Schizophrenia Patients With a History of Severe Violence Differ From Nonviolent Schizophrenia Patients in Perception of Emotions but Not Cognitive Function
J Clin Psychiatry 2005;66(3):300-308
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Background: Impaired processing of emotions may
relate to violent behavior in schizophrenia patients. We compared
emotional function in schizophrenia patients with and without a
history of severe violent behavior.
Method: Tests of identification and
differentiation of facial emotions were performed to compare 35
patients with chronic schizophrenia or schizoaffective disorder
(DSM-IV criteria) and a history of severe violent behavior with
35 nonviolent schizophrenia patients and 46 healthy controls.
Tests of executive function, attention, visual orientation,
working memory, memory for faces and objects, and motor function
were also administered.
Results: Violent and nonviolent schizophrenia
patients showed impaired emotional and cognitive function
compared with controls. Violent patients showed a significantly
better ability to identify facial emotional expressions but a
poorer ability to discriminate between intensity of emotions than
nonviolent schizophrenia patients. There was no difference in
cognitive performance between the 2 patient groups.
Conclusion: Violent schizophrenia patients may
have a better ability to identify facial emotional cues than
nonviolent schizophrenia patients but may be less able to assess
the intensity of these cues. This trait may contribute to
conflict generation and failure to recognize resolution signals,
leading to conflict escalation and violence in violence-prone