153. Facial Emotion Recognition in Individuals With Schizophrenia With or Without Social Anxiety

Abstract

Background: Social anxiety is highly prevalent in individuals with schizo-phrenia with studies suggesting rates from 15% to 30%. This study aimed at determining if social anxiety was linked to specifc emotion perception defcits and to specifc social functioning defcits. We hypothesized that individuals with schizophrenia and more social anxiety would have worse social functioning and would be better at recognizing facial emotions of fear or anger than individuals without social anxiety, because they are more likely to have an attentional bias towards those emotions. Methods: 47 participants with a diagnosis of schizophrenia, average age of 38 (SD 9.7) were recruited in the Psychotic program (outpatient service) of a large psychiatric hospital in Montreal (IUSMM). The assessments included measures of facial recognition (Eckman; FEIT), facial discrimination (FEDT), ToM (Cartoon Stories), social anxiety (SIAS, BSPS), psychiatric symptoms (BPRS), and social functioning (SFS and role-plays). Results: 22 (47%) of participants rated as signifcantly socially anxious according to the SIAS. Between group comparisons revealed that those with social anxiety did indeed have worse social functioning, particularly in the domains of inter-personal communication (t(45) = 2.28, P =.025) and engagement (in con-versations; t(45) = 2.89, P =.000). Participants with high social anxiety also had more diffculties in recognizing neutral emotional faces, compared to individuals with schizophrenia without social anxiety (t(31) = 2.19, P =.036). Although not specifc to social anxiety, results on the facial emotional tasks were correlated with specifc social functioning domains (e.g., those with poor facial recognition overall had fewer recreational (r =-.49) and social activities, r =-.56). The results were not linked to negative symptoms of schizophrenia or to psychiatric symptoms (BPRS). In the role-play, individuals with social anxiety were better than those without social anxiety at recognizing 2/4 of the emotions targeted (joy and anger, chi2 = 3.58, P =.05). Conclusion: These fndings suggest that specifc comorbidities, such as social anxiety, might affect facial emotional recognition, particularly for neutral emotions. More studies are warranted in order to determine whether social anxiety brings an attentional bias, therefore making individuals more prone to seeing emotions (even when not present). This study did confrm that social anxiety and facial emotional recognition have an important impact on social functioning and should be targeted in treatments.