The Impact of Social Stress on Trustworthiness Judgments in Schizophrenia

Abstract

The present study examines the impact of induced social stress on facial trustworthiness judgments in individuals with schizophrenia (SCZ) and the associations between symptoms and trustworthiness ratings. Thirty-three individuals with SCZ and forty healthy controls (HC) were asked to rate the trustworthiness of 24 digitally morphed faces in two counterbalanced conditions. Mild social stress was induced by listening to loud noises from a busy street. BPRS, CAPE-42, and the Paranoia Scale measured the severity of symptoms. We did not observe significant differences in trustworthiness judgments between the patient and control groups. Social stress did not impact trust judgments. Paranoia was negatively connected to trustworthiness ratings in the control group. Subjective rating of stress in noise condition was negatively associated with paranoia only in the control sample. In the patient group, a negative correlation was found between trustworthiness ratings in stress conditions and the severity of self-reported negative symptoms. Our results suggest that mild social stress does not significantly affect trustworthiness judgments in either patients with SCZ or in HC. Differences between the patient and control groups in trustworthiness judgments were negligible. Overall, the results of this study can be considered mainly negative and contrast with previous studies. The stress induction paradigm or a smaller sample size might cause observed results. In controls, biased face perception was linked to trait paranoia. By contrast, in SCZ, other factors might impact trust perception and need further examination.

Keywords

facial trustworthiness / schizophrenia / social stress / trust

References

[1] Baas, D., M. van't Wout, A. Aleman, and R. S. Kahn. 2008. “Social Judgement in Clinically Stable Patients With Schizophrenia and Healthy Relatives: Behavioural Evidence of Social Brain Dysfunction.” Psychological Medicine 38, no. 5: 747-754. https://doi.org/10.1017/S0033291707001729.

[2] Bentall, R. P., R. Corcoran, R. Howard, N. Blackwood, and P. Kinderman. 2001. “Persecutory Delusions: A Review and Theoretical Integration.” Clinical Psychology Review 21, no. 8: 1143-1192. https://doi.org/10.1016/s0272-7358(01)00106-4.

[3] Buck, B., N. R. Hester, A. Pinkham, P. D. Harvey, L. F. Jarskog, and D. L. Penn. 2018. “The Bias Toward Intentionality in Schizophrenia: Automaticity, Context, and Relationships to Symptoms and Functioning.” Journal of Abnormal Psychology 127, no. 5: 503-512. https://doi.org/10.1037/abn0000360.

[4] Catalano, L. T., E. A. Heerey, and J. M. Gold. 2018. “The Valuation of Social Rewards in Schizophrenia.” Journal of Abnormal Psychology 127, no. 6: 602-611. https://doi.org/10.1037/abn0000366.

[5] Clark, C., and K. Paunovic. 2018. “WHO Environmental Noise Guidelines for the European Region: A Systematic Review on Environmental Noise and Cognition.” International Journal of Environmental Research and Public Health 15, no. 2: 285. https://doi.org/10.3390/ijerph15020285.

[6] Combs, D. R., D. L. Penn, M. Wicher, and E. Waldheter. 2007. “The Ambiguous Intentions Hostility Questionnaire (AIHQ): A New Measure for Evaluating Hostile Social-Cognitive Biases in Paranoia.” Cognitive Neuropsychiatry 12, no. 2: 128-143. https://doi.org/10.1080/13546800600787854.

[7] Couture, S. M., D. L. Penn, M. Losh, R. Adolphs, R. Hurley, and J. Piven. 2010. “Comparison of Social Cognitive Functioning in Schizophrenia and High Functioning Autism: More Convergence Than Divergence.” Psychological Medicine 40, no. 4: 569-579. https://doi.org/10.1017/S003329170999078X.

[8] Dickerson, S. S., and M. E. Kemeny. 2004. “Acute Stressors and Cortisol Responses: A Theoretical Integration and Synthesis of Laboratory Research.” Psychological Bulletin 130, no. 3: 355-391. https://doi.org/10.1037/0033-2909.130.3.355.

[9] Dyer, M. L., A. S. Attwood, I. S. Penton-Voak, and M. R. Munafò. 2022. “The Role of State and Trait Anxiety in the Processing of Facial Expressions of Emotion.” Royal Society Open Science 9, no. 1: 210056. https://doi.org/10.1098/rsos.210056.

[10] Ellett, L., D. Freeman, and P. A. Garety. 2008. “The Psychological Effect of an Urban Environment on Individuals With Persecutory Delusions: The Camberwell Walk Study.” Schizophrenia Research 99, no. 1-3: 77-84. https://doi.org/10.1016/j.schres.2007.10.027.

[11] Engell, A., J. Haxby, and A. Todorov. 2007. “Implicit Trustworthiness Decisions: Automatic Coding of Face Properties in the Human Amygdala.” Journal of Cognitive Neuroscience 19: 1508-1519. https://doi.org/10.1162/jocn.2007.19.9.1508.

[12] Fan, L., E. Bass, H. Klein, C. Springfield, and A. Pinkham. 2022. “A Preliminary Investigation of Paranoia Variability and Its Association With Social Functioning.” Schizophrenia Research: Cognition 29: 100258. https://doi.org/10.1016/j.scog.2022.100258.

[13] Fenigstein, A., and P. A. Vanable. 1992. “Paranoia and Self-Consciousness.” Journal of Personality and Social Psychology 62: 129-138. https://doi.org/10.1037/0022-3514.62.1.129.

[14] Forgas, J. P.1994. “Sad and Guilty? Affective Influences on the Explanation of Conflict in Close Relationships.” Journal of Personality and Social Psychology 66: 56-68. https://doi.org/10.1037/0022-3514.66.1.56.

[15] Forgas, J. P.1995. “Mood and Judgment: The Affect Infusion Model (AIM).” Psychological Bulletin 117: 39-66. https://doi.org/10.1037/0033-2909.117.1.39.

[16] Freeman, D.2016. “Persecutory Delusions: A Cognitive Perspective on Understanding and Treatment.” Lancet Psychiatry 3, no. 7: 685-692. https://doi.org/10.1016/S2215-0366(16)00066-3.

[17] Freeman, D., R. Emsley, G. Dunn, et al. 2015. “The Stress of the Street for Patients With Persecutory Delusions: A Test of the Symptomatic and Psychological Effects of Going Outside Into a Busy Urban Area.” Schizophrenia Bulletin 41, no. 4: 971-979. https://doi.org/10.1093/schbul/sbu173.

[18] Freeman, D., and P. A. Garety. 2000. “Comments on the Content of Persecutory Delusions: Does the Definition Need Clarification?” British Journal of Clinical Psychology 39, no. 4: 407-414.

[19] Freeman, D., B. S. Loe, D. Kingdon, et al. 2021. “The Revised Green et al., Paranoid Thoughts Scale (R-GPTS): Psychometric Properties, Severity Ranges, and Clinical Cut-Offs.” Psychological Medicine 51, no. 2: 244-253. https://doi.org/10.1017/S0033291719003155.

[20] Frost-Karlsson, M., M. A. Galazka, C. Gillberg, et al. 2019. “Social Scene Perception in Autism Spectrum Disorder: An Eye-Tracking and Pupillometric Study.” Journal of Clinical and Experimental Neuropsychology 41, no. 10: 1024-1032. https://doi.org/10.1080/13803395.2019.1646214.

[21] Green, M. J., and M. L. Phillips. 2004. “Social Threat Perception and the Evolution of Paranoia.” Neuroscience & Biobehavioral Reviews 28, no. 3: 333-342. https://doi.org/10.1016/j.neubiorev.2004.03.006.

[22] Hajdúk, M., H. S. Klein, P. D. Harvey, D. L. Penn, and A. E. Pinkham. 2019. “Paranoia and Interpersonal Functioning Across the Continuum From Healthy to Pathological—Network Analysis.” British Journal of Clinical Psychology 58, no. 1: 19-34. https://doi.org/10.1111/bjc.12199.

[23] Hajdúk, M., D. Krajčovičová, M. Zimányiová, V. Kořínková, A. Heretik, and J. Pečeňák. 2019. “Trustworthiness Judgments Are Associated With Interpersonal Functioning in Individuals With Schizophrenia.” Journal of Experimental Psychopathology 10, no. 1: 204380871982709. https://doi.org/10.1177/2043808719827094.

[24] Haut, K. M., and A. W. MacDonald. 2010. “Persecutory Delusions and the Perception of Trustworthiness in Unfamiliar Faces in Schizophrenia.” Psychiatry Research 178, no. 3: 456-460. https://doi.org/10.1016/j.psychres.2010.04.015.

[25] Hooker, C. I., L. M. Tully, S. C. Verosky, M. Fisher, C. Holland, and S. Vinogradov. 2011. “Can I Trust You? Negative Affective Priming Influences Social Judgments in Schizophrenia.” Journal of Abnormal Psychology 120, no. 1: 98-107. https://doi.org/10.1037/a0020630.

[26] Kinderman, P., and R. Bentall. 1996. “A New Measure of Causal Focus: The Internal, Personal and Situational Attributions Questionnaire.” Personality and Individual Differences 20: 261-264. https://doi.org/10.1016/0191-8869(95)00186-7.

[27] Kirk, H., A. Gilmour, R. Dudley, and D. Riby. 2013. “Paranoid Ideation and Assessments of Trust.” Journal of Experimental Psychopathology 4: 360-367. https://doi.org/10.5127/jep.027812.

[28] Kirschbaum, C., K.-M. Pirke, and D. H. Hellhammer. 1993. “The ‘Trier Social Stress Test’—A Tool for Investigating Psychobiological Stress Responses in a Laboratory Setting.” Neuropsychobiology 28, no. 1-2: 76-81. https://doi.org/10.1159/000119004.

[29] Kopelowicz, A., J. Ventura, R. P. Liberman, and J. Mintz. 2008. “Consistency of Brief Psychiatric Rating Scale Factor Structure Across a Broad Spectrum of Schizophrenia Patients.” Psychopathology 41, no. 2: 77-84. https://doi.org/10.1159/000111551.

[30] Köther, U., T. M. Lincoln, and S. Moritz. 2018. “Emotion Perception and Overconfidence in Errors Under Stress in Psychosis.” Psychiatry Research 270: 981-991. https://doi.org/10.1016/j.psychres.2018.03.044.

[31] Lakens, D.2022. “Sample size justification.” Collabra: Psychology 8, no. 1: 33267. https://doi.org/10.1525/collabra.33267.

[32] Lederbogen, F., L. Haddad, and A. Meyer-Lindenberg. 2013. “Urban Social Stress—Risk Factor for Mental Disorders. The Case of Schizophrenia.” Environmental Pollution (Barking, Essex: 1987) 183: 2-6. https://doi.org/10.1016/j.envpol.2013.05.046.

[33] Lee, J., A. M. Jimenez, E. A. Reavis, W. P. Horan, J. K. Wynn, and M. F. Green. 2019. “Reduced Neural Sensitivity to Social vs Nonsocial Reward in Schizophrenia.” Schizophrenia Bulletin 45, no. 3: 620-628. https://doi.org/10.1093/schbul/sby109.

[34] Lincoln, T. M., U. Köther, M. Hartmann, J. Kempkensteffen, and S. Moritz. 2015. “Responses to Stress in Patients With Psychotic Disorders Compared to Persons With Varying Levels of Vulnerability to Psychosis, Persons With Depression and Healthy Controls.” Journal of Behavior Therapy and Experimental Psychiatry 47: 92-101. https://doi.org/10.1016/j.jbtep.2014.11.011.

[35] Lincoln, T. M., J. Lange, J. Burau, C. Exner, and S. Moritz. 2010. “The Effect of State Anxiety on Paranoid Ideation and Jumping to Conclusions. An Experimental Investigation.” Schizophrenia Bulletin 36, no. 6: 1140-1148. https://doi.org/10.1093/schbul/sbp029.

[36] Lincoln, T. M., N. Peter, M. Schäfer, and S. Moritz. 2009. “Impact of Stress on Paranoia: An Experimental Investigation of Moderators and Mediators.” Psychological Medicine 39, no. 7: 1129-1139. https://doi.org/10.1017/S0033291708004613.

[37] McGrath, J., S. Saha, J. Welham, O. El Saadi, C. MacCauley, and D. Chant. 2004. “A Systematic Review of the Incidence of Schizophrenia: The Distribution of Rates and the Influence of Sex, Urbanicity, Migrant Status and Methodology.” BMC Medicine 2: 13. https://doi.org/10.1186/1741-7015-2-13.

[38] Moritz, S., P. Burnette, S. Sperber, et al. 2011. “Elucidating the Black Box From Stress to Paranoia.” Schizophrenia Bulletin 37, no. 6: 1311-1317. https://doi.org/10.1093/schbul/sbq055.

[39] Moritz, S., U. Köther, M. Hartmann, and T. M. Lincoln. 2015. “Stress Is a Bad Advisor. Stress Primes Poor Decision Making in Deluded Psychotic Patients.” European Archives of Psychiatry and Clinical Neuroscience 265, no. 6: 461-469. https://doi.org/10.1007/s00406-015-0585-1.

[40] Oosterhof, N. N., and A. Todorov. 2008. “The Functional Basis of Face Evaluation.” Proceedings of the National Academy of Sciences 105, no. 32: 11087-11092. https://doi.org/10.1073/pnas.0805664105.

[41] Pinkham, A. E., P. D. Harvey, and D. L. Penn. 2016. “Paranoid Individuals With Schizophrenia Show Greater Social Cognitive Bias and Worse Social Functioning Than Non-paranoid Individuals With Schizophrenia.” Schizophrenia Research: Cognition 3: 33-38. https://doi.org/10.1016/j.scog.2015.11.002.

[42] Pinkham, A. E., J. Hopfinger, and D. L. Penn. 2012. “Context Influences Social Cognitive Judgments in Paranoid Individuals With Schizophrenia.” Schizophrenia Research 135, no. 1: 196-197. https://doi.org/10.1016/j.schres.2011.11.024.

[43] Pinkham, A. E., D. L. Penn, M. F. Green, and P. D. Harvey. 2016. “Social Cognition Psychometric Evaluation: Results of the Initial Psychometric Study.” Schizophrenia Bulletin 42, no. 2: 494-504. https://doi.org/10.1093/schbul/sbv056.

[44] Pot-Kolder, R., W. Veling, J. Counotte, and M. van der Gaag. 2018. “Self-Reported Cognitive Biases Moderate the Associations Between Social Stress and Paranoid Ideation in a Virtual Reality Experimental Study.” Schizophrenia Bulletin 44, no. 4: 749-756. https://doi.org/10.1093/schbul/sbx119.

[45] Randjbar, S., R. Veckenstedt, F. Vitzthum, B. Hottenrott, and S. Moritz. 2011. “Attributional Biases in Paranoid Schizophrenia: Further Evidence for a Decreased Sense of Self-Causation in Paranoia.” Psychosis 3, no. 1: 74-85. https://doi.org/10.1080/17522431003717675.

[46] Reininghaus, U., M. J. Kempton, L. Valmaggia, et al. 2016. “Stress Sensitivity, Aberrant Salience, and Threat Anticipation in Early Psychosis: An Experience Sampling Study.” Schizophrenia Bulletin 42, no. 3: 712-722. https://doi.org/10.1093/schbul/sbv190.

[47] Selten, J.-P., and E. Cantor-Graae. 2005. “Social Defeat: Risk Factor for Schizophrenia?” British Journal of Psychiatry: The Journal of Mental Science 187: 101-102. https://doi.org/10.1192/bjp.187.2.101.

[48] Sheehan, D. V., Y. Lecrubier, K. H. Sheehan, et al. 1998. “The Mini-International Neuropsychiatric Interview (M.I.N.I.): The Development and Validation of a Structured Diagnostic Psychiatric Interview for DSM-IV and ICD-10.” Journal of Clinical Psychiatry 59, no. Suppl 20: 22-33. quiz 34-57.

[49] Stefanis, N. C., M. Hanssen, N. K. Smirnis, et al. 2002. “Evidence That Three Dimensions of Psychosis Have a Distribution in the General Population.” Psychological Medicine 32, no. 2: 347-358. https://doi.org/10.1017/s0033291701005141.

[50] Strauss, G. P., W. P. Horan, B. Kirkpatrick, et al. 2013. “Deconstructing Negative Symptoms of Schizophrenia: Avolition-Apathy and Diminished Expression Clusters Predict Clinical Presentation and Functional Outcome.” Journal of Psychiatric Research 47, no. 6: 783-790. https://doi.org/10.1016/j.jpsychires.2013.01.015.

[51] Todorov, A., S. G. Baron, and N. N. Oosterhof. 2008. “Evaluating Face Trustworthiness: A Model Based Approach.” Social Cognitive and Affective Neuroscience 3: 119-127. https://doi.org/10.1093/scan/nsn009.

[52] Toet, A., M. Bijlsma, and A.-M. Brouwer. 2017. “Stress Response and Facial Trustworthiness Judgments in Civilians and Military.” SAGE Open 7, no. 3: 2158244017725386. https://doi.org/10.1177/2158244017725386.

[53] Trémeau, F., D. Antonius, A. Todorov, et al. 2016. “What Can the Study of First Impressions Tell Us About Attitudinal Ambivalence and Paranoia in Schizophrenia?” Psychiatry Research 238: 86-92. https://doi.org/10.1016/j.psychres.2016.02.014.

[54] Urbańska, D., S. Moritz, and Ł. Gawęda. 2019. “The Impact of Social and Sensory Stress on Cognitive Biases and Delusions in Schizophrenia.” Cognitive Neuropsychiatry 24: 217-232. https://doi.org/10.1080/13546805.2019.1611551.

[55] van Os, J., G. Kenis, and B. P. F. Rutten. 2010. “The Environment and Schizophrenia.” Nature 468, no. 7321: 203-212. https://doi.org/10.1038/nature09563.

[56] Ventura, J., M. F. Green, A. Shaner, and R. P. Liberman. 1993. “Training and Quality Assurance With the Brief Psychiatric Rating Scale: ‘The Drift Busters’.” International Journal of Methods in Psychiatric Research 3: 221-244.

[57] Willis, J., and A. Todorov. 2006. “First Impressions: Making up Your Mind After a 100-Ms Exposure to a Face.” Psychological Science 17, no. 7: 592-598. https://doi.org/10.1111/j.1467-9280.2006.01750.x.

[58] Woolley, J. D., B. Chuang, C. Fussell, et al. 2017. “Intranasal Oxytocin Increases Facial Expressivity, but Not Ratings of Trustworthiness, in Patients With Schizophrenia and Healthy Controls.” Psychological Medicine 47, no. 7: 1311-1322. https://doi.org/10.1017/S0033291716003433.

[59] Wright, B., E. Peters, U. Ettinger, E. Kuipers, and V. Kumari. 2014. “Understanding Noise Stress-Induced Cognitive Impairment in Healthy Adults and Its Implications for Schizophrenia.” Noise & Health 16, no. 70: 166-176. https://doi.org/10.4103/1463-1741.134917.

RIGHTS & PERMISSIONS

2024 The Author(s). PsyCh Journal published by Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.