Prefrontal cortical deficits and impaired cognition-emotion interactions in schizophrenia.

OBJECTIVE: Despite schizophrenia patients' reports of diminished experience of emotion in interviews and self-report measures, their emotional experience in the presence of emotional stimuli and in daily life ("in the moment") appears largely intact. To examine emotion-cognition interactions, the authors tested the hypothesis that schizophrenia patients have unimpaired in-the-moment emotional reactivity but have a deficit in prefrontal cortical mechanisms needed to maintain and report on experience following exposure to emotional stimuli. METHOD: Using a slow event-related functional MRI paradigm, the authors examined the brain activity of 23 schizophrenia patients and 24 healthy comparison subjects during trials in which they viewed an affective picture and, after a delay, reported their emotional experience while viewing it. RESULTS: The patients' self-reports of emotional experience differed from those of the healthy subjects when they rated their experience on dimensions inconsistent with the stimulus valence but not when the dimension was consistent with it. In the presence of emotional stimuli, brain activity in the patients was similar to that of the comparison subjects. During the delay, however, patients showed decreased activation in a network of brain structures, including the dorsolateral prefrontal cortex and other prefrontal, limbic, and paralimbic areas. In patients, the delay-related response of the dorsolateral prefrontal cortex to pleasant stimuli correlated negatively with an anhedonia measure. CONCLUSIONS: These results suggest that schizophrenia is characterized by a failure of prefrontal circuitry supporting the link between emotion and goal-directed behavior and that the failure of this mechanism may contribute to deficits in processes related to emotion-cognition interaction.

Impact of motivational salience on affect modulated startle at early and late probe times.

This study systematically manipulated both picture content and noise probe time in order to evaluate the effects of motivational salience (as distinguished from affective valence) on both early and late modulation of the startle response. Specifically, modulation was compared for erotic versus action/adventure scenes, and for direct threat versus victim scenes, at early (300 and 800 ms) and late (3500 ms) probe times -- all relative to neutral. Blink inhibition was observed at all probe times during presentation of erotic pictures, and blink potentiation was evident at all times during presentation of direct threat pictures. Patterns of blink modulation were less consistent for action and victim picture contents. These findings are consistent with the hypothesis that under conditions of high motivational salience, affective startle modulation indexes the activation of appetitive-approach and defensive motivational states, even at early stages of picture processing.

Sex differences in the time course of emotion.

Conventional wisdom holds that women are more "emotional" than men. However, research evidence suggests that sex differences in emotion are considerably more complex. The authors tested hypotheses about sex differences in the engagement of the approach and avoidance motivational systems thought to underpin emotional responses. The authors measured reported emotional experience and startle response magnitude both during the presentation and after the offset of emotional stimuli that engage these motivational systems to assess whether men and women differ in their patterns of immediate response to emotional stimuli and in their patterns of recovery from these responses. Our findings indicated that women were more experientially reactive to negative, but not positive, emotional pictures compared to men, and that women scored higher than men on measure of aversive motivational system sensitivity. Although both men and women exhibited potentiation of the startle response during the presentation of negative pictures relative to neutral pictures, only women continued to show this relative potentiation during the recovery period, indicating that women were continuing to engage the aversive motivational system after the offset of negative emotional pictures.

Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure.

Research on anhedonia in schizophrenia has revealed mixed results, with patients reporting greater anhedonia than healthy controls on self-report measures and semi-structured interviews, but also reporting comparable experiences of positive emotions in response to pleasurable stimuli. Basic science points to the importance of distinguishing between anticipatory and consummatory (or in-the-moment) pleasure experiences, and this distinction may help to reconcile the mixed findings on anhedonia in schizophrenia. In two studies, we tested the hypothesis that anhedonia in schizophrenia reflects a deficit in anticipatory pleasure but not consummatory pleasure. In Study 1, we used experience sampling methodology to assess reported experiences of consummatory and anticipated pleasure among schizophrenia patients and controls. In Study 2, schizophrenia patients and controls completed a self-report trait measure of anticipatory and consummatory pleasure and interviews that assessed negative symptoms, including anhedonia, and community functioning. In both studies, we found evidence for an anticipatory but not a consummatory pleasure deficit in schizophrenia. In addition, anticipatory pleasure was related to clinical ratings of anhedonia and functional outcome. Clinical and research implications of these findings are discussed.