Newswise — A study by a University of Tulsa psychology professor has found why people with schizophrenia have difficulty perceiving another person's emotions as expressed by facial cues. The findings have led to current experiments to determine if such patients can be shown how to focus on the human face to comprehend key emotions such as happiness, sadness and fear.

The study by Dennis Combs appears in the current issue of Schizophrenia Bulletin. Combs says his research is a first step in understanding how a single cognitive skill -- attention -- can affect social functioning.

His research involved 65 people diagnosed with chronic schizophrenia in two psychiatric hospitals in Louisiana.

"Most of these patients don't focus on the right parts of the face and they don't look at the face for a long enough time," says Combs. Missing those facial cues impairs their ability to recognize emotion and interact normally with others.

Schizophrenia is a very debilitating mental disorder that makes it hard for a person to function out of a hospital, says Combs. The National Institute of Mental Health estimates that in a given year in the United States approximately 2.2 million adults have schizophrenia. The institute says that most people with schizophrenia are not violent toward others, but are withdrawn and prefer to be left alone.

Medication can control hallucinations and delusions, but not a person's difficulty in perceiving someone else's emotional state, Combs says. If one is unable to shift attention from one facial expression to another, that person "may become stuck on one emotion and miss subsequent changes in emotion."

Attention was measured with various tests focusing on four factors: being able to look at a person long enough to recognize their emotion, the ability to detect when emotions shift from one to another, taking in all features of the face, and the degree to which the person examines non-relevant areas of the face and how quickly one responds to a communicated emotion.

For example, the 36 men and 29 women were asked to indicate which emotion they thought was depicted in 19 photographs of people with expressions including fear, anger, sadness and surprise. "Normal people have few errors," he said. For his subjects, the average number of correct responses was about 9 out of 19.

Now, Combs is conducting a study with patients in two area hospitals to see if a visual cue added to a photograph can help train people to focus on the key areas of a face.

Participants are shown a series of photographs and asked to indicate what emotion is conveyed. When they are tested again, a colored cross has been added in the middle of the face to encourage the subjects to focus there. To determine the effectiveness of this learning strategy, the test is repeated several times that day and a week later.

The Oklahoma study is funded through a $23,000 grant from the Oklahoma Center for the Advancement of Science and Technology. Combs is working in cooperation with the Oklahoma Department of Mental Health. He is conducting the research with psychology graduate students Jill Wanner of Tulsa and Ani Tosheva of Missouri, through the department's Psychotic Disorders Research Laboratory.

Combs conducted the study in Louisiana for his doctoral dissertation. The article is titled "The Role of Attention in Affect Perception: An Examination of Mirsky's Four Factor Model of Attention in Chronic Schizophrenia."

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Schizophrenia Bulletin