6 April 2018

Affective face processing in schizophrenia: disorder-specific or transdiagnostic deficit?


  • Social cognitive dysfunction is common in patients with schizophrenia and is associated with significant functional deficits.
  • Facial emotion recognition is a core aspect of social cognition and has been consistently demonstrated to be impaired in this population.
  • However, it remains unclear whether these deficits are unique to patients with schizophrenia.
  • Scientists at Cambridge Cognition compared the severity of facial emotion recognition deficits in patients with both sub- and full-threshold psychotic symptoms to those observed across a range of psychiatric, neurological and developmental disorders in order to determine to what extent this represents a disorder-specific or transdiagnostic aspect of cognitive dysfunction.


  • Our scientists conducted an electronic database search in order to identify published, peer-reviewed meta-analyses that compared facial emotion recognition task performance between individuals meeting clinical criteria for a psychiatric, neurological or developmental condition against healthy controls.
  • Facial emotion recognition standardised mean difference effect size estimates (Cohen’s d or Hedges’ g) were required to have been derived from tasks in which participants had to identify, label or match images of faces consisting of all or any combination of the six basic emotions (happiness, sadness, anger, fear, surprise or disgust).
  • Effect size estimates must have been derived from two or more independent studies in order for the meta-analysis to be included.


  • We identified 19 meta-analyses eligible for inclusion that examined performance across relevant tasks among 24 different clinical populations.
  • Effect size estimates indicated that deficits were common transdiagnostically, though deficits among patients with schizophrenia were larger, and more robust, than many of the other clinical populations sampled.
  • Deficits were also evident even among those individuals with subthreshold psychotic symptoms who met clinical criteria for being at ultra-high risk of developing a psychotic disorder.


  • Facial emotion recognition deficits are a transdiagnostic issue, potentially serving as a biomarker of neurological abnormality.
  • Improved characterisation and operationalization of social cognition and other ‘hot’ cognitive processes are necessary to facilitate and advance treatment efforts, both in schizophrenia and across other clinical groups.

This social cognition article provides a full discussion on the topic.

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Affective face processing in schizophrenia: disorder-specific or transdiagnostic deficit

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Dr Jack Cotter

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