Emotional granularity and social functioning in individuals with schizophrenia: An experience sampling study

Abstract

Previous research has shown that healthy individuals who fail to differentiate among emotional states (i.e., those with low emotional granularity; EG) have poorer social functioning (SF) than those with high EG. It is unknown, however, whether these associations extend to clinical disorders characterized by impaired SF, such as schizophrenia. In the present study, we compared SF and EG in individuals with schizophrenia and healthy controls, and then, within the schizophrenia group, we examined the links between EG and SF. Employing an Experience Sampling Method approach, 77 individuals with schizophrenia and 27 healthy controls rated their momentary emotions (sadness, anxiety, anger, and happiness) up to 10 times/day over a two-day period using mobile electronic devices. For each participant, we then calculated the within-subject average correlations among the momentary emotion ratings, producing two EG indices – EGIall for all emotions and EGIneg for negative ones. A subsample of participants with schizophrenia also completed self-report, interview, and ability-based measures of SF. Compared to healthy controls, individuals with schizophrenia displayed significantly poorer SF and lower EGIall, but comparable EGIneg. Within the schizophrenia group, hierarchical multiple regression analyses indicated that EGIall, but not EGIneg, significantly predicted social dysfunction after controlling for emotional awareness, symptoms, and emotional intensity and variability. Our findings indicate that individuals with schizophrenia have a relatively intact ability to differentiate among negative emotions in everyday life. However, they experience significant difficulties differentiating between positive and negative emotions, and this may contribute to their social difficulties.

Daily life evidence of environment-incongruent emotion in schizophrenia

“…We did not find evidence for a disconnect between positive emotion and the environment, and, in contrast to Kimhy et al (2014), we did not find that people with and without schizophrenia differed in the extent to which their positive and negative emotions were related. Our data suggest that schizophrenia is not characterized by a disconnect between positive emotion and pleasure appraisals of the environment or more independence of positive and negative emotion, but rather is limited specifically to the elevation and dysregulation of negative emotion.…”

“…These results are in line with neuroimaging studies that indicate elevated amygdala activation during neutral stimuli in schizophrenia (Anticevic et al, 2012) and reduced activation in frontal regions supporting emotional processing (Taylor et al, 2012). EMA studies support negative emotion dysregulation, finding that that people with schizophrenia report more negative emotion than people without schizophrenia (Myin-Germeys et al, 2000; Myin-Germeys, et al, 2003; Myin-Germeys et al, 2005, Oorschot et al, 2013), and, intriguingly, a recent EMA study found that people with schizophrenia evidenced less differentiation of positive and negative emotions in daily life (Kimhy et al, 2014). Although individuals typically reciprocally activate positive and negative emotion (Larson et al, 2001) people with schizophrenia may have more independent or even coactivation of positive and negative emotion.…”

Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis

“…However, the finding that the ability to be aware of, tolerate and accept emotions was predictive of how individuals with psychosis responded to stress, not only emotionally, but also with regard to symptom increase, is extremely valuable in regard to the further development of interventions for these patients. Furthermore, it underlines that these abilities are relevant to psychosis, as has also been demonstrated in two studies by Kimhy et al (2012Kimhy et al ( , 2014 who found the ability to identify and describe emotions and the ability to differentiate between different emotional states to go along with higher levels of social functioning.…”

“…Several recent studies point to ER difficulties in people with psychotic disorders: These studies found participants with psychosis to have problems in being aware of emotions (Kimhy et al, 2012(Kimhy et al, , 2014Lincoln et al, 2015a), which is a precondition for tolerating and accepting them. Compared to healthy controls, people with psychosis also use more dysfunctional and less functional strategies, for example, they tend to suppress rather than accept emotions and are less successful in using cognitive strategies to change emotions in the desired direction (O'Driscoll et al, 2014).…”

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

“…Impaired emotional awareness and use of suppression is associated with worse social functioning in individuals with a diagnosis of schizophrenia [90][91][92] and CHR individuals [93•]. Moreover, these impairments appear to contribute to symptoms and social functioning impairments over and above neurocognitive deficits [91, 93•, 94].…”