Impaired facial emotion recognition may suggest an increased vulnerability to schizophrenia in children, and may therefore represent a target for early intervention, researchers report.
They found that children with multiple antecedents of schizophrenia commonly misattributed neutral expressions to faces displaying other emotions and were more likely than typically developing children to mislabel a neutral expression as sad.
"The inability to accurately discriminate subtle differences in facial emotion and the misinterpretation of neutral expressions as sad may contribute to the initiation and/or persistence of PLEs [psychotic-like experiences]," say Hannah Dickson (Institute of Psychiatry, London, UK) and colleagues.
"Interventions that are effective in teaching adults to recognize emotions in faces could potentially benefit children presenting with antecedents of schizophrenia."
The team used an established facial emotion recognition task (ER40) to study the abilities of 34 children aged 9 to 14 years old who presented with a triad of well-replicated antecedents for schizophrenia, including motor and/or speech delays, clinically relevant internalizing and/or externalizing problems, and psychotic-like experiences.
These children, compared with 34 typically developing children without these antecedents, found it more difficult to interpret facial emotions.
They were more likely to misattribute other emotions as "sad" expressions, in an average 2.5% of responses versus 1.4% for controls, as well as misattribute other emotions as "neutral" expressions, in an average 3.9% of responses versus 2.5 %.
Angry expressions were mislabeled as other emotions by the children with schizophrenia antecedents in an average 4.0% of responses compared with just 3.0% of responses for controls, while neutral expressions were mislabeled as other emotions in an average 1.7% of responses versus 0.8%.
The children with schizophrenia antecedents also mislabeled 70% of neutral expressions as "sad," compared with a corresponding 40% for controls.
These mislabeling and misattribution of facial emotions may "represent early risk markers for the later development of schizophrenia," the researchers write in Schizophrenia Bulletin.
They conclude: "These impairments may represent targets for preventive interventions, which may in turn facilitate generalized improvements in social and emotional functioning among individuals at risk for schizophrenia."
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