Findings suggest that although SZ attempt to control their emotions using various strategies, often applying more effort than CN, these efforts are unsuccessful; emotion regulation abnormalities may result from difficulties at the identification, selection, and implementation stages.

Emotion regulation dysfunction is characteristic of psychotic disorders, but little is known about how the use of specific types of emotion regulation strategies differs across phases of psychotic illness. This information is vital for understanding factors contributing to psychosis vulnerability states and developing targeted treatments. Three studies were conducted to examine emotion regulation across phases of psychosis, which included (a) adolescent community members with psychotic-like experiences (PLEs; n = 262) and adolescents without PLEs (n = 1,226); (b) adolescents who met clinical high-risk criteria for a prodromal syndrome (n = 29) and healthy controls (n = 29); and (c) outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ; n = 61) and healthy controls (n = 67). In each study, participants completed the Emotion Regulation Questionnaire and measures of psychiatric symptoms and functional outcome. The three psychosis groups did not differ from each other in reported use of suppression; however, there was evidence for a vulnerability-related, dose-dependent decrease in reappraisal. Across each sample, a lower use of reappraisal was associated with poorer clinical outcomes. Findings indicate that emotion regulation abnormalities occur across a continuum of psychosis vulnerability and represent important targets for intervention.

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.

No abstract

No abstract