Ecological momentary assessment (EMA) was used to examine emotional reactivity and regulation abnormalities during the presence and absence of psychosis. Participants included 28 outpatients with schizophrenia or schizoaffective disorder (SZ) who completed 6 days of EMA. Mathematical models were applied to the EMA data to evaluate stochastic dynamic changes in emotional state and determine how the presence of psychosis influenced the interaction between emotional reactivity and regulation processes across time. Markov chain analysis indicated that although SZ tried to implement emotion regulation strategies frequently during psychotic experiences, those attempts were ineffective at reducing negative emotion from one time point to the next. Network analysis indicated that patients who were less effective at regulating their emotions during psychotic experiences had more dense connections among individual emotions. Findings indicate that psychotic experiences are associated with abnormally strong connections among discrete emotional states that are difficult to regulate despite efforts to do so.

Hedonic response is preserved in schizophrenia. However, it is unclear whether this is also true in individuals meeting criteria for “prodromal” psychosis, who are considered to be at symptomatic high risk for developing the disorder. In this study, we examined neurophysiological and self-reported response to emotional stimuli in UHR (n = 23) and healthy control (CN: n = 30) participants who passively viewed pleasant, unpleasant, and neutral images for 500 ms while the electroencephalogram was recorded and then provided self-reports of valence and arousal to the stimuli. The Late Positive Potential (LPP) event related potential (ERP) component was used as a neurophysiological marker of emotional reactivity. Results indicated that CN participants had higher LPP amplitude for pleasant and unpleasant compared to neutral stimuli; however, UHR youth displayed no differences in LPP amplitude among pleasant, unpleasant, and neutral stimuli. Self-report data mirrored neurophysiological data, as UHR youth had lower reports of positive emotion to pleasant stimuli and negative emotion to unpleasant stimuli compared to CN participants. Furthermore, the presence of a mood disorder diagnosis predicted reduced neurophysiological emotional reactivity in UHR youth.Findings suggest that youth at UHR for psychosis display diminished subjective and neurophysiological reactivity to emotional stimuli, and that symptoms of depression may result in diminished emotional reactivity.

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