Skip to main content
    • Aa
    • Aa

Facial emotion recognition in adolescents with psychotic-like experiences: a school-based sample from the general population

  • S. Roddy (a1), L. Tiedt (a1), I. Kelleher (a1), M. C. Clarke (a1), J. Murphy (a1), C. Rawdon (a2), R. A. P. Roche (a2), M. E. Calkins (a3), J. A. Richard (a3), C. G. Kohler (a3) and M. Cannon (a2) (a4)...

Psychotic symptoms, also termed psychotic-like experiences (PLEs) in the absence of psychotic disorder, are common in adolescents and are associated with increased risk of schizophrenia-spectrum illness in adulthood. At the same time, schizophrenia is associated with deficits in social cognition, with deficits particularly documented in facial emotion recognition (FER). However, little is known about the relationship between PLEs and FER abilities, with only one previous prospective study examining the association between these abilities in childhood and reported PLEs in adolescence. The current study was a cross-sectional investigation of the association between PLEs and FER in a sample of Irish adolescents.


The Adolescent Psychotic-Like Symptom Screener (APSS), a self-report measure of PLEs, and the Penn Emotion Recognition-40 Test (Penn ER-40), a measure of facial emotion recognition, were completed by 793 children aged 10–13 years.


Children who reported PLEs performed significantly more poorly on FER (β=−0.03, p=0.035). Recognition of sad faces was the major driver of effects, with children performing particularly poorly when identifying this expression (β=−0.08, p=0.032).


The current findings show that PLEs are associated with poorer FER. Further work is needed to elucidate causal relationships with implications for the design of future interventions for those at risk of developing psychosis.

Corresponding author
*Address for correspondence: Dr S. Roddy, Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J Addington , D Penn , SW Woods , D Addington , DO Perkins (2008). Facial affect recognition in individuals at clinical high risk for psychoses. British Journal of Psychiatry 192, 6768.

S Alemany , B Arias , M Aguilera , H Villa , J Moya , MI Ibanez , H Vossen , C Gasto , G Ortet , L Fananas (2011). Childhood abuse, the BDNF-Val66Met polymorphism and adult psychotic-like experiences. British Journal of Psychiatry 199, 3842.

M Barrera , D Maurer (1981). The perception of facial expressions by the three-month-old. Child Development 52, 203206.

A Bartels-Velthuis , JA Jenner , G van de Willigie , J van Os , D Wiersma (2010). Prevalence and correlates of auditory vocal hallucinations in middle childhood. British Journal of Psychiatry 196, 4146.

RV Bijl , A Ravelli , G van Zessen (1998). Prevalence of psychiatric disorder in the general population: results of the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Social Psychiatry and Psychiatric Epidemiology 33, 587595.

ME Calkins , P Tepper , RC Gur , JD Ragland , L Klei , HW Wiener , J Richard , RM Savage , TB Allen , J O'Jile , B Devlin , J Kwentus , MH Ailyu , LD Bradford , N Edwards , PD Lyons , VL Nimgaonkar , AB Santos , RC Go , RE Gur (2010). Project among African-Americans to explore risks for schizophrenia (PAARTNERS): evidence for impairment and heritability of neurocognitive functioning in families of schizophrenic patients. American Journal of Psychiatry 167, 459472.

L Camras , K Allison (1985). Children's understanding of emotional facial expressions and verbal labels. Journal of Nonverbal Behavior 9, 8494.

R Corcoran , G Mercer , C Frith (1995). Schizophrenia, symptomatology and social inference: investigating theory of mind in people with schizophrenia. Schizophrenia Research 17, 5–13.

SM Couture , DL Penn , DL Roberts (2006). The functional significance of social cognition in schizophrenia: a review. Schizophrenia Bulletin 32 (Suppl. 1), S44S63.

CC Dickey , LP Panych , MM Voglmaier , MA Niznikiewicz , DP Terry , C Murphy , R Zacks , ME Shenton , RW McCarley (2011). Facial emotion recognition and facial affect display in schizotypal personality disorder. Schizophrenia Research 131, 242249.

K Durand , M Gallay , A Seigneuric , F Robichon , J-Y Baudouin (2007). The development of facial emotion recognition: the role of configural information. Journal of Experimental Child Psychology 97, 1427.

SM Eack , DE Mermon , DM Montrose , J Miewald , RE Gur , RC Gur , JA Sweeney , MS Keshavan (2010). Social cognition deficits among individuals at familial high risk for schizophrenia. Schizophrenia Bulletin 36, 10811088.

J Edwards , HJ Jackson , PE Pattison (2002). Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review. Clinical Psychology Review 22, 789832.

J Edwards , PE Pattison , HJ Jackson , RJ Wales (2001). Facial affect and affective prosody recognition in first-episode schizophrenia. Schizophrenia Research 48, 235253.

W Gaebel , W Wolwer (1992). Facial expression and emotional face recognition in schizophrenia and depression. European Archives of Psychiatry and Clinical Neuroscience 242, 4652.

TA Greenwood , DL Braff , GA Light , KS Cadenhead , ME Calkins , DJ Dobie , R Freedman , MF Green , RE Gur , RC Gur , J Mintz , KH Nuechterlein , A Olincy , AD Radant , LJ Seidman , LJ Siever , JM Silverman , WS Stone , NR Swerdlow , DW Tsaung , MT Tsaung , BI Turetsky , NJ Schork (2007). Initial heritability analyses of endophenotypic measures of schizophrenia: the consortium on the genetics of schizophrenia. Archives of General Psychiatry 64, 12421250.

RC Gur , JD Ragland , PJ Moberg , TH Turner , WB Bilker , C Kohler , SJ Siegel , RE Gur (2001). Computerized neurocognitive scanning: I. Methodology and validation in healthy people. Neuropsychopharmacology 25, 766776.

RE Gur , VL Nimgaonkar , L Almasy , ME Calkins , JD Ragland , MF Pogue-Geile , S Kanes , J Blangero , RC Gur (2007). Neurocognitive endophenotypes in a multiplex multigenerational family study of schizophrenia. American Journal of Psychiatry 164, 813819.

M Hanssen , M Bak , R Bijl , W Vollebergh , J van Os (2005). The incidence and outcome of subclinical psychotic experiences in the general population. British Journal of Clinical Psychology 44, 181191.

S Hoehl , J Brauer , G Brasse , T Striano , AD Friederici (2010). Children's processing of emotions expressed by peers and adults: an fMRI study. Social Neuroscience 5, 543559.

C Hooker , S Park (2002). Emotion processing and its relationship to social functioning in schizophrenia patients. Psychiatry Research 112, 4150.

J Horwood , G Salvi , K Thomas , L Duffy , D Gunnell , C Hollis , G Lewis , P Menezes , A Thompson , D Wolke , S Zammit , G Harrison (2008). IQ and non-clinical psychotic symptoms in 12-year-olds: results from the ALSPAC birth cohort. British Journal of Psychiatry 193, 185191.

LC Johns , M Cannon , N Singleton , RM Murray , M Farrell , T Brugha , P Bebbington , R Jenkins , H Meltzer (2004). Prevalence and correlates of self-reported psychotic symptoms in the British population. British Journal of Psychiatry 185, 298305.

KS Kee , WP Horan , J Mintz , MF Green (2004). Do the siblings of schizophrenia patients demonstrate affect perception deficits? Schizophrenia Research 67, 8794.

I Kelleher , M Harley , F Lynch , L Arseneault , C Fitzpatrick , M Cannon (2008). Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample. British Journal of Psychiatry 193, 378382.

I Kelleher , M Harley , A Murtagh , M Cannon (2011). Are screening instruments valid for psychotic-like experiences? A validation study of screening questions for psychotic-like experiences using in-depth clinical interview. Schizophrenia Bulletin 37, 362369.

KS Kendler , TJ Gallagher , JM Abelson , RC Kessler (1996). Lifetime prevalence, demographic risk factors, and diagnostic validity of non-affective psychosis as assessed in a US community sample. The National Comorbidity Survey. Archives of General Psychiatry 53, 10221031.

RC Kessler , KA McGonagle , S Zhao , CB Nelson , M Hughes , S Eshleman , H-U Wittchen , KS Kendler (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States: results from the National Comorbidity Survey. Archives of General Psychiatry 51, 89.

CG Kohler , TH Turner , WB Bilker , CM Bresinger , SJ Siegel , SJ Kanes , RE Gur , RC Gur (2003). Facial emotion recognition in schizophrenia: intensity effects and error pattern. American Journal of Psychiatry 160, 17681774.

CG Kohler , TH Turner , NM Stolar , WB Bilker , CM Brensinger , RE Gur , RC Gur (2004). Differences in facial expressions of four universal emotions. Psychiatry Research 128, 235244.

CG Kohler , JB Walker , EA Martin , KM Healey , PJ Moberg (2010). Facial emotion perception in schizophrenia: a meta-analytic review. Schizophrenia Research 36, 10091019.

KR Laurens , S Hodgins , B Maughan , RM Murray , ML Rutter , EA Taylor (2007). Community screening for psychotic-like experiences and other putative antecedents of schizophrenia in children aged 9–12 years. Schizophrenia Research 90, 130146.

H Li , RCK Chan , GM McAlonan , Q Gong (2010). Facial emotion processing in schizophrenia: a meta-analysis of functional neuroimaging data. Schizophrenia Bulletin 36, 10291039.

F Lynch , C Mills , I Daly , C Fitzpatrick (2004). Challenging times: a study to detect Irish adolescents at risk of psychiatric disorders and suicidal ideation. Journal of Adolescence 27, 441451.

F Lynch , C Mills , I Daly , C Fitzpatrick (2006). Challenging times: prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents. Journal of Adolescence 29, 555573.

MK Mandal , R Pandey , AB Prasad (1998). Facial expressions of emotions and schizophrenia: a review. Schizophrenia Bulletin 24, 399412.

S Marenco , DR Weinberger (2000). The neurodevelopmental hypothesis of schizophrenia: following a trail of evidence from cradle to grave. Developmental Psychopathology 12, 501527.

ES Mikhailova , TV Vladimirova , AF Iznak , EJ Tsusulkovskaya , NV Sushko (1996). Abnormal recognition of facial expression of emotions in depressed patients with major depression disorder and schizotypal personality disorder. Biological Psychiatry 40, 697705.

D Norton , R McBain , DJ Holt , D Ongur , Y Chen (2009). Association of impaired facial affect recognition with basic facial and visual processing deficits in schizophrenia. Biological Psychiatry 65, 10941098.

Jr. S Nowicki , MP Duke (1994). Individual differences in the nonverbal communication of affect: the Diagnostic Analysis of Nonverbal Accuracy Scale. Journal of Nonverbal Behavior 18, 9–35.

DL Penn , PW Corrigan , RP Bentall , JM Racenstein , L Newman (1997). Social cognition in schizophrenia. Psychological Bulletin 121, 114132.

LK Philips , LJ Seidman (2008). Emotion processing in persons at risk for schizophrenia. Schizophrenia Bulletin 34, 888903.

AE Pinkham , DL Penn , DO Perkins , J Lieberman (2003). Implications for the neural basis of social cognition for the study of schizophrenia. American Journal of Psychiatry 160, 815824.

AE Pinkham , NJ Sasson , ME Calkins , J Richard , P Hughett , RE Gur , RC Gur (2008). The other-race effect in face processing among African American and Caucasian individuals with schizophrenia. American Journal of Psychiatry 165, 639645.

AR Poreh , RD Whitman , M Weber , T Ross (1994). Facial recognition in hypothetically schizotypic college students: the role of generalized poor performance. Journal of Nervous and Mental Disease 182, 503507.

R Poulton , A Caspi , TE Moffit , M Cannon , R Murray , HL Harrington (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 10531058.

F Schneider , RC Gur , K Koch , V Backes , K Amunts , NJ Shah , W Bilker , RE Gur , U Habel (2006). Impairment in the specificity of emotion processing in schizophrenia. American Journal of Psychiatry 163, 442447.

SD Simonian , D Beidel , S Turner , J Berkes , J Long (2001). Recognition of facial affect by children and adolescents diagnosed with social phobia. Child Psychiatry and Human Development 32, 137145.

A Thompson , S Sullivan , J Heron , K Thomas , S Zammit , J Horwood , D Gunnell , C Hollis , G Lewis , D Wolke , G Harrison (2011). Childhood facial emotion and psychosis-like symptoms in a nonclinical population at 12 years of age: results from the ALSPAC birth cohort. Cognitive Neuropsychiatry 16, 136157.

R Toomey , D Schuldberg (1995). Recognition and judgment of facial stimuli in schizotypal subjects. Journal of Communication Disorders 28, 193203.

J van Os , M Hanssen , RV Bijl , A Ravelli (2000). Strauss (1969) revisited: a psychosis continuum in the general population? Schizophrenia Research 45, 1120.

M van 't Wout , A Aleman , RPC Kessels , F Laroi , RS Kahn (2004). Emotional processing in a non-clinical psychosis-prone sample. Schizophrenia Research 68, 271281.

TL Waldeck , LS Miller (2000). Social deficits in schizotypal personality disorder. Psychiatry Research 93, 237246.

AS Walker-Andrews (1997). Infants’ perception of expressive behaviors: differentiation of multimodal information. Psychological Bulletin 121, 437456.

AR Yung , B Nelson , K Baker , JA Buckby , G Baksheev , EM Cosgrave (2009). Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia. Australia and New Zealand Journal of Psychiatry 43, 118128.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 4
Total number of PDF views: 27 *
Loading metrics...

Abstract views

Total abstract views: 143 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 27th June 2017. This data will be updated every 24 hours.