# Exploring the Relationship Between Childhood Maltreatment, Alexithymia, and Facial Emotional Recognition in Schizophrenia

## TL;DR

The study finds that childhood maltreatment and difficulty identifying emotions are linked to worse facial emotion recognition in schizophrenia patients, especially for anger.

## Contribution

The study reveals a novel connection between childhood maltreatment, alexithymia, and impaired recognition of anger in schizophrenia patients.

## Key findings

- Schizophrenia patients showed more severe impairments in facial emotional recognition compared to healthy controls.
- Childhood maltreatment and alexithymia were negatively correlated with accurate facial emotion recognition.
- Difficulty describing feelings was associated with greater difficulty recognizing anger in schizophrenia patients.

## Abstract

Background: Childhood maltreatment is a significant factor affecting social cognition in schizophrenia (SCZ) patients. However, the relationship between childhood maltreatment, alexithymia, and facial emotional recognition in SCZ remains unclear.

Methods: SCZ patients in stable phase (n = 90) and healthy controls (n = 47) were included according to the DSM‐5 criteria. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS), childhood maltreatment was evaluated using the Childhood Trauma Questionnaire (CTQ), and alexithymia was assessed using the Toronto Alexithymia Scale‐20 (TAS‐20) to evaluate the ability to identify, describe, and express emotions. Social cognition was assessed using the Facial Emotion Recognition Test.

Results: Our findings indicate significant differences in CTQ, TAS‐20, and facial emotional recognition between the two groups, with the SCZ group showing more severe impairments. Pearson correlation analysis showed that correct facial emotion recognition was negatively correlated with childhood maltreatment and alexithymia (p < 0.05). Stepwise regression analysis further revealed that the total PANSS score, positive symptom, CTQ total score, and difficulty describing feelings negatively affected the accuracy of facial emotional recognition (p < 0.05). Patients who find it difficult to describe feelings may also have greater difficulty in recognizing facial expressions of anger.

Conclusion: Good psychosocial functioning can mitigate the negative impact of childhood maltreatment on the severity of illness in SCZ patients. Therefore, psychotherapy that promotes personal expression is useful in the treatment of SCZ.

The study investigates the relationship between childhood maltreatment, alexithymia, and facial emotional recognition in patients with schizophrenia. The results indicate that childhood maltreatment and alexithymia negatively affect facial emotion recognition in patients with schizophrenia, especially their ability to recognize anger. Improving emotional expression abilities may help alleviate the negative effects of childhood maltreatment on the patients' social cognitive functions.