Abnormal emotional experience in schizophrenia

Ambivalence is defined as the state of simultaneously experiencing antithetical emotions towards a single attitude object (Bleuler, 1911/1950). Recent studies have evidenced ambivalence as a prominent aspect of schizophrenia patients’ in-the-moment emotional experiences (Cohen & Minor, 2010; Trémeau et al., 2009). The present study extended this line of work through the use of an experimental mood-induction methodology to explore the amount, frequency, and average duration of univalent positive, negative, and ambivalent emotional episodes within individuals with schizophrenia and those without psychiatric disturbance. The results indicate that, when exposed to a film clip stimulus selected for its documented (Larsen & McGraw, 2011) capacity to induce ambivalent emotions, individuals with and without schizophrenia do not reliably differ in any measured dimension of univalent or ambivalent emotional experience. Potential explanations for observed inconsistencies in the schizophrenia emotional experience literature are reviewed and study limitations as well as directions for future research are discussed

Movement abnormalities predict transitioning to psychosis in individuals at clinical high risk for psychosis

Improving upon the predictive validity of determining the transition from high risk to actual psychosis is a primary aim of early intervention research. Previous research has suggested that premorbid spontaneous dyskinesias may be one possible predictor. In this study, dyskinetic movements were assessed with the Abnormal Involuntary Movement Scale (AIMS) at baseline of a longitudinal study of 148 individuals at clinical high risk (CHR) of developing psychosis. Twenty-eight individuals transitioned to a psychotic disorder over the course of the study. Group comparisons between transitioned and non-transitioned individuals indicated that, relative to those that were not observed to transition, participants that developed a psychotic disorder exhibited greater spontaneous dyskinesias at baseline. Moreover, increased dyskinetic movements at baseline resulted in a more than two-fold increase in odds of developing a psychosis for each point increase in AIMS scale score. These findings suggest that individuals with greater premorbid dyskinetic movements may comprise a subset of CHR individuals at inordinate risk to decompensate into psychosis. Future work should employ assessments of spontaneous dyskinesias by instrumentation (e.g., electromyography) and look to ascertain whether specific dyskinesias (e.g., dystonia) or dyskinesias of specific body regions are associated with transitioning to psychosis

Movement abnormalities predict transitioning to psychosis in individuals at clinical high risk for psychosis

Improving upon the predictive validity of determining the transition from high risk to actual psychosis is a primary aim of early intervention research. Previous research has suggested that premorbid spontaneous dyskinesias may be one possible predictor. In this study, dyskinetic movements were assessed with the Abnormal Involuntary Movement Scale (AIMS) at baseline of a longitudinal study of 148 individuals at clinical high risk (CHR) of developing psychosis. Twenty-eight individuals transitioned to a psychotic disorder over the course of the study. Group comparisons between transitioned and non-transitioned individuals indicated that, relative to those that were not observed to transition, participants that developed a psychotic disorder exhibited greater spontaneous dyskinesias at baseline. Moreover, increased dyskinetic movements at baseline resulted in a more than two-fold increase in odds of developing a psychosis for each point increase in AIMS scale score. These findings suggest that individuals with greater premorbid dyskinetic movements may comprise a subset of CHR individuals at inordinate risk to decompensate into psychosis. Future work should employ assessments of spontaneous dyskinesias by instrumentation (e.g., electromyography) and look to ascertain whether specific dyskinesias (e.g., dystonia) or dyskinesias of specific body regions are associated with transitioning to psychosis

Computerized facial analysis for understanding constricted/blunted affect: Initial feasibility, reliability, and validity data

Diminished expression is a diagnostic feature of a range of schizophrenia-spectrum disorders/conditions and is often unresponsive to treatment, is present across premorbid, first episode and various clinical states, and is considered a poor prognostic indicator. Surprisingly, little is known about diminished expression. The present study sought to address this issue by evaluating a commercially-available computerized facial analysis software for understanding diminished expressivity. We analyzed natural facial expression from a series of laboratory interaction tasks in 28 individuals with psychometric schizotypy – defined as the personality organization reflecting a putative genetic schizophrenia liability, and 26 matched controls. We evaluated (a) feasibility – defined in terms of the number of video frames recognized by the software, (b) reliability – defined in terms of correlations between facial expression variables across the three laboratory interactions, and (c) construct validity – defined in terms of relationships to clinical variables. For most subjects (~ 80%), approximately three-quarters of the video frames were analyzable by the software; however, a minority of the videos was essentially unreadable. The facial expression variables showed excellent reliability across interaction conditions. In terms of construct validity, facial expression variables were significantly related to a measure of psychoticism, tapping subjective cognitive concerns and “first-rank” schizophrenia symptoms, but were generally not different between groups. Facial expression variables were generally not significantly related to measures of depression, anxiety, paranoia or, surprisingly, self-reported negative schizotypy. While computerized facial analysis appears to be a reliable and promising method of understanding diminished expressivity across the schizophrenia-spectrum, some work remains. Implications are discussed

A temporal examination of co-activated emotion valence networks in schizophrenia and schizotypy

Emotional abnormalities are prominent across the schizophrenia spectrum. To better define these abnormalities, we examined state emotional functions across opposing ends of the spectrum, notably in chronic outpatients with schizophrenia (Study 1) and college students with psychometrically defined schizotypy (Study 2). In line with existing studies, we predicted that individuals with schizophrenia would show unusually co-activated positive and negative emotions while college students with schizotypy would show abnormally low positive and abnormally high negative emotions. Drawing from the affective science literature, we employed continuous emotion ratings in response to a dynamic and evocatively “bittersweet” stimulus. Participants included 27 individuals with schizophrenia, 39 individuals with psychometrically defined schizotypy and 26 community and 35 college control participants. Participants continuously rated their state happiness and sadness throughout a six-minute clip from a tragicomic film (i.e., Life is Beautiful). In contrast to expectations as well as the extant literature, there were no state emotional abnormalities noted from either schizophrenia-spectrum group. Of particular note, neither individuals with schizophrenia nor individuals with schizotypy were abnormal in their experience of state negative, positive or coactivated emotions. Conversely, abnormalities in trait emotion were observed in both groups relative to their respective control groups. These results help confirm that the schizophrenia-spectrum is not characterized by deficits in state emotional experience and suggest that sadness is not abnormally co-activated with pleasant emotions. These results are critical for clarifying the “chronometry” of emotional dysfunctions across the schizophrenia-spectrum