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Abstract

Schizophrenia is associated with impairments in social cognition, emotion perception and face processing. These deficits have a significant impact on the social and occupational outcomes of people with schizophrenia and are thought to contribute to the formation of certain symptoms. In this series of presentations, a number of young investigators will present the latest research findings generated using innovative methods and techniques. Melissa Green will open the session by examining the issue of social contextual disturbances in schizophrenia, followed by Robyn Langdon who will discuss problems with perspective taking. Pritha Das will present the latest MRI findings with regard to face perception and the role of the amygdala, while Carmel Loughland will discuss the issue of the familial transmission of face processing deficits. Lastly, Tamara Russell and Kathryn McCabe will discuss the remediation of face processing deficits in schizophrenia using two novel approaches. Discussion at the end of the session will centre on whether these deficits represent ‘core’ deficits in schizophrenia and the relevance of remediation to these disturbances.

O:23 Social cognition in schizophrenia: Paying attention to context

M.J. Green∗, J.H. Waldron, M. Coltheart

Macquarie Centre for Cognitive Science, Macquarie University, Australia

Poor context processing is related to multiple cognitive dysfunctions in schizophrenia and may constitute a core deficit of the disorder. We examined attention to social contextual information when interpreting the mental state of characters within naturalistic social scenes. Groups of healthy (n = 26) and schizophrenia (n = 24) participants viewed a series of image-pairs depicting target characters presented in isolation (Series 1: no-context) and within a social context (Series 2: context). Gaze position was recorded using the SR Eye-Link binocular eye tracker while participants performed a mental state inference task. Mean eye movement variables were calculated for each image series (context versus no-context) to examine group differences in social context processing, while detailed analysis of attention to specific contextual items was conducted using one image-pair. Overall, the schizophrenia group demonstrated significantly fewer eye movements (saccades) when viewing faces alone (Series 1). When viewing faces within social scenes (Series 2), healthy individuals significantly shortened the duration of fixations (versus Series 1), but this was not as pronounced in schizophrenia. Analysis of attention to contextual details (secondary faces and objects) in a single image-pair revealed that schizophrenia patients spent relatively more time than controls viewing the target face under both conditions (i.e., at the expense of attending to contextual information in Series 2) and showed a significant delay in directing attention to secondary faces in the scene. These findings demonstrate abnormal attention to social contextual information in schizophrenia when viewing faces in naturalistic contexts. Implications for face processing in real world situations are discussed.

O:24 Theory-of-mind impairment in schizophrenia: a domain-general difficulty with perspective-taking

R. Langdon∗^1,2,3,4, M. Coltheart¹, P.B. Ward^2,3

¹Macquarie Centre for Cognitive Science, Macquarie University. ²Schizophrenia Research Unit, Sydney South West Area Health Service. ³Cognitive Neuroscience Research Panel, Neuroscience Institute for Schizophrenia & Allied Disorders (NISAD). ⁴School of Psychiatry, UNSW

Background “Theory of mind” (ToM) refers to the capacity to ascribe mental states in order to predict and/or explain observed behaviour in terms of psychological causation. Schizophrenia and autism are clinically distinct, yet both disorders are characterized by ToM deficits. Autistic individuals, who show a difficulty with inferring beliefs from observed behaviour, show some appreciation of the situational determinants of emotions. Findings of this type have promoted the view that ToM deficits in autism reflect a domain-specific difficulty with representing and reasoning about epistemic mental states (e.g. beliefs and pretence). This study examines whether the same holds true for schizophrenia.

Methodology Understanding of the causal links between situations and inner states (both beliefs and emotions) was examined in 22 schizophrenic patients and 18 healthy controls. A false-belief picture sequencing task assessed the capacity to infer beliefs from observed behaviour. To assess emotion attribution, participants were shown cartoon-strips of emotional situations with story characters' faces blanked out. Participants were instructed to think about how the story characters would most likely feel in the depicted circumstances in order to match cartoon depictions of facial expressions.

Results Patients were as capable as controls of naming the emotions depicted in the facial-affect cards, yet had greater difficulties with (a) attributing emotions based on circumstances and (b) inferring false beliefs from observed behaviour.

Conclusions Schizophrenic patients, unlike autistic individuals, suffer a domain-general difficulty with perspective-taking that affects equally their appreciation of other people's beliefs, percepts and emotions.

O:25 Automated and controlled processing of fear facial expression display dysfunctions in the amygdala pathways in schizophrenia: a functional connectivity approach

P. Das∗^1,2, G. Flynn^2,6, A.W.F. Harris^2,7, A.H. Kemp², B.J. Liddell^2,3, T. Whitford^2,3, A. Peduto^2,4, E. Gordon^2,5,7, L.M. Williams^2,7

¹Neuroscience Institute of Schizophrenia and Allied Disorders, Darlinghurst, NSW 2010, Australia. ²Brain Dynamics Centre, Westmead Millennium Institute and Western Clinical School, University of Sydney, Westmead Hospital, NSW 2145, Australia. ³School of Psychology, University of Sydney, NSW 2006, Australia. ⁴MRI Unit, Department of Radiology, Westmead Hospital, NSW 2145, Australia. ⁵The Brain Resource International Database, Ultimo, NSW 2007, Australia. ⁶Liverpool Mental Health Service, Liverpool Hospital, NSW 2170, Australia. ⁷Psychological Medicine, Western Clinical School, University of Sydney, Westmead Hospital, NSW 2145, Australia

Background Schizophrenia is characterized by impairments in emotion processing as well as cognition. In a series of studies we have previously observed that individuals with schizophrenia have difficulty processing negative emotions in particular, reflected in attentional biases (assesed by visual scanpath)[1] and delayed neuronal activity[2]. Evidence from functional magnetic resonance imaging (fMRI) suggests these impairments are due to a dysjunction in amygdala, medial prefrontal (MPFC) and brainstem arousal networks[3]. Together, these findings suggest that there is a failure in the integration of emotional brain networks in schizophrenia consistent with a ‘disconnection syndrome’ model. In this study we undertook the first explicit investigation of whether schizophrenia is characterized by a disturbed functional connectivity in amygdala pathways.

Methods fMRI were acquired in 14 first episode schizophrenia patients and 14 matched healthy control subjects during the pseudorandom presentation of fearful and neutral facial expression stimuli. Faces were presented under both overt (conscious) and covert (nonconscious) conditions shown to engage indirect cortical and direct brainstem pathways to the amygdala respectively[4,5].

Results Controls showed expected patterns of positive connectivity in the direct (nonconscious) and indirect (conscious) pathways and also in the amygdala-MPFC interaction (positive for nonconscious, negative for conscious)[4]. Schizophrenia was distinguished mainly by a reversal of the normal pattern of connectivity in these networks.

Conclusions The findings support the proposal that schizophrenia is defined by a lack of integration in amygdala ‘fear pathways’. A reversal of normal connectivity regardless of awareness may contribute to an inability to determine the source and relative salience of signals of potential danger.

Footnotes

O:26 Are visuo-cognitive disturbances in firstdegree relatives of schizophrenia patients evidence for a vulnerability marker?

C.M. Loughland∗^1,2, K. McCabe^1,2, P. Johnston², T.J. Lewin³, V.J. Carr^1,2

¹Neuroscience Institute for Schizophrenia and Allied Disorders. ²Centre for Mental Health Studies, University of Newcastle, NSW Australia. ³Hunter and New England Health Service

Symposium presentation: Emotion, social cognition and psychophysiology (oral).

Background and Aims Previous research demonstrates that schizophrenia patients' exhibit abnormally ‘restricted’ visual scanpaths to facial expression stimuli (Loughland et al., 2001), which may be diagnostically specific (Loughland et al., 2002). This study explored whether the observed scanpath deficits to faces in schizophrenia are associated with 1) dysfunction in information sequencing or information retention/integration of facial information, and 2) whether these disturbances are observable in the first-degree relatives of schizophrenia probands.

Methods The pilot sample consisted of 24 schizophrenia subjects, 10 first-degree relatives and 10 non-related ‘healthy’ controls. Scanpaths were recorded while subjects viewed seven facial expression stimuli (happy, sad, neutral, fear, disgust, surprise, anger). The information sequencing and information retention/integration tasks consisted of different face stimuli depicting the same seven emotions, overlaid by a five-by-five tile matrix. In the sequencing task, subjects removed as few tiles as was necessary for them to identify the facial expressions. In the integration/retention task, removed tiles were immediately replaced as each new tile was selected.

Results The results support previous findings of a restricted visual scanpath pattern to faces in schizophrenia patients, with a shorter fixation scanpath length and a reduced distance between fixations. Scanpath disturbances were most apparent in patients and first-degree relatives for the surprise facial expression, where they differed significantly on these scanpath parameters from controls, but not each other. Patients also had a significantly reduced distance between fixations compared to controls for the happy, sad and neutral face stimuli. In the sequencing and retention/integration tasks, schizophrenia patients and first-degree relatives required significantly more tile removals compared to controls, particularly for the retention/integration task.

Conclusions These findings suggest that visuo-cognitive disturbances in schizophrenia may involve a familial transmission component.

O:27 Emotion recognition training normalizes visual scan paths to faces in schizophrenia

T.A. Russell^1,2,3, M. Rozmin¹, E. Chu², M.J. Green∗¹, M. Phillips², M. Coltheart¹

¹Macquarie Centre for Cognitive Science, Macquarie University, Sydney, Australia. ²Section of Neuroscience and Emotion, Institute of Psychiatry, London, United Kingdom. ³Neuroscience Institute of Schizophrenia and Allied Disorders, NSW

Background Individuals with schizophrenia have difficulty recognizing facial expressions of emotion. These difficulties have a major impact on day-to-day functioning and quality of life. A new wave of research has begun to explore ways to remediate emotion recognition. This study investigates a new remediation tool designed to re-direct attention to relevant facial features, and utilizes eye-movement recordings to monitor changes in visual attention.

Methods A computerized intervention (the Micro Expression Training Tool) was administered to 20 stable, medicated, out-patients with schizophrenia and 20 healthy control participants. Performance on two tasks of emotion recognition (emotion labelling and emotion matching) was assessed before and after visual attention remediation, and eye-movement recordings were used to determine visual attention to facial emotional stimuli before and after training. Preliminary eye-movement data on 10 schizophrenia and 10 control participants is reported.

Results The performance of schizophrenia participants, on both emotion labeling and matching tasks, was significantly improved following remediation. Furthermore, following training the performance of schizophrenia participants was no longer significantly different to that of pre-trained controls. Eye movement data indicated that the extended viewing strategies used prior to training were normalized following training such that visual attention was directed at important facial features such as the eyes, nose and mouth (regions previously avoided by schizophrenia participants).

Conclusions Using a short computer-based intervention it is possible to improve the ability of patients with schizophrenia to decode facial expressions of emotion. The improvement in emotion recognition accuracy may be due to the “normalizing” of visual attention to important facial features.

O:28 Remediation of facial affect decoding and visual scanpath deficits in schizophrenia

K. McCabe∗^1,2, C.M. Loughland^1,2, M. Cohen^1,3, P. Johnston², M. Hunter⁴, T. Lewin³, V. Carr^1,2

¹Neuroscience Institute for Schizophrenia and Allied Disorders. ²Centre for Mental Health Studies, University of Newcastle, NSW Australia. ³Hunter and New England Health Service. ⁴School of Behavioural Sciences, University of Newcastle, NSW Australia

Recent research has explored the potential clinical utility of cognitive remediation strategies to improve facial emotion recognition in patients with schizophrenia. These observed facial identity and facial emotion recognition deficits are commonly interpreted as a dysfunction in the neurocognitive mechanisms that underlie face processing. The role of extraocular muscle (EOM) proprioception is largely neglected in these accounts. This study uses an EOM training task to determine whether proprioceptive retraining of eye movements delivered using visual scanpath technology improves emotion perception by assisting schizophrenia patients to develop more adaptive face viewing strategies. Subjects will be randomly assigned to one of three remediation groups (proprioception retraining group, face perception retraining group and control group [computerised information only]) for six, thirty minute weekly sessions and will complete post treatment follow-ups at 1 and 6 months in order to explore the potential sustainability of gains made as a consequence of remediation training. It is predicted that EOM proprioceptive retraining will produce greater improvements in affect recognition accuracy and visual scanpath strategies to face stimuli, and that these gains will be more stable over time, than either face perception retraining or information provision alone. The theoretical underpinnings of this unique line of enquiry will be presented, as will the novel methodology and stimulus proposed for this research. Clinical significance and preliminary findings will be discussed.

References

1. Williams , . Schizophr. Res. 1999.

2. Horley , . Int. J. Neurosci. 2001.

3. Williams , . Am. J. Psychiatry 2004.

4. Dast , . NeuroImage 2005.

5. Williams , . Hum. Brain Mapp. 2006.

Symposium: Emotion,Social Cognition and Psychophysiology