Schizophrenia Patients Are More Emotionally Active Than Is Assumed Based on Their Behavior

Abstract

Flat affect is a core symptom of schizophrenia. To date, researchers have focused primarily on emotional expression. Only recently has the emotional experience of patients with schizophrenia been studied in laboratory settings. The goal of this study is to assess emotional experience in the complex world of daily life. A structured time-sampling technique, the Experience Sampling Method, was used to collect data. Schizophrenia subjects (n = 58) were compared to 65 nonpatient controls. Patients were divided into blunted and nonblunted subgroups on the basis of Brief Psychiatric Rating Scale (BPRS) behavioral ratings of flat affect. Schizophrenia subjects experienced more intense and more variable negative emotions than controls. For the positive emotions, we found less intensity and less variability in the schizophrenia subjects. No difference in patterns of affect was found between the blunted and the nonblunted schizophrenia subgroups. Our findings suggest that patients with schizophrenia are more emotionally active than has been assumed based on behavioral observations.

Computerized experience sampling method (ESMc): Assessing feasibility and validity among individuals with schizophrenia

“…Thus, the relatively higher response rate using ESMc may reflect the initial higher response rate associated with the novelty of participating in an ESM research protocol and/or the designation of an assessment period that is characterized by a higher response rate. Similarly, participants in our study were presented with 27-32 ESM questions per beep (depending on branching) compared to approximately 50 in typical ESMp studies with individuals with schizophrenia (Delespaul, 1995;Myin-Germeys et al, 2000, 2001, which may have influence the response rate. Additionally, the current study was carried out in an inpatient unit, whereas most ESMp studies were carried out among outpatient individuals with schizophrenia.…”

“…The questionnaire was derived from previous ESM studies with individuals with schizophrenia and psychosis using ESMp (Delespaul, 1995;Myin-Germeys et al, 2000, 2001Tournier et al, 2003;Verdoux et al, 2003). Table 2 presents the descriptions of the symptom and mood items assessed.…”

“…The subjects are instructed to complete the questionnaire upon hearing beeps from the wristwatches, which are preprogrammed to beep randomly a number of times a day to elicit experience samples. Over the past decade, ESMp has been used extensively to study diverse psychiatric populations including individuals with schizophrenia (Delespaul, 1995;Delespaul et al, 2002;Myin-Germeys et al, 2000, 2001, psychosis (Myin-Germeys et al, 2003a,b, 2004, psychosis-proneness (Husky et al, 2004;Tournier et al, 2003;Verdoux et al, 2003), depression and bipolar disorder (Barge-Schaapveld and Nicolson, 2002;Barge-Schaapveld et al, 1995, 1999Peeters et al, 2003;Swendsen and Compagnone, 2000;Wang et al, 2004), criminal offenders and violent psychiatric patients (Hillbrand and Waite, 1994;Hillbrand et al, 2000), as well as cannabis users Verdoux et al, 2003).…”

Adolescent alcohol involvement and suicide attempts: Toward the development of a conceptual framework

“…It might seem that individuals who are highly dysregulated, under extreme stress, or consuming alcohol are ill-suited to participate in EMA studies requiring high compliance rates "in the field." However, experience to date clearly demonstrates that patients with major mental illness including schizophrenia (Myin-Germeys, Delespaul, & deVries, 2000), unspecified psychotic disorders (Myin-Germeys, Delespaul, & Van Os, 2005;Thewissen, Bentall, Lecomte, van Os, & Myin-Germeys, 2008), and bipolar disorder (Scharer et al, 2002) can employ this methodology to study dynamic aspects of pathology-relevant constructs and individuals can reliably use electronic diaries to record even high levels of drinking in the field (Hufford, Shields, Shiffman, Paty, & Balabanis, 2002). In fact, a recent EMA study (Trull et al, in press) measuring affective instability among those with BPD or current major depressive disorder (MDD), found high compliance rates across the two groups (BPD: 87% and MDD: 88%).…”

Neural Response to Emotional Salience in Schizophrenia

“…The PET technique, with [O-15] water as a radiotracer, permitted the measurement of relative cerebral blood flow during each condition (tonic activity) and changing with the salience of stimuli containing aversive and positive emotional content (phasic activity). The use of positive stimuli was an important addition over our prior study , since patients with schizophrenia tend to report equal intensity of negative experience as controls, but reduced intensity of positive experience (Myin-Germeys et al, 2000). The prediction was tested that schizophrenic patients would exhibit less phasic activity (activation to salient stimuli) and greater tonic activity in the amygdala and ventral striatum (VS).…”