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Attentional biases in facial emotion processing in individuals at clinical high risk for psychosis

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Abstract

Individuals at clinical high risk (CHR) for psychosis exhibit altered facial emotion processing (FEP) and poor social functioning. It is unclear whether FEP deficits result from attentional biases, and further, how these abnormalities are linked to symptomatology (e.g., negative symptoms) and highly comorbid disorders that are also tied to abnormal FEP (e.g., depression). In the present study, we employed an eye-tracking paradigm to assess attentional biases and clinical interviews to examine differences between CHR (N = 34) individuals and healthy controls (HC; N = 46), as well as how such biases relate to symptoms and functioning in CHR individuals. Although no CHR-HC differences emerged in attentional biases, within the CHR group, symptoms and functioning were related to biases. Depressive symptoms were related to some free-view attention switching biases (e.g., to and from fearful faces, r = .50). Negative symptoms were related to more slowly disengaging from happy faces (r = .44), spending less time looking at neutral faces (r =  – .42), and more time looking at no face (Avolition, r = .44). In addition, global social functioning was related to processes that overlapped with both depression and negative symptoms, including time looking at no face (r =  – .68) and free-view attention switching with fearful faces (r =  – .40). These findings are consistent with previous research, indicating that negative symptoms play a prominent role in the CHR syndrome, with distinct mechanisms relative to depression. Furthermore, the results suggest that attentional bias indices from eye-tracking paradigms may be predictive of social functioning.

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Acknowledgements

This research was funded by grants from the National Institutes to Dr. Vijay Mittal (R01MH112545-01, R21MH119677, R21MH110374, R21MH115231, and R21/R33MH103231). All authors contributed meaningfully to this study and manuscript development. All authors read and approved the final manuscript.

Funding

This research was funded by grants from the National Institutes to Dr. Vijay Mittal (R01MH112545-01, R21MH119677, R21MH110374, R21MH115231, and R21/R33MH103231).

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Authors and Affiliations

  1. Department of Psychology, Northwestern University, Evanston, IL, 60208, USA

    Trevor F. Williams & Vijay A. Mittal

  2. Department of Psychology, Louisiana State University, Baton Rouge, LA, 70803, USA

    Alex S. Cohen

  3. Department of Clinical Psychology, Complutense University of Madrid, Madrid, 28223, Spain

    Alvaro Sanchez-Lopez

  4. Department of Psychology, Yale University, New Haven, CT, 06520, USA

    Jutta Joormann

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  1. Trevor F. Williams
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Correspondence to Trevor F. Williams.

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Approval was obtained from the ethics committee (i.e., institutional review board) of Northwestern University (STU00203263, 5/30/2016). The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Williams, T.F., Cohen, A.S., Sanchez-Lopez, A. et al. Attentional biases in facial emotion processing in individuals at clinical high risk for psychosis. Eur Arch Psychiatry Clin Neurosci 273, 1825–1835 (2023). https://doi.org/10.1007/s00406-023-01582-1

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