Performance and response time in emotion recognition and mentalizing measures in patients with schizophrenia.
12 affiliations
- 1Servicio Cántabro de Salud. Hospital de Laredo, Laredo, Cantabria, Spain.
- 2Department of Educational Sciences, Area of Developmental and Educational Psychology, University of Alcalá, Alcalá de Henares, Madrid, Spain. [email protected].
- 3Isabel I University, Burgos, Spain. [email protected].
- 4Mental Health Research Group (MHeRG), Faculty of Biomedical and Health Sciences, Alfonso X el Sabio University, Villanueva de la Cañada, Madrid, Spain.
- 5Psychiatry and Mental Health Research Group, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain.
- 6Facultad de Ciencias de la Salud y la Educación, Universidad a Distancia de Madrid, Madrid, Spain.
- 7Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- 8Department of Psychiatry | University of Cambridge, Cambridge, UK.
- 9Cambridge Psychosis Centre | Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK.
- 10Universidad Complutense de Madrid (UCM) / Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.
- 11CIBERSAM-ISCIII (Biomedical Research Networking Centre in Mental Health), Madrid, Spain.
- 12Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, Madrid, Spain / Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Madrid, Spain.
Abstract
Background
Schizophrenia is associated with marked impairments in social cognition, particularly in emotion recognition and mentalizing. Although these deficits have been extensively documented, most studies rely on static, highly controlled measures and focus primarily on accuracy-based outcomes, thereby limiting ecological validity. This study aimed to examine performance and response times across static and dynamic social-cognitive measures in patients with schizophrenia compared to healthy controls, and to investigate the effects of speed instructions on emotion recognition performance.Methods
In a sample of patients with schizophrenia (n = 90) and matched healthy controls (n = 100), we evaluated social cognition through two validated measures: the Penn Emotion Recognition Test (ER-40) for emotion recognition and the Movie for the Assessment of Social Cognition (MASC) for mentalizing, respectively. Performance and response times were the main outcome variables.Results
Patients showed worse performance and longer response times than controls on the ER-40 and MASC measures. Across the entire sample, there was a statistically significant inverse association between response time and the rate of correct answers in both ER-40 and MASC measures. Speed instructions in the ER-40 did not influence performance or response times in either group. In the MASC, patients exhibited more mentalizing errors than controls. Additionally, patients identified anger more quickly than fear or sadness, a pattern not observed in the healthy control group.Conclusions
Integrating accuracy and response time provides a comprehensive characterization of social-cognitive deficits in patients with schizophrenia. These findings highlight the importance of incorporating response time and dynamic measures to enhance the ecological validity of social-cognitive assessment and suggest that future rehabilitation programs may benefit from addressing both accuracy and response speed in emotion recognition and mentalizing domains.
Related
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BibTeX
@article{ruiztoca2026performance,
title = {{Performance and response time in emotion recognition and mentalizing measures in patients with schizophrenia.}},
author = {Alicia Ruiz-Toca and Alba Hernández-Gómez and Nelson Andrade-González and Cristina Fernández-Aragón and Bryan J Stiles and Emilio Fernandez-Egea and Roberto Rodriguez-Jimenez and Guillermo Lahera},
journal = {BMC psychiatry},
year = {2026},
month = jul,
doi = {10.1186/s12888-026-08379-1},
url = {https://europepmc.org/article/MED/42928192},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Performance and response time in emotion recognition and mentalizing measures in patients with schizophrenia.
AU - Alicia Ruiz-Toca
AU - Alba Hernández-Gómez
AU - Nelson Andrade-González
AU - Cristina Fernández-Aragón
AU - Bryan J Stiles
AU - Emilio Fernandez-Egea
AU - Roberto Rodriguez-Jimenez
AU - Guillermo Lahera
PY - 2026
DA - 2026/07/28
JO - BMC psychiatry
DO - 10.1186/s12888-026-08379-1
UR - https://europepmc.org/article/MED/42928192
AB - Background Schizophrenia is associated with marked impairments in social cognition, particularly in emotion recognition and mentalizing. Although these deficits have been extensively documented, most studies rely on static, highly controlled measures and focus primarily on accuracy-based outcomes, thereby limiting ecological validity. This study aimed to examine performance and response times across static and dynamic social-cognitive measures in patients with schizophrenia compared to healthy controls, and to investigate the effects of speed instructions on emotion recognition performance.Methods In a sample of patients with schizophrenia (n = 90) and matched healthy controls (n = 100), we evaluated social cognition through two validated measures: the Penn Emotion Recognition Test (ER-40) for emotion recognition and the Movie for the Assessment of Social Cognition (MASC) for mentalizing, respectively. Performance and response times were the main outcome variables.Results Patients showed worse performance and longer response times than controls on the ER-40 and MASC measures. Across the entire sample, there was a statistically significant inverse association between response time and the rate of correct answers in both ER-40 and MASC measures. Speed instructions in the ER-40 did not influence performance or response times in either group. In the MASC, patients exhibited more mentalizing errors than controls. Additionally, patients identified anger more quickly than fear or sadness, a pattern not observed in the healthy control group.Conclusions Integrating accuracy and response time provides a comprehensive characterization of social-cognitive deficits in patients with schizophrenia. These findings highlight the importance of incorporating response time and dynamic measures to enhance the ecological validity of social-cognitive assessment and suggest that future rehabilitation programs may benefit from addressing both accuracy and response speed in emotion recognition and mentalizing domains.
SN - 1471-244X
ER -