The Impact of Executive Function on Emotion Recognition and Emotion Experience in Patients with Schizophrenia

OBJECTIVE: This study investigated the impact of executive function on the performance of two different affective tasks, the Facial Affect Identification Task (FAIT) and the Iowa Gambling Task (IGT), in patients with schizophrenia. METHODS: Thirty-nine patients with schizophrenia and 33 healthy controls completed the FAIT and the IGT, followed by the Wisconsin Card Sorting Test (WCST) and the intelligence quotient (IQ) test. In addition to correlation analysis, regression analysis was used to determine the extent to which the performance of the WCST, in particular, perseverative error (PE), accounted for the variation in both the FAIT and the IGT. RESULTS: Relative to normal controls, patients with schizophrenia showed significant impairments in the IGT, the FAIT and the WCST even after controlling for IQ. While normal controls did not show any relationships between the WCST and two affective tasks, patients with schizophrenia showed that variables in the WCST correlated not only with the FAIT total correct score (r=-0.503, p=0.001 for PE) but also with the IGT net score (r=0.385, p=0.016 for PE). The PE score was a better predictor of the performance on the FAIT (R(2)=0.25) than that of the performance on the IGT (R(2)=0.15). CONCLUSION: Our findings imply that deficits in executive function in schizophrenia can affect performance on facial emotion recognition task more than performance on task based on emotion experience, that is, the feedback from the body. Therefore, more consideration is needed of the impact of executive function when interpreting the result of "conventional" facial affect recognition tests as opposed to interpreting the IGT.