The effects of perceptual load in processing emotional facial expression in psychotic disorders

Psychotic disorders are some of the most severe psychiatric conditions. Patients have difficulties in identifying facial expressions and appear to be highly sensitive to the presence of emotional distractors. Yet, no study has investigated whether perceptual load modulates the interference of emotional distractors. Our goal was to test whether psychotic patients were more sensitive to irrelevant emotional stimulus, even when the task demands a high amount of attentional resources. Twenty-two participants with schizophrenia or schizoaffective disorder and twenty-two healthy controls, performed a target letter discrimination task with emotional task-irrelevant stimulus (angry, happy and neutral facial expressions). Target-letters were presented among distrator-letters, which could be similar (low perceptual load) or different (high load); participants should discriminate the target-letter and ignore the facial expression. Results showed that patients were more prone to distraction by task-irrelevant stimulus, especially under high load, suggesting difficulties in attention control. Moreover, in psychotic patients, happy faces caused higher interference with the task, whereas neutral and angry faces resulted in less interference. These findings could provide innovative approaches regarding attentional deficits on social contexts in patients with schizophrenia spectrum disorders.