Differential Responses to Emotional Interference in Paranoid Schizophrenia and Bipolar Mania

Abstract

Background: Studies on emotional biases towards threat-related stimuli in schizophrenia and bipolar disorder have provided, so far, inconsistent results. The aim of the present study was to investigate emotional interference in acute schizophrenic and manic patients and its clinical correlates by using a card version of the Emotional Stroop Task designed with neutral, paranoid, depressive and manic words. Methods: Thirty paranoid schizophrenia patients, 30 manic patients and 60 healthy controls were compared on the Emotional Stroop Test. Response times (RT) were collected for each card. Interference indices were calculated by subtracting the RT for the neutral card from the RT for the depressive, paranoid and manic cards. Results: The schizophrenic and manic patient groups showed an increased interference effect when the emotional valence was relating to the disorder-specific psychopathology. In addition, the paranoid interference index correlated with positive symptoms in schizophrenic patients. By contrast, no correlation was evidenced between interference indices and mood symptoms in the manic group. Conclusions: Among schizophrenic patients, paranoid interference might be a state-related emotional abnormality associated with persecutory delusions. In mania, we suggest that emotional biases towards depressive as well as manic information might be trait features of the emotional hyperreactivity involved in the vulnerability to bipolar disorder.

Do Psychosis Patients with Poor Insight Show Implicit Awareness on the Emotional Stroop Task?

“…We minimised the effect of general performance by subtracting the average time taken to react to neutral words from the RT to negative words and psychosis-related words, a procedure used in recent studies in schizophrenia [35]. A mixed ANOVA confirmed the presence of an interaction between type of interference and case-control status [Wilks' lambda = 0.92, F(1,64) = 5.81, p = 0.019] in the first block of words, which was at trend level using the mean RT rather than an interference score.…”

Disconnection Between Amygdala and Medial Prefrontal Cortex in Psychotic Disorders

“…[40][41][42] Compared to controls, individuals with SCZ and BDP show greater deficits in attention towards the task-relevant dimension in the presence of the task-irrelevant emotional dimension that is an integral part of the stimulus. 15,43,44 A recent study found no difference between SCZ and controls for interference from emotional pictures while maintaining object information. 18 However, in this prior study the distraction was from a separate stimulus rather than an integral dimension of the target stimulus.…”

Beyond “Cold” Cognition: Exploring Cognitive Control of Emotion as a Risk Factor for Psychosis

“…Maladaptive ER strategies (e.g., suppression, rumination, self-blame, catastrophizing), commonly assessed using the Cognitive Emotion Regulation Reduced ACC and LPFC activation during ECA in anxiety [84]; reduced DLPFC and increased amygdala activation in depression [85] Findings in psychosis-spectrum samples Behavioral Suppression associated with more severe paranoia [87], auditory hallucinations [88], and poorer social functioning [94] Impaired ECA associated with paranoia [99], disorganized symptoms [100], and reduced positive affect [108] Neuroimaging Reduced frontal-limbic connectivity during reappraisal in schizophrenia [103] and PP [104] Reduced LPFC, medial PFC, and ACC activation during ECA in schizophrenia [105] and PP [104] ACC anterior cingulate cortex, BPD borderline personality disorder, CERQ Cognitive Emotion Regulation Questionnaire, DLPFC dorsolateral prefrontal cortex, ECA emotion conflict adaptation, ER emotion regulation, LPFC lateral prefrontal cortex, PFC prefrontal cortex, PP psychosis proneness Questionnaire (CERQ) [75], are increasingly recognized as vulnerability factors that contribute to the development and maintenance of psychopathology [28], particularly disorders characterized by affective instability, such as anxiety [76], depression [77,78], and substance use [79]. Similarly, impaired performance on ECA paradigms requiring inhibition of irrelevant negative emotional stimuli has been observed in depression [80], anxiety [81], borderline personality disorder [82], and those at risk for developing a mood disorder [83].…”

“…Similarly, GHR individuals show increased emotion interference effects on working memory performance, particularly in male subjects [96], and on emotional Stroop tasks [97]. In schizophrenia, impaired emotional Stroop performance relates to persecutory delusions [98], paranoia [99], and symptoms of disorganization [100]. Additionally, negative affective primes have been shown to negatively bias valence judgments of neutral Fig.…”