A multimethod, multichannel assessment of affective flattening in schizophrenia.

Flat affect was examined across multiple contexts (during interviews and emotional films), multiple channels of expression (facial and vocal), and different assessment techniques (clinical ratings, observational ratings of facial expression, and acoustic analyses) in 23 medication-free schizophrenic patients. Patients participated in three different interviews during which either clinical ratings were made or their voices were audiotaped for later acoustic analyses. Patients were also videotaped while they viewed positive and negative emotional films. The videotapes were then coded for the frequency, intensity, and duration of positive and negative facial expressions. Results indicated that general clinical ratings were related across different interviews. However, only those items specific to affective flattening bore significant relationships to vocal and facial expressiveness. Vocal expressiveness and negative facial expressiveness were related, but vocal expressiveness was not related to positive facial expressiveness.