Dear Dr. Todua-Lennigk,

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PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #1: Yes

Reviewer #2: No

Reviewer #3: Yes

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Reviewer #1: I have reviewed the manuscript titled “Facial Emotion Recognition Abilities of Individuals with Schizophrenia and the Influence of Parental Bonding – An Exploratory Study in a Forensic Sample.” The study addresses an important and underexplored area, investigating how parental bonding patterns influence facial emotion recognition (FER) performance in individuals with schizophrenia within a forensic sample. The findings are clinically relevant, as they suggest that optimal parental attachment may mitigate FER deficits, while neglectful parenting is associated with poorer performance.

To further strengthen the study, I suggest the authors consider sharing their full analysis code and data processing pipeline (where ethically possible) to promote reproducibility. Including a more detailed subgroup or ablation analysis could help disentangle the specific contributions of different parental bonding dimensions (care vs. overprotection) to FER outcomes. Validation on independent or more diverse cohorts would also help confirm the robustness of the findings. The discussion would benefit from a state of the art comparison table summarizing existing FER studies in schizophrenia to better contextualize the current results. A dedicated limitations and future work section should be expanded to explicitly address issues such as sample size, gender restriction, retrospective bias in PBI reporting, and generalizability. Finally, the inclusion and exclusion criteria for participant selection should be clearly summarized for clarity.

For further methodological inspiration, particularly on advanced feature extraction and classification in psychiatric populations, the authors may consider reviewing the following works: “Zipper Pattern: An Investigation into Psychotic Criminal Detection Using EEG Signals,” “Multilevel Hybrid Handcrafted Feature Extraction Based Depression Recognition Method Using Speech,” and “Automated Schizophrenia Detection Model Using Blood Sample Scattergram Images and Local Binary Pattern.” These studies illustrate how explainable and structured computational models can enhance the understanding and classification of complex psychiatric and neurocognitive phenomena offering valuable insights for future extensions of this important research on schizophrenia and emotion processing.

Reviewer #2: The article addresses a relatively unexplored issue: the role of parental attachment in facial emotion recognition (FER) among individuals with schizophrenia in forensic settings. Below some methodological and scientific limitations:

1. The sample size (n = 32) is limited and does not allow for generalizable conclusions. Additionally, one parenting style category (“affectionate constraint”) is not represented in the sample. Please, include a power analysis to justify the sample size or explicitly acknowledge the lack of such analysis as a limitation.

2. Although justified to minimize gender-related biases in FER, this choice significantly limits the generalizability of the findings. Please discuss in more depth the potential gender differences in schizophrenia spectrum disorders and in facial emotion recognition.

3. The use of the PBI, a retrospective self-report instrument, may introduce recall bias or social desirability distortions. to encompass these limits, please cite studies validating the PBI in schizophrenia populations and strengthen the discussion of its methodological limitations.

4. The study does not report on important variables such as current symptomatology (e.g., PANSS), Functioning level (e.g., GAF, PSP) and ongoing pharmacological treatment (type, dosage, duration); please explicitly acknowledge them as potential uncontrolled confounders.

5. Subtest A of the emotional recognition test includes only five basic emotions and a limited number of stimuli. It omits more complex emotions (e.g., contempt, surprise) and variations in intensity. You can richer data incorporating measures such as reaction times and confidence ratings.

6. Although the authors acknowledge the correlational nature of the study, certain statements (e.g., “optimal parenting could ameliorate...”) may be interpreted as causal or overly speculative. I think that it will be better to reformulate these statements with greater caution, using expressions such as “could be associated with...” or “might mitigate...”.

Additional suggestions for improving the scientific strenght of the paper would be:

1.to include correlations between PBI scores and FER error rates (FERerr) within each group, not just main effects and interactions;

2.to provide a more detailed discussion of the forensic context: what distinguishes these patients from non-forensic individuals with schizophrenia?

3.to examine potential differences in FER error patterns—for example, whether certain emotions such as fear are systematically misrecognized, as suggested by previous studies.

4.to discuss the role of childhood trauma separately from parental bonding to avoid conceptual confusion between the two constructs.

Overall the article addresses an original and relevant topic in forensic and social psychiatry and is methodologically well-structured. However, it presents several limitations related to sample size, retrospective assessment tools, generalizability, and causal interpretation. With some revisions, this study could make a significant contribution to the understanding of the role of early parental relationships in the social cognition of individuals with schizophrenia, particularly in high-complexity settings such as forensic contexts.

Reviewer #3: The study explores whether retrospectively assessed parenting style moderates facial emotion recognition (FER) deficits in men with paranoid schizophrenia recruited from Swiss forensic clinics. Sixteen patients and 16 age- and education-matched healthy males completed the Parental Bonding Instrument and a 35-trial FER. A general linear model showed significant main effects of group and parenting style, plus an interaction whereby neglectful parenting was linked to markedly higher FER error rates among patients but not controls. The authors conclude that optimal parental bonding may buffer FER impairment in schizophrenia and suggest clinical and forensic implications. The topic is novel, the paper is clearly organized, and the forensic sample adds ecological relevance for violence-risk research. Nonetheless, several methodological and interpretive issues warrant clarification, as detailed below.

- Prior FER literature is largely cited, but the authors focus exclusively on male forensic patients to control for the potential confounding effects of sex. Did the authors hypothesize that violent behavior would moderate the relationship between schizophrenia and facial emotion recognition, and if so, could they clarify how this informed the study design?

- Sample size (N = 32) is small; was an a priori power calculation performed? Multiple post-hoc contrasts were run—were p-values adjusted (e.g., Bonferroni or Holm) to control Type I error?

- The PBI’s 25-item version is specified, yet cut-offs are provided without citation; would the authors report reliability coefficients (Cronbach’s α) for care/overprotection in this sample?

- The decision to merge maternal and paternal PBI scores may obscure parent-specific effects; have the authors tested mother vs father bonding separately?

- The authors suggest patients with optimal attachment “learn effectively” pre-morbidly; can they cite developmental data supporting this protective mechanism?

- Clinical implications mention neuromodulation studies but do not connect directly to parenting interventions; I am curious about how realistic the proposal is to modify parental bonding retrospectively in adult populations.

- The affectionless control group was excluded due to imbalance—could an exploratory analysis retaining this category (with caution) be placed in Supplementary Material?

- Occasional grammatical slips (e.g., “was has been approved,” p.6) need correction.

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what does this mean? ). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

Reviewer #3: No

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Facial emotion recognition abilities of individuals with schizophrenia and the influence of parental bonding  – an exploratory study in a forensic sample.

PONE-D-25-17462R1

Dear Dr. Salome Todua-Lennigk,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Mu-Hong Chen, M.D., Ph.D.

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions??>

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously? -->?>

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available??>

The PLOS Data policy

Reviewer #3: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English??>

Reviewer #3: Yes

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Reviewer #3: (No Response)

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what does this mean? ). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy

Reviewer #3: No

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