Facial emotion recognition and reactive-proactive aggression in violent schizophrenia

Abstract

Patients with schizophrenia are often linked to violence. The present study aimed to compare the facial emotion recognition abilities and the reactive- proactive aggressiveness between schizophrenia patients with and without antisocial personality disorder (ASPD).

Three groups of 30 male participants were included in the present study: schizophrenia patients with ASPD, schizophrenia patients without ASPD and healthy controls. Age and IQ were matched across groups.

Reactive- Proactive Aggression Questionnaire, Facial Emotion Identification Test (FEIT), Facial Emotion Discrimination Test (FEDT) and the modified Wisconsin Card Sorting Test (WSCT) were administered to all participants.

Results showed that the schizophrenia patient group with ASPD performed worse in FEIT and FEDT; rated higher in reactive aggression than the patient group without ASPD and healthy controls after controlling for age, education, WSCT and IQ. Similar significant differences were found even after controlling for the age of onset, frequency of psychiatric hospitalizations, and chlorpromazine dose equivalent. In addition, the patient group with ASPD had higher level of proactive aggression.

Findings of the present study suggest that the lack of capacity in facial emotion recognition and increased reactive aggression level might underlie the violence in schizophrenia.