Interaction of emotion and cognitive control along the psychosis continuum: A critical review

Abstract

To better understand how emotion impacts cognitive control is important as both influence adaptive behavior in complex real-life situations. Performance changes in emotion and cognitive control as well as in their interaction are often described in psychotic patients as well as in non-clinical participants who experience psychosis-like symptoms. These changes are linked to low motivation and limited social interaction. However, it is unclear whether these changes are driven by emotion, cognitive control, or an interaction of both. This review provides an overview of neuroimaging evidence on the potential interaction of emotion and cognitive control along the psychosis continuum. The literature confirms that over-sensitivity towards negative and lowered sensitivity towards positive emotional stimuli in tasks exploring emotion-cognitive control interaction are associated with the severity of positive and negative symptoms in psychosis. Changes in the dynamic interplay between emotion and context-sensitive cognitive control, mediated by arousal, motivation, and reward processing may underlie poor interpersonal communication and real-life skills in psychosis. In addition, structural and functional changes in subcortical and cortical associative brain regions (e.g., thalamus, basal ganglia, and angular gyrus) may contribute to alterations in emotion and cognitive control interaction along the psychosis continuum. There is limited evidence on how antipsychotic medication and age at illness-onset affect this interaction.