Differentiating facial incongruity and flatness in schizophrenia, using structured light camera data.

Incongruity between emotional experience and its outwardly expression is one of the prominent symptoms in schizophrenia. Though widely reported and used in clinical evaluation, this symptom is inadequately defined in the literature and may be confused with mere affect flattening. In this study we used structured-light depth camera and dedicated software to automatically measure facial activity of schizophrenia patients and healthy individuals during an emotionally evocative task. We defined novel measures for the congruence of emotional experience and emotional expression and for Flat Affect, compared them between patients and controls, and examined their consistency with clinical evaluation. We found incongruity in schizophrenia to be manifested in a less specific range of facial expressions in response to similar emotional stimuli, while the emotional experience remains intact. Our study also suggests that when taking into consideration affect flatness, no contextually inappropriate facial expressions are evident.