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Facial affect processing in delusion-prone and deluded individuals: A continuum approach to the study of delusion formation

This thesis examines attentional and cognitive biases for particular facial expressions in delusion-prone and deluded individuals. The exploration of cognitive biases in delusion-prone individuals provides one means of elucidating psychological processes that might be involved in the genesis of delusions. Chapter 1 provides a brief review of the continuum approach to schizophrenia, and outlines recent theoretical conceptualisations of delusions. The study of schizophrenia phenomena at the symptom level has become a popular method of inquiry, given the heterogeneous phenotypic expression of schizophrenia, and the uncertainty surrounding the existence of a core neuropathology. Delusions are one of the most commonly experienced symptoms of schizophrenia, and have traditionally been regarded as fixed, false beliefs that are pathognomonic of an organic disease process. However, recent phenomenological evidence of delusional ideation in the general population has led to the conceptualisation of delusions as multi-dimensional entities, lying at the extreme end of a continuum from normal through to maladaptive beliefs. Recent investigations of the information processing abnormalities in deluded individuals are reviewed in Chapter 2. This strand of research has revealed evidence of various biases in social cognition, particularly in relation to threat-related material, in deluded individuals. These biases are evident in probabilistic reasoning, attribution style, and attention, but there has been relatively little investigation of cognitive aberrations in delusion-prone individuals. In the present thesis, social-cognitive biases were examined in relation to a standard series of faces that included threat-related (anger, fear) and non-threatening (happy, sad) expressions, in both delusion-prone and clinically deluded individuals. Chapters 3 and 4 present the results of behavioural (RT, affect recognition accuracy) and visual scanpath investigations in healthy participants assessed for level of delusion- proneness. The results indicate that delusion-prone individuals are slower at processing angry faces, and show a general (rather than emotion-specific) impairment in facial affect recognition, compared to non-prone healthy controls. Visual scanpath studies show that healthy individuals tend to direct more foveal fixations to the feature areas (eyes, nose, mouth) of threat-related facial expressions (anger, fear). By contrast, delusion-prone individuals exhibit reduced foveal attention to threat-related faces, combined with �extended� scanpaths, that may be interpreted as an attentional pattern of �vigilance-avoidance� for social threat. Chapters 5 and 6 extend the work presented in Chapters 3 and 4, by investigating the presence of similar behavioural and attentional biases in deluded schizophrenia, compared to healthy control and non-deluded schizophrenia groups. Deluded schizophrenia subjects exhibited a similar delay in processing angry faces, compared to non-prone control participants, while both deluded and non-deluded schizophrenia groups displayed a generalised affect recognition deficit. Visual scanpath investigations revealed a similar style of avoiding a broader range of negative (anger, fear, sad) faces in deluded schizophrenia, as well as a common pattern of fewer fixations with shorter duration, and reduced attention to facial features of all faces in both deluded and non-deluded schizophrenia. The examination of inferential biases for emotions displayed in facial expressions is presented in Chapter 7 in a study of causal attributional style. The results of this study provide some support for a �self-serving� bias in deluded schizophrenia, as well as evidence for an inability to appreciate situational cues when making causal judgements in both delusion-prone and deluded schizophrenia. A theoretical integration of the current findings is presented in Chapter 8, with regard to the implications for cognitive theories of delusions, and neurobiological models of schizophrenia phenomena, more generally. Visual attention biases for threat-related facial expressions in delusion-prone and deluded schizophrenia are consistent with proposals of neural dysconnectivity between frontal-limbic networks, while attributional biases and impaired facial expression perception may reflect dysfunction in a broader �social brain� network encompassing these and medial temporal lobe regions. Strong evidence for attentional biases and affect recognition deficits in delusion-prone individuals implicates their role in the development of delusional beliefs, but the weaker evidence for attributional biases in delusion-prone individuals suggests that inferential biases about others� emotions may be relevant only to the maintenance of delusional beliefs (or that attributional biases for others� emotional states may reflect other, trait-linked difficulties related to mentalising ability). In summary, the work presented in this thesis demonstrates the utility of adopting a single-symptom approach to schizophrenia within the continuum framework, and attests to the importance of further investigations of aberrant social cognition in relation to the development of delusions.

  1. http://hdl.handle.net/2123/792
Identiferoai:union.ndltd.org:ADTP/220772
Date January 2002
CreatorsGreen, Melissa Jayne
PublisherUniversity of Sydney. Psychology
Source SetsAustraliasian Digital Theses Program
LanguageEnglish, en_AU
Detected LanguageEnglish
RightsCopyright Green, Melissa Jayne;http://www.library.usyd.edu.au/copyright.html

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