Alejandro de la Torre-Luque1, Alba Viera-Campos2, Amy C Bilderbeck3, Maria Teresa Carreras2, Jose Vivancos2, Covadonga M Diaz-Caneja4, Moji Aghajani5, Ilja M J Saris5, Andreea Raslescu3, Asad Malik3, Jenna Clark6, Brenda W J H Penninx5, Nic van der Wee7, Inge Winter-van Rossum8, Bernd Sommer9, Hugh Marston10, Gerard R Dawson3, Martien J Kas11, Jose Luis Ayuso-Mateos12, Celso Arango4. 1. Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, The Netherlands; Amsterdam UMC, Vrije Universiteit and GGZ inGeest Research & Innovation, The Netherlands. Electronic address: af.delatorre@ucm.es. 2. La Princesa University Hospital, Spain. 3. P1vital Ltd., UK. 4. Institute of Education & Child Studies, Section Forensic Family & Youth Care, Leiden University, The Netherlands; Amsterdam UMC, Vrije Universiteit and GGZ inGeest Research & Innovation, The Netherlands; Gregorio Marañon University Hospital, Spain. 5. Amsterdam UMC, Vrije Universiteit and GGZ inGeest Research & Innovation, the Netherlands. 6. University of Nottingham, UK. 7. Leiden University Medical Centre, the Netherlands. 8. King's College London, UK. 9. Boehringer Ingelheim International, Germany. 10. Eli Lilly and Company Ltd., UK. 11. University of Groningen, the Netherlands. 12. Amsterdam UMC, Vrije Universiteit and GGZ inGeest Research & Innovation, The Netherlands; La Princesa University Hospital, Spain.
Abstract
BACKGROUND: Emotion recognition constitutes a pivotal process of social cognition. It involves decoding social cues (e.g., facial expressions) to maximise social adjustment. Current theoretical models posit the relationship between social withdrawal factors (social disengagement, lack of social interactions and loneliness) and emotion decoding. OBJECTIVE: To investigate the role of social withdrawal in patients with schizophrenia (SZ) or probable Alzheimer's disease (AD), neuropsychiatric conditions associated with social dysfunction. METHODS: A sample of 156 participants was recruited: schizophrenia patients (SZ; n = 53), Alzheimer's disease patients (AD; n = 46), and two age-matched control groups (SZc, n = 29; ADc, n = 28). All participants provided self-report measures of loneliness and social functioning, and completed a facial emotion detection task. RESULTS: Neuropsychiatric patients (both groups) showed poorer performance in detecting both positive and negative emotions compared with their healthy counterparts (p < .01). Social withdrawal was associated with higher accuracy in negative emotion detection, across all groups. Additionally, neuropsychiatric patients with higher social withdrawal showed lower positive emotion misclassification. CONCLUSIONS: Our findings help to detail the similarities and differences in social function and facial emotion recognition in two disorders rarely studied in parallel, AD and SZ. Transdiagnostic patterns in these results suggest that social withdrawal is associated with heightened sensitivity to negative emotion expressions, potentially reflecting hypervigilance to social threat. Across the neuropsychiatric groups specifically, this hypervigilance associated with social withdrawal extended to positive emotion expressions, an emotional-cognitive bias that may impact social functioning in people with severe mental illness.
BACKGROUND: Emotion recognition constitutes a pivotal process of social cognition. It involves decoding social cues (e.g., facial expressions) to maximise social adjustment. Current theoretical models posit the relationship between social withdrawal factors (social disengagement, lack of social interactions and loneliness) and emotion decoding. OBJECTIVE: To investigate the role of social withdrawal in patients with schizophrenia (SZ) or probable Alzheimer's disease (AD), neuropsychiatric conditions associated with social dysfunction. METHODS: A sample of 156 participants was recruited: schizophrenia patients (SZ; n = 53), Alzheimer's disease patients (AD; n = 46), and two age-matched control groups (SZc, n = 29; ADc, n = 28). All participants provided self-report measures of loneliness and social functioning, and completed a facial emotion detection task. RESULTS: Neuropsychiatric patients (both groups) showed poorer performance in detecting both positive and negative emotions compared with their healthy counterparts (p < .01). Social withdrawal was associated with higher accuracy in negative emotion detection, across all groups. Additionally, neuropsychiatric patients with higher social withdrawal showed lower positive emotion misclassification. CONCLUSIONS: Our findings help to detail the similarities and differences in social function and facial emotion recognition in two disorders rarely studied in parallel, AD and SZ. Transdiagnostic patterns in these results suggest that social withdrawal is associated with heightened sensitivity to negative emotion expressions, potentially reflecting hypervigilance to social threat. Across the neuropsychiatric groups specifically, this hypervigilance associated with social withdrawal extended to positive emotion expressions, an emotional-cognitive bias that may impact social functioning in people with severe mental illness.