpersonal functioning in both clinical and non-clinical samples. Patterns of these relationships differed slightly across groups. Results in general support a continuum model of paranoia. PRACTITIONER POINTS: Network analyses were used to identify central aspects of persecutory ideation in both clinical and non-clinical samples. Qualitative assessment of clinical and non-clinical networks revealed similar central symptoms and supported a continuum model of paranoia. Central aspects of paranoia, that is, feeling that others have talked about oneself behind one's back, being disappointed by others, and having distressing feelings of being watched by others, were associated with deficits in interpersonal functioning in both samples. Central aspects of paranoia may be beneficial targets for psychosocial interventions aimed at reducing paranoid ideation and improving interpersonal functioning. Demographic characteristics for this study differed between samples which may limit generalization of findings. Future research is needed to explore temporal associations and moment-to-moment dynamics between paranoid ideation and problems in interpersonal functioning.

Identity recognition from faces and bodies in schizophrenia spectrum disorders.

Deficits in facial identity recognition and its association with poor social functioning are well documented in schizophrenia, but none of these studies have assessed the role of the body in these processes. Recent research in healthy populations shows that the body is also an important source of information in identity recognition, and the current study aimed to thoroughly examine identity recognition from both faces and bodies in schizophrenia. Sixty-five individuals with schizophrenia and forty-nine healthy controls completed three conditions of an identity matching task in which they attempted to match unidentified persons in unedited photos of faces and bodies, edited photos showing faces only, or edited photos showing bodies only. Results revealed global deficits in identity recognition in individuals with schizophrenia (ηp2 = 0.068), but both groups showed better recognition from bodies alone as compared to faces alone (ηp2 = 0.573), suggesting that the ability to extract useful information from bodies when identifying persons may remain partially preserved in schizophrenia. Further research is necessary to understand the relationship between face/body processing, identity recognition, and functional outcomes in individuals with schizophrenia-spectrum disorders.

The limited effect of neural stimulation on visual attention and social cognition in individuals with schizophrenia.

BACKGROUND: Research demonstrates a relationship between faulty visual attention and poorer social cognition in schizophrenia. One potential explanatory model suggests abnormal neuromodulation in specific neural networks may result in reduced attention to socially important cues, leading to poorer understanding of another's emotional state or intentions. OBJECTIVE: The current study experimentally manipulated neural networks using tDCS to examine this potential causal mechanism. The primary aim was to determine whether stimulation to the right temporoparietal junction (rTPJ) improves visual attention, and secondary aims were to determine whether 1) stimulation improves social cognitive performance and 2) visual attention moderates this improved performance. METHOD: Using a double-blind crossover design, 69 individuals with schizophrenia underwent both active and sham stimulation to either the rTPJ of the ventral attention network (n = 36) or the dorsomedial prefrontal cortex of the social brain network (dmPFC; n = 33). Following stimulation, participants completed tasks assessing emotion recognition and mentalizing. Concurrent eye tracking assessed visual attention, measuring proportion of time spent attending to areas of interest. RESULTS: For emotion recognition, stimulation failed to impact either visual attention or social cognitive task accuracy. Similarly, neurostimulation failed to affect visual attention on the mentalizing task. However, exploratory analyses demonstrated that mentalizing accuracy significantly improved after stimulation to the active comparator, dmPFC, with no improvement after stimulation to rTPJ. CONCLUSION: Results demonstrate limited effect of a single stimulation session on visual attention and emotion recognition accuracy but provide initial support for an alternate neural mechanism for mentalizing, highlighting the importance of executive functions over visual attention.

Measuring mentalizing: A comparison of scoring methods for the hinting task.

OBJECTIVE: The Social Cognition Psychometric Evaluation (SCOPE) study supported the utility and practicality of the Hinting task as a measure of social cognition/mentalizing in clinical trials, specifically with the SCOPE authors' stringent scoring system. However, it remains unclear whether the SCOPE scoring system is necessary for the task to be judged as psychometrically sound. METHOD: Independent raters rescored data from the three phases of SCOPE using the Hinting task's original scoring criteria. Psychometric properties of the task when scored with the original criteria versus more stringent SCOPE criteria were compared in a large sample of individuals with chronic schizophrenia (n = 397) and matched controls (n = 300) as well as a smaller sample of individuals with early psychosis (n = 38) and controls (n = 39). RESULTS: In both samples, SCOPE criteria resulted in lowered average scores and reduced ceiling effects. Further, revised scoring resulted in strengthened relationships between the hinting task and outcome measures in the chronic sample, and better differentiated early psychosis patients from controls. Conversely, test-retest reliability and internal consistency estimates were not improved using revised scoring and remained suboptimal, particularly for healthy controls. CONCLUSION: Overall, SCOPE scoring criteria improved some psychometric properties and clinical utility, suggesting that these criteria should be considered for implementation.

Examining reasoning biases in schizophrenia using a modified "Jumping to Conclusions" probabilistic reasoning task.

Although the Jumping To Conclusion (JTC) bias has been extensively studied in relation to schizophrenia and persecutory delusions, the relationship between JTC and other reasoning biases implicated in delusional ideation is not fully understood. We modified the traditional JTC task to assess co-occurrence of reasoning biases in decision making. Forty-six patients with schizophrenia and 46 healthy controls completed two versions [neutral colored beads and salient comments] of the modified task. We replicated previous findings indicating that patients showed a greater JTC bias, and in both groups, the JTC bias was more pronounced for the salient task. However, we observed a significant effect for non-Bayesian judgments, indicating that patients showed greater difficulty in probabilistic reasoning. When controlling for probabilistic reasoning ability, the observed JTC bias effects were diminished. Our findings that faulty probability assessment accounts for the JTC bias indicates that the traditional JTC bias task may not represent an inherent hasty decision-making bias, but rather an inability to fully understand and execute the stated goals of the task. These results call into question the current understanding of the JTC bias and the independence of this bias apart from the cognitive demands of the task.

Neural correlates of social cognitive introspective accuracy in schizophrenia.

Introspective accuracy (IA) refers to the ability to accurately assess one's own skills and capabilities. Recent work provides evidence of IA deficits in schizophrenia that are predictive of everyday functioning. Thus, IA deficits are an important target to understand mechanistically. The current study used fMRI to assess neural activation in 32 healthy controls and 31 individuals with schizophrenia as they completed IA and control versions of a social cognitive task (i.e., emotion recognition). Analyses revealed different areas of IA-specific neural activity between groups including activations of rostrolateral prefrontal cortex (rlPFC) and dorsal anterior cingulate cortex in healthy individuals that were absent in patients. Direct group comparisons revealed greater IA-specific activation for healthy individuals in right rlPFC, a region thought to be critical for successful IA. For healthy individuals only, activation in rlPFC was positively correlated with IA ability, but no association was observed for patients. Further, among individuals with schizophrenia, increased activation of rlPFC during judgments of IA was positively correlated with better informant-reported interpersonal functioning. These results suggest that reduced specialization of IA-related neural activation may contribute to impaired IA in schizophrenia and also highlight IA as a potential target for remediation programs aimed at improving real-world functioning.