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 (1911Bleuler ( /1950 and Kraepelin (1919Kraepelin ( /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, Bartko, Strauss, & Hawk, 1978; Knight, Roff, Barmen, & Moss, 1979).Most of what is known about affective flatness has come from studies in which psychiatric patients were observed during clinical interviews and received unidimensional ratings of emotional expressiveness. Unfortunately, in such studies there is a risk of overlooking several important factors. For example, it is essential to specify which facets of the emotional response are blunted. Neurological evidence indicates that the systems controlling HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript facial expressions and subjective experience can act independently (e.g., Ross & Mesulam, 1979). This suggests the need to systematically examine both the subjective experience and the outward expression of emotion. Another important factor that has generally been overlooked is the distinction between positive and negative emotions. Knowledge concerning how groups of psychiatric patients differ from each other and from normal persons, such as whether the differences are restricted to a particular facet of emotional responding or are limited to positive or negative emotions, has implications beyond its potential diagnostic utility. The answers to these questions can provide clues to the origins of affective disturbances in psychopathologic disorder.The mechanism that mediates schizophrenics' affective dis...

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