Emotion in Schizophrenia: Where Feeling Meets Thinking

Abstract

Our understanding of the nature of emotional difficulties in schizophrenia has been greatly enhanced by translational research over the past two decades. By incorporating methods and theories from affective science, researchers have been able to discover that people with schizophrenia exhibit very few outward displays of emotion but report experiencing strong feelings in the presence of emotionally evocative stimuli or events. Recent behavioral, psychophysiological, and brain imaging research has pointed to the importance of considering the time course of emotion in schizophrenia. This work has shown that people with schizophrenia have the ability to experience emotion in the moment; however, they appear to have difficulties when anticipating future pleasurable experiences, and this perhaps affects their motivation to have such experiences. While advancements in our understanding of emotional experience and expression in individuals with schizophrenia have been made, these developments have led to a new collection of research questions directed at understanding the time course of emotion in schizophrenia, including the role of memory and anticipation in motivated behavior, translating laboratory findings to the development of new assessment tools and new treatments targeting emotional impairments in people with this disorder.

Fig. 1

A model of the temporal experience of pleasure. A pleasurable experience may involve activating a cognitive representation of a past, related experience that will then trigger a process of predicting or anticipating what the new experience will feel like as well as a feeling of pleasure knowing that the experience is going to be happening in the future. These anticipatory processes will activate the motivation and behavior to go after or approach the experience. In the moment of “consuming” the experience, pleasure is experienced and savored or maintained so that it will be remembered at a later time.