The association between childhood trauma and facial emotion recognition in patients with stable schizophrenia

Abstract

IntroductionThe impairment of facial emotion recognition (FER) among patients with schizophrenia (SCZ) is a significant feature of the illness. Childhood trauma (CT) is reported with a high prevalence in SCZ and is considered one of its risk factors.ObjectivesTo investigate the relationship between FER and CT in SCZ.MethodsFifty-eight outpatients with stable SCZ completed the Childhood Trauma Questionnaire retrospectively assessing five types of childhood trauma (emotional, physical and sexual abuse, and emotional and physical neglect). They also completed a newly developed and validated FER task constructed from photographs of the face of a famous Tunisian actress and evaluating the ability to correctly identify Ekman's six basic facial emotions (happiness, sadness, anger, disgust, fear and surprise).ResultsPatients with higher scores of CT performed significantly worse in FER task. Our results suggest that the presence of sexual abuse is specifically correlated to a poor identification of anger (P = 0.02) and disgust (P = 0.03) while the presence of emotional abuse and physical neglect are correlated to a poor identification of happiness and sadness.ConclusionsCT may represent one of the causes of the FER deficits in schizophrenia. Further studies are necessary to confirm the link between specific kinds of childhood trauma and deficits in the recognition of discrete emotions.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Facial Expression Processing Across the Autism–Psychosis Spectra: A Review of Neural Findings and Associations With Adverse Childhood Events

“…Furthermore, the authors suggested that the type of abuse could be associated with specific emotion recognition deficits. In particular, in this study, sexual abuse was associated with poor recognition of anger and disgust, and emotional abuse and physical neglect were associated with poor recognition of happy and sad faces (169).…”

“…On the one hand, an enhanced neural processing of negative stimuli [i.e., increased brain activity; (170)] has been reported, but this does not seem to translate in improved behavioral processing. Indeed, behaviorally, individuals with primary psychosis, and a history of ACE perform significantly worse on emotion recognition tasks than adults with primary psychosis without ACE exposure (169). This pattern may suggest that ACE may further boost the general aberrant salience in primary psychosis, thereby causing overarousal and impeding a differentiated behavioral facial expression processing performance.…”

“…Despite consistent evidence of the impact of ACE on facial expression processing, despite the large comorbidity between ACE and primary psychosis, and despite the potential confounder of this comorbidity for findings on facial expression processing in the psychosis literature, only a limited number of studies have assessed facial expression processing in individuals with psychosis and a history of ACE. At the behavioral level, Mrizak et al (169) showed that adults with primary psychosis and a high exposure to ACE perform significantly worse on facial emotion recognition tasks compared with adults with primary psychosis without a history of ACE. Furthermore, the authors suggested that the type of abuse could be associated with specific emotion recognition deficits.…”