Emotional correlates of the different dimensions of schizotypal personality disorder

Abnormalities in emotion regulation are associated with negative, but not positive or disorganized schizotypy: An experience sampling study

BACKGROUND

Schizotypy, a multidimensional construct with positive, negative, and disorganized dimensions, represents a vulnerability marker for the development of schizophrenia. Although there has been increasing evidence linking schizotypy to emotion regulation (ER) deficits, the specific association between different schizotypal dimensions and alterations in ER strategy use in daily life remains poorly understood.

METHODS

Using the experience sampling method (ESM), the present study examined the associations between positive, negative, and disorganized schizotypy and ER strategy use in daily life in a nonclinical young adult sample (N = 258). Participants were instructed to report their ER strategy use 5 times a day for 14 days. Four adaptive ER strategies (reflection, reappraisal, social sharing, and distraction) and two maladaptive ER strategies (suppression and rumination) were included.

RESULTS

Multilevel modeling analyses showed that positive schizotypal traits predicted greater use of adaptive ER strategies, while negative schizotypal traits predicted less use of adaptive ER strategies and more frequent use of emotional suppression in daily life. No associations between disorganized schizotypal traits and any ER strategy use were found.

CONCLUSION

Schizotypy dimensions are differentiated by preferences for different ER strategies in daily life. The findings suggest a strong association between negative schizotypy and notable dysfunctions in ER, emphasizing the significance of negative schizotypy as a vulnerability factor for psychosis.

Meta-Analysis of the Associations Among Constructs of Intrapersonal Emotion Knowledge

To better define the boundaries of conceptually overlapping constructs of intrapersonal emotion knowledge (EK), we examined meta-analytic correlations among five intrapersonal EK-related constructs (affect labelling, alexithymia, emotional awareness, emotional clarity, emotion differentiation) and attention to emotion. Affect labelling, alexithymia, and emotional clarity were strongly associated, and they were moderately associated with attention to emotion. Alexithymia and emotional awareness were weakly associated, and emotion differentiation was unrelated with emotional clarity. Sample characteristics and measures moderated some of the associations. Publication bias was not found, except for the alexithymia-emotional awareness association. This study helped to clarify the extent to which similarly defined constructs overlap or are distinct, which can inform our decision to adequately label important constructs and employ corresponding measures.

Shared and unique affective abnormalities in schizotypy dimensions

Attention to affect is theoretically a precursor to one's ideal affect (i.e., preference for feeling low- and high-arousal positive and negative affect) and emotion regulation (ER). In schizotypy, there have been mixed findings regarding abnormalities in attention to affect. At the same time, little is known about ideal affect in schizotypy or whether differences in ideal affect or ER difficulties in schizotypy are driven by attention to affect. Thus, this study aimed to identify shared and unique abnormalities in attention to affect, ideal affect, and ER difficulties in schizotypy, and to test whether attention to affect underlies differences in ideal affect and ER difficulties. Using groups of individuals with either extreme levels of social anhedonia (SocAnh; n = 181), extreme levels of perceptual aberrations/magical ideation (PerMag; n = 105), or individuals low on both (i.e., controls; n = 531), we tested group differences in attention to affect, ideal affect, and ER difficulties. Our findings suggest both shared and unique affective abnormalities; compared to controls, the SocAnh group paid the least attention to positive affect. Only PerMag had heightened attention to negative affect compared to controls. Additionally, we found unique abnormalities relating to ideal affect but mostly shared difficulties in ER in schizotypy. Abnormalities in ideal affect and ER remain largely consistent after accounting for attention to affect for PerMag, suggesting that attention to affect is not the primary mechanism driving these abnormalities. However, we found evidence that attention to affect underlies some SocAnh-control group differences in ideal affect and ER difficulties. Our work helps to clarify prior work and contributes to the understanding of shared and unique affective abnormalities in schizotypy. Future research may consider longitudinal approaches to test causal mechanisms of affective abnormalities in schizotypy.

Explicit and Implicit Affect and Judgment in Schizotypy

Although emotion deficits in schizotypy have been reported, the exact nature of these deficits is now well understood. Specifically, for social anhedonia (SocAnh), there are questions about whether any decrease in positive affect only reflects an explicit bias not observed in other measures (e.g., implicit affect measure). At the same time, for individuals with elevated levels of perceptual aberrations or magical ideation (PerMag), there is some evidence of an increased influence of affect on judgment. It is also possible that the influence of implicit affect on judgment might be especially pronounced in PerMag; however, this has not been previously examined. The current study involved people with elevated levels of SocAnh (n = 95), elevated levels of PerMag (n = 62), and people with average or lower levels of both (n = 246). We found that SocAnh was associated with decreases in both explicit and implicit positive affect. We also found that PerMag was related to stronger relationships between implicit affect, both positive and negative, and a judgment task. These results suggest that decreased positive affect is a core feature of SocAnh and that a heightened influence of affect could be related to the development of peculiar beliefs/experiences associated with PerMag.

Differential emotional abnormalities among schizotypy clusters

Schizotypy, a multidimensional personality organization that reflects liability to develop schizophrenia-spectrum disorders, has been associated with a number of emotional abnormalities. Yet, the exact nature of any emotional abnormalities in schizotypy is relatively unclear. Using an ethnically diverse nonclinical sample (N = 2637), the present study identified homogenous clusters of individuals based on positive and negative schizotypy dimensions and explored three interrelated domains of emotion traits closely tied to functional outcomes and quality of life: affective experience, emotional awareness, and meta-level emotions. Consistent with prior research, four schizotypy clusters were obtained: low ("nonschizotypic"), high positive, high negative, and mixed (high positive and high negative). Regarding emotion correlates of schizotypy clusters, the mixed cluster was found to be the most deviant on almost all emotion traits (e.g., heightened trait negative affect, diminished emotional clarity), suggesting that the effects of positive and negative schizotypy are additive. In addition, positive and negative schizotypy clusters were associated with differential abnormalities, with the negative cluster presenting a wider range of, and more severe, impairments compared to the low cluster (e.g., reduced trait positive affect and reduced attention to positive emotion). The current study highlights the heterogeneity in emotional traits among schizotypy dimensions and the importance of studying the mixed schizotypy in terms of emotional dysfunction.

Personality dimensions emerging during adolescence and young adulthood are underpinned by a single latent trait indexing impairment in social functioning

BACKGROUND

Personality with stable behavioural traits emerges in the adolescent and young adult years. Models of putatively distinct, but correlated, personality traits have been developed to describe behavioural styles including schizotypal, narcissistic, callous-unemotional, negative emotionality, antisocial and impulsivity traits. These traits have influenced the classification of their related personality disorders. We tested if a bifactor model fits the data better than correlated-factor and orthogonal-factor models and subsequently validated the obtained factors with mental health measures and treatment history.

METHOD

A set of self-report questionnaires measuring the above traits together with measures of mental health and service use were collected from a volunteer community sample of adolescents and young adults aged 14 to 25 years (N = 2443).

RESULTS

The bifactor model with one general and four specific factors emerged in exploratory analysis, which fit data better than models with correlated or orthogonal factors. The general factor showed high reliability and validity.

CONCLUSIONS

The findings suggest that a selected range of putatively distinct personality traits is underpinned by a general latent personality trait that may be interpreted as a severity factor, with higher scores indexing more impairment in social functioning. The results are in line with ICD-11, which suggest an explicit link between personality disorders and compromised interpersonal or social function. The obtained general factor was akin to the overarching dimension of personality functioning (describing one's relation to the self and others) proposed by DSM-5 Section III.

Emotion processing deficits in the different dimensions of psychometric schizotypy

Schizotypy refers to a personality structure indicating "proneness" to schizophrenia. Around 10% of the general population has increased schizotypal traits, they also share other core features with schizophrenia and are thus at heightened risk for developing schizophrenia and spectrum disorders. A key aspect in schizophrenia-spectrum pathology is the impairment observed in emotion-related processes. This review summarizes findings on impairments related to central aspects of emotional processes, such as emotional disposition, alexithymia, facial affect recognition and speech prosody, in high schizotypal individuals in the general population. Although the studies in the field are not numerous, the current findings indicate that all these aspects of emotional processing are deficient in psychometric schizotypy, in accordance to the schizophrenia-spectrum literature. A disturbed frontotemporal neural network seems to be the critical link between these impairments, schizotypy and schizophrenia. The limitations of the current studies and suggestions for future research are discussed.

Sex Differences in Affective Expression Among Individuals with Psychometrically Defined Schizotypy: Diagnostic Implications

The present investigation uses facial electromyography (fEMG) to measure patterns of affective expression in individuals with psychometrically defined schizotypy during presentation of neutral and negative visual images. Twenty-eight individuals with elevated schizotypal features and 20 healthy controls observed a series of images from the International Affective Picture System (IAPS) and provided self-report ratings of affective valence and arousal while their physiological responses were recorded. The groups were evenly divided by sex. A three-way interaction in fEMG measurement revealed that while males with psychometrically defined schizotypy demonstrated the expected pattern of blunted/constricted facial affective expression relative to male controls in the context of negative images, females displayed the opposite pattern. That is, females with psychometrically defined schizotypy demonstrated significant elevations in negative facial affective expression relative to female controls while viewing negative images. We argue that these findings corroborate previously reported impressions of sex differences in affective expression in schizotypy. We discuss implications for assessment and diagnostic procedures among individuals with disorders along the schizophrenia spectrum.

Emotional Functioning in Obsessive-Compulsive Personality Disorder: Comparison to Borderline Personality Disorder and Healthy Controls

Few studies have investigated emotional functioning in obsessive-compulsive personality disorder (OCPD). To explore the nature and extent of emotion difficulties in OCPD, the authors examined four domains of self-reported emotional functioning--negative affectivity, anger, emotion regulation, and emotion expressivity--in women with OCPD and compared them to a borderline personality disorder (BPD) group and a healthy control group. Data were collected as part of a larger psychophysiological experimental study on emotion regulation and personality. Compared to healthy controls, participants with OCPD reported significantly higher levels of negative affectivity, trait anger, emotional intensity, and emotion regulation difficulties. Emotion regulation difficulties included lack of emotional clarity, nonacceptance of emotional responses, and limited access to effective emotion regulation strategies. Participants with OCPD scored similarly to participants with BPD on only one variable, namely, problems engaging in goal-directed behavior when upset. Results suggest that OCPD may be characterized by notable difficulties in several emotional domains.

Perceived emotional intelligence is impaired and associated with poor community functioning in schizophrenia and bipolar disorder

Schizophrenia and bipolar disorder have been associated with shared and distinct emotion processing abnormalities. Initial findings indicate that these disorders differ with respect to the domain of emotional intelligence (EI). Individuals with schizophrenia display deficits on performance measures of EI, whereas those with bipolar disorder do not. However, no research has examined patients' subjective beliefs about their own EI (referred to as "perceived EI"). This study examined perceived EI, assessed with the Trait Meta-Mood Scale (TMMS), and its clinical and functional correlates in outpatients with schizophrenia (n=35) or bipolar disorder I (n=38) and matched healthy controls (n=35). The TMMS includes three subscales that assess beliefs about one's ability to attend to (Attention to Feelings), understand (Clarity of Feelings), and repair emotions (Mood Repair). Participants in the clinical groups also completed community functioning and symptom assessments. Both clinical groups reported significantly lower perceived EI than controls, but did not differ from each other. Higher total TMMS correlated with higher levels of independent living in the schizophrenia group (r=.36) and better social functioning in the bipolar group (r=.61). In addition, although higher Attention to Feelings scores correlated with greater psychiatric symptoms in the schizophrenia group, higher scores across all subscales correlated with less manic symptoms in the bipolar group. The findings suggest that perceived EI is impaired and related to community functioning in both disorders.

Emotional awareness and delusions in schizophrenia and schizoaffective disorder

BACKGROUND AND OBJECTIVES

Emotion plays a significant role in schizophrenia. Emotional awareness (i.e., attention to and clarity of emotions) is associated with a wide range of outcomes. Given that individuals with schizophrenia and schizoaffective disorder differ in the significance of their mood symptoms, the present research examined whether the association between emotional awareness and delusions differs for these two groups of patients.

METHODS

Emotional awareness (i.e., attention to and clarity of emotions) was measured with self-report in a sample of 44 individuals diagnosed with either schizophrenia or schizoaffective disorder. Clinical ratings of delusions were made using the Scale for the Assessment of Positive Symptoms.

RESULTS

For the sample as a whole, individuals with higher levels of attention to emotion tended to have more severe delusions. In addition, diagnostic group significantly moderated the relation between emotional clarity and delusions.

LIMITATIONS

Conclusions regarding causality cannot be drawn due to the cross-sectional design. Replication is particularly important given the small sample sizes.

CONCLUSIONS

The present research indicates that emotional awareness is associated with delusions. The results raise the possibility that the emotional factors that contribute to delusional beliefs among individuals with schizophrenia differ in at least some ways from the emotional factors that contribute to delusional beliefs among individuals with schizoaffective disorder.

Neural correlates of suspiciousness and interactions with anxiety during emotional and neutral word processing

Suspiciousness is usually classified as a symptom of psychosis, but it also occurs in depression and anxiety disorders. Though how suspiciousness overlaps with depression is not obvious, suspiciousness does seem to overlap with anxious apprehension and anxious arousal (e.g., verbal iterative processes and vigilance about environmental threat). However, suspiciousness also has unique characteristics (e.g., concern about harm from others and vigilance about social threat). Given that both anxiety and suspiciousness have been associated with abnormalities in emotion processing, it is unclear whether it is the unique characteristics of suspiciousness or the overlap with anxiety that drive abnormalities in emotion processing. Event-related brain potentials were obtained during an emotion-word Stroop task. Results indicated that suspiciousness interacts with anxious apprehension to modulate initial stimulus perception processes. Suspiciousness is associated with attention to all stimuli regardless of emotion content. In contrast, anxious arousal is associated with a later response to emotion stimuli only. These results suggest that suspiciousness and anxious apprehension share overlapping processes, but suspiciousness alone is associated with a hyperactive early vigilance response. Depression did not interact with suspiciousness to predict response to emotion stimuli. These findings suggest that it may be informative to assess suspiciousness in conjunction with anxiety in order to better understand how these symptoms interact and contribute to dysfunctional emotion processing.

Individuals with psychometric schizotypy show similar social but not physical anhedonia to patients with schizophrenia

Very few studies have examined physical and social anhedonia across the spectrum of schizophrenia. In the present study, we recruited three groups of participants (n=84 in each group): patients with schizophrenia, schizotypy and non-schizotypy as assessed by the Schizotypal Personality Questionnaire (SPQ). All participants completed the self-reported trait anhedonia scales (the Revised Physical Anhedonia Scale and the Social Anhedonia Scale). The clinical symptoms of schizophrenia patients were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Scale for Assessment of Negative Symptoms (SANS). We found that the three groups differed in both physical and social anhedonia. The schizotypy group reported higher levels of physical anhedonia than the non-schizotypy group, and the patient group reported higher levels of physical anhedonia than the schizotypy group. For social anhedonia, the non-schizotypy group differed significantly from both the schizotypy and the patient group, while no significant difference was found between the last two groups. Our findings show that individuals with schizotypy exhibits similar social but not physical anhedonia compared with patients with schizophrenia, which further suggests that decreased pleasure experiences in the social environment may be a valuable target for identification and early intervention in high-risk populations.

Comorbidity of schizotypy and psychopathy: skin conductance to affective pictures

Prior research indicates a relationship between psychopathy and schizophrenia, elucidating a specific trajectory toward violence. Recent research has suggested that this relationship exists at the nonclinical trait level of schizotypy; however, this finding has not been examined objectively. To explore this relationship using both subjective and objective measures, 54 undergraduates (50% male; mean age 20.41) who endorsed a wide range of schizotypy on the Schizotypal Personality Questionnaire (SPQ) completed a laboratory-based protocol. Participants viewed 15 pictures (five neutral, five threatening, and five of others in distress) from the International Affective Pictures System while electrodermal activity was recorded. As expected, all participants exhibited increased skin conductance levels (SCL) to threat and distress pictures compared to neutral pictures; however, no difference in SCL was found between threat and distress pictures. A unique relationship between psychopathy and schizotypy was found (i.e., schizotypy was related to higher Self-Centered Impulsivity and lower Fearless Dominance); however, schizotypy was related to increased SCL in response to emotional and neutral pictures. Although results do not support autonomic hyporesponsiveness often found in clinical psychopathy, a positive relationship was found between schizotypy and self-reported physical aggression. Findings highlight the need to examine other trajectories of violence within the schizophrenia spectrum disorders.

Schizotypal personality disorder

Early phenomenological descriptions of schizophrenia have acknowledged the existence of milder schizophrenia spectrum disorders characterized by the presence of attenuated symptoms typically present in chronic schizophrenia. The investigation of the schizophrenia spectrum disorders offers an opportunity to elucidate the pathophysiological mechanisms giving rise to schizophrenia. Differences and similarities between subjects with schizotypal personality disorder (SPD), the prototypical schizophrenia personality disorder, and chronic schizophrenia have been investigated with genetic, neurochemical, imaging, and pharmacological techniques. Patients with SPD and the more severely ill patients with chronic schizophrenia share cognitive, social, and attentional deficits hypothesized to result from common neurodevelopmentally based cortical temporal and prefrontal pathology. However, these deficits are milder in SPD patients due to their capacity to recruit other related brain regions to compensate for dysfunctional areas. Individuals with SPD are also less vulnerable to psychosis due to the presence of protective factors mitigating subcortical DA hyperactivity. Given the documented close relationship to other schizophrenic disorders, SPD will be included in the psychosis section of DSM-5 as a schizophrenia spectrum disorder as well as in the personality disorder section.

Examination of affective and cognitive interference in schizophrenia and relation to symptoms

The nature of emotion deficits in schizophrenia and anhedonia is still unclear, and understanding the nature of these deficits could help improve treatment of chronic symptoms and functional disability. An important mechanism in emotional functioning is attention to affective information. People with schizophrenia (n = 48) and a nonpsychiatric comparison group (n = 28) completed an affective interference task, a task used to assess attention to affective information. Given that the affective interference task also involves prepotent response inhibition, participants also completed a very similar, but nonaffective, cognitive interference task that involves prepotent inhibition but does not require attention to affective information. Results revealed that people with schizophrenia exhibited decreased affective interference on trials with a shorter length of time between the onset of the cue and onset of the target but increased cognitive interference at all time lengths between the cue and target onsets used in the study. In addition, decreased affective interference was associated with increased anhedonia and increased reports of wanting to ignore positive emotions. In contrast, increased cognitive interference was associated with increased communication disturbances and alogia. Overall, these results suggest that there may be a decrease in attention to affective information in schizophrenia and that affective interference is related to anhedonia. At the same time, these results provide further evidence of cognitive control prepotent inhibition deficits in schizophrenia, which are related to communication disturbances and alogia.

The interactive effects of emotional clarity and cognitive reappraisal on problematic cannabis use among medical cannabis users

This study examined whether emotional clarity (i.e., the extent to which one can identify and understand the type and source of emotions one experiences) and cognitive reappraisal (i.e., altering how potentially emotion-eliciting situations are construed to change their emotional impact) would individually or jointly be associated with problematic cannabis use among individuals receiving cannabis for medical reasons (n=153). Findings indicated that problematic cannabis use was predicted by the interaction between emotional clarity and cognitive reappraisal. In particular, low levels of emotional clarity combined with high levels of cognitive reappraisal predicted problematic cannabis use. The current study is the first to demonstrate the interactive effects of emotional clarity and the use of cognitive reappraisal in predicting substance use disorder outcomes. Such findings are important given the lack of empirical data demonstrating for whom and for which conditions cannabis is either beneficial or detrimental.

Are emotional clarity and emotion differentiation related?

Distinct literatures have developed regarding the constructs of emotional clarity (people's meta-knowledge of their affective experience) and emotion differentiation (people's ability to differentiate affective experience into discrete categories, e.g., anger vs. fear). Conceptually, emotion differentiation processes might be expected to contribute to increased emotional clarity. However, the relation between emotional clarity and emotion differentiation has not been directly investigated. In two studies with independent, undergraduate student samples, we measured emotional clarity using a self-report measure and derived emotion differentiation scores from scenario-based (Study 1) and event-sampling-based (Study 2) measures of affect. We found that emotional clarity and emotion differentiation are: (i) associated to a very small and statistically insignificant degree; and (ii) differentially associated with trait and scenario-based/event-sampling-based measures of affect intensity and variability. These results suggest that emotional clarity and differentiation are distinct constructs with unique relations to various facets of affective experience.

The expression of positive and negative schizotypy in daily life: an experience sampling study

BACKGROUND

Psychometrically identified positive schizotypy and negative schizotypy are differentially related to psychopathology, personality and social functioning. However, little is known about the experience and expression of schizotypy in daily life and the psychological mechanisms that trigger psychotic-like experiences.

METHOD

The present study employed experience sampling methodology (ESM) to assess positive and negative schizotypy in daily life in a non-clinical sample of 412 young adults. ESM is a structured diary technique in which participants are prompted at random times during the day to complete assessments of their current experiences.

RESULTS

As hypothesized, positive schizotypy was associated with increased negative affect, thought impairment, suspiciousness, negative beliefs about current activities and feelings of rejection, but not with social disinterest or decreased positive affect. Negative schizotypy, on the other hand, was associated with decreased positive affect and pleasure in daily life, increased negative affect, and decreases in social contact and interest. Both positive schizotypy and negative schizotypy were associated with the desire to be alone when with others. However, this was moderated by anxiety in positive schizotypy and by diminished positive affect in negative schizotypy.

CONCLUSIONS

The results support the construct validity of a multidimensional model of schizotypy and the ecological validity of the positive and negative schizotypy dimensions. ESM appears to be a promising method for examining the daily life experiences of schizotypic individuals.

Exploring the utility of emotional awareness and negative affect in predicting body satisfaction and body distortion

In a sample of 304 female college students, the present study examined how body image is associated with (a) clarity of emotion; (b) attention to emotion; and (c) negative affect. Two separate facets of body image were examined: body satisfaction and body distortion. Greater clarity of emotion was associated with greater body satisfaction and less body distortion, and these associations could not be accounted for by negative affect. Body satisfaction was significantly predicted by the three-way interaction of clarity of emotion, attention to emotion, and negative affect. Attention to emotion moderated the association between clarity of emotion and body satisfaction only among high negative affect individuals. Specifically, greater clarity of emotion was associated with greater body satisfaction in all participants except those who were high in both negative affect and attention to emotion.

Prospective memory in schizophrenia and schizotypy

INTRODUCTION

Most evidence suggests that schizophrenia is associated with pervasive prospective memory (PM) impairment that does not vary as a function of task demands. However, a central tenet of the Multiprocess Framework is that PM involves both automatic and strategic processes, and that their relative prominence varies as a function of PM task characteristics, such as target-cue saliency.

METHODS

Participants with schizophrenia (n = 30), matched controls (n = 29), low schizotypes (n = 35), and high schizotypes (n = 36) were administered a PM measure in which saliency was manipulated. To further clarify the relationship between PM and schizotypy, high and low schizotypies were additionally assessed on Virtual Week, a laboratory measure which has documented sensitivity to schizophrenia-related impairment.

RESULTS

Relative to controls, participants with schizophrenia exhibited PM difficulties, but the magnitude of this deficit did not vary as a function of target-cue saliency. High and low schizotypes did not differ on any PM test parameter.

CONCLUSIONS

These data are consistent with other evidence showing that schizophrenia is characterised by generalised PM impairment. However, the absence of any schizotypy effects on PM does not support the recent suggestion that PM may represent an endophenotype for schizophrenia.

Experience of pleasure and emotional expression in individuals with schizotypal personality features

Difficulties in feeling pleasure and expressing emotions are one of the key features of schizophrenia spectrum conditions, and are significant contributors to constricted interpersonal interactions. The current study examined the experience of pleasure and emotional expression in college students who demonstrated high and low levels of schizotypal personality disorder (SPD) traits on self-report questionnaires. One hundred and seventeen subjects with SPD traits and 116 comparison controls were recruited to participate. Cluster analyses conducted in the SPD group identified negative SPD and positive SPD subgroups. The negative SPD group exhibited deficient emotional expression and anticipatory pleasure, but showed intact consummatory pleasure. The positive SPD group reported significantly greater levels of anticipatory, consummatory and total pleasure compared to the control group. Both SPD groups reported significantly more problems in everyday memory and greater levels of depressive and anxiety-related symptoms.

Magical ideation, schizotypy and the impact of emotions

Research indicates that emotions can interfere with basic cognitive functions such as attention and memory, and that schizotypal traits may be related to vulnerability to such interference, The schizotypal trait magical ideation, expressed as illogicality and tendencies to endorse peculiar or eccentric beliefs, has been reported to be related to impairments in social cognitive functioning as well risk for psychosis. This study examined the impact of emotionally arousing films on heart rate activity, affect ratings, and working memory. Participants were university students. Results indicated that high magical ideation scores were associated with impairments in short-term memory, higher post-film affect ratings, decreased clarity of affect awareness, and increased heart rate in response to emotionally arousing films. These results suggest that magical ideation may be an indicator of lower thresholds for arousal and increased vulnerability to disruption of cognitive processes by situations that elicit strong emotions.

Facets of Emotional Clarity and Suspiciousness

In a college student sample, we explored the relations between individual differences in facets of emotional clarity and suspiciousness. Previous theory and research has treated emotional clarity as a one-dimensional construct. Boden and Berenbaum (2011) proposed that a second facet of emotional clarity, source awareness (a general understanding of the cause of their emotions), could be distinguished from type awareness (a general understanding of the type of emotions [anger, fear] experienced). We found that source and type awareness were incrementally, inversely associated with suspiciousness when statistically accounting for the extent to which emotions are attended to, and gender. Additionally, source awareness significantly predicted suspiciousness after accounting for anger, anxious arousal, and social anxiety, whereas type awareness did not. Findings are consistent with the hypothesis that, among individuals with low source and type awareness, suspicious beliefs are formed to make sense of and explain emotional arousal.

Intuition, Affect, and Peculiar Beliefs

Research with college students has found that intuitive thinking (e.g., using hunches to ascribe meaning to experiences) and positive affect interactively predict ideas of reference and odd/magical beliefs. We investigated whether these results would generalize to a diverse community sample of adults that included individuals with elevated levels of peculiar perceptions and beliefs. We measured positive and negative affect and intuitive thinking through questionnaires, and peculiar beliefs (i.e., ideas of reference and odd/magical beliefs) through structured clinical interviews. We found that peculiar beliefs were associated with intuitive thinking and negative affect, but not positive affect. Furthermore, in no instance did the interaction of affect and intuitive thinking predict peculiar beliefs. These results suggest that there are important differences in the factors that contribute to peculiar beliefs between college students and clinically meaningful samples.

A study of trait anhedonia in non-clinical Chinese samples: evidence from the Chapman Scales for Physical and Social Anhedonia

Background

Recent studies suggest that anhedonia, an inability to experience pleasure, can be measured as an enduring trait in non-clinical samples. In order to examine trait anhedonia in a non-clinical sample, we examined the properties of a range of widely used questionnaires capturing anhedonia.

Methods

887 young adults were recruited from colleges. All of them were administered a set of checklists, including Chapman Scale for Social Anhedonia (CRSAS) and the Chapman Scale for Physical Anhedonia Scale (CPAS), The Temporal Experience of Pleasure Scale(TEPS), and The Schizotypal Personality Questionnaire (SPQ).

Results

Males showed significantly higher level of physical (F = 5.09, p<0.001) and social (F = 4.38, p<0.005) anhedonia than females. As expected, individuals with schizotypal personality features also demonstrated significantly higher scores of physical (t = 3.81, p<0.001) and social (t = 7.33, p<0.001) trait anhedonia than individuals without SPD features, but no difference on self-report anticipatory and consummatory pleasure experience.

Conclusions

Concerning the comparison on each item of physical and social anhedonia, the results indicated that individuals with SPD feature exhibited higher than individuals without SPD features on more items of social anhedonia than physical anhedonia scale. These preliminary findings suggested that trait anhedonia can be identified a non-clinical sample. Exploring the demographic and clinical correlates of trait anhedonia in the general population may provide clues to the pathogenesis of psychotic disorder.

The interactive effects of emotional clarity and cognitive reappraisal in Posttraumatic Stress Disorder

The goal of this investigation was to examine how emotional clarity and a specific emotion regulation strategy, cognitive reappraisal, interact to predict Posttraumatic Stress Disorder (PTSD) symptom severity and positive affect among treatment seeking military Veterans (N=75, 93% male) diagnosed with PTSD. PTSD is a highly relevant context because PTSD features include heightened stress reactivity, diminished ability to differentiate and understand emotions, and reliance on maladaptive forms of emotion regulation. We found that the combination of high levels of emotional clarity and frequent use of cognitive reappraisal were associated with (a) lesser total PTSD severity after accounting for shared variance with positive affect and the extent to which emotions are attended to (attention to emotions), and (b) greater positive affect after accounting for shared variance with total PTSD severity and attention to emotions. This is the first study to demonstrate interactive effects of emotional clarity and cognitive reappraisal.

Correlates of perceptual distortions in clinical and non-clinical populations using the Cardiff Anomalous Perceptions Scale (CAPS): associations with anxiety and depression and a re-validation using a representative population sample

Although the literature on hallucinations in psychiatric patients shows clear links with anxiety and depression, associations of affect with a wider array of anomalous perceptual experiences have been much less studied. This study investigated patients with psychosis (N=29) and a non-clinical population (N=193) using the Cardiff Anomalous Perceptions Scale (CAPS), a measure of perceptual distortion and associated distress, intrusiveness and frequency; along with measures of depression, anxiety and worry. The study also allowed a re-validation of the CAPS in a more representative sample of the UK population. Moderate, reliable correlations with depression, anxiety and worry were found in the non-clinical population with the association being stronger in psychotic patients. The study re-confirmed that anomalous perceptual experiences are common in the general population and that a significant minority (11.9%) have higher levels than the mean of psychotic patients. Scale reliability and validity were also re-confirmed, and the CAPS score was found to be unrelated to age or gender in either sample. As in the original study, factor analysis produced a three-factor solution, although factor theme was not fully replicated: as before, a cluster of first-rank symptoms emerged, but with equivocal evidence for a temporal lobe factor and no replication of a 'chemosensation' component.

Affective dysfunctions in adolescents at risk for psychosis: emotion awareness and social functioning

Studies of individuals at ultra high risk (UHR) for psychosis have revealed deviations in cognitive and neural development before the onset of psychosis. As affective impairments are among the core dysfunctions in psychotic disorders such as schizophrenia, this study assessed emotion processing and the relationship with social competence in adolescents at risk for psychosis. Thirty-four adolescents at UHR for psychosis and twenty-three non-clinical controls completed the Bermond-Vorst Alexithymia Questionnaire, a measure of emotion awareness. Social inadequacy was measured using the Dutch Personality Questionnaire. Schizophrenia spectrum psychopathology was assessed using self-report and clinical instruments. The Wechsler Adult Intelligence Scale (WAIS) was used to evaluate intellectual functioning. UHR adolescents showed difficulties in identifying and verbalizing their own emotions, independent of intelligence scores. Emotion awareness problems were related to social inadequacy and schizotypal traits in the high risk group. These findings suggest that UHR adolescents may have reduced emotion awareness, independent of intellectual functioning. The relationship with social inadequate behavior fits with the idea that emotion awareness is a prerequisite for the regulation of emotions in social contexts. In the search for early vulnerability markers of risk for psychosis, studying emotion processing besides cognitive abilities might increase our understanding of 'at risk' developmental pathways.

Differential associations between schizotypy facets and emotion traits

Although emotional deficits in schizotypy have been reported, the exact nature of these deficits is not well understood. The goal of the current research was to further differentiate possible emotion deficits in schizotypy. In the current study, individuals with elevated social anhedonia (SocAnh; n=54) and elevated perceptual aberration/magical ideation (PerMag; n=27) were compared to control participants (n=304) on measures of attention to either positive or negative affect, level of anticipatory versus consummatory pleasure, and on the influence of negative mood on judgment of future risk. SocAnh was associated with decreased attention to positive emotions. At the same time, SocAnh was associated with both decreased anticipatory and decreased consummatory pleasure. In addition, in contrast to the other groups, there was no association in the SocAnh group between current negative mood and performance on a judgment task. In contrast to SocAnh, PerMag was associated with increased attention to negative emotions. Overall, these results suggest that SocAnh is associated with decreased attention to and experience of positive emotions and that PerMag is associated with increased attention to negative emotions.

Social anhedonia and schizotypy in a community sample: the Maryland longitudinal study of schizotypy

Social anhedonia has been employed in psychometric high-risk studies to identify putative schizotypes. To date, this research has focused almost exclusively on college samples. The current study sought to examine the validity of social anhedonia as an indicator of risk for schizophrenia-spectrum disorders within a community sample. Furthermore, we evaluated the role of other individual difference variables in accounting for variable clinical severity within the social anhedonia group including trait affectivity, social support, and family environment. Following the mailed questionnaire screening of 2434 eighteen-year olds, laboratory assessments were conducted with individuals identified as being high in social anhedonia (n=86) and a comparison sample (n=89). Compared with the control group, individuals in the social anhedonia group were found to have higher rates of mood disorders, elevated schizophrenia-spectrum personality disorder characteristics, greater negative symptom characteristics, and lower global functioning. Individuals within the social anhedonia group also reported greater trait negative affectivity, lower positive affectivity, less social support, and more family conflict. Low social support and problematic family environment were found to be related to elevations in spectrum personality disorder characteristics and poorer functioning within the social anhedonia group. These cross-sectional findings from a community sample provide further support for social anhedonia as a possible indicator of schizotypy.

Is social anhedonia related to emotional responsivity and expressivity? A laboratory study in women

Social anhedonia is an important feature of schizophrenia and it is a promising indicator of schizotypy. Although social anhedonia is defined as an affective construct (less pleasure derived from social encounters), little is known about the emotional responsivity and expressivity of individuals with high levels of social anhedonia. After screening a large sample of female undergraduate students (N = 1 085), a cohort of psychometrically identified individuals with high levels of social anhedonia (n = 34) and normally hedonic controls (n = 45) participated in laboratory assessments involving trait affectivity, self-reported dispositional emotional expressiveness, and the expression and experience of emotion in response to neutral, non-affiliative (i.e., comedy) and affiliative film clips. Results revealed that individuals with high levels of social anhedonia are characterized by lower positive affect, both as a trait and in response to emotionally evocative stimuli, and are less facially expressive, both by their own self-report and in response to film clips. Attenuated positive affect was observed across film stimuli, indicating a general reduction in affective response rather than a specific decrease in responsivity for affiliative stimuli. Future work should continue to investigate whether there is a unique role for social stimuli in the emotional lives of individuals with high levels of social anhedonia or whether these individuals tend to experience anhedonia more broadly regardless of social context.

Can disorganized and positive schizotypy be discriminated from dissociation?

Schizotypy is thought to reflect liability for schizophrenia and involves at least 3 facets: disorganized, positive, and negative. However, it is unclear whether disorganized and positive facets can be discriminated from dissociation. In the current study with college students (N=325), the best-fitting confirmatory factor model included 3 factors: (a) disorganization, (b) positive-dissociation, and (c) negative. In addition, the pattern of associations with the disorganization and the positive-dissociation factors with individual difference variables was very different. Disorganization was associated with (a) poor cognitive estimation and increased ADHD symptoms, (b) increased emotional confusion, and (c) increased neuroticism and decreased conscientiousness. In contrast, the positive-dissociation factor was associated with (a) an increased influence of emotion on thinking, (b) self-reported childhood abuse, and (c) increased openness to experience. Overall, these results suggest that disorganized schizotypy can be discriminated from dissociation but that positive schizotypy may not be easily discriminated from dissociation.

Altered activation and functional connectivity of neural systems supporting cognitive control of emotion in psychosis proneness

Emotion regulation processes, such as reappraisal, are thought to operate through interactions between prefrontal emotion-control regions and subcortical emotion-generation regions such as the amygdala. Impairments in emotional processing and regulation have been reported in schizophrenia and at-risk populations. Psychometric measures may be used to detect vulnerability to schizophrenia in non-clinical samples, or psychosis proneness (PP). It has been shown that individuals with PP have a more than tenfold increased risk of developing a schizophrenia-spectrum disorder. In the present study, we used fMRI to examine the neural dynamics underlying reappraisal in such a sample. 600 undergraduate students completed the Community Assessment of Psychic Experiences Questionnaire (CAPE), positive subscale. Two groups were subsequently formed from the extremes of the distribution (total N=34). Blood-oxygenated-level-dependent activity elicited with a task involving 3 conditions was analyzed: viewing neutral pictures, viewing negative pictures, and reappraising negative pictures. Subjects reported the strength of experienced negative affect after each trial. Functional connectivity between prefrontal control regions and amygdala was investigated. At the behavioral level, both groups reported successful diminishment of experienced negative emotion. However, high psychosis-prone subjects showed stronger activation than low subjects in a number of prefrontal regions during reappraisal, relative to attending to negative pictures. The amygdala response to negative stimuli was decreased through reappraisal only in the low group. Functional connectivity analysis revealed less prefrontal-amygdala coupling in high psychosis-prone subjects. Thus, reduced cognitive control of emotion at a neural level appeared to be associated with PP. These findings extend the hypothesis of emotion dysregulation in schizophrenia to PP, and suggest that emotion regulation difficulties may be at the core of a vulnerability to psychosis.

Facial emotion perception in Chinese patients with schizophrenia and non-psychotic first-degree relatives

Although there is a consensus that patients with schizophrenia have certain deficits in perceiving and expressing facial emotions, previous studies of facial emotion perception in schizophrenia do not present consistent results. The objective of this study was to explore facial emotion perception deficits in Chinese patients with schizophrenia and their non-psychotic first-degree relatives. Sixty-nine patients with schizophrenia, 56 of their first-degree relatives (33 parents and 23 siblings), and 92 healthy controls (67 younger healthy controls matched to the patients and siblings, and 25 older healthy controls matched to the parents) completed a set of facial emotion perception tasks, including facial emotion discrimination, identification, intensity, valence, and corresponding face identification tasks. The results demonstrated that patients with schizophrenia performed significantly worse than their siblings and younger healthy controls in accuracy in a variety of facial emotion perception tasks, whereas the siblings of the patients performed as well as the corresponding younger healthy controls in all of the facial emotion perception tasks. Patients with schizophrenia also showed significantly reduced speed than younger healthy controls, while siblings of patients did not demonstrate significant differences with both patients and younger healthy controls in speed. Meanwhile, we also found that parents of the schizophrenia patients performed significantly worse than the corresponding older healthy controls in accuracy in terms of facial emotion identification, valence, and the composite index of the facial discrimination, identification, intensity and valence tasks. Moreover, no significant differences were found between the parents of patients and older healthy controls in speed after controlling the years of education and IQ. Taken together, the results suggest that facial emotion perception deficits may serve as potential endophenotypes for schizophrenia.

Measuring clarity of and attention to emotions

Previous research has found that understanding one's emotions and attending to them are 2 dimensions of emotional awareness. In this research, we examined whether improved subscales for measuring clarity of and attention to emotions could be developed by selecting the best items from 2 frequently used measures of emotional awareness. Using multidimensional scaling and confirmatory factor analysis, we analyzed the Toronto Alexithymia Scale-20 (Bagby, Parker, & Taylor, 1994) and the Trait Meta-Mood Scale (Salovey, Mayer, Goldman, Turvey, & Palfai, 1995) data from 867 college students. Results supported distinct clarity and attention constructs. New subscales were internally consistent and fared as well as or better than previous versions in terms of internal consistency and convergent validity.

Emotion dysregulation and schizotypy

In schizophrenia, blunted affect has been argued to reflect difficulties with the amplification of emotion expressive behavior. The aim of the present study was to assess whether ostensibly healthy individuals vulnerable to schizophrenia present with similar difficulties. In the first component of the study, 843 non-clinical participants completed the Schizotypal Personality Questionnaire, of which 27 scoring in the upper 15% (high schizotypy group) and 27 scoring in the lower 15% (low schizotypy group) were asked to watch amusing film clips, whilst engaging in different emotion regulatory strategies, and specifically, amplify the expression of an experienced emotion ('amplification') or suppress the expression of an experienced emotion ('suppression'). The results indicate that highly schizotypal participants present with specific difficulties with the amplification (but not suppression) of emotion expressive behavior. These difficulties are significantly correlated with total negative schizotypy, particularly blunted affect. In the second component of the study, an individual differences approach was used to assess the interrelationship between self-reported use of suppression and schizotypy in an independent sample of 204 community volunteers. The results suggest that, although blunted affect is associated with increased use of suppression, it cannot be regarded as the primary mechanism underpinning this disturbance. Implications for understanding blunted affect in schizophrenia and related disorders are discussed.

The relationship between PTSD symptom factors and emotion

The relationship between posttraumatic stress disorder (PTSD) symptom factors and two facets of emotion were examined. Emotional congruence effects were examined using an affective priming word pronunciation (naming) task, and negative affect was measured using self-report. Current PTSD symptoms were assessed using the Clinician-Administered PTSD Scale in 95 adults with trauma histories. Two alternative PTSD symptom factor structures were examined, one of which included an emotional numbing factor, and one of which included a dysphoria factor. Emotional congruence effects were significantly associated with an emotional numbing factor, but not with any other PTSD factors. Negative affect was significantly associated with a dysphoria factor, but not with any other PTSD factors.

Affective traits in schizophrenia and schizotypy

This article reviews empirical studies of affective traits in individuals with schizophrenia spectrum disorders, population-based investigations of vulnerability to psychosis, and genetic and psychometric high-risk samples. The review focuses on studies that use self-report trait questionnaires to assess Negative Affectivity (NA) and Positive Affectivity (PA), which are conceptualized in contemporary models of personality as broad, temperamentally-based dispositions to experience corresponding emotional states. Individuals with schizophrenia report a pattern of stably elevated NA and low PA throughout the illness course. Among affected individuals, these traits are associated with variability in several clinically important features, including functional outcome, quality of life, and stress reactivity. Furthermore, evidence that elevated NA and low PA (particularly the facet of anhedonia) predict the development of psychosis and are detectable in high-risk samples suggests that these traits play a role in vulnerability to schizophrenia, though they are implicated in other forms of psychopathology as well. Results are discussed in terms of their implications for treatment, etiological models, and future research to advance the study of affective traits in schizophrenia and schizotypy.

Emotion processing in persons at risk for schizophrenia

Evidence suggests that individuals with schizophrenia demonstrate emotion-processing deficits. However, the nature and extent of emotion abnormalities in individuals considered at risk for schizophrenia have not been previously summarized. This article provides a review of the recent literature pertaining to emotion processing in 3 at-risk populations: those at familial high risk, those with schizotypal characteristics, and those in the putative prodrome to psychosis. Studies are reviewed across the components of emotion perception, experience, and expression. Further, we discuss investigations into psychophysiology, brain structure, and brain function that employ emotion probes. Review of the literature suggests that individuals at high risk demonstrate similar abnormalities to those with schizophrenia but at an attenuated level. The most robust findings in at-risk groups are in the areas of reduced emotion perception, self-reported anhedonia, and increased negative affect. We conclude with an agenda for future research.

Cognitive correlates of schizophrenia signs and symptoms: III. Hallucinations and delusions

We examined the cognitive correlates of hallucinations and delusions in 47 schizophrenia spectrum individuals. Hallucinations were significantly negatively correlated with performance on episodic memory tasks, and were not significantly associated with performance on tasks measuring fluency or concentration/attention. Although hallucinations were more strongly associated with performance on verbal than non-verbal memory tasks, the difference was not statistically significant. There was also a trend for hallucinations to be associated with poorer performance on working memory tasks, though this association was eliminated when episodic memory performance was taken into account. Delusions were not significantly associated with any of the cognitive measures.

The relation between emotional awareness and hallucinations and delusions in acute psychiatric inpatients

BACKGROUND

Although negative affect has been frequently implicated in the formation of cognitive and perceptual disturbances ranging from odd perceptions and beliefs to delusions and hallucinations it represents only one of the many aspects of emotional disturbances that may contribute to psychopathology. Surprisingly, no past research has examined in a psychiatric sample whether levels of cognitive-perceptual symptoms are associated with levels of emotional awareness (i.e., attention to emotion and clarity of emotion). In the present study we examined, in an acute psychiatric inpatient sample, the relations between emotional awareness and the severity of delusions and hallucinations.

METHOD

Two groups were included: 34 schizophrenia and schizophrenia spectrum disordered inpatients and 30 mood and substance use disordered inpatients. Patients were assessed on emotional awareness (attention to emotion and emotional clarity) and severity of psychiatric symptomatology.

RESULTS

We found that lower levels of emotional clarity were associated with more severe hallucination ratings in both groups of patients. Among schizophrenia spectrum patients, lower levels of attention to emotion were also associated with more severe hallucination ratings. Among mood/substance disorder participants, higher levels of attention to emotion were associated with more severe delusion ratings, whereas the opposite pattern was found among schizophrenia spectrum participants.

CONCLUSIONS

Consistent with the results of past research using college and community samples, we found that diminished emotional clarity is associated with elevated levels of hallucinations in both mood disorder/substance abuse and schizophrenia spectrum inpatients. We also found that greater attention to emotion was associated with more severe delusions, though only among the mood disorder/substance use group. The present research findings support the role of emotional awareness in hallucination formation and suggest that the factors that contribute to delusions in schizophrenia spectrum patients differ, in part, from the factors that contribute to delusion formation in other groups of individuals.

Emotional awareness, gender, and suspiciousness

We investigated the causal relation between emotional awareness (EA) and suspiciousness, and whether this relation is moderated by gender. After inducing an unpleasant mood, we manipulated EA by having participants read one of two versions of a story (the high EA condition provided cues to what the participant was feeling and why, whereas the low EA condition did not). Following the manipulation, one sample of participants completed a measure of suspiciousness, and a second, independent sample of participants described their emotional state. Emotional Awareness Condition x Gender effects were obtained for suspiciousness and EA. Men in the low EA condition reported significantly higher levels of suspiciousness and lower levels of EA than men in the high EA condition. Women in both conditions reported equally high levels of EA, which were greater than those of men in both conditions, and the manipulation did not affect their levels of suspiciousness.