Attention to threat in schizophrenia: Investigation of the cognitive processes underlying paranoia using visual scan paths

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the left side/LHF first significantly more than the right of all stimuli. Schizophrenics viewed the LHF first only for stimuli with a LHF affect choice (50%). Neither group demonstrated an overall LHF perceptual bias for the chimeric faces. In normals this probably resulted from increased attention to nonleft-sided stimulus detail with scanning. In schizophrenics, a possible explanation was the difficultyin re-directing the focus of attention from the hemi-faceviewedfirst. The study therefore highlights the role of visual scan paths as a marker of abnormal attentional processes in schizophrenia. ~t1\

ATIENTION TO THREAT IN SCHIZOPHRENIA: INVESTIGATION OF THE COGNITIVE PROCESSES UNDERLYING PARANOIA USING VISUAL SCAN PATHS Mary L. Phillips, Anthony S. David Department ofPsychological Medicine. Institute ofPsychiatry. 103 Denmark Hill. London SE58AZ. UK

One theory to explain persecutory delusion formation in schizophrenia is that such patients demonstrate selectiveattention to threatening stimuli. We investigated this using visual scan path measurement-a technique previously employed by the authors as an on-line marker of visual attention in schizophrenia. Stimuli comprised black-and-white photographs of social scenes rated beforehand as depicting either neutral, ambiguous or threatening activity. Viewing strategies for such stimuli were measured in acute schizophrenics with persecutory delusions (SAPS~3) (n=12), schizophrenics without persecutory delusions (SAPS>3) (n= 10), matched for negative symptoms and medication, and normal controls (n = 15). It was hypothesised that schizophrenics with persecutory delusions would scan all stimuli for actual or potential threatening activity, viewing such areas earlier and for longer than control groups. Results have indicated that whilst normals scanned all stimulus regions, patients with persecutory delusions viewed fewer areas and attended more to regions depicting threatening activity-supporting the above hypothesis. Furthermore, when requested to attend specifically to threatening activity, normals demonstrated viewing strategies similar to paranoid patients. The study demonstrates that visual scan path measurement is a useful technique to employ in the investigation of cognitive abnormalities underlying symptomatology in schizophrenia.

'31 "2'THEORY OF MIND' AND CONTEXTUAL PROCESSING IN SCHIZOPHRENIA Graham J. Pickup, Christopher D. Frith Department of Psychology. University College London. London WCl E 6BT. England

Several studies have supported Frith's suggestion that an .impaired 'theory of mind' (TOM-the ability to infer one's

own and others' mental states) underlies many of the symptoms of schizophrenia. TOM tasks typically require subjects to make mental state inferences using contextual cues. Many studies have shown schizophrenic deficits in the use of context, so we investigate whether correlations occur between patient scores on separate tests of TOM and contextual processing. The Hints Test of theory of mind, and a new context task involving the naming of objects both in isolation and then in a scene, were administered to 39 schizophrenic, 17 depressed control and 30 normal control subjects. With current verbal IQ controlled, it was found that all groups scored equally when naming objects in isolation, but schizophrenics with negative or paranoid symptoms were significantly worse than controls both at naming objects within context and at understanding hints. Context and hints scores were significantlycorrelated for the schizophrenic sample but not for controls, suggesting that TOM and contextual deficits may reflect a single underlying cognitive impairment in schizophrenia. Future work will explore this relationship using other existing theory of mind and context tasks.

1.31 COGNITIVE AND CLINICAL CORRELATES OF INACCURATE AFFECT RECOGNITION IN SCHIZOPHRENIA John Poole, Faith Corwin, Sophia Vinogradov Department of Psychiatry (116W). University ofCalifornia at San Francisco. 4150 Clement Street. San Francisco. CA 94121. USA

Schizophrenia patients substantially misperceive other people's emotions, but prior studies disagree whether this reflects a specific or generalized cognitive deficit. The present study of 40 schizophrenics examined the association of facialand vocal-emotion recognition with two non-affective tasks (face and prosody discrimination), general intellectual abilities (verbal, perceptual, attentional), and clinical symptoms (positive, negative, disorganized, cognitive, excited, and depressed/ anxious scales of the PANSS). In terms of cognitive abilities, prosodic affect-recognition ability was significantlycorrelated with non-emotional prosody discrimination, verbal comprehension, and attentional control. Facial affect recognition ability correlated with verbal comprehension. In terms of psychopathology, inaccurate affect recognition (in both the visual and the auditory modality) was associated with the following: Disorganized Symptoms (conceptual and behavioral), Positive Symptoms (hallucinations, delusions, unusual thoughts), and Cognitive Symptoms (impaired attention, stereotyped thinking). Partialling for non-affective perceptual accuracy and IQ had little effect on the association with Disorganized Symptoms, and only partially attenuated the relation with Positive and Cognitive Symptoms. These findings indicate that, while general cognitive factors influence affect perception, a core disturbance of affect recognition exists in schizophrenia, independent of general cognitive problems. This affect-recognition deficit crosses sensory modalities and is associated with specificpsychopathologic symptoms.