Loneliness in the Daily Lives of People With Mood and Psychotic Disorders.

BACKGROUND AND HYPOTHESIS: Loneliness, the subjective experience of feeling alone, is associated with physical and psychological impairments. While there is an extensive literature linking loneliness to psychopathology, limited work has examined loneliness in daily life in those with serious mental illness. We hypothesized that trait and momentary loneliness would be transdiagnostic and relate to symptoms and measures of daily functioning. STUDY DESIGN: The current study utilized ecological momentary assessment and passive sensing to examine loneliness in those with schizophrenia (N = 59), bipolar disorder (N = 61), unipolar depression (N = 60), remitted unipolar depression (N = 51), and nonclinical comparisons (N = 82) to examine relationships of both trait and momentary loneliness to symptoms and social functioning in daily life. STUDY RESULTS: Findings suggest that both trait and momentary loneliness are higher in those with psychopathology (F(4,284) = 28.00, P < .001, ηp2 = 0.27), and that loneliness significantly relates to social functioning beyond negative symptoms and depression (ß = -0.44, t = 6.40, P < .001). Furthermore, passive sensing measures showed that greater movement (ß = -0.56, t = -3.29, P = .02) and phone calls (ß = -0.22, t = 12.79, P = .04), but not text messaging, were specifically related to decreased loneliness in daily life. Individuals higher in trait loneliness show stronger relationships between momentary loneliness and social context and emotions in everyday life. CONCLUSIONS: These findings provide further evidence pointing to the importance of loneliness transdiagnostically and its strong relation to social functioning. Furthermore, we show that passive sensing technology can be used to measure behaviors related to loneliness in daily life that may point to potential treatment implications or early detection markers of loneliness.

Cognitive Control in Schizophrenia: Advances in Computational Approaches.

Psychiatric research is undergoing significant advances in an emerging subspeciality of computational psychiatry, building upon cognitive neuroscience research by expanding to neurocomputational modeling. Here, we illustrate some research trends in this domain using work on proactive cognitive control deficits in schizophrenia as an example. We provide a selective review of formal modeling approaches to understanding cognitive control deficits in psychopathology, focusing primarily on biologically plausible connectionist-level models as well as mathematical models that generate parameter estimates of putatively dissociable psychological or neural processes. We illustrate some of the advantages of these models in terms of understanding both cognitive control deficits in schizophrenia and the potential roles of effort and motivation. Further, we highlight critical future directions for this work, including a focus on establishing psychometric properties, additional work modeling psychotic symptoms and their interaction with cognitive control, and the need to expand both behavioral and neural modeling to samples that include individuals with different mental health conditions, allowing for the examination of dissociable neural or psychological substrates for seemingly similar cognitive impairments across disorders.

A Transdiagnostic Study of Effort-Cost Decision-Making in Psychotic and Mood Disorders.

BACKGROUND: Research suggests that effort-cost decision-making (ECDM), the estimation of work required to obtain reward, may be a relevant framework for understanding motivational impairment in psychotic and mood pathology. Specifically, research has suggested that people with psychotic and mood pathology experience effort as more costly than controls, and thus pursue effortful goals less frequently. This study examined ECDM across psychotic and mood pathology. HYPOTHESIS: We hypothesized that patient groups would show reduced willingness to expend effort compared to controls. STUDY DESIGN: People with schizophrenia (N = 33), schizoaffective disorder (N = 28), bipolar disorder (N = 39), major depressive disorder (N = 40), and controls (N = 70) completed a physical ECDM task. Participants decided between completing a low-effort or high-effort option for small or larger rewards, respectively. Reward magnitude, reward probability, and effort magnitude varied trial-by-trial. Data were analyzed using standard and hierarchical logistic regression analyses to assess the subject-specific contribution of various factors to choice. Negative symptoms were measured with a clinician-rated interview. STUDY RESULTS: There was a significant effect of group, driven by reduced choice of high-effort options in schizophrenia. Hierarchical logistic regression revealed that reduced choice of high-effort options in schizophrenia was driven by weaker contributions of probability information. Use of reward information was inversely associated with motivational impairment in schizophrenia. Surprisingly, individuals with major depressive disorder and bipolar disorder did not differ from controls. CONCLUSIONS: Our results provide support for ECDM deficits in schizophrenia. Additionally, differences between groups in ECDM suggest a seemingly similar behavioral phenotype, reduced motivation, could arise from disparate mechanisms.

Dissociation of Cognitive Effort-Based Decision Making and Its Associations With Symptoms, Cognition, and Everyday Life Function Across Schizophrenia, Bipolar Disorder, and Depression.

BACKGROUND: Anhedonia and amotivation are symptoms of many different mental health disorders that are frequently associated with functional disability, but it is not clear whether the same processes contribute to motivational impairments across disorders. This study focused on one possible factor, the willingness to exert cognitive effort, referred to as cognitive effort-cost decision making. METHODS: We examined performance on the deck choice task as a measure of cognitive effort-cost decision making, in which people choose to complete an easy task for a small monetary reward or a harder task for larger rewards, in 5 groups: healthy control (n = 80), schizophrenia/schizoaffective disorder (n = 50), bipolar disorder with psychosis (n = 58), current major depression (n = 60), and past major depression (n = 51). We examined cognitive effort-cost decision making in relation to clinician and self-reported motivation symptoms, working memory and cognitive control performance, and life function measured by ecological momentary assessment and passive sensing. RESULTS: We found a significant diagnostic group × reward interaction (F8,588 = 4.37, p < .001, ηp2 = 0.056). Compared with the healthy control group, the schizophrenia/schizoaffective and bipolar disorder groups, but not the current or past major depressive disorder groups, showed a reduced willingness to exert effort at the higher reward values. In the schizophrenia/schizoaffective and bipolar disorder groups, but not the major depressive disorder groups, reduced willingness to exert cognitive effort for higher rewards was associated with greater clinician-rated motivation impairments, worse working memory and cognitive control performance, and less engagement in goal-directed activities measured by ecological momentary assessment. CONCLUSIONS: These findings suggest that the mechanisms contributing to motivational impairments differ among individuals with psychosis spectrum disorders versus depression.

Effort-cost decision-making in psychotic and mood disorders.

Avolition and anhedonia are core symptoms across psychosis and mood disorders. One important mechanism thought to relate to these symptoms is effort-cost decision-making (ECDM), the valuation and estimation of work required to obtain a given reward. While recent work suggests impairments in ECDM in both mood disorders and psychosis relative to controls, limited work has taken a transdiagnostic approach to examine how these deficits relate to different symptom profiles across disorders. The present study investigated ECDM across schizophrenia/schizoaffective disorder (N = 33), bipolar disorder (N = 47), unipolar depression (N = 61), and healthy controls (N = 58) to examine willingness to expend physical effort. Moreover, we examined the relationship between ECDM and motivation and pleasure symptoms across participants. We found that people with schizophrenia and bipolar disorder showed a reduced willingness to expend physical effort at high reward values relative to controls, while as a group, those with depression showed no differences relative to controls. However, individual differences in self-reported motivation and pleasure predicted reduced ECDM, particularly at high reward values, suggesting that both severity of symptoms and diagnostic categories are important for understanding altered ECDM in psychopathology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Associations Between Cognitive and Physical Effort-Based Decision Making in People With Schizophrenia and Healthy Control Subjects.

BACKGROUND: Effort can take a variety of forms including physical (e.g., button pressing) and cognitive (e.g., working memory tasks). Few studies have examined whether individual differences in willingness to expend effort are similar or different across modalities. METHODS: We recruited 30 individuals with schizophrenia and 44 healthy control subjects to complete 2 effort-cost decision-making tasks: the Effort Expenditure for Rewards Task (physical effort) and the cognitive effort discounting task (cognitive effort). RESULTS: Willingness to expend cognitive and physical effort was positively associated for both individuals with schizophrenia and control subjects. Further, we found that individual differences in motivation and pleasure dimension of negative symptoms modulated the association between physical and cognitive effort. Specifically, participants with lower motivation and pleasure scores, irrespective of group status, showed stronger associations between task measures of cognitive and physical effort-cost decision making. CONCLUSIONS: These results suggest a generalized deficit across effort modalities in individuals with schizophrenia. Further, reductions in motivation and pleasure may impact effort-cost decision making in a domain-general manner.

Anhedonia in Schizophrenia.

Anhedonia has long been considered a cardinal symptom of schizophrenia. This symptom is strongly associated with poor functional outcome, and limited treatment options are available. While originally conceptualized as an inability to experience pleasure, recent work has consistently shown that individuals with schizophrenia have an intact capacity to experience pleasure in-the-moment. Adjacent work in basic affective neuroscience has broadened the conceptualization of anhedonia to include not only the capacity to experience pleasure but highlights important temporal affective dynamics and decision-making processes that go awry in schizophrenia. Here we detail these mechanisms for emotional and motivational impairment in people with schizophrenia including: (1) initial response to reward; (2) reward anticipation; (3) reward learning; (4) effort-cost decision-making; (5) working memory and cognitive control. We will review studies that utilized various types of rewards (e.g., monetary, social), in order to draw conclusions regarding whether findings vary by reward type. We will then discuss how modern assessment methods may best incorporate each of the mechanisms, to provide a more fine-grained understanding of anhedonia in individuals with schizophrenia. We will close by providing a discussion of relevant future directions.

Extracting brain disease-related connectome subgraphs by adaptive dense subgraph discovery.

Group-level brain connectome analysis has attracted increasing interest in neuropsychiatric research with the goal of identifying connectomic subnetworks (subgraphs) that are systematically associated with brain disorders. However, extracting disease-related subnetworks from the whole brain connectome has been challenging, because no prior knowledge is available regarding the sizes and locations of the subnetworks. In addition, neuroimaging data are often mixed with substantial noise that can further obscure informative subnetwork detection. We propose a likelihood-based adaptive dense subgraph discovery (ADSD) model to extract disease-related subgraphs from the group-level whole brain connectome data. Our method is robust to both false positive and false negative errors of edge-wise inference and thus can lead to a more accurate discovery of latent disease-related connectomic subnetworks. We develop computationally efficient algorithms to implement the novel ADSD objective function and derive theoretical results to guarantee the convergence properties. We apply the proposed approach to a brain fMRI study for schizophrenia research and identify well-organized and biologically meaningful subnetworks that exhibit schizophrenia-related salience network centered connectivity abnormality. Analysis of synthetic data also demonstrates the superior performance of the ADSD method for latent subnetwork detection in comparison with existing methods in various settings.

Schizophrenia Patients Show Largely Similar Salience Signaling Compared to Healthy Controls in an Observational Task Environment.

Recent evidence suggests that the aberrant signaling of salience is associated with psychotic illness. Salience, however, can take many forms in task environments. For example, salience may refer to any of the following: (1) the valence of an outcome, (2) outcomes that are unexpected, called reward prediction errors (PEs), or (3) cues associated with uncertain outcomes. Here, we measure brain responses to different forms of salience in the context of a passive PE-signaling task, testing whether patients with schizophrenia (SZ) showed aberrant signaling of particular types of salience. We acquired event-related MRI data from 29 SZ patients and 23 controls during the performance of a passive outcome prediction task. Across groups, we found that the anterior insula and posterior parietal cortices were activated to multiple different types of salience, including PE magnitude and heightened levels of uncertainty. However, BOLD activation to salient events was not significantly different between patients and controls in many regions, including the insula, posterior parietal cortices, and default mode network nodes. Such results suggest that deficiencies in salience processing in SZ may not result from an impaired ability to signal salience per se, but instead the ability to use such signals to guide future actions. Notably, no between-group differences were observed in BOLD signal changes associated with PE-signaling in the striatum. However, positive symptom severity was found to significantly correlate with the magnitudes of salience contrasts in default mode network nodes. Our results suggest that, in an observational environment, SZ patients may show an intact ability to activate striatal and cortical regions to rewarding and non-rewarding salient events. Furthermore, reduced deactivation of a hypothesized default mode network node for SZ participants with high levels of positive symptoms, following salient events, point to abnormalities in interactions of the salience network with other brain networks, and their potential importance to positive symptoms.

An ecological examination of loneliness and social functioning in people with schizophrenia.

Loneliness is associated with a myriad of detrimental outcomes in mental and physical health. Previous studies have found that people with schizophrenia report greater loneliness than controls, and that loneliness is related to depressive symptoms. However, research has been limited, particularly regarding contributions of loneliness to social and occupational functioning. Further, few studies have examined associations between loneliness and daily experience in schizophrenia. Thus, we recruited 35 individuals with schizophrenia and 37 controls. All participants completed the UCLA loneliness scale, symptom assessments, and measures of social and occupational functioning. Additionally, participants with schizophrenia completed an ecological momentary assessment (EMA) protocol that indexed daily social and emotional experiences, including loneliness. Similar to previous reports, we found that those with schizophrenia reported greater loneliness than controls. Further, loneliness was positively associated with depressive and negative symptoms, and negatively associated with self-reported social functioning. Interestingly, loneliness remained a significant predictor of functioning even when controlling for other symptoms, suggesting that severity of depressive and negative symptoms cannot fully explain the relationship between loneliness and functioning. In our EMA analyses, loneliness did not significantly differ when individuals were alone versus with others, underscoring the notion that being alone is not the same as feeling lonely. However, self-reported engagement during social interactions was negatively associated with loneliness, at a trend-level, suggesting that quality of social interactions is a potentially important consideration. Taken together, these findings suggest that loneliness is an important treatment target and provide understanding for how loneliness may manifest in daily life in schizophrenia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Retention of Value Representations Across Time in People With Schizophrenia and Healthy Control Subjects.

BACKGROUND: The current study aimed to further etiological understanding of the psychological mechanisms underlying negative symptoms in people with schizophrenia. Specifically, we tested whether negative symptom severity is associated with reduced retention of reward-related information over time and thus a degraded ability to utilize such information to guide future action selection. METHODS: Forty-four patients with a diagnosis of schizophrenia or schizoaffective disorder and 28 healthy control volunteers performed a probabilistic reinforcement-learning task involving stimulus pairs in which choices resulted in reward or in loss avoidance. Following training, participants indicated their valuation of learned stimuli in a test/transfer phase. The test/transfer phase was administered immediately following training and 1 week later. Percent retention was defined as accuracy at week-long delay divided by accuracy at immediate delay. RESULTS: Healthy control subjects and people with schizophrenia showed similarly robust retention of reinforcement learning over a 1-week delay interval. However, in the schizophrenia group, negative symptom severity was associated with reduced retention of information regarding the value of actions across a week-long interval. This pattern was particularly notable for stimuli associated with reward compared with loss avoidance. CONCLUSIONS: Our results show that although individuals with schizophrenia may initially learn about rewarding aspects of their environment, such learning decays at a more rapid rate in patients with severe negative symptoms. Thus, previously learned reward-related information may be more difficult to access to guide future decision making and to motivate action selection.

Temporal-thalamic and cingulo-opercular connectivity in people with schizophrenia.

A growing body of research has suggested that people with schizophrenia (SZ) exhibit altered patterns of functional and anatomical brain connectivity. For example, many previous resting state functional connectivity (rsFC) studies have shown that, compared to healthy controls (HC), people with SZ demonstrate hyperconnectivity between subregions of the thalamus and sensory cortices, as well as hypoconnectivity between subregions of the thalamus and prefrontal cortex. In addition to thalamic findings, hypoconnectivity between cingulo-opercular brain regions thought to be involved in salience detection has also been commonly reported in people with SZ. However, previous studies have largely relied on seed-based analyses. Seed-based approaches require researchers to define a single a priori brain region, which is then used to create a rsFC map across the entire brain. While useful for testing specific hypotheses, these analyses are limited in that only a subset of connections across the brain are explored. In the current manuscript, we leverage novel network statistical techniques in order to detect latent functional connectivity networks with organized topology that successfully differentiate people with SZ from HCs. Importantly, these techniques do not require a priori seed selection and allow for whole brain investigation, representing a comprehensive, data-driven approach to determining differential connectivity between diagnostic groups. Across two samples, (Sample 1: 35 SZ, 44 HC; Sample 2: 65 SZ, 79 HC), we found evidence for differential rsFC within a network including temporal and thalamic regions. Connectivity in this network was greater for people with SZ compared to HCs. In the second sample, we also found evidence for hypoconnectivity within a cingulo-opercular network of brain regions in people with SZ compared to HCs. In summary, our results replicate and extend previous studies suggesting hyperconnectivity between the thalamus and sensory cortices and hypoconnectivity between cingulo-opercular regions in people with SZ using data-driven statistical and graph theoretical techniques.

Neurophysiological evidence for emotion regulation impairment in schizophrenia: The role of visual attention and cognitive effort.

Prior research indicates that individuals with schizophrenia (SZ) display emotion regulation abnormalities that are critically linked to increased symptom severity and poor functional outcome. However, processes contributing to the aberrant implementation of various strategies are unclear. The current study took a multimodal approach to identifying mechanisms underlying the impaired implementation of 2 strategies: reappraisal and distraction. Participants included 25 individuals with SZ and 25 healthy controls (CN) who completed separate event-related potential and eye-tracking/pupil dilation tasks. On each task, participants were required to either passively view unpleasant or neutral stimuli or reduce negative affect using reappraisal or distraction emotion regulation strategies. The late positive potential (LPP) event related potential component was used as an objective neurophysiological indicator of emotion regulation effectiveness. Eye tracking and pupil dilation were used to determine whether the implementation of reappraisal and distraction were associated with abnormal patterns of visual attention and reduced cognitive effort, respectively. Results indicated that CN could effectively decrease the amplitude of the LPP for both reappraisal and distraction compared with unpleasant passive viewing; however, individuals with SZ showed comparable LPP amplitude among conditions, indicating a failure to effectively implement these strategies. In CN, successful down-regulation of negative affect was associated with different patterns of visual attention across regulation strategies. During reappraisal, there was an increase in fixations to arousing scene regions, whereas distraction was associated with reduced attention to arousing interest areas. In contrast, individuals with SZ made fewer fixations to arousing interest areas during reappraisal and more fixations to arousing interest areas during distraction. Furthermore, pupil dilation results suggested that individuals with SZ failed to exert adequate effort while implementing reappraisal. Collectively, these findings suggest that individuals with SZ are ineffective at implementing reappraisal and distraction; dysfunctional patterns of visual attention and low cognitive effort may contribute to these difficulties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Effort, avolition and motivational experience in schizophrenia: Analysis of behavioral and neuroimaging data with relationships to daily motivational experience.

Recent research suggests that schizophrenia is associated with reduced effort allocation. We examined willingness to expend effort, neural correlates of effort allocation, and the relationship of effort to daily motivational experience in schizophrenia. We recruited 28 individuals with schizophrenia and 30 controls to perform an effort task during fMRI. Individuals with schizophrenia also completed an ecological momentary assessment (EMA) protocol. Individuals with schizophrenia with high negative symptoms were less willing to expend effort for rewards. Daily EMA assessments of motivation were positively associated with effort allocation at a trend-level. Individuals with schizophrenia and controls displayed similar increases in BOLD activation in frontal, cingulate, parietal, and insular regions during effort-based decision-making. However, negative symptoms were associated with reduced BOLD activation in bilateral ventral striatum. These results replicate previous reports of reduced effort allocation in schizophrenia patients with severe negative symptoms, and provide evidence for the role of ventral striatum in effort impairments.

Effort in daily life: relationships between experimental tasks and daily experience.

Recently, experimental tasks have been developed which index individual differences in willingness to expend effort for reward. However, little is known regarding whether such measures are associated with daily experience of effort. To test this, 31 participants completed an ecological momentary assessment (EMA) protocol, answering surveys regarding the mental and physical demand of their daily activities, and also completed two effort-based decision-making tasks: the Effort Expenditure for Rewards Task (EEfRT) and the Cognitive Effort Discounting (COGED) Task. Individuals who reported engaging in more mentally and physically demanding activities via EMA were also more willing to expend effort in the COGED task. However, EMA variables were not significantly associated with EEfRT decision-making. The results demonstrate the ecological, discriminant, and incremental validity of the COGED task, and provide preliminary evidence that individual differences in daily experience of effort may arise, in part, from differences in trait-level tendencies to weigh the costs versus benefits of actions.

From neuroimaging to daily functioning: A multimethod analysis of reward anticipation in people with schizophrenia.

Negative symptoms are a core clinical feature of schizophrenia that are only marginally responsive to current treatments. Recent work suggests that deficits in reinforcement learning and anticipatory responses to reward may be two mechanisms that help explain impairments in motivation in those with schizophrenia. The present study utilized a reinforcement-learning paradigm, which allowed us to examine both reward anticipation and reinforcement learning. Twenty-eight people with schizophrenia and 30 healthy controls completed a reinforcement-learning task while undergoing functional MRI. Participants with schizophrenia also completed a weeklong ecological momentary assessment protocol reporting anticipated motivation and pleasure in their daily activities. Unexpectedly, we found no significant group differences in performance or neural response in reinforcement learning. However, we found that poorer reward learning was associated with greater clinician ratings of negative symptoms and daily reports of anticipatory motivation and pleasure negative symptoms. In regards to anticipatory responses, we found that people with schizophrenia showed blunted activation in the anterior cingulate, insula, caudate, and putamen while anticipating reward. Further, blood oxygen level-dependent (BOLD) response in reward related regions during anticipation of reward was significantly related to both clinician-rated motivation and pleasure deficits as well as daily reports of motivation and pleasure. Our results provide further evidence of deficits during reward anticipation in individuals with schizophrenia, particularly for those with severe negative symptoms, and some evidence for worse reward learning among those with greater negative symptoms. Moreover, our findings suggest that these deficits show important relationships with emotional and motivational functioning in everyday life. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Psychotic like experiences as part of a continuum of psychosis: Associations with effort-based decision-making and reward responsivity.

Research examining psychotic disorders typically involves comparison between individuals with a clinical disorder and healthy controls. However, research suggests that psychotic symptoms, such as delusions and hallucinations, may exist on a continuum ranging from variation in healthy individuals to diagnosable psychotic disorders. On this continuum, some individuals endorse occasional psychotic like experiences (PLEs) that do not cause sufficient impairment or distress to warrant a clinical diagnosis. Given this continuum model, one might expect to observe impairments in those with PLEs in the same behavioral domains impaired in schizophrenia. Thus, we examined two domains typically impaired in schizophrenia, effort allocation and reward responsivity, in a large university sample (n = 126). Participants completed tasks assessing effort-based decision-making, reward responsivity, and questionnaires assessing PLEs. Greater PLEs were associated with greater effort expenditure regardless of probability of receiving a reward or reward value. Higher PLEs were related to greater positive feelings when receiving rewards. Importantly, these relationships remained the same when controlling for other symptoms such as depression, anhedonia, and anxiety. These findings suggest that PLEs may be associated with hypersensitivity to reward at the less severe end of the psychotic continuum, with effort to attain a reward expended in a potentially inefficient manner. This pattern is consistent with models of hyperdopaminergic states in psychotic individuals not taking antipsychotic medications, given the role of dopamine in modulating effort allocation and reward anticipation.

Electrocortical Responses to Emotional Stimuli in Psychotic Disorders: Comparing Schizophrenia Spectrum Disorders and Affective Psychosis.

Emotion dysfunction has long been considered a cardinal feature across psychotic disorders, including schizophrenia and affective psychosis. However, few studies have used objective markers of emotional function to compare psychotic disorders to one another, and fewer studies have examined such markers within a longitudinal framework. Here, we examine one objective marker of emotional responsivity, the late positive potential (LPP), which is a centro-parietal event-related potential (ERP) that tracks the dynamic allocation of attention to emotional vs. neutral stimuli. We used the LPP to characterize abnormal emotional responsivity by relating it to negative, depressive, and psychotic symptoms among two clinical groups: individuals diagnosed with affective psychosis and individuals with schizophrenia. We also used a long-term longitudinal framework, examining concurrent associations between LPP amplitude and symptom severity, as well as prospective associations with symptoms 4 years later. Participants were 74 individuals with psychotic illness: 37 with schizophrenia spectrum disorders and 37 with a primary affective disorder (psychotic bipolar disorder, psychotic depression). There were no mean-level differences in LPP amplitude between the schizophrenia spectrum and primary affective psychosis group. In the primary affective psychosis group, reduced LPP amplitude was associated with greater depressive, negative, and psychotic symptom severity, both concurrently and at follow-up; associations between LPP and symptoms were not observed within the schizophrenia spectrum group. This pattern of results suggests that the neural correlates of emotion dysfunction may differ across psychotic disorders. One possibility is that schizophrenia is characterized by a decoupling of symptom severity and emotional processing. Such findings underscore the importance of analyzing transdiagnostic samples to determine common or specific symptom relationships across various patient populations.

Emotion Regulation Predicts Everyday Emotion Experience and Social Function in Schizophrenia.

While recent evidence has pointed to disturbances in emotion regulation strategy use in schizophrenia, few studies have examined how these regulation strategies relate to emotionality and social behavior in daily life. Using ecological momentary assessment (EMA), we investigated the relationship between emotion regulation, emotional experience and social interaction in the daily lives of individuals with schizophrenia. Participants (N=30) used mobile phones to complete online questionnaires reporting their daily emotional experience and social interaction. Participants also completed self-report measures of habitual emotion regulation. Hierarchical linear modeling revealed that self-reported use of cognitive reappraisal and savoring of emotional experiences were related to greater positive emotion in daily life. In contrast, self-reported suppression was related to greater negative emotion, reduced positive emotion and reduced social interaction in daily life. These findings suggest that individual differences in habitual emotion regulation strategy usage have important relationships to every day emotional and social experiences in schizophrenia.