A search for autoprosopagnosia in schizophrenia

Farzin Irani

doi:10.17918/etd-2818

Introduction: Converging evidence from rare neurological and psychiatric cases, and findings from normative, neuroimaging and electrophysiological studies reveal a dissociation between processing of self and other types of familiar faces. When the ability to distinguish your own face is comparatively impaired, we call it "autoprosopagnosia." Schizophrenia is a disorder characterized by impairments in social interactions, a capacity that is influenced by the ability to accurately process faces of others and perhaps oneself. Experimental and anectdotal evidence of self-processing deficits in other physical domains (e.g. self-voice, self-hand) makes schizophrenia a valuable model for investigation of self face recognition efficiency. The current study extended prior research that provided preliminary evidence for a self-face recognition deficit in 20% of patients with schizophrenia (Irani et al., 2006). Methods: A sample of 21 patients with schizophrenia, 19 first degree relatives and 21 age, sex and race matched controls made 'unfamiliar', 'familiar' and 'self' decisions about a series of randomly presented faces. The impact of demographic variables, clinical rating scales, schizotypal personality traits (relatives) and performance on computerized neuropsychological tests was investigated. Results: Irrespective of age, patients were slower than controls and relatives when recognizing facial images. There was a trend for patients to take longer to identify self versus other familiar faces. Accuracy rates were generally high, but reduced in patients due to 5 patients who were unable to recognize their own faces. These "autoprosopagnosia" patients were defined by their inability to recognize their own faces despite above chance accuracy for familiar (70% accurate) and unfamiliar (78% accurate) faces. These patients had more severe deficits in abstraction and spatial functioning as measured by neuropsychological tests, and lower levels of social functioning and education. Discussion: Results are discussed with regard to a self-face deficit spectrum ranging from transitory phenomena in neurologically normal individuals to neurological/psychiatric conditions complicated by self-face recognition deficits (e.g. mirror misidentification, prosopagnosia, Capgras delusion) to the autoprosopagnosia effect observed in the current study. Taken together results raise questions about a functional double dissociation between self and familiar face recognition. The putative role of a right frontoparietal network in self-face recognition is discussed.

A search for autoprosopagnosia in schizophrenia

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A search for autoprosopagnosia in schizophrenia

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