Comparison of emotional processing assessed with fear conditioning by interpersonal conflicts in patients with depression and schizophrenia

Abstract

Aim While emotional processing is implicated in various psychiatric illnesses, its differences among diagnoses are unclear. We compared associative learning of social values in patients with depression and schizophrenia by measuring skin conductance response to interpersonal stimuli. Methods We included 20 female outpatients each with depression and schizophrenia. They underwent Pavlovian conditioning experiments in response to a classical aversive sound, and an interpersonal stimulus that was designed to cause aversive social conditioning with actors’ faces coupled with negative verbal messages. Multiple regression analysis was performed to examine the associations between the degree of conditioned response and the clinical characteristics of the participants. Results Conditioned responses during the acquisition phase in both conditions were higher in depression compared to schizophrenia. Patients with depression successfully showed fear conditioning in both conditions, and they exhibited slower extinction in the interpersonal condition. The conditioned response during the extinction phase showed a positive association with Emotion Regulation Questionnaire Expressive Suppression score, and a negative association with the Emotion Regulation Questionnaire Cognitive Reappraisal score and the use of antidepressants. Patients with schizophrenia did not become conditioned in either of the conditions. The Positive and Negative Syndrome Scale Negative Syndrome score was negatively associated with the degree of conditioned response during the acquisition phase in the interpersonal condition. Conclusion Female patients with schizophrenia, especially those who prominently demonstrated negative symptoms, suggested their intrinsic impairments in the associative learning of social context. Antidepressants and adaptive emotional regulation strategy may enhance the extinction learning of aversive social conditioning in depression.

Schizotypal personality traits and the social learning of fear

“…Previous researches have reported that patients with schizophrenia do not show differential SCRs to an aversive social stimulus during the acquisition phase, suggesting an intrinsic impairment of the Pavlovian conditioning in associative learning in schizophrenia 23 . Even though they measure the differential SCR to the CS+ and the CS−, we consider it highly interesting to have obtained similar results in our social fear conditioning experiment depending on the level of Cognitive-Perceptual schizotypal personality traits.…”

“…Additionally, a recent study reported that positive schizotypal traits were significantly and negatively related to empathy for other’s pain using Evoked Response Potential (ERP) measurements 68 , which is in line with this finding, suggesting a lack of responsivity when watching a person receiving an electric shock. Future studies are needed to further explore the modulation of the SCR during the observational phase of social fear learning experiments by the Cognitive-perceptual factor, and whether the impairments of the Pavlovian conditioning processes are affected in a similar way to what happens in people with schizophrenia with the differential SCR to the CS+ and the CS− 23 .…”

Physical condition, psychological status, and posttraumatic stress disorder among recovered COVID-19 subjects: A mediation analysis

“…Aberrant fear conditioning is widely recognized as an underlying mechanism in various psychiatric disorders, particularly post-traumatic stress disorder ( 53 ). Fear conditioning is a phenomenon mainly involved in the central nervous system, especially the pre-frontal cortical-amygdala-hippocampal circuit ( 54 , 55 ).…”

Maladaptive avoidance patterns in Parkinson’s disease are exacerbated by symptoms of depression

“…To date, however, very few studies have investigated extinction learning in depressed patients. In a recent study, Tani et al [33] found slower extinction of a fear response following social aversive conditioning in patients with depression. In contrast, Kuhn et al [34] found enhanced extinction of fear responses in depressed patients, but this study used an instructed extinction manipulation, so it is difficult to evaluate learning from feedback during extinction.…”