The impact of alexithymia on the negative bias in facial emotion recognition among stable patients with schizophrenia

ObjectiveTo investigate the impact of alexithymia on the characteristics of facial emotion recognition in patients with stable schizophrenia.MethodsA total of 59 patients with stable schizophrenia and 28 healthy controls were recruited. Based on scores from the Toronto alexithymia scale (TAS-20), patients were divided into an alexithymia group (n=31) and a non-alexithymia group (n=28). All participants completed a basic emotion recognition task, which required them to identify facial expressions (positive, neutral, negative) presented against backgrounds of varying emotional valence (unpleasant, pleasant, neutral). The primary outcomes assessed were reaction time (RT), accuracy, and error response patterns.ResultsThe reaction times for both the alexithymia and non-alexithymia groups were significantly longer than those of the healthy controls across all experimental conditions (PP>0.05). Regarding accuracy, the alexithymia group performed worse than the non-alexithymia group specifically when identifying non-negative expressions (across all background conditions) (PPConclusionAlexithymia is an important factor associated with the heterogeneity of emotion recognition deficits in patients with schizophrenia. The core manifestation in patients with alexithymia is a significant negative bias specifically targeting the processing of non-negative facial expressions.