Executive functions and static versus dynamic facial emotion recognition in schizophrenia

Abstract

Abstract Background Facial emotion recognition (FER) deficits constitute a clinically consequential dimension of schizophrenia, yet the contribution of specific executive function (EF) components, and whether this contribution varies between static and dynamic stimulus modalities, remains insufficiently understood, particularly outside Western samples. This study examined the relationships among inhibitory control, cognitive flexibility, central executive functioning, and the recognition of six basic emotions under both static and dynamic conditions in a Moroccan clinical sample. Methods Thirty-six patients with schizophrenia and 36 matched healthy controls completed the Stroop Color-Word Test, the Wisconsin Card Sorting Test (WCST), Baddeley’s Dual-Task Paradigm, and static and dynamic FER tasks. Symptom severity was evaluated using the Positive and Negative Syndrome Scale (PANSS). Analyses included Mann-Whitney U tests with Bonferroni correction, Spearman correlations with Holm-Bonferroni correction (66 tests), multiple regression with leave-one-out cross-validation (LOO-CV), and bootstrap mediation (5,000 resamples). Results Patients exhibited selective FER deficits for fear, surprise, and sadness under dynamic conditions (r rb = 0.89–1.00) but only for fear under static conditions. The dynamic–static performance gap was four times larger in patients than controls. Executive functions correlated significantly with dynamic (4 Holm-corrected) but not static emotion recognition. Inhibitory control predicted dynamic fear recognition ( R ² = 0.73; LOO-CV R ² = 0.26, indicating overfitting). Preliminary mediation analyses (reported in Supplementary Material) raised the hypothesis that central executive functioning may partially account for the symptom severity–dynamic surprise recognition link; these results are underpowered and purely exploratory. Conclusions These findings provide preliminary evidence for a modality-specific model in which dynamic, but not static, emotion recognition is associated with executive function performance. The substantial discrepancy between standard and cross-validated R² underscores the need for replication with larger samples. The modality effect may partly reflect differential task difficulty rather than exclusively modality-specific processing demands (see Discussion). This is the first study to examine the EF–FER relationship across stimulus modalities in a Moroccan sample.