Distress and negative experiences of the caregiving relationship in early psychosis: does social cognition play a role?

AIM: This study explored the relationship between individuals with early psychosis and first-degree relatives who were carers, to see whether negative and distressing experiences of the patient-carer relationship were associated with social cognition difficulties in both groups. METHOD: The study had a cross-sectional correlational design. A total of 33 patients with early psychosis (within 3 years of first psychotic episode) and 24 first-degree relative carers (all parents) completed measures of mood, expressed emotion and negative experiences of caregiving. Social cognition measures of theory of mind and emotion recognition were also collected. RESULTS: Patient perceptions of carer criticism were related to increased anxiety and depression. Carer negative experiences of caregiving were related to higher levels of expressed emotion, anxiety and depression. Both patients and carers showed impaired performance on social cognition tasks. However, patient social cognition was not related to perceptions of carer criticism or symptoms. Carer social cognition was not related to expressed emotion or carer burden. CONCLUSION: Even in the early stages of psychosis, both patients and carers were reporting negative experiences of the caregiving relationship. These were related to higher levels of anxiety and depression. Social cognition difficulties were found in both early psychosis patients and first-degree relatives, but did not relate to caregiving relationships. The findings underscore the importance of providing targeted family interventions to individuals with early psychosis and their carers that address appraisals of the relationship and low mood.

Face classification in schizophrenia: evidence for a sensitivity to distinctiveness.

The face-processing skills of people with schizophrenia were compared with those of a group of unimpaired individuals. Participants were asked to make speeded face-classification decisions to faces previously rated as being typical or distinctive. The schizophrenic group responded more slowly than the unimpaired group; however, both groups demonstrated the customary sensitivity to the distinctiveness of the face stimuli. Face-classification latencies made to typical faces were shorter than those made to distinctive faces. The implication of this finding with the schizophrenic group is discussed with reference to accounts of face-processing deficits attributed to these individuals.

Facial emotion recognition from moving and static point-light images in schizophrenia.

It is well established that schizophrenia is associated with difficulties recognising facial expressions of emotion. It has been suggested that this impairment could be specific to moving faces [Archer, J., Hay, D., Young, A., 1994. Movement, face processing and schizophrenia: evidence of a differential deficit in expression analysis. British Journal of Clinical Psychology, 33, 517-528]. The current study used point-light images to assess whether people with schizophrenia can interpret emotions from isolated patterns of facial movement in the absence of featural cues. Emotion recognition from moving and static images was assessed using a forced choice design with two sets of three emotions (anger, sadness and surprise; disgust, fear and happiness). The schizophrenia group was significantly better at recognising the emotions from moving images than static images. Although the control group was more accurate overall than the schizophrenia group, both groups presented the same characteristic patterns of performance across tasks. For example, in terms of which emotions were better recognised than others and the types of misidentifications that were made. Hence, it is concluded that people with schizophrenia are sensitive to the motion patterns which underlie individual expressions of emotion and can use this information to accurately recognise emotions.