It is established that individuals diagnosed with schizophrenia report experiencing emotions (e.g., joy, sadness), however, facial expressivity is blunted meaning the facial expressions that correspond with what we would expect to see with emotions such as joy are not facially expressed). To date, it is unknown what the nature of facial expressivity is prior to the onset of psychosis and if we see this discrepancy with the experience of emotion. One study found after hand-coding home-videos (during childhood/adolescents) of patients that later developed schizophrenia, these individuals showed decreased positive facial expressions and increased negative facial expressions (7). This study, however, is the first to unravel the nature of facial expressivity among adolescents at clinical high-risk (CHR) for developing psychosis, which can have critical translational implications given the detrimental impacts alterations in facial expressivity can have in social relationships, resulting in social withdrawal, isolation, and other mental health issues (e.g., anxiety and depression). Furthermore, understanding facial expressivity may be informative for identifying factors contributing to the pathogenesis of psychosis, decline in social functioning, and increased symptoms. Additionally, the proposed study can allow for analysis of underlying neural circuitry (both independent of behavior data and in terms of relationships with facial expressivity) which is needed within this area. In the current study, a total of 100 participants will participate in clinical interviews, a cognitive battery, an emotionally evocative film clip viewing task, and a magnetic resonance imaging (MRI) scan. The project aims to (1) determine if CHR youth exhibit alterations in facial expressions during emotionally evocative film clip viewing task compared to controls (also assessing the experience of emotion) (2) determine relevant neural circuitry underlying facial expressivity using structural and functional connectivity analyses, and (3) examine relationships between facial expressivity and social functioning and symptoms at baseline and 12 months later. The training plan proposed, in addition to training in theory and career development, relies on methodology in (1) human and automated facial analysis and (2) structural/functional connectivity. Training environment: The project will take place at Northwestern University which is an excellent training environment in which (1) there are valuable and accessible resources (e.g., equipment, courses, workshops) and (2) both the Sponsor and Co-Sponsor are located at this institution and have expertise in the areas of motor/neuroscience (connectivity analyses), and emotion, respectively. Training plan: The training plan will consist of learning about theory, data collection/processing/analysis and interpretation in Year 1 and Year 2. Furthermore, coursework and career development will be topics of focus through the award period. The training from this award is an extension of current knowledge and offers the opportunity to integrate novel theory and methods in emotional processes.
This study is the first to assess the nature of facial expressivity among CHR youth and aims to do so using a multimodal approach (human-coding and automated facial analysis) employing multiple levels of analysis (behavioral and neural). We can provide further evidence as to factors impacting social functioning impairments, understand emotive deficits, and symptom progression more broadly. Studying facial expressivity may also provide insights regarding whether primary or secondary (i.e., depression and medications) negative symptoms are related to these deficits and shed light on neural circuitry in both limbic and motor regions which have received little attention in this area.