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J Nerv Ment Dis. 2019 Mar;207(3):140-144. doi: 10.1097/NMD.0000000000000934.

Can Social Anxiety Impact Facial Emotion Recognition in Schizophrenia?

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Department of Psychology, University of Montreal.
Department of Psychiatry, University of Montreal, Montreal.
Department of Psychiatry, University Laval, Quebec, Canada.


Social anxiety is highly prevalent in individuals with schizophrenia, with studies suggesting rates of 30%. This study aimed at determining if social anxiety is linked to specific emotion recognition deficits and to specific social functioning deficits. A total of 47 participants with a diagnosis of schizophrenia and receiving outpatient services answered measures of facial recognition (Ekman; Facial Emotion Identification Test), facial discrimination (Facial Emotion Discrimination Test), role-play, social anxiety (Social Interaction Anxiety Scale and Brief Social Phobia Scale), psychiatric symptoms (Brief Psychiatric Rating Scale), self-esteem (Self-Esteem Rating Scale-Short Form), and social functioning (Social Functioning Scale). A total of 22 (47%) participants were rated as socially anxious. Those with social anxiety had worse social functioning in the domains of interpersonal communication (t[45] = 2.28, p = 0.025) and engagement (in conversations) (t[45] = 2.89, p = 0.000) and had lower self-esteem (t[45] = 4.05, p = 0.001). Participants with social anxiety also had more difficulties in recognizing neutral emotional faces (t[31] = 2.19, p = 0.036). More studies are warranted to better understand the link between neutral expression recognition and social anxiety in schizophrenia.

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