Emotional Experience in Patients With Schizophrenia Revisited: Meta-analysis of Laboratory Studies

Department of Psychology, Louisiana State University, 206 Audubon Hall Baton Rouge, LA 708080, USA.
Schizophrenia Bulletin (Impact Factor: 8.45). 07/2008; 36(1):143-50. DOI: 10.1093/schbul/sbn061
Source: PubMed


Our understanding of the emotion deficits in schizophrenia is limited. Findings from studies employing trait emotion instruments
suggest that patients have attenuated levels of positive emotion (ie, anhedonia) and increased levels of negative emotion.
Conversely, patients and controls have not statistically differed in their subjective reactions to positive or negative valenced
stimuli in most laboratory studies to date. Further obfuscating this issue is the fact that many of these laboratory studies
are underpowered and a handful of emotion induction studies have found evidence of anhedonia. We conducted a meta-analysis
of 26 published studies employing laboratory emotion induction procedures in patients with schizophrenia and healthy controls.
Patients did not differ from controls when strictly rating their subjective hedonic reactions to the stimuli. However, they
reported experiencing relatively strong aversion to both positive and neutral stimuli (Hedges D = .72 and .64, respectively). These findings were not the result of demonstrable sample or methodological differences across
studies. Patients’ ability to experience hedonic emotion is preserved, although they also show relatively strong, simultaneously
occurring aversive emotion when processing laboratory stimuli considered by others to be pleasant or neutral.

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Available from: Alex S Cohen, Jan 06, 2014
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    • "The novel aspect of this research concerned the role of the emotional and cognitive variables in the affective reactivity effect. Our clinical group reported more NA during the interviews (especially the salient interview), which is consistent with the literature on emotional experience in schizophrenia (Cohen and Minor, 2010). Although performance on the DST was not affected by condition, the discrimination indices on the iSM were, but the effect was only observed in patients. "
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    ABSTRACT: Thought disorder (TD) has been shown to vary in relation to negative affect. Here we examine the role internal source monitoring (iSM, i.e. ability to discriminate between inner speech and verbalized speech) in TD and whether changes in iSM performance are implicated in the affective reactivity effect (deterioration of TD when participants are asked to talk about emotionally-laden topics). Eighty patients diagnosed with schizophrenia-spectrum disorder and thirty healthy controls received interviews that promoted personal disclosure (emotionally salient) and interviews on everyday topics (non-salient) on separate days. During the interviews, participants were tested on iSM, self-reported affect and immediate auditory recall. Patients had more TD, poorer ability to discriminate between inner and verbalized speech, poorer immediate auditory recall and reported more negative affect than controls. Both groups displayed more TD and negative affect in salient interviews but only patients showed poorer performance on iSM. Immediate auditory recall did not change significantly across affective conditions. In patients, the relationship between self-reported negative affect and TD was mediated by deterioration in the ability to discriminate between inner speech and speech that was directed to others and socially shared (performance on the iSM) in both interviews. Furthermore, deterioration in patients' performance on iSM across conditions significantly predicted deterioration in TD across the interviews (affective reactivity of speech). Poor iSM is significantly associated with TD. Negative affect, leading to further impaired iSM, leads to increased TD in patients with psychosis. Avenues for future research as well as clinical implications of these findings are discussed.
    Full-text · Article · Feb 2016 · Schizophrenia Research
    • "Subjects with schizophrenia, stabilized on SGAs only, have lower motivation but comparable hedonic experience and anticipatory pleasure with respect to healthy controls, when controlling for the effect of lower general cognitive abilities. Our findings are in line with several previous studies reporting comparable levels of anticipatory pleasure in subjects with schizophrenia with respect to healthy controls, especially when patients were treated with SGAs, (Kring and Moran, 2008; Cohen and Minor, 2010; Strauss et al., 2011a; Llerena et al., 2012). Several fMRI findings are also in line with these results: subjects medicated with SGAs did not show a significant difference from healthy controls in the ventral striatum activation during reward anticipation (Walter et al., 2009; Nielsen et al., 2012; Mucci et al., 2015b). "
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    ABSTRACT: Investigate impairment of reward anticipation in subjects with schizophrenia (SCZ) and its association with negative symptom dimensions and hedonic experience.
    No preview · Article · Jan 2016
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    • "The most straightforward explanation of avolition is that patients do not engage in activities because they do not nd them enjoyable. However, experience sampling and laboratory-based studies do not support this hypothesis, indicating that SZ patients have a normal hedonic capacity (Cohen and Minor, 2010; Gard et al., 2007; Kring and Moran, 2008; Llerena et al., 2012; Oorschot et al., 2013; Strauss and Gold, 2012). Rather, motivational symptoms appear to be more closely tied to a range of reward processing abnormalities, such as impaired reward anticipation (Juckel et al., 2006; Waltz et al., 2010), reinforcement learning (Culbreth et al., 2015; Gold et al., 2012; Strauss et al., 2011a; Waltz et al., 2007), and difculty generating, updating, or maintaining mental representations of value (Gard et al., 2011; Heerey et al., 2007; Kring et al., 2011; Strauss et al., 2011b; Ursu et al., 2011) (for reviews see Barch and Dowd, 2010; Kring and Barch, 2014; Strauss et al., 2014). "
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    ABSTRACT: The current study examined whether effort-cost computation was associated with negative symptoms of schizophrenia (SZ). Participants included outpatients diagnosed with SZ (n=27) and demographically matched healthy controls (n=32) who completed a Progressive Ratio task that required incrementally greater amounts of physical effort to obtain monetary reward. Breakpoint, the point at which participants was no longer willing to exert effort for a certain reward value, was examined as an index of effort-cost computation. There were no group differences in breakpoint for low, medium, or high value rewards on the Progressive Ratio task. However, lower breakpoint scores were associated with greater severity of avolition and anhedonia symptoms in SZ patients. Findings provide further evidence that impaired effort-cost computation is linked to motivational abnormalities in SZ.
    Full-text · Article · Dec 2015 · Schizophrenia Research
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