Expanding the positivity offset theory of anhedonia to the psychosis continuum

Riehle, Marcel; Pillny, Matthias; Lincoln, Tania M.

doi:10.1038/s41537-022-00251-x

Cited by 5 publications

(10 citation statements)

References 84 publications

(111 reference statements)

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“…Stimulation of all sensory systems was eligible in addition to semantic (words, narratives) and behavioral (social interaction) stimuli. We excluded studies (or experimental conditions) in which evocative stimuli could not be categorized as pleasant, neutral, or unpleasant (definitions available in protocol), were intendedly ambiguous, or were paired with incongruent or emotion-regulating stimuli or instructions …”

Section: Methodsmentioning

confidence: 99%

“…Negative symptoms are possibly associated with a diminished experience of pleasure 8 and an increased experience of negative emotion 9 for pleasant stimuli, and positive symptoms are possibly associated with an overall excess of negative emotion. 8 Another question is, to which degree the identified aberrations of the emotional experience also exist in people at risk for psychosis. For example, excessive negative affect is related to positive symptoms in people at risk for psychosis.…”

mentioning

confidence: 99%

“…One open question is whether aberrations in the emotional experience covary with the level of positive or negative symptoms of participants with schizophrenia. Negative symptoms are possibly associated with a diminished experience of pleasure 8 and an increased experience of negative emotion 9 for pleasant stimuli, and positive symptoms are possibly associated with an overall excess of negative emotion. 8 Another question is, to which degree the identified aberrations of the emotional experience also exist in people at risk for psychosis.…”

mentioning

confidence: 99%

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Emotional Experience of People With Schizophrenia and People at Risk for Psychosis

Riehle,

Straková,

Lincoln

2024

JAMA Psychiatry

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ImportancePsychotic symptoms are associated with subjective reports of aberrant emotion, such as excessive fear or anhedonia, but whether these aberrations reflect aberrant emotional experience of normative stimuli is uncertain both for individuals with schizophrenia and those at risk for psychosis.ObjectiveTo provide a meta-analysis of study samples of emotional experience in individuals with schizophrenia and those at risk for psychosis as assessed in laboratory-based emotion-induction studies.Data SourcesMEDLINE and PsycINFO databases were searched for articles published from January 1986 and Google Scholar citations of a relevant earlier meta-analysis until August 2022. Reference lists were manually searched for additional studies.Study SelectionIncluded studies measured positive or negative emotional experience in response to standardized emotionally evocative stimuli and compared participants diagnosed with schizophrenia or participants at risk for psychosis with healthy controls.Data Extraction and SynthesisThe meta-analysis was registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Data were extracted by 2 independent coders, and random-effects analyses were conducted.Main Outcomes and MeasuresOutcomes were 3 scales of emotional experience (unipolar positive emotion, unipolar negative emotion, bipolar valence), analyzed separately for pleasant, neutral, and unpleasant stimuli. A meta-analysis was conducted for differences between the 2 clinical groups combined and controls. Subgroup differences (schizophrenia vs at risk) and the influence of several other variables were tested in moderator analyses.ResultsThis systematic review and meta-analysis included data from 111 studies and 6913 participants (schizophrenia: 2848 [41.2%]; at risk: 877 [12.7%]; healthy controls: 3188 [46.1%]). Compared with controls, people with schizophrenia and those at risk for psychosis experienced pleasant stimuli as less positive (unipolar positive: standardized mean difference [SMD] Hedges g = −0.19; P =.001; bipolar valence: SMD Hedges g = −0.28; P &lt;.001) and more negative (Hedges g = 0.52; P &lt;.001), neutral stimuli as more negative (Hedges g = 0.55; P &lt;.001), and unpleasant stimuli as both more positive (unipolar positive: SMD Hedges g = 0.23; P =.005; bipolar valence: Hedges g = 0.12; P =.01) and more negative (Hedges g = 0.22; P &lt;.001). Moderator analyses indicated a less aberrant emotional experience for odors than for visual stimuli (unipolar negative, pleasant z score = −2.97; P =.003; unipolar negative, neutral z score = −2.70; P =.007), an association between higher negative symptoms and diminished positive emotion for pleasant stimuli in schizophrenia (z score = −2.98; P =.003), and that subgroup differences were limited to neutral stimuli.Conclusions and RelevanceResults suggest a pattern of aberrant emotional experience of normative stimuli in schizophrenia and that this already was observable before disorder onset. In particular, the aberrant experience of pleasant stimuli needs to be considered as an intervention target.

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Emotional Experience of People With Schizophrenia and People at Risk for Psychosis

Riehle,

Straková,

Lincoln

2024

JAMA Psychiatry

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“…We used the same emotional evocation task that has demonstrated strong associations with anhedonia in community participants in an earlier study (Riehle et al, 2022). Thus, we presented 16 pleasant images (e.g.…”

Section: Emotional Evocation Taskmentioning

confidence: 99%

“…However, recent studies have found specific associations of diminished positive emotion in response to pleasant stimuli and higher anhedonia levels (Riehle et al, 2022;Saxena et al, 2017) indicating that these paradigms capture anhedonia. To mechanistically test the D2R blockade's effect on experiential anhedonia, without having to consider confounding effects of the disorder, an important first step would be to investigate its effect on responses in emotion evocation paradigms in a sample of healthy volunteers before expanding the research to various clinical populations.…”

Section: Introductionmentioning

confidence: 99%