Schizophrenia is linked to broad difficulty reading emotions from body language and faces

A small study of men in Germany found that those with schizophrenia were less accurate than healthy men at recognizing emotions from both body movements and facial expressions shown as simple moving dots. Among the men with schizophrenia, those who were better at reading emotions from body movements also tended to be better at reading them from faces, a link that did not appear in healthy men. The paper was published in Schizophrenia.

Understanding other people’s emotions, intentions, and social signals is a basic skill that helps us navigate everyday interactions. In typical individuals, the brain combines information from faces, body movements, and other cues to build a picture of what someone else may be feeling or thinking. In people with mental disorders, however, this process can become less reliable.

Different disorders appear to produce different patterns of difficulty. In depression and bipolar disorder, problems tend to affect the recognition of particular emotions, such as sadness, rather than social cognition, the mental processes involved in perceiving and understanding other people, as a whole. Schizophrenia, by contrast, is associated with broader problems in interpreting nonverbal social information. People with schizophrenia tend to have difficulty reading emotions from the eyes, facial expressions, and body movements, which can make social relationships harder to establish and maintain.

Researchers often study these abilities using point-light displays, in which only a handful of moving dots, placed on a person’s joints or face, represent the body or face. Because viewers see only motion, emotion recognition can be tested without cues such as clothing, body shape, or facial features. While healthy individuals can usually recognize emotions from these simplified displays, people with schizophrenia tend to perform less accurately.

Study author Annika Resch of the University of Tübingen and colleagues examined whether men with schizophrenia differ from healthy men in recognizing emotions from point-light faces and bodies. Because schizophrenia differs between men and women in how common it is, when it starts, and how severe it tends to be, the researchers included only men to reduce variability. They also wanted to know whether any difficulties were global, affecting all tasks and emotions, or selective, affecting only some, and whether people’s performance on the face and body tasks was related.

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The participants were 28 men diagnosed with schizophrenia or related disorders, recruited from inpatient units at the University Hospital Tübingen, and 28 healthy men from the local community who were matched to them in age. Participants’ average age was 32 years. Most of the patients had been diagnosed with paranoid schizophrenia, and eight had schizoaffective disorder, a condition that combines symptoms of schizophrenia with those of a mood disorder. Nearly all of the patients were taking medication, and more than half had other conditions, mostly involving substance use.

In the body task, participants watched 2-second videos of a walking figure made of 15 white dots placed on the head, neck, pelvis, and major joints of an otherwise invisible body. In each of 144 trials, they pressed a key to indicate whether the walker’s movement expressed anger or was emotionally neutral. The walkers were based on recordings of four actors, two men and two women.

In the face task, participants watched 2-second videos of faces represented by 50 white dots and indicated whether each face expressed happiness or anger. This task included 108 trials featuring six actors, three men and three women. The researchers recorded both how accurately and how quickly participants responded.

Men with schizophrenia were less accurate than healthy men on both tasks, and the gap was especially large for faces. On the face task, they correctly identified the emotion about 59% of the time, compared with 76% for healthy men; on the body task, the figures were about 55% and 63%, where 50% would reflect random guessing. Men with schizophrenia were also slower to respond on both tasks.

Both groups were more accurate with faces than with bodies. The body task proved difficult for everyone, mainly because angry walking was hard to recognize: on angry walkers, the two groups did not differ, while men with schizophrenia were less accurate at recognizing neutral walking. On the face task, men with schizophrenia were less accurate at recognizing both happy and angry expressions.

The researchers describe the impairment as global because men with schizophrenia showed the same overall pattern as healthy men, finding the same emotions easier or harder to recognize, just at a lower level of accuracy. Among men with schizophrenia, those who were more accurate on the body task also tended to be more accurate on the face task, but this link was absent in healthy men. In both groups, people who responded quickly on one task also tended to respond quickly on the other.

“For SZ [schizophrenia] patients, inferring social signals from dynamic faces and bodies may be rather challenging in terms of neurocognitive mechanisms, which is reflected in the tight link in recognition accuracy. Along with previous data on inferring emotions in the eyes collected in the same cohort, this work provides novel insights into the specific global aberrations in social cognition in SZ and offers a blueprint for the development of strategies for the targeted treatment of gender-specific mental disorders,” study authors concluded.

In other words, the authors suggest that schizophrenia may affect a shared set of mental processes involved in reading both faces and bodies, so that difficulties with one tend to go along with difficulties with the other.

The study contributes to the scientific understanding of social cognition in people with schizophrenia. However, it should be noted that the study was conducted on a relatively small sample of participants and used a very small number of emotional expressions. Results on larger samples and using a wider range of emotions might differ.

The study included only men, so it is not known whether the findings apply to women with schizophrenia. Nearly all patients were taking medication and many had other conditions, which could have affected their performance. The authors also note that it remains unknown whether the difficulties reflect problems specific to social cognition or broader cognitive difficulties associated with schizophrenia.

The paper, “Reading body and face language in male schizophrenia,” was authored by Annika Resch, Alexander N. Sokolov, Patrick Steinwand, Andreas J. Fallgatter, and Marina A. Pavlova.