Relationships between social withdrawal and facial emotion recognition in neuropsychiatric disorders

Alejandro de la Torre-Luque*, Alba Viera-Campos, Amy C. Bilderbeck, Maria Teresa Carreras, Jose Vivancos, Covadonga M. Diaz-Caneja, Moji Aghajani, Ilja M.J. Saris, Andreea Raslescu, Asad Malik, Jenna Clark, Brenda W.J.H. Penninx, Nic van der Wee, Inge Winter van Rossum, Bernd Sommer, Hugh Marston, Gerard R. Dawson, Martien J. Kas, Jose Luis Ayuso-Mateos, Celso Arango

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)


Background: Emotion recognition constitutes a pivotal process of social cognition. It involves decoding social cues (e.g., facial expressions) to maximise social adjustment. Current theoretical models posit the relationship between social withdrawal factors (social disengagement, lack of social interactions and loneliness) and emotion decoding. Objective: To investigate the role of social withdrawal in patients with schizophrenia (SZ) or probable Alzheimer's disease (AD), neuropsychiatric conditions associated with social dysfunction. Methods: A sample of 156 participants was recruited: schizophrenia patients (SZ; n = 53), Alzheimer's disease patients (AD; n = 46), and two age-matched control groups (SZc, n = 29; ADc, n = 28). All participants provided self-report measures of loneliness and social functioning, and completed a facial emotion detection task. Results: Neuropsychiatric patients (both groups) showed poorer performance in detecting both positive and negative emotions compared with their healthy counterparts (p < .01). Social withdrawal was associated with higher accuracy in negative emotion detection, across all groups. Additionally, neuropsychiatric patients with higher social withdrawal showed lower positive emotion misclassification. Conclusions: Our findings help to detail the similarities and differences in social function and facial emotion recognition in two disorders rarely studied in parallel, AD and SZ. Transdiagnostic patterns in these results suggest that social withdrawal is associated with heightened sensitivity to negative emotion expressions, potentially reflecting hypervigilance to social threat. Across the neuropsychiatric groups specifically, this hypervigilance associated with social withdrawal extended to positive emotion expressions, an emotional-cognitive bias that may impact social functioning in people with severe mental illness.

Original languageEnglish
Article number110463
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Early online date10 Nov 2021
Publication statusPublished - 8 Mar 2022


  • Alzheimer's disease
  • Emotion recognition
  • Neuropsychiatric disorder
  • PRISM study
  • Schizophrenia
  • Social cognition
  • Social functioning


Dive into the research topics of 'Relationships between social withdrawal and facial emotion recognition in neuropsychiatric disorders'. Together they form a unique fingerprint.

Cite this