Impaired emotional functioning in schizophrenia is a prominent clinical feature that manifests primarily as flat affect. Studies have examined the perception, experience, and expression of emotions in schizophrenia and reported normal ratings of experience but impaired affect identification. However, the relation between flat affect and performance on facial affect identification and cognitive tasks has not been systematically examined in relation to premorbid adjustment and clinical outcome. We report a prospective study of 63 patients with at least moderate severity of flat affect and 99 patients without flat affect, who were compared on functional domains, emotion processing tasks, and neurocognitive measures. Flat affect was more common in men and was associated with poorer premorbid adjustment, worse current quality of life, and worse outcome at 1-year follow-up.
Psychiatry & Behavior Sciences Clerkship - University of Washington School of Medicine
The social isolation experienced by some service users is made worse by their inability to read the emotions of others. Steve Smith and Alec Grant describe how photography can help them. Not being able to accurately detect and respond to the emotions conveyed in the facial expressions of others is a significant issue for many people with mental health problems. Facial affect recognition is crucial to successful social interaction and has an evolutionary and neural basis. Being unable to read the faces of others accurately contributes to social isolation and a vicious cycle of social impairment, and can be compounded by the effects of medication. This article draws on empirically validated work and suggests initiatives, including the use of photography, which mental health practitioners could use in helping people with facial affect recognition difficulties. Mental Health Practice.
Flat Affect in Schizophrenia: Relation to Emotion Processing and Neurocognitive Measures
One can express feelings verbally, by talking about events with emotional word choices and tone. Someone with a blunted affect displays little feeling in emotional contexts. The person might not share much information about how they felt. They may show little facial expression or speak in a monotone voice.
For people with flat affect, emotional expression is limited, reduced, or nonexistent. Flat affect is the face of lethargy and voice of apathy: no eye rolling, no winking, no smirking. Though experts are mixed on whether depression on its own leads to a flat affect, Kirkham describes a lack of connection to her emotions that she says reads across her face. Wakilah Majied, 35, who experiences flat affect as a symptom of schizophrenia.