Emotional Experience In Schizophrenia Research Articles

How do social factors relate to blunted facial affect in schizophrenia? A digital phenotyping study using ambulatory video recordings

Clinical interviews and laboratory-based emotional induction paradigms provide consistent evidence that facial affect is blunted in many individuals with schizophrenia. Although it is clear that blunted facial affect is not a by-product of diminished emotional experience in schizophrenia, factors contributing to blunted affect remain unclear. The current study used a combination of ambulatory video recordings that were evaluated via computerized facial affect analysis and concurrently completed ecological momentary assessment surveys to assess whether blunted affect reflects insufficient reactivity to affective or contextual factors. Specifically, whether individuals with schizophrenia require more intense affective experiences to produce expression, or whether they are less reactive to social factors (i.e. being in the presence of others, social motivation). Participants included outpatients with schizophrenia (n = 33) and healthy controls (n = 31) who completed six days of study procedures. Multilevel linear models were evaluated using both Null-Hypothesis Statistical Testing and Bayesian analyses. Individuals with schizophrenia displayed comparable expression of positive and negative emotion to controls during daily life, and no evidence was found for a different intensity of experience required for expression in either group. However, social factors differentially influenced facial expression in schizophrenia compared to controls, such that individuals with schizophrenia did not modulate their expressions based on social motivation to the same extent as controls. These findings suggest that social motivation may play an important role in determining when blunting occurs.

Heterogeneity of emotional experience in schizophrenia: Trait affect profiles predict clinical presentation and functional outcome.

The current study examined whether subgroups of individuals with schizophrenia could be identified based on their profiles of trait positive and negative emotional experience, and whether those subgroups differed in their symptom presentation and functional outcome. Participants included 192 outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ) and 149 demographically matched healthy controls who completed the trait version of the Positive and Negative Affect Scale, as well as symptom and functional outcome assessments. Cluster analysis determined whether patients could be separated into meaningful subgroups based on their trait emotional experience profiles, and discriminant function analysis determined whether these groups were valid and adequately separated. Forty-two percent of the patients fell into an affectively normal cluster, whereas 28% and 30% fell into low positive affect (PA) and high negative affect (NA) clusters, respectively. These subgroups differed significantly on positive symptoms, negative symptoms, Diagnostic and Statistical Manual of Mental Disorders diagnoses, and functional outcomes. Trait emotional experience is heterogeneous in outpatients with psychotic disorders, and meaningful subgroups of patients with different profiles of PA and NA can be identified. These subgroups show meaningful differences in clinical presentation, which may necessitate different treatment approaches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Supplemental Material for Heterogeneity of Emotional Experience in Schizophrenia: Trait Affect Profiles Predict Clinical Presentation and Functional Outcome

Supplemental Material for Heterogeneity of Emotional Experience in Schizophrenia: Trait Affect Profiles Predict Clinical Presentation and Functional Outcome

Depression and reduced emotional experience in schizophrenia: Correlations with self-reported and informant-rated everyday social functioning

Negative symptoms and depression persist in one third of patients with schizophrenia. Previous studies suggested that depression has more impact on self-perceived compared to observer-rated social functions. Reduced emotional experience, a subdomain of negative symptoms, predicts social functioning deficits, although its role in self-assessment is unclear. We examined depression and reduced emotional experience and self-reports and informant ratings of social functioning and social cognitive abilities in 135 patients with schizophrenia. Discrepancies between sources were used to index the accuracy and bias in self-assessment. Less severe depression was associated with self-reports of reduced impairments in social functioning and better social cognitive abilities. Reduced emotional experience was related to informant ratings and self-reports of social functioning. Neither reduced emotional experience nor depression was correlated with discrepancies between sources, despite the bias of patients with lower depression to report that they were higher functioning and more competent. These findings suggest that patients with schizophrenia make global judgments about functioning based on current mood states. There was minimal association between the depression severity and the accuracy of self-assessment, despite positive biases associated with lower depression severity. The determinants of accuracy and bias in self-assessment requires more detailed examination and subdivision of patients based on their depression.

Emotion regulation abnormalities in schizophrenia: cognitive change strategies fail to decrease the neural response to unpleasant stimuli.

Contrary to early conceptualizations of emotional experience in schizophrenia (SZ), recent research indicates that patients do not self-report less in-the-moment pleasure than controls (CN). Rather, patients report experiencing elevated levels of negative emotionality in response to a range of evocative stimuli. In this study, we examined the possibility that elevations in negative emotionality in SZ may reflect an underlying emotion regulation abnormality. Event-related potentials (ERPs) were recorded from outpatients with SZ (n = 25) and demographically matched healthy controls (n = 21) during passive viewing of unpleasant and neutral photographs. Unpleasant images were preceded by an audio description that described the image as being either negative or neutral. Neutral images were preceded by neutral audio descriptions. The late positive potential (LPP), an ERP component sensitive to cognitive change strategies, was examined as an index of emotion regulation. Both CN and SZ showed an increased LPP to negatively described unpleasant images compared with neutral images. In addition, CN showed evidence of emotion regulation, as reflected by a smaller LPP for unpleasant images preceded by a neutral descriptor, relative to a negative descriptor. In contrast, SZ patients showed an inability to downregulate emotional response, as evidenced by no difference in the amplitude of the LPP for unpleasant images preceded by negative or neutral descriptors. Findings provide neurophysiological evidence for an emotion regulation abnormality in SZ and suggest that failures in cognitive change may underlie increased negative emotionality in SZ.

Hyperactivation balances sensory processing deficits during mood induction in schizophrenia.

While impairments in emotion recognition are consistently reported in schizophrenia, there is some debate on the experience of emotion. Only few studies investigated neural correlates of emotional experience in schizophrenia. The present functional magnetic resonance imaging study compared a standard visual mood induction paradigm with an audiovisual method aimed at eliciting emotions more automatically. To investigate the interplay of sensory, cognitive and emotional mechanisms during emotion experience, we examined connectivity patterns between brain areas. Sixteen schizophrenia patients and sixteen healthy subjects participated in two different mood inductions (visual and audiovisual) that were administered for different emotions (happiness, sadness and neutral). Confirming the dissociation of behavioral and neural correlates of emotion experience, patients rated their mood similarly to healthy subjects but showed differences in neural activations. Sensory brain areas were activated less, increased activity emerged in higher cortical areas, particularly during audiovisual stimulation. Connectivity was increased between primary and secondary sensory processing areas in schizophrenia. These findings support the hypothesis of a deficit in filtering and processing sensory information alongside increased higher-order cognitive effort compensating for perception deficits in the affective domain. This may suffice to recover emotion experience in ratings of clinically stable patients but may fail during acute psychosis.

Trait and state positive emotional experience in schizophrenia: a meta-analysis.

BackgroundPrior meta-analyses indicated that people with schizophrenia show impairment in trait hedonic capacity but retain their state hedonic experience (valence) in laboratory-based assessments. Little is known about what is the extent of differences for state positive emotional experience (especially arousal) between people with schizophrenia and healthy controls. It is also not clear whether negative symptoms and gender effect contribute to the variance of positive affect.Methods and FindingsThe current meta-analysis examined 21 studies assessing state arousal experience, 40 studies measuring state valence experience, and 47studies assessing trait hedonic capacity in schizophrenia. Patients with schizophrenia demonstrated significant impairment in trait hedonic capacity (Cohen’s d = 0.81). However, patients and controls did not statistically differ in state hedonic (valence) as well as exciting (arousal) experience to positive stimuli (Cohen’s d = −0.24 to 0.06). They also reported experiencing relatively robust state aversion and calmness to positive stimuli compared with controls (Cohen’s d = 0.75, 0.56, respectively). Negative symptoms and gender contributed to the variance of findings in positive affect, especially trait hedonic capacity in schizophrenia.ConclusionsOur findings suggest that schizophrenia patients have no deficit in state positive emotional experience but impairment in “noncurrent” hedonic capacity, which may be mediated by negative symptoms and gender effect.

A New Perspective on Anhedonia in Schizophrenia

Previous research provides evidence for discrepancies in various types of emotional self-report in individuals with schizophrenia; patients and healthy subjects report similar levels of positive emotion when reporting current feelings, yet patients report lower levels of positive emotion when reporting on noncurrent feelings. Such apparent discrepancies, which have come to be termed the "emotion paradox" in schizophrenia, have complicated our understanding of what anhedonia actually reflects in this patient population. The authors sought to resolve this paradox. The authors reviewed the empirical literature on anhedonia and emotional experience in schizophrenia through the lens of the accessibility model of emotional self-report, a well-validated model of emotional self-report developed in the affective science literature that clarifies the sources of emotion knowledge that individuals access when providing different types of self-report. The authors used this model to propose a resolution to the "emotion paradox" and to provide a new psychological conceptualization of anhedonia. Data are presented in support of this new perspective on anhedonia and to demonstrate how cognitive impairments may influence reports of noncurrent feelings in schizophrenia. The authors conclude that anhedonia should no longer be considered an experiential deficit or a diminished "capacity" for pleasure in patients with schizophrenia. Rather, anhedonia reflects a set of beliefs related to low pleasure that surface when patients are asked to report their noncurrent feelings. Encoding and retrieval processes may serve to maintain these beliefs despite contrary real-world pleasurable experiences. Implications for assessment and treatment are discussed in relation to this new conceptualization of anhedonia.

Patterns of emotional experience in schizophrenia: Differences in emotional response to visual stimuli are associated with clinical presentation and functional outcome

The current study examined whether patterns of emotional response are differentially associated with symptom presentation and functional outcome in individuals with schizophrenia. Participants included 49 outpatients with schizophrenia and 50 demographically matched controls. All participants rated their emotional response to 131 images from the International Affective Picture Systems (IAPS) library on both arousal and valence scales. Stimuli were split into categories of positive versus negatively valenced stimuli based on control subject ratings. Cluster analysis was used to assess whether there were reliably distinct patterns of emotional response within the patient sample. Follow-up discriminant function analysis indicated that these groups were adequately separated. Sixty percent of the individuals with schizophrenia rated valence and arousal similarly to healthy subjects, while 40% displayed an atypical profile. Schizophrenia sub-groups classified by these two emotional response styles significantly differed on measures of functional outcome, severity of negative symptoms, and self-reported anhedonia. Findings are discussed in relation to current theories of emotional experience in schizophrenia.

Anhedonia and Emotional Experience in Schizophrenia: Neural and Behavioral Indicators

Emotional impairments such as anhedonia are often considered key features of schizophrenia. However, self-report research suggests that emotional experience in response to affect-eliciting stimuli is intact in schizophrenia. Investigation of neural activity during emotional experience may help clarify whether symptoms of anhedonia more likely reflect alterations of in-the-moment hedonic experience or impairments in other aspects of goal-directed behavior. Forty individuals with DSM-IV-TR schizophrenia or schizoaffective disorder and 32 healthy control subjects underwent functional magnetic resonance imaging while making valence and arousal ratings in response to emotional pictures, words, and faces. Blood oxygen level-dependent responses were compared between patients and control subjects and were correlated with questionnaire measures of anhedonia. Patients showed some evidence of blunted valence but not arousal ratings in response to emotional stimuli compared with control subjects. Higher anhedonia scores were associated with blunted valence ratings in both groups and fully mediated the group differences in valence ratings. Functional activity was largely intact in patients, except for regions in right ventral striatum and left putamen, which showed reduced responses to positive stimuli. Higher anhedonia was associated with reduced activation to positive versus negative stimuli in bilateral amygdala and right ventral striatum in patients and in bilateral caudate in control subjects. Increased anhedonia is associated with a reduced experience of valence in both patients and control subjects, and group differences in experienced valence are likely driven by individual differences in anhedonia. Reduced activation of the striatum and amygdala may contribute to symptoms of anhedonia by failing to signal the salience of positive events.

Aberrantly flattened responsivity to emotional pictures in paranoid schizophrenia

To investigate the nature of emotional experience in schizophrenia, we examined emotional responses to affective stimuli. Twenty-one outpatients with schizophrenia (9 paranoid, 12 nonparanoid) and 20 normal controls rated the arousal and valence that they experienced from the presentation of 60 pictures. Schizophrenia patients displayed less emotional responsivity to the positive stimuli and they displayed diverse responsivity to the negative stimuli, which depended upon arousal level. Further analysis, using schizophrenia subtype, indicated that nonparanoid patients reported increased negative responsivity and decreased positive responsivity, regardless of arousal level. However, paranoid schizophrenia patients showed enhanced self-reported experiences of emotion to the low arousing stimuli and diminished responsivity to the high arousing stimuli. This pattern was robust to the negative stimuli. These findings suggest that paranoid schizophrenia patients might suffer from aberrantly flattened responses to negative emotional stimuli, and that this may account for paranoid tendency and secondary social isolation in paranoid schizophrenia.

Subjective Awareness on the Iowa Gambling Task: The Key Role of Emotional Experience in Schizophrenia

The key role of emotion in complex decision-making is commonly assessed using the Iowa Gambling Task, and has recently been a substantial research topic in neuropsychology. However, the question of subjective experience on such emotion-based learning measures has yet to be fully investigated, largely because previous studies have focussed primarily on behavioral performance measures. The present study investigated subjective experience on the Gambling Task, using a more systematic and quantitative method than that previously employed: evaluating the ability of participants to ‘interrogate’ emotion-based learning systems. The study also investigated subjective experience in a population (people with schizophrenia) in whom the question of emotional awareness is of especial interest. People with schizophrenia showed learning on the Gambling Task at levels entirely comparable with that of controls. Both groups of participants also showed substantial, and rapidly developing, awareness of which decks were 'good' and 'bad'. Importantly, greater awareness was a significant correlate of good performance on the Gambling Task, for both groups, suggesting that there may be greater conscious awareness of emotion-related information in complex decision-making than had previously been appreciated. We would like to thank Sohee Park and Brad Folley for their assistance with various aspects of the study. This research was funded by the National Alliance for Research on Schizophrenia and Depression (NARSAD) and the Wellcome Trust.

Diminished facial expression despite the existence of pleasant emotional experience in schizophrenia.

In order to investigate the relationship between pleasant emotional experience and facial expression (i.e., laughter), mood before and after watching comic film clips, self-rated pleasant emotional experience for each film clip and electromyographic activities of facial muscles involved in laughter while watching film clips were measured for 25 patients with schizophrenia and 20 normal controls. Patients with schizophrenia who showed a significant correlation between self-rated emotional experience and major zygomatic activity were equivalent to normal controls in self-rated emotional experience and in mood after film clips; they had a significant increase in mood scores related with pleasure. Although these patients were thought to have sufficient pleasant emotional experience, they showed significantly low major zygomatic activity as compared to normal controls. It is suggested that these patients have a disturbance in the process of emotional expression rather than emotional experience.

Effects of expressive behavior on subsequent emotional experience in schizophrenia

Effects of expressive behavior on subsequent emotional experience in schizophrenia