Emotional experience and expression in schizophrenia and depression.

Abstract

The emotional responses of schizophrenic, depressed, and normal subjects and whether differences in the emotional responding of these groups depended on how emotional responses were elicited or measured were examined. Twenty-three blunted and 20 nonblunted schizophrenics, 17 unipolar depressed subjects, and 20 normal subjects were exposed to a series of affect-eliciting stimuli. The stimuli varied in valence (positive vs. negative) and in level of cognitive demand. Subjects reported their subjective experiences, and their facial expressions were videotaped. Blunted schizophrenics were the least facially expressive, although their reported subjective experiences did not differ from those of the other groups. The nonblunted schizophrenics were more responsive than the depressed subjects to the positive stimuli, although the two groups did not differ in their clinical ratings of affective flatness. Historically, psychopathologists have placed a great deal of emphasis on the role of emotional disturbance in schizophrenia. Whereas both Bleuler (1911/1950) and Kraepelin (1919/1971) considered affective flatness to be a universal symptom of schizophrenia, the International Pilot Study of Schizophrenia (World Health Organization, 1973) revealed that only 66% of the schizophrenic patients studied exhibited flat affect. People with major depression have also been found to have flat affect (e.g., Andreasen, 1979; Pogue-Geile & Harrow, 1984). Although blunted affect may not be a universal symptom of schizophrenia and is not specific to the disorder, it does appear to have prognostic importance (Carpenter,

Influence of nicotine on positive affect in anhedonic smokers

“…Such fi ndings might suggest that regular smoking increases positive emotional responding to environmental rewards, regardless of whether nicotine is (Cook et al 2004a,b;Cacioppo and Gardner 1999;Clark and Watson 1988;Watson et al 1988a,b), our data indicate that nicotine's infl uence on positive affect was largely independent of changes in negative affect. Nicotine's selective infl uence on low positive affect may be especially clinically salient considering that anhedonia is an important feature of depression (Berenbaum and Oltmanns 1992), a psychiatric disorder that frequently co-occurs with smoking (Glassman et al 1990). Although negative affect has been posited as a mechanism maintaining smoking in depression-prone smokers (Carmody 1992), defi cient positive affect may be an additional pathway infl uencing comorbidity between nicotine dependence and depression.…”

“…Recognized as a prominent characteristic in major depressive episodes (Berenbaum and Oltmanns 1992), anhedonia is also conceptualized as a personality characteristic in the general population (Meehl 2001). Individuals at the upper end of the hedonic spectrum experience positive affect easily in response to natural rewards, whereas those at the lower end of the hedonic spectrum (anhedonia) experience more pronounced defi cits in their ability to experience positive affect (Meehl 1975(Meehl , 2001.…”

Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings

“…Patients report normal intrapsychic emotional experience, but communicate symptoms of anhedonia during structured interview [386]. Individuals with schizophrenia show diminished positive and negative emotions in response to emotional movie clips [387], food [388], and social exchange [389-391], even when taking medication [388]. However, individuals with schizophrenia also report similar or heightened subjective emotional experience [392], including in response to movie clips [393], pictures [394], food [395], and even odors [396].…”

The expression and assessment of emotions and internal states in individuals with severe or profound intellectual disabilities

“…Kring & Neale, 1996;Salem, Kring, & Kerr, 1996;Tremeau et al, 2005) using a range of methodologies (e.g. self-ratings; Schneider, Gur, Gur, & Shtasel, 1995; informant rating scales; Andreasen, 1984a,b; facial coding systems; Berenbaum & Oltmanns, 1992). The significant impairments in facial expression in individuals with schizophrenia are not due to reduced emotional experience; individuals report emotional experiences equal to or possibly greater than individuals without a psychiatric diagnosis (Herbener, Song, Khine, & Sweeney, 2008;Kring, Kerr, Smith, & Neale, 1993), nor are they simply due to side effects of medication (Earnst et al, 1996;Putnam & Kring, 2007).…”