Effects of nicotine on social cognition, social competence and self-reported stress in schizophrenia patients and healthy controls.

More than 80 % of patients diagnosed with schizophrenia are nicotine-dependent. Self-medication of cognitive deficits and an increased vulnerability to stress are discussed as promoting factors for the development of nicotine dependence. However, the effects of nicotine on social cognition and subjective stress responses in schizophrenia are largely unexplored. A 2 × 2-factorial design (drug × group) was used to investigate the effects of nicotine versus placebo in smoking schizophrenia patients and healthy controls after 24 h of abstinence from smoking. Participants performed a facial affect recognition task and a semi-standardized role-play task, after which social competence and self-reported stress during social interaction were assessed. Data analysis revealed no significant group differences in the facial affect recognition task. During social interaction, healthy controls showed more non-verbal expressions and a lower subjective stress level than schizophrenia patients. There were no significant effects of nicotine in terms of an enhanced recognition of facial affect, more expressive behaviour or reduced subjective stress during social interaction. While schizophrenia patients unexpectedly recognized facial affect not significantly worse than healthy controls, the observed group differences in subjective stress and non-verbal expression during social interaction in the role-play situation are in line with previous findings. Contrary to expectations derived from the self-medication hypothesis, nicotine showed no significant effects on the dependent variables, perhaps because of the dosage used and the delay between the administration of nicotine and the performance of the role-play.

Training of Affect Recognition impacts electrophysiological correlates of facial affect recognition in schizophrenia: Analyses of fixation-locked potentials.

OBJECTIVES: Training of Affect Recognition (TAR) is a useful approach to restoring cognitive function in schizophrenic patients. Along with improving visual exploration of faces and altering central information processing in relevant brain areas, TAR attenuates impairments in facial affect recognition. In the present study, we investigate the effects of TAR on early electrophysiological correlates of facial affect recognition in schizophrenia. METHODS: The study population comprised 12 schizophrenic patients and 14 healthy controls. In each individual, we carried out EEG, concomitant measurements of scanning eye movements and fixation-based low resolution electromagnetic tomography (sLORETA) analyses of brain electric activity. All analyses were performed at baseline and after participation in TAR. RESULTS: In patients, brain activation patterns significantly changed after completing the TAR. Functional improvements were particularly pronounced in the superior parietal and inferior parietal lobes, where trained patients showed a larger increase in activation than untrained healthy controls. CONCLUSIONS: The TAR activates compensatory brain processes involved in the perception, attention and evaluation of emotional stimuli. This may underlie the established behavioral effects of the TAR in schizophrenic patients, which include improvements in facial affect recognition and alterations of visual exploration strategies.

Effects of Training of Affect Recognition on the recognition and visual exploration of emotional faces in schizophrenia.

BACKGROUND: Schizophrenia patients have impairments in facial affect recognition and display scanpath abnormalities during the visual exploration of faces. These abnormalities are characterized by fewer fixations on salient feature areas and longer fixation durations. The present study investigated whether social-cognitive remediation not only improves performance in facial affect recognition but also normalizes patients' gaze behavior while looking at faces. METHODS: Within a 2 × 2-design (group × time), 16 schizophrenia patients and 16 healthy controls performed a facial affect recognition task with concomitant infrared oculography at baseline (T0) and after six weeks (T1). Between the measurements, patients completed the Training of Affect Recognition (TAR) program. The influence of the training on facial affect recognition (percent of correct answers) and gaze behavior (number and mean duration of fixations into salient or non-salient facial areas) was assessed. RESULTS: In line with former studies, at baseline patients showed poorer facial affect recognition than controls and aberrant scanpaths, and after TAR facial affect recognition was improved. Concomitant with improvements in performance, the number of fixations in feature areas ('mouth') increased while fixations in non-feature areas ('white space') decreased. However, the change in fixation behavior did not correlate with the improvement in performance. CONCLUSIONS: After TAR, patients pay more attention to facial areas that contain information about a displayed emotion. Although this may contribute to the improved performance, the lack of a statistical correlation implies that this factor is not sufficient to explain the underlying mechanism of the treatment effect.