Abstract
While investigating social cognitive impairments in schizophrenia, prominent evidence has been found that patients with schizophrenia show a tendency to misclassify neutral stimuli as negatively valenced. Within this population, patients presenting delusions are more prone to this phenomenon. In a previous study, Schizophrenia spectrum (SzSp) patients rated positive, negative and neutral stimuli that were multimodally presented, while assessed with a checklist exploring anomalous subjective experiences and evaluated for positive and negative symptomatology. In the present work, we aimed to further explore the relationship between neutral stimuli misperception, anomalous experiences and positive/negative symptoms in SzSp patients. To this end, we adopted a dimensional approach by reconstructing from available data: (1) four a priori scales representing essential dimensions of SzSp experiential pathology following Parnas et al. (2005); and (2) five clinically meaningful factors to describe illness severity derived by Toomey et al. (1997). Results showed that although overall patients correctly recognized the target emotions, those who misinterpreted neutral auditory cues as negatively valenced also presented higher scores in Perplexity (PY), Bizarre Delusions (BD) and Disorganization (Di) dimensions. Moreover, a positive association between BD and both PY and Self-Disorder (SD) dimensions emerged, suggesting that psychotic symptoms may be directly linked to patients’ subjectivity. In an attempt to comprehensively capture the multilayered neutral stimuli misperception phenomenon in SzSp, we aimed at bridging phenomenology and neurobiology by connecting the levels of molecular neurochemistry (i.e., altered dopaminergic neurotransmission), system neuroscience (aberrant salience of perceptual details) and psychopathology (the chain involving hyper-reflexivity, self-disorders and the emergence of delusions).
Highlights
Identifying neurobiologically rooted impairments in cognition has become an increasingly reliable way to detect endophenotypes of core components of schizophrenia
With the rationale to begin to address this matter, we considered behavioral and clinical data gathered from a previous study (Sestito et al, 2015), whereby Schizophrenia spectrum (SzSp) patients were tested with a multimodal paradigm in order to investigate affect recognition
Post hoc comparisons (Bonferroni corrected for multiple comparisons) revealed that Cry was rated by SzSp participants more negatively than Laugh, and Neutral stimuli were considered as devoid of any emotional content (Laugh vs. Cry; Neutral vs. Cry and Laugh all ps < 0.004)
Summary
Identifying neurobiologically rooted impairments in cognition has become an increasingly reliable way to detect endophenotypes of core components of schizophrenia. In psychosis, increased dopamine is observed in the mesolimbic pathway, with dopamine being a key neurochemical determinant of the significance of environmental cues to human motivations Abnormal increases in this neurotransmitter are proposed to influence the perceived salience of such environmental signs, leading to their aberrant assignment of salience (Kapur, 2003). This mechanism is thought to mediate the tendency to interpret neutral faces as emotionally meaningful (Kapur, 2003). Recent findings showed elevated dopamine synthesis even in prodromal individuals, which is correlated with psychotic symptoms severity (Howes et al, 2009) and predicts later psychotic disorder transition (Howes et al, 2011; Allott et al, 2014)
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