Association of expression recognition abnormalities with deficits in theory of mind and empathy in patients with schizophrenia
Objective:To explore the deficits of facial expression recognition,theory of mind and empathy in patients with schizophrenia and to examine the association of facial expression recognition with theory of mind and empathy.Methods:Totally 47 patients with schizophrenia who met the diagnostic criteria of the Diagnostic and Sta-tistical Manual of Mental Disorders,Fifth Edition(DSM-5)and 35 normal participants were selected.The Facial E-motion Identification Test(FEIT),Yoni task,and the Questionnaire of Cognitive and Affective Empathy(QCAE)were used to measure expression recognition,theory of mind,and empathy.The main indicators were task accuracy and questionnaire scores.Results:Compared to normal controls,patient group showed significantly poorer perform-ance on facial expression recognition accuracy and the Yoni task,and lower scores on cognitive empathy and pe-ripheral responsivity subscale of the QCAE(Ps<0.05).Regression analyses showed that performance on cognitive theory of mind(β=0.33,P<0.01)and affective theory of mind(β=0.33,P<0.01)of the Yoni task were posi-tively associated with accuracy in recognizing happy expressions.Cognitive empathy scores of the QCAE were neg-atively associated with accuracy in recognizing neutral expressions(β=-0.23,P<0.05).Patients had lower af-fective theory of mind accuracy(β=-0.23,P<0.05)and QCAE cognitive empathy scores(β=-0.34,P<0.01).Conclusion:Patients with schizophrenia have deficits in expression recognition,theory of mind,and empa-thy,and that their abnormal expression recognition may be associated with deficits in theory of mind and empathy.
schizophreniasocial cognitionfacial expression recognitiontheory of mindempathy