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

Attentional biases in facial emotion processing in individuals at clinical high risk for psychosis

Individuals at clinical high risk (CHR) for psychosis exhibit altered facial emotion processing (FEP) and poor social functioning. It is unclear whether FEP deficits result from attentional biases, and further, how these abnormalities are linked to symptomatology (e.g., negative symptoms) and highly comorbid disorders that are also tied to abnormal FEP (e.g., depression). In the present study, we employed an eye-tracking paradigm to assess attentional biases and clinical interviews to examine differences between CHR (N = 34) individuals and healthy controls (HC; N = 46), as well as how such biases relate to symptoms and functioning in CHR individuals. Although no CHR-HC differences emerged in attentional biases, within the CHR group, symptoms and functioning were related to biases. Depressive symptoms were related to some free-view attention switching biases (e.g., to and from fearful faces, r = .50). Negative symptoms were related to more slowly disengaging from happy faces (r = .44), spending less time looking at neutral faces (r =  - .42), and more time looking at no face (Avolition, r = .44). In addition, global social functioning was related to processes that overlapped with both depression and negative symptoms, including time looking at no face (r =  - .68) and free-view attention switching with fearful faces (r =  - .40). These findings are consistent with previous research, indicating that negative symptoms play a prominent role in the CHR syndrome, with distinct mechanisms relative to depression. Furthermore, the results suggest that attentional bias indices from eye-tracking paradigms may be predictive of social functioning.

Dynamic cognitive inhibition in the context of frustration: Increasing racial representation of adolescent athletes using mobile community-engaged EEG methods

Introduction

Concussive events and other brain injuries are known to reduce cognitive inhibition, a key aspect of cognition that supports ones' behaviors and impacts regulation of mood or affect. Our primary objective is to investigate how induction of negative affect (such as frustration) impacts cognitive inhibition and the dynamic process by which youth athletes modulate responses. Secondary objective is to address the lack of Black representation in the scientific literature that promotes brain health and investigates pediatric sports-related brain injury. In particular, neuroscience studies predominantly include White participants despite broad racial representation in sport, in part due to technological hurdles and other obstacles that challenge research access for Black participants.

Methods

Using electroencephalography (EEG), we evaluate the dynamic brain processes associated with cognitive inhibition in the context of frustration induction in adolescent athletes during pre-season conditioning (i.e., prior to contact; N = 23) and a subset during post-season (n = 17).

Results

The N2 component was sensitive to frustration induction (decreased N2 amplitude, slower N2 latency), although effects were less robust at postseason. Trial-by-trial changes indicated a steady decrease of the N2 amplitude during the frustration block during the preseason visit, suggesting that affective interference had a dynamic effect on cognitive inhibition. Lastly, exploratory analyses provide preliminary evidence that frustration induction was less effective for athletes with a previous history of concussion or migraines (trending result) yet more effective for athletes endorsing a history with mental health disorders.

Discussion

We emphasize the urgent need to improve representation in cognitive neuroscience, particularly as it pertains to brain health. Importantly, we provide detailed guides to our methodological framework and practical suggestions to improve representative participation in studies utilizing high-density mobile EEG.

A transdiagnostic meta-analysis of physical and social Anhedonia in major depressive disorder and schizophrenia spectrum disorders

INTRODUCTION

Anhedonia is a transdiagnostic construct conceptualized as physical or social, however, the extent to which these subtypes differ across psychotic and mood pathology remains poorly understood. We aimed to quantify the severity of physical and social anhedonia across Major Depressive Disorder (MDD) and Schizophrenia Spectrum Disorder (SSDs).

METHODS

We conducted meta-analyses of the Chapman Physical and Social Anhedonia Scales (PAS;SAS). We reviewed data from participants with MDD, and SSDs separately.

RESULTS

Our first meta-analysis (n = 8 studies, 409 participants) with MDD revealed elevated SAS and PAS in MDD compared to controls. Within-group differences were not significant. Depressive symptom severity moderated the between-group effect of PAS. Our second meta-analysis (n = 44 studies, 3352 participants) revealed elevated SAS and PAS in SSDs compared to controls. We detected a moderate difference between the SAS and PAS within the SSD group. Age moderated within-group differences of SAS and PAS.

DISCUSSION

People with SSD or MDD experience elevated SAS and PAS compared to controls. People with SSDs endorse greater challenges experiencing social rewards relative to physical rewards. People with MDD experience social and physical rewards similarly. The moderating role of depressive symptoms in MDD suggests that physical anhedonia is more state-like than social anhedonia.

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.

Attentional engagement and inhibitory control according to positive and negative symptoms in schizophrenia: An emotional antisaccade task

Despite schizophrenia (SZ) is characterized by a high psychopathological heterogeneity, the underlying psychological mechanisms that result in different clinical profiles are unclear. This study examined the cognitive processing of emotional faces (angry, happy, neutral, and sad) by means of assessing inhibitory control (antisaccade task) and attentional engagement (prosaccade task) with the eye-tracking paradigm. Firstly, two clinical SZ subgroups classified according to the predominance of positive (PSZ; n = 20) or negative symptoms (NSZ; n = 34) and a control group of 32 individuals were compared. Secondly, the association between prosaccade and antisaccade measurements and the severity of positive and negative symptoms were analyzed. The PSZ group showed slower antisaccades when angry faces were displayed, and higher positive symptoms were associated with slower prosaccade latencies to ones. Conversely, the NSZ group made overall slower prosaccades with an emotional advantage for angry faces, and higher negative symptoms were associated with faster antisaccade latencies to ones. Hence, whereas positive SZ profile is related to a lack of attentional engagement and an impaired inhibitory control to threatening information; negative SZ profile is linked to a lack of attentional engagement to faces, mainly with non-threat ones, and with an advantage to ignore distracting threatening stimuli. These findings support affective information-processing theories suggesting a hypersensitivity to threat for positive SZ profiles, and a desensitization to socio-emotional information for negative ones. Consequently, characterizing psychological mechanisms of SZ may allow improving current treatments to threat management when positive symptoms are predominant, or emotion sensitization when negative symptoms prevail.

Transcultural Adaptation of the Following Affective States Test (FAST) for the Brazilian Context

Abstract Individuals differ in their tendency to follow or ignore feelings as a source of information to guide behavior, and it is relevant to examine these particularities. This study presents an assessment of the psychometric properties of the transcultural adaptation of the Following Affective States Test (FAST) for the Brazilian context. After translation and back translation, the adapted version was applied among adult volunteers (n=302), both sexes (208 women, 68.9%), aged between 18 and 61 years old (M=28.6; SD=9.4) along with the Positive and Negative Affect Scale (PANAS) and the Emotion Regulation Questionnaire (ERQ). The confirmatory factor analysis (CFA) of the Brazilian version presented appropriate goodness of fit for the four-factor model (GFI=0.92; CFI=0.83; RMSEA=0.07) with appropriate internal consistency (Cronbach’s alpha=0.60-0.72). Statistically significant positive correlations were found between the FAST and positive/negative affects (PANAS) and emotion regulation strategies (ERQ). The adapted version of the FAST presented promising indicators concerning validity and reliability evidence for the Brazilian context.

Electrophysiological responses to images ranging in motivational salience: Attentional abnormalities associated with schizophrenia-spectrum disorder risk

Individuals at risk for schizophrenia-spectrum disorders display abnormalities related to motivational salience, or the ability of stimuli to elicit attention due to associations with rewards or punishments. However, the nature of these abnormalities is unclear because most focus on responses to stimuli from broad “pleasant” and “unpleasant” categories and ignore the variation of motivational salience within these categories. In two groups at risk for schizophrenia-spectrum disorders—a Social Anhedonia group and a Psychotic-like Experiences group—and a control group, the current study examined event-related potential components sensitive to motivational salience—the Early Posterior Negativity (EPN), reflecting earlier selective attention, and the Late Positive Potential (LPP), reflecting sustained attention. Compared to controls, the Social Anhedonia group showed smaller increases in the EPN in response to erotica and smaller increases in the LPP as the motivational salience of pleasant images increased (exciting<affiliative<erotica). In contrast, the Psychotic-like Experiences group had larger increases in LPP amplitudes as the motivational salience of pleasant images increased. Also, both at-risk groups showed larger increases in the LPP to threatening images but smaller increases to mutilation images. These findings suggest that examining abnormalities beyond those associated with broad categories may be a way to identify mechanisms of dysfunction.

Late electrophysiological potentials and emotion in schizophrenia: A meta-analytic review

INTRODUCTION

There is mixed evidence about emotional processing abnormalities in schizophrenia and schizoaffective disorder, with self-reports and clinician ratings indicating significant differences between patients and controls, but studies of in-the-moment, self-reported emotional experience finding only small differences between these groups. The current meta-analysis synthesizes statistics from studies measuring the P3 and LPP, two event-related potential (ERP) components sensitive to attentional allocation, to examine whether patients exhibit ERP response abnormalities to neutral and valenced visual stimuli.

METHODS

Standardized mean amplitudes and standard errors of P3 and/or LPP waveforms (300-2000 ms) in response to neutral and valenced images were calculated for 13 studies (total n = 339 individuals with schizophrenia, 331 healthy controls).

RESULTS

In response to neutral images, there were very small, non-significant differences in ERP amplitudes between patient and control groups (k = 9; Hedges' g = -0.06, 95% CI: -055, 0.43, p = 0.81). In contrast, patients showed a small, significant reduction in ERP amplitudes compared to controls in response to negative images (k = 13; Hedges' g = -0.32, 95% CI: -0.59, -0.05, p = 0.02) and a small, but nonsignificant, reduction in amplitudes in response to positive images (k = 7; Hedges' g = -0.27, 95% CI: -0.71, 0.18, p = 0.24).

CONCLUSIONS AND IMPLICATIONS

The current review indicates that compared to controls, patients have slightly diminished P3 and LPP amplitudes in response to positive and negative stimuli. This small reduction may reflect decreased attention allocation, possibly indicating an abnormality during a distinct stage of early processing related to evaluating the motivational salience of a stimulus.

The subjective-objective deficit paradox in schizotypy extends to emotion regulation and awareness

There is an emerging subjective-objective deficit paradox in schizotypy. Individuals with schizotypy report severe subjective complaints in several key functional domains commensurate with that of individuals with schizophrenia. However, objective assessments of the same domains show relatively intact performance. We examined whether this subjective-objective deficit paradox extends to two closely linked affective processes: emotion regulation and awareness. Individuals with elevated social anhedonia (SocAnh; n = 61) and elevated perceptual aberration/magical ideation (PerMag; n = 73) were compared to control participants (n = 81) on subjective and objective measures of emotion regulation and awareness. Subjective measures included self-report questionnaires assessing regulatory ability, attention to emotion, and emotional clarity. Implicit emotion regulation was assessed by the Emotion Regulation-Implicit Association Test (ER-IAT) while objective emotional awareness was assessed by the Levels of Emotional Awareness Scale (LEAS), a performance-based test. Results showed that both SocAnh and PerMag groups reported notable deficits in almost all subjective measures relative to controls (composite ds > 0.55). In contrast, performance on ER-IAT and LEAS was very similar to controls (composite ds < 0.11). The current study suggests that the subjective-objective deficit paradox extends to emotion regulation and awareness, highlighting the importance of higher-order cognitive bias in understanding emotional abnormalities in schizotypy.

Emotional response in schizophrenia to the "36 questions that lead to love": Predicted and experienced emotions regarding a live social interaction

Evidence suggests that individuals with schizophrenia (SZ) report anticipatory pleasure deficits compared to controls and that these deficits are linked to decreased motivation to engage socially. However, these deficits have been identified via self-report measures of hypothetical pleasant stimuli, leaving it unclear whether they exist in reference to actual social situations. To address this issue, we created a live social interaction that minimized the reliance of higher-order cognitive processes. SZ and control participants were told that they would be playing an "enjoyable sharing game" with another study participant (who was actually a confederate) that involved asking and answering questions (36 interpersonal closeness generation questions; Aron et al., 1997). Participants then reported their current mood and the emotions they anticipated experiencing during the pleasant social interaction. Immediately following the interaction, they reported their experienced emotions. We found that the SZ group anticipated more negative emotion (d = 1.0), but were less accurate in forecasting negative emotion (d = .81), than controls, and these effects were large. There were small, non-significant group differences in anticipation, experience, and accuracy in forecasting of positive emotion (all ds < .29). Also, social anhedonia was positively correlated with anticipated negative affect and negatively associated with experienced positive emotion. At the same time, controls reported finding the interaction to be a more positive emotional experience overall, d = 0.75. This is the first study to show that "anticipatory pleasure deficits" in SZ might actually be heightened anticipated negative emotion and that inaccurate forecasting could be linked to decreased social motivation.

Timing matters in elaborative processing of positive stimuli: Gamma band reactivity in schizophrenia compared to depression and healthy adults

Some individuals with schizophrenia report similar feelings of positive affect "in the moment" compared to control participants but report decreased trait positive affect overall. One possible explanation for this disconnection between state and trait positive affect is the extent to which individuals with schizophrenia engage in elaborative processing of positive stimuli. To assess this, we examined evoked gamma band activity in response to positive words over several seconds in a group with schizophrenia, a group with major depressive disorder, and a healthy control group. From a pre-stimulus baseline to 2000 ms after onset of the stimulus (henceforth, "early period"), the schizophrenia group showed a reliable increase in gamma activity compared to both the control and depressed groups, who did not differ from each other. In contrast, the depressed group showed a reliable increase in gamma activity from 2001 to 8000 ms (henceforth, "late period") compared to the other groups, who did not differ from each other. At the same time, the schizophrenia group showed a reliable decrease from the early to late period while the depressed group showed the opposite pattern. In addition, self-reported depression and social anhedonia in the schizophrenia group were related to decreased gamma band activity over the entire processing window. Overall, these results suggest that schizophrenia is associated with increased initial reactivity but decreased sustained elaborative processing over time, which could be related to decreased trait positive affect. The results also highlight the importance of considering depressive symptomology and anhedonia when examining emotional abnormalities in schizophrenia.

Affective symptoms in schizophrenia are strongly associated with neurocognitive deficits indicating disorders in executive functions, visual memory, attention and social cognition

The aim of this study was to assess the neurocognitive correlates of affective symptoms in schizophrenia. Towards this end, 40 healthy controls and 80 schizophrenia patients were investigated with six tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), assessing spatial working memory, paired-association learning, one touch stocking, rapid visual information (RVP), emotional recognition test and intra/extradimensional set shifting. The Hamilton Depression (HDRS) and Anxiety (HAMA) Rating Scales and the Calgary Depression Scale for Schizophrenia (CDSS) as well as the Positive and Negative Syndrome Scale (PANSS) were also used. There were highly significant associations between all 6 CANTAB tests and HDRS, HAMA and CDSS (except RVP) scores. The most significant items associating with neurocognitive impairments in schizophrenia were self-depreciation (CDSS), fatigue, psychomotor retardation and agitation, psychic and somatic anxiety (HDRS), fears, cognitive symptoms, somatic-muscular, genito-urinary and autonomic symptoms and anxious behavior (HAMA). The selected HDRS and HAMA symptoms indicate fatigue, fears, anxiety, agitation, retardation, somatization and subjective cognitive complaints (SCC) and are therefore labeled "FAARS". Up to 28.8% of the variance in the 6 CANTAB measurements was explained by FAARS, which are better predictors of neurocognitive impairments than the PANSS negative subscale score. Neurocognitive deficits in schizophrenia are best predicted by FAARS combined with difficulties in abstract thinking. In conclusion, depression and anxiety symptoms accompanying the negative and positive symptoms of schizophrenia are associated with neurocognitive deficits indicating disorders in executive functions, attention, visual memory, and social cognition. Neurocognitive deficits in schizophrenia reflect difficulties in abstract thinking and FAARS, including subjective cognitive complaints.

The Role of Conformity in Relation to Cohesiveness and Intimacy in Day-Hospital Groups of Patients with Schizophrenia

OBJECTIVE

Conformity is defined as the act of adjusting one's behavior to match the social responses of others. Patients with schizophrenia often adjust their maladaptive behaviors by conforming in group treatment settings. This study aimed to examine whether the opinions of group members influence conformity of patients with schizophrenia who attend day-hospital programs.

METHODS

Nineteen patients with schizophrenia from four different day-hospital programs and 23 healthy controls from four different social clubs completed the homographic meaning choice task under conditions of prior exposure to the pseudo-opinions of their group members, strangers, and unknown information sources. Group influences on conformity were observed when the level of group cohesiveness was high and the level of intimacy was low across participant groups.

RESULTS

Controls did not exhibit a significant effect of group influence on conformity, whereas patients were significantly influenced by their group members when making conformity-based decisions despite significantly lower intimacy and cohesiveness levels.

CONCLUSION

These findings suggest that unlike controls, patients with schizophrenia tend to respond with conformity when influenced by the opinions of their affiliated group. In patients with schizophrenia group conformity may be used to select a more accurate decision and to enhance feelings of affiliation among them.

Emotional word usage in groups at risk for schizophrenia-spectrum disorders: An objective investigation of attention to emotion

Both extreme levels of social anhedonia (SocAnh) and extreme levels of perceptual aberration/magical ideation (PerMag) indicate increased risk for schizophrenia-spectrum disorders and are associated with emotional deficits. For SocAnh, there is evidence of self-reported decreased trait positive affect and abnormalities in emotional attention. For PerMag, there is evidence of increased trait negative affect and increased attention to negative emotion. Yet, the nature of more objective emotional abnormalities in these groups is unclear. The goal of this study was to assess attention to emotions more objectively in a SocAnh, PerMag, and control group by using a positive (vs. neutral) mood induction procedure followed by a free writing period. Linguistic analyses revealed that the SocAnh group used fewer positive emotion words than the control group, with the PerMag group falling in between the others. In addition, both at-risk groups used more negative emotion words than the control group. Also, for the control group only, those in the positive mood induction used more positive emotion words, suggesting their emotions influenced their linguistic expression. Overall, SocAnh is associated with decreased positive emotional expression and at-risk groups are associated with increased negative emotional expression and a decreased influence of emotions on linguistic expression.

An electrophysiological investigation of emotional abnormalities in groups at risk for schizophrenia-spectrum personality disorders

Both extreme levels of social anhedonia (SocAnh) and perceptual aberration/magical ideation (PerMag) are associated with risk for schizophrenia-spectrum disorders and with emotional abnormalities. Yet, the nature of any psychophysiological-measured affective abnormality, including the role of automatic/controlled processes, is unclear. We examined the late positive potential (LPP) during passive viewing (to assess automatic processing) and during cognitive reappraisal (to assess controlled processing) in three groups: SocAnh, PerMag, and controls. The SocAnh group exhibited an increased LPP when viewing negative images. Further, SocAnh exhibited greater reductions in the LPP for negative images when told to use strategies to alter negative emotion. Similar to SocAnh, PerMag exhibited an increased LPP when viewing negative images. However, PerMag also exhibited an increased LPP when viewing positive images as well as an atypical decreased LPP when increasing positive emotion. Overall, these results suggest that at-risk groups are associated with shared and unique automatic and controlled abnormalities.

Attention and memory bias to facial emotions underlying negative symptoms of schizophrenia

INTRODUCTION

This study assessed bias in selective attention to facial emotions in negative symptoms of schizophrenia and its influence on subsequent memory for facial emotions.

METHODS

Thirty people with schizophrenia who had high and low levels of negative symptoms (n = 15, respectively) and 21 healthy controls completed a visual probe detection task investigating selective attention bias (happy, sad, and angry faces randomly presented for 50, 500, or 1000 ms). A yes/no incidental facial memory task was then completed. Attention bias scores and recognition errors were calculated.

RESULTS

Those with high negative symptoms exhibited reduced attention to emotional faces relative to neutral faces; those with low negative symptoms showed the opposite pattern when faces were presented for 500 ms regardless of the valence. Compared to healthy controls, those with high negative symptoms made more errors for happy faces in the memory task. Reduced attention to emotional faces in the probe detection task was significantly associated with less pleasure and motivation and more recognition errors for happy faces in schizophrenia group only.

CONCLUSIONS

Attention bias away from emotional information relatively early in the attentional process and associated diminished positive memory may relate to pathological mechanisms for negative symptoms.

Social Anhedonia Is Not Just Extreme Introversion: Empirical Evidence of Distinct Constructs

Social anhedonia and introversion, two closely related constructs associated with decreased positive emotions and decreased sociability, are common in schizophrenia-spectrum personality disorders. In light of a myriad of mixed findings regarding positive emotionality in anhedonia, there has been a call to reconceptualize "anhedonia." To clarify the nature of social anhedonia, we used confirmatory factor analysis to investigate the relationship between social anhedonia and introversion. Findings were consistent with the conceptualization of social anhedonia as a separate construct from introversion-the best fitting model was one in which social anhedonia and introversion measures loaded separately. Also consistent with the conceptualization of social anhedonia as separate, we found evidence that it was associated with aspects of alexithymia above and beyond any relationship with introversion. Overall, these results have implications for the understanding of social anhedonia and for the use of it as a discriminating factor between personality disorders characterized by introversion.

Decreased Self-Concept Clarity in People with Schizophrenia

Disturbances in the perception of self are thought to be central to the development of psychosis. Self-concept clarity (SCC) is the extent to which one's beliefs about oneself are internally consistent, stable, and clear. Participants with schizophrenia (N = 54) and healthy controls (N = 32) completed the Me Not-Me Decision Task (MNMDT), in which they decided whether 60 adjectives (30 pairs of antonyms) did or did not describe themselves. SCC is conceptualized as the number of consistent responses. Participants also completed the Self-Concept Clarity Scale (SCCS). Compared to healthy controls, participants with schizophrenia scored lower on the MNMDT and SCCS, and scores were negatively correlated with positive and negative symptoms. In a simultaneous regression, SCCS scores were uniquely associated with positive symptoms, whereas MNMDT scores were uniquely associated with negative symptoms. This suggests that people with schizophrenia have decreased self-concept clarity that is related to positive and negative symptoms.

Self-reported affective traits and current affective experiences of biological relatives of people with schizophrenia

Schizophrenia is characterized by self-reported trait anhedonia but intact hedonic responses during laboratory experiments. Affective traits of first-degree biological relatives may be similar to those of people with schizophrenia, and measures of hedonic response in relatives may be free of antipsychotic medication or cognitive confounds. Relatives also self-report increased anhedonia, yet it is unclear whether, like in patients, this anhedonia is paired with largely intact hedonic self-report. In this study, first-degree relatives of people with schizophrenia (n=33) and nonpsychiatric controls (n=25) completed a wide range of questionnaires and tasks assessing social and physical anhedonia, positive and negative affective experience, and anticipatory and consummatory pleasure. Valence, intensity, frequency, and the arousal of current emotion were assessed. Extraversion and current positive and negative affective state were also examined in relation to self-reported social anhedonia. Relatives evidenced the same disjunction of increased self-reported anhedonia and intact affective response observed in people with schizophrenia. Group differences in anhedonia were not better accounted for by decreased current positive affect, increased current negative affect, or decreased extraversion in relatives. Results suggest that, like people with schizophrenia, first-degree relatives report intact hedonic response on both questionnaire and laboratory measures despite significant elevations in self-reported social anhedonia.