Schizophrenia and affective disorder show different visual scanning behavior for faces: A trait versus state-based distinction?

Background: Abnormal visual scanpaths to faces and facial expressions in schizophrenia may underlie schizophrenic subjects' disturbed interpersonal communication. This study is the first to examine the specificity of these impairments to schizophrenia, by including an affective disorder psychiatric control group. Methods: The visual scanpath performance of 65 schizophrenia, 52 affective disordered, and 61 control subjects were compared in two experiments. In the face recognition experiment, subjects viewed four identifiable (nondegraded) neutral faces versus four matched non-identifiable (degraded) control faces. In the facial affect recognition experiment, subjects viewed positive (happy), negative (sad), and neutral (control) facial emotion stimuli. Concurrent behavioral tasks were face matching (face recognition) and expression matching (facial affect recognition), each under two multiple-choice conditions (7 or 3 options). Results: Scanpath disturbances were most apparent in schizophrenia subjects, who maintained a comparatively restricted scanpath style to all face stimuli. Schizophrenics subjects also showed the greatest recognition difficulties, particularly for neutral and happy faces. Scanpath parameters for affective disorder subjects differed only from the schizophrenia (but not the control) group, except for attention to facial features where they generally avoided facial features in all expressions and showed the greatest attentional problems of all groups for degraded faces. Conclusions: Our results suggest that a global restriction of visual scanpaths is specific to schizophrenic psychosis and might be a trait marker for this disorder, whereas scanpath abnormalities in affective disorder might instead reflect severe state-based (or discrete) attentional disturbances. (C) 2002 Society of Biological Psychiatry.