1. Research has shown that individuals with schizophrenia have impairments in emotional facial recognition that can be associated with aberrant visual scanning. The goal of the current study was to examine the ability and perceptual-attentional mechanisms in distinguishing enjoyment and non-enjoyment smiles in persons diagnosed with schizophrenia. Individuals with schizophrenia were less accurate than controls in judging non-Duchenne smiles as non-enjoyment smiles. This difficulty could be explained by a bias towards the mouth. Like their healthy counterparts, individuals with schizophrenia showed difficulty with the judgement of asymmetric smiles. Perceptual processing remains a possible explanation for the difficulty for individuals with schizophrenia, but not the control group. Abstract Results Analysis of eye-movements in the judgment of the authenticity of smiles in schizophrenia Annalie Pelot, Melanie Perron, Annie Roy-Charland, Randal Joseph Ryan, Albert P. Gouge, & Stacey Roles The control group was extremely accurate in their response to the symmetric Duchenne as a happy smile as well as the non-Duchenne as a non-happy smile. Individuals with schizophrenia were not as sensitive to the Duchenne marker and were significantly less accurate in labeling the non-Duchenne smile as non-enjoyment. Eye movement patterns suggest impairments in perceptual and attentional processing in the clinical group. While the control group made more saccades between the two sides of the face for the asymmetric smile, the individuals with schizophrenia did not show differential processing as a function of asymmetry. Individuals with schizophrenia also spent significantly more time fixating the mouth area, this bias towards the mouth might be an obstacle in their judgement of enjoyment and non-enjoyment smiles. The results suggest an impairment in the judgement of authenticity of facial expressions in people with schizophrenia. Symmetric Duchenne smile Asymmetric Duchenne smile Non-Duchenne smile Research has shown that non-clinical decoders are sensitive to these two cues of enjoyment, and that these groups possess the ability to perceptually and attentionally process these cues in the judgement of sincerity of smiles (Gosselin et al., 2002; Perron & Roy-Charland, 2013). The same might not be true for individuals with schizophrenia. In addition to the impairment in emotional facial expression recognition observed in patients with schizophrenia, eye movement research suggests that they have a restricted scanning strategy involving shorter scanpaths, fewer fixations, increased fixation durations, and notable avoidance of relevant facial features, such as the eyes (Loughland et al., 2002). Consequently, given their difficulty to categorize basic emotions and their suboptimal use of facial features, the judgement of authenticity of smiles might represent a challenge for individuals with schizophrenia. Method Participants Control/non-clinical group Experimental group 16 undergraduate students16 outpatients diagnosed with schizophrenia Materials Symmetric Duchenne smile Contains the characteristics of an enjoyment smile with the activation of the orbicularis oculi and zygomatic major muscles (intensity D). Asymmetric Duchenne smile Intensity varied from one side of the face to the other for both muscles (C vs. D) Non-Duchenne smile Did not include the activation of the orbicularis oculi but only the zygomatic major was activated (intensity D) Apparatus Eye movements were recorded with the Eyelink 1000 system. This apparatus is a highly accurate system (<0.5º) that also has a very high sampling rate (1000Hz). Procedure Participants were presented with 64 randomly assorted pictures of smiles on a computer screen (32 symmetric Duchenne smiles and 32 non-enjoyment smiles). They were instructed to judge the sincerity of the smiles by responding whether they believed the person in the picture was “really happy” or “not really happy”. References Couture, S.M., Penn, D.L. & Roberts, D.L. (2006). The functional significance of social cognition in schizophrenia: A review. Schizophrenia Bulletin, 32, S44-S63. doi:10.1093/schbul/sbl029 Duchenne, G. B. (1990). The mechanism of human facial expression or an electro- physiological analysis of the expression of the emotions (A. Cuthbertson, Trans). Cambridge: Cambridge University Press. (Original work published 1862). Frank, M.G. & Ekman, P. (1993). Not all smiles are created equal: The differences between enjoyment and nonenjoyment smiles. Humor: International Journal of Humor Research, 6, 9-26. doi: 10.1515/humr. 1993.6.1.9 Gosselin, P., Perron, M., Legault, M. & Campanella, P. (2002). Children’s and adults’ knowledge of the distinction between enjoyment and nonenjoyment smiles. Journal of Nonverbal Behavior, 26, 83-108. Kohler, C.G., Walker, J.B., Martin, E.A., Healey, K.M. & Moberg, P.J. (2010). Facial emotion perception in schizophrenia: A meta-analytic review. Schizophrenia Bulletin, 36, 1009-1019. doi:10.1093/schbul/sbn192 Loughland, C.M., Williams, L.M. & Gordon, E. (2002). Visual scanpaths to positive and negative facial emotions in an outpatient schizophrenia sample. Schizophrenia Research, 55, 159-170. doi: 10.1016/S0920-9964(01)00186-4 Perron, M. & Roy-Charland, A. (2013). Analysis of eye-movements in the judgment of enjoyment and non-enjoyment smiles. Frontiers in Psychology, 4, 1-11. Introduction A considerable body of research has provided robust findings supporting the notion that patients with schizophrenia are severely impaired in their ability to process emotional facial expressions (Kohler, Walker, Martin, Healey & Moberg, 2010). Importantly, several researchers have linked emotion recognition deficits with poor social outcomes and day-to-day functioning (Couture, Penn & Roberts, 2006). While substantial evidence has been gathered on the impairments in facial expression recognition of basic emotions in individuals with schizophrenia, less is known about their ability to judge the authenticity of the smile. To extract the emotional meaning, the decoder has to pay attention not only to the emotion expressed, but also to subtle details that may indicate hidden or simulated emotions. Felt happiness or enjoyment smiles have been documented as comprising the activation of the Zygomatic Major and the Orbicularis Oculi muscles (Duchenne, 1862/1990). The contraction of the orbicularis oculi, known as the Duchenne marker, lifts the cheeks, pushes the skin surrounding the eye towards the eye socket narrowing the eye opening, bagging or wrinkling the skin below the eye, and may cause crows’ feet. Furthermore, when an individual experiences true enjoyment, the expression is also more often symmetrical (Frank & Ekman, 1993). Discussion The aim of the current study was to conduct a systematic examination of the ability and perceptual-attentional mechanisms used in distinguishing enjoyment and non- enjoyment smiles in individuals with schizophrenia. More specifically, we examine the use of the Duchenne marker and symmetry.