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Alterations in facial expressions in individuals at risk for psychosis: a facial electromyography approach using emotionally evocative film clips

Published online by Cambridge University Press:  26 October 2022

Tina Gupta*
Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
K. Juston Osborne
Department of Psychology, Northwestern University, Evanston, IL, USA
Ajay Nadig
Harvard/MIT MD-PhD Program, Harvard Medical School, Boston, MA, 02115
Claudia M. Haase
Department of Psychology, Northwestern University, Evanston, IL, USA School of Education and Social Policy, Northwestern University, Evanston, IL, USA
Vijay A. Mittal
Department of Psychology, Northwestern University, Evanston, IL, USA
Author for correspondence: Tina Gupta, E-mail:



Negative symptoms such as blunted facial expressivity are characteristic of schizophrenia. However, it is not well-understood if and what abnormalities are present in individuals at clinical high-risk (CHR) for psychosis.


This experimental study employed facial electromyography (left zygomaticus major and left corrugator supercilia) in a sample of CHR individuals (N = 34) and healthy controls (N = 32) to detect alterations in facial expressions in response to emotionally evocative film clips and to determine links with symptoms.


Findings revealed that the CHR group showed facial blunting manifested in reduced zygomatic activity in response to an excitement (but not amusement, fear, or sadness) film clip compared to controls. Reductions in zygomatic activity in the CHR group emerged in response to the emotionally evocative peak period of the excitement film clip. Lower zygomaticus activity during the excitement clip was related to anxiety while lower rates of change in zygomatic activity during the excitement video clip were related to higher psychosis risk conversion scores.


Together, these findings inform vulnerability/disease driving mechanisms and biomarker and treatment development.

Original Article
Copyright © The Author(s), 2022. Published by Cambridge University Press

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Co-Senior Authors.


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