The tendency of people to more easily remember faces—and to
more easily recognize emotions in the faces—of people from their same
race appears to exist as well in patients with schizophrenia, according to a
study in the March 17 AJP in Advance.
This finding is important because it suggests that past studies of face
memory and emotion recognition showing that African-American patients perform
worse than Caucasians may be compromised by test bias if they use only
Caucasian faces as the test stimuli.
It also tells researchers something important about the disease and
underlying neuroanatomy involved in facial and emotion
recognition—namely, that while that capacity is generally impaired in
people with schizophrenia, the developmental influences that most likely shape
recognition of faces (and the tendency to more easily remember faces of the
same race) are shared by people with and without schizophrenia.
The study is scheduled for the print publication in May.
"The study has implications for research, but it also has clinical
implications because of how it can affect the doctor-patient
relationship," said Robert Freedman, M.D., editor of the American
Journal of Psychiatry.
"As psychiatrists we read our patients' faces, and we know that our
faces are read by our patients," Freedman told Psychiatric
News. "And we know that patients with schizophrenia sometimes
misinterpret what they read. This study points out that racial differences can
further skew that misinterpretation.
The tendency of people to more easily recognize faces and facial emotions
in the faces of others who share the same race is referred to by cognitive
neuroscientists as the "other-race" effect. It has been documented
that healthy individuals perform worse on face memory and emotion recognition
when processing faces of people of a different race
According to the AJP study, Amy Pinkham, Ph.D., and colleagues in
the Department of Neuropsychiatry at the University of Pennsylvania found this
other-race effect in both schizophrenia patients and in nonpatients on
immediate and delayed memory of faces and emotion recognition.
"These interactions demonstrate the presence of an intact other-race
effect in schizophrenia that affects both face memory and emotion
recognition," they wrote.
At least two previous studies, by some of the same researchers at the
University of Pennsylvania, had found that among patients with schizophrenia,
Caucasians performed better on emotion recognition tasks than non-Caucasians.
But those studies had used only Caucasian faces for the test stimuli.
One of those studies, "Cross-Ethnic Differences in Perception of
Emotion in Schizophrenia," was published in the September 2005
Schizophrenia Research. The other study, published in the March 2000
Schizophrenia Research, was titled "Emotional Processing in
Schizophrenia Across Cultures: Standardized Measures of Discrimination and
"Whereas these studies used only Caucasian stimuli, our tasks
included stimuli with both Caucasian and African-American faces and failed to
find a main effect of race in comparison subjects or patients," Pinkham
and colleagues wrote. "Notably, had we analyzed only responses to
Caucasian stimuli, our results would have replicated those of the previous
studies. Instead, our findings indicate that an other-race effect may account
for the differences described in these earlier studies and highlight an
important measurement issue in the extension of face processing and emotion
research to clinical populations."
The study encompassed 540 participants in four groups—african
Americans with schizophrenia, Caucasians with schizophrenia, African-American
community comparison subjects, and Caucasian community comparison subjects.
Each group had 135 subjects.
All participants completed face-recognition and facial-emotion
identification tasks that included both Caucasian and African-American faces
The researchers found that comparison participants performed better than
individuals with schizophrenia across all tasks. However, both comparison
participants and participants with schizophrenia exhibited a strong and
significant other-race effect for face memory and emotion recognition. The
magnitude of the other-race effect did not differ between these two
In addition to methodological concerns with regard to neurocognitive
testing, the results also suggest that the regions of the brain that influence
face memory and emotion recognition, though impaired in people with
schizophrenia, are subject to the same developmental influences as are
experienced by people without schizophrenia.
Pinkham and colleagues stated that the fusiform face area of the brain
located on the ventral surface of the temporal lobe on the fusiform gyrus is
believed to be modulated by experience—such as disproportionate exposure
to same-race faces relative to other-race faces during childhood—and has
shown sensitivity to racial information in healthy individuals.
So, despite the deficits shown by patients in face and emotion recognition,
the other-race effect exhibited by individuals with schizophrenia in the study
by Pinkham and colleagues may reflect normative developmental experience with
faces and normative development of the neural mechanisms of face
"It would be informative, therefore, to compare individuals with
schizophrenia with individuals with other neurodevelopmental disorders such as
autism who similarly show face-processing deficits in adulthood but
demonstrate qualitative and quantitative deficits with facial experience
throughout childhood," Pinkham and colleagues wrote.
"The Other-Race Effect in Face Processing Among African
American and Caucasian Individuals With Schizophrenia" can be accessed
Cross-Ethnic Differences in Perception of Emotion in
Schizophrenia" and "Emotional Processing in Schizophrenia Across
Cultures: Standardized Measures of Discrimination and Experience" can be