Skip to main content
SpringerLink
Log in

Subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

From the clinical practice and some experimental studies, it is apparent that paranoid schizophrenia patients tend to assign emotional salience to neutral social stimuli. This aberrant cognitive bias has been conceptualized to result from increased emotional arousal, but direct empirical data are scarce. The aim of the present study was to quantify the subjective emotional arousal (SEA) evoked by emotionally non-salient (neutral) compared to emotionally salient (negative) social stimuli in schizophrenia patients and healthy controls. Thirty male inpatients with paranoid schizophrenia psychosis and 30 demographically matched healthy controls rated their level of SEA in response to neutral and negative social scenes from the International Affective Picture System and the Munich Affective Picture System. Schizophrenia patients compared to healthy controls had an increased overall SEA level. This relatively higher SEA was evoked only by the neutral but not by the negative social scenes. To our knowledge, the present study is the first designed to directly demonstrate subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. This finding might explain previous clinical and experimental data and could be viewed as the missing link between the primary neurobiological and secondary psychological mechanisms of paranoid psychotic-symptom formation. Furthermore, despite being very short and easy to perform, the task we used appeared to be sensitive enough to reveal emotional dysregulation, in terms of emotional disinhibition/hyperactivation in paranoid schizophrenia patients. Thus, it could have further research and clinical applications, including as a neurobehavioral probe for imaging studies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Blanchard JJ, Mueser KT, Bellack AS (1998) Anhedonia, positive and negative affect, and social functioning in schizophrenia. Schizophr Bull 24:413–424

    PubMed  CAS  Google Scholar 

  2. Tso IF, Grove TB, Taylor SF (2010) Emotional experience predicts social adjustment independent of neurocognition and social cognition in schizophrenia. Schizophr Res 122(1–3):156–163

    Article  PubMed  Google Scholar 

  3. Horan WP, Blanchard JJ, Clark LA, Green MF (2008) Affective traits in schizophrenia and schizotypy. Schizophr Bull 34:856–874

    Article  PubMed  Google Scholar 

  4. Harvey PD, Penn D (2010) Social cognition: the key factor predicting social outcome in people with schizophrenia? Psychiatry (Edgmont) 7:41–44

    Google Scholar 

  5. Yamada M, Ueda K, Namiki C, Hirao K, Hayashi T, Ohigashi Y, Murai T (2009) Social cognition in schizophrenia: similarities and differences of emotional perception from patients with focal frontal lesions. Eur Arch Psychiatry Clin Neurosci 259(4):227–233

    Article  PubMed  Google Scholar 

  6. Giovanbattista E, Roncone R, Casacchia M, Galzio RJ (2007) Deficit of social cognition in subjects with surgically treated frontal lobe lesions and in subjects affected by schizophrenia. Eur Arch Psychiatry Clin Neurosci 257:12–22

    Article  PubMed  Google Scholar 

  7. Bigelow N, Paradiso S, Adolphs R, Moser D, Arndt S, Heberlein A, Nopoulos P, Andreasen NC (2006) Perception of socially relevant stimuli in schizophrenia. Schizophr Res 83:257–267

    Article  PubMed  Google Scholar 

  8. Hempel RJ, Tulen JH, van Beveren NJ, van Steenis HG, Mulder PG, Hengeveld MW (2005) Physiological responsivity to emotional pictures in schizophrenia. J Psychiatr Res 39:509–518

    Article  PubMed  Google Scholar 

  9. Kring AM, Moran EK (2008) Emotional response deficits in schizophrenia: insights from affective science. Schizophr Bull 34:819–834

    Article  PubMed  Google Scholar 

  10. Paradiso S, Andreasen NC, Crespo-Facorro B, O’Leary DS, Watkins GL, Boles Ponto LL, Hichwa RD (2003) Emotions in unmedicated patients with schizophrenia during evaluation with positron emission tomography. Am J Psychiatry 160:1775–1783

    Article  PubMed  Google Scholar 

  11. Sander D, Koenig O, Georgieff N, Terra JL, Franck N (2005) Emotional processes in schizophrenia: investigation of the evaluative component. Encephale 31(6 Pt 1):672–682

    Article  PubMed  CAS  Google Scholar 

  12. Schneider F, Gur RC, Koch K, Backes V, Amunts K, Shah NJ, Bilker W, Gur RE, Habel U (2006) Impairment in the specificity of emotion processing in schizophrenia. Am J Psychiatry 163:442–447

    Article  PubMed  Google Scholar 

  13. Wölwer W, Streit M, Polzer U, Gaebel W (1996) Facial affect recognition in the course of schizophrenia. Eur Arch Psychiatry Clin Neurosci 246(3):165–170

    Article  PubMed  Google Scholar 

  14. Taylor SF, Phan KL, Britton JC, Liberzon I (2005) Neural response to emotional salience in schizophrenia. Neuropsychopharmacology 30:984–995

    Article  PubMed  Google Scholar 

  15. Bleuler E (1911/1950) Dementia praecox or the group of schizophrenias. International Universities Press, New York

  16. Haralanov S, Haralanova E, Shkodrova D (2006) Cognitive-emotional bipolarity in schizophrenia. Neurol Psychiatry 4:22–24

    Google Scholar 

  17. Ziauddeen H, Dibben C, Kipps C, Hodges JR, McKenna PJ (2011) Negative schizophrenic symptoms and the frontal lobe syndrome: one and the same? Eur Arch Psychiatry Clin Neurosis 261(1):59–67

    Article  CAS  Google Scholar 

  18. Bleuler E (1906) Affectivitat suggestibilitat paranoia. Marhold, Halle

    Google Scholar 

  19. Jung CG (1907/1960) The psychology of dementia praecox. In: Routledge and Kegan Paul (eds) The psychogenesis of mental disease, collected works, vol 3. London, pp 3–151

  20. Bleuler E, Jung CG (1908) Komplexe und Krankheitsursachen bei dementia praecox. Zentralblatt fur Nervenheilkunde und Psychiatrie XIX:220–227

    Google Scholar 

  21. Jung CG (1934/1969) A Review of the complex theory. In: The structure and dynamics of the psyche, collected works, vol 8. 2nd edn. Bollingen Series XX, Princeton University Press, Princeton, pp 92–106

  22. Freeman D (2007) Suspicious minds: the psychology of persecutory delusions. Clin Psychol Rev 27:425–457

    Article  PubMed  Google Scholar 

  23. Freeman D, Garety PA (2003) Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations. Behav Res Ther 41:923–947

    Article  PubMed  Google Scholar 

  24. Bell V, Halligan PW, Ellis HD (2006) Explaining delusions: a cognitive perspective. Trends Cogn Sci 10:219–226

    Article  PubMed  Google Scholar 

  25. Haralanova E, Haralanov S, Shkodrova D (2007) Emotional dysregulation and psychotic-symptom formation in paranoid schizophrenia. Bulg Neurol Psychiatr Pract 4:13–16

    Google Scholar 

  26. van der Gaag M (2006) A neuropsychiatric model of biological and psychological processes in the remission of delusions and auditory hallucinations. Schizophr Bull 32(suppl 1):S113–S122

    Article  PubMed  Google Scholar 

  27. Corcoran R, Cummins S, Rowse G, Moore R, Blackwood N, Howard R, Kinderman P, Bentall RP (2006) Reasoning under uncertainty: heuristic judgments in patients with persecutory delusions or depression. Psychol Med 36:1109–1118

    Article  PubMed  Google Scholar 

  28. Phillips ML, David AS (2002) Cognitive impairments as causes of positive symptoms in schizophrenia. In: Sharma T, Harvey P (eds) Cognition in schizophrenia: impairments, importance, and treatment strategies, 3rd edn. Oxford University Press, New York, pp 210–228

    Google Scholar 

  29. Shkodrova D, Haralanova E, Haralanov S (2007) Cognitive mechanisms of delusion formation in paranoid psychosis. Bulg Neurol Psychiatr Pract 4:17–20

    Google Scholar 

  30. Freeman D, Garety PA (2004) The psychology of persecutory delusions. Psychology Press, Hove

    Google Scholar 

  31. Birchwood M (2004) The paradox of emotional dysfunction in non-affective psychosis. In: McDonald C, Schulze K, Murray RM, Wright P (eds) Schizophrenia: challenging the orthodox. Taylor & Francis, London and New York, pp 57–66

    Google Scholar 

  32. Speechley WJ, Ngan ET (2008) Dual-stream modulation failure: a novel hypothesis for the formation and maintenance of delusions in schizophrenia. Med Hypotheses 70:1210–1214

    Article  PubMed  Google Scholar 

  33. Gard DE, Kring AM (2009) Emotion in the daily lives of schizophrenia patients: context matters. Schizophr Res 115:379–380

    Article  PubMed  Google Scholar 

  34. Myin-Germeys I, van Os J, Schwartz JE, Stone AA, Delespaul PA (2001) Emotional reactivity to daily life stress in psychosis. Arch Gen Psychiatry 58:1137–1144

    Article  PubMed  CAS  Google Scholar 

  35. Mueser KT, Curran PJ, McHugo GJ (1997) Factor structure of the brief psychiatric rating scale in schizophrenia. Psychol Assess 9:196–204

    Article  Google Scholar 

  36. Berenbaum H, Fujita F (1994) Schizophrenia and personality: exploring the boundaries and connections between vulnerability and outcome. J Abnorm Psychol 103:148–158

    Article  PubMed  CAS  Google Scholar 

  37. Trémeau F, Antonius D, Cacioppo JT, Ziwich R, Jalbrzikowski M, Saccente E, Silipo G, Butler P, Javitt D (2009) In support of bleuler: objective evidence for increased affective ambivalence in schizophrenia based upon evocative testing. Schizophr Res 107:223–231

    Article  PubMed  Google Scholar 

  38. Cohen AS, Minor KS (2010) Emotional experience in patients with schizophrenia revisited: meta-analysis of laboratory studies. Schizophr Bull 36:143–150

    Article  PubMed  Google Scholar 

  39. Berenbaum H, Oltmanns TF (1992) Emotional experience and expression in schizophrenia and depression. J Abnorm Psychol 101:37–44

    Article  PubMed  CAS  Google Scholar 

  40. Kring AM, Kerr SL, Smith DA, Neale JM (1993) Flat affect in schizophrenia does not reflect diminished subjective experience of emotion. J Abnorm Psychol 102:507–517

    Article  PubMed  CAS  Google Scholar 

  41. Kring AM, Neale JM (1996) Do schizophrenic patients show a disjunctive relationship among expressive, experiential, and psychophysiological components of emotion? J Abnorm Psychol 105:249–257

    Article  PubMed  CAS  Google Scholar 

  42. Holt DJ, Titone D, Long LS, Goff DC, Cather C, Rauch SL, Judge A, Kuperbrg GR (2006) The misattribution of salience in delusional patients with schizophrenia. Schizophr Res 83:247–256

    Article  PubMed  Google Scholar 

  43. Galderisi S, Piegari G, Mucci A, Acerra A, Luciano L, Rabasca AF, Santucci F, Valente A, Volpe M, Mastantuono P, Maj M (2010) Social skills and neurocognitive individualized training in schizophrenia: comparison with structured leisure activities. Eur Arch Psychiatry Clin Neurosci 260(4):305–315

    Article  PubMed  Google Scholar 

  44. Harris LT, McClure SM, Van den Bos W, Cohen JD, Fiske ST (2007) Regions of the MPFC differentially tuned to social and nonsocial affective evaluation. Cogn Affect Behav Neurosci 7:309–316

    Article  PubMed  Google Scholar 

  45. Britton JC, Taylor SF, Berridge KC, Mikels JA, Liberzon I (2006) Differential subjective and psychophysiological responses to socially and nonsocially generated emotional stimuli. Emotion 6:150–155

    Article  PubMed  Google Scholar 

  46. Kohler CG, Turner TH, Bilker WB, Brensinger CM, Siegel SJ, Kanes SJ, Gur RE, Gur RC (2003) Facial emotion recognition in schizophrenia: intensity effects and error pattern. Am J Psychiatry 160:1768–1774

    Article  PubMed  Google Scholar 

  47. Haralanova E, Haralanov S, Shkodrova D (2008) Emotional production in non-affective psychoses: clinical and theoretical implications. Neurol Psychiatry 4:24–27

    Google Scholar 

  48. Kring AM, Barrett LF, Gard DE (2003) On the broad applicability of the affective circumflex: representations of affective knowledge among schizophrenia patients. Psychol Sci 14:207–214

    Article  PubMed  Google Scholar 

  49. Wager TD, Phan KL, Liberzon I, Taylor SF (2003) Valence, gender, and lateralization of functional brain anatomy in emotion: a meta-analysis of findings from neuroimaging. Neuroimage 19:513–531

    Article  PubMed  Google Scholar 

  50. World Health Organization (1992) The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. World Health Organization, Genève

  51. Janca A, Ustün TB, Early TS, Sartorius N (1993) The ICD-10 symptom checklist: a companion to the ICD-10 classification of mental and behavioural disorders. Soc Psychiatry Psychiatr Epidemiol 28:239–242

    PubMed  CAS  Google Scholar 

  52. Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    PubMed  CAS  Google Scholar 

  53. Lang PJ, Bradley MM, Cuthbert BN (2008) International affective picture system (IAPS): affective ratings of pictures and instruction manual. University of Florida, Gainesville

    Google Scholar 

  54. Beraldi A, Haralanova E, Engel RR, Fast K (2006) New affective picture database: the munich affective picture system–MAPS. (eine neue affektive bildersammlung: die münchner affektive bildersammlung–MABS). In: DGPs. Nürnberg, Germany

  55. McRae K, Hughes B, Chopra S, Gabrieli JDE, Gross JJ, Ochsner KN (2010) The neural bases of distraction and reappraisal. J Cogn Neurosci 22:248–262

    Article  PubMed  Google Scholar 

  56. Ochsner KN, Bunge SA, Gross JJ, Gabrieli JD (2002) Rethinking feelings: an FMRI study of the cognitive regulation of emotion. J Cogn Neurosci 14:1215–1229

    Article  PubMed  Google Scholar 

  57. Lang PJ (1980) Behavioral treatment and bio-behavioral assessment: computer applications. In: Sidowski JB, Johnson JH, Williams TA (eds) Technology in mental health care delivery systems. Ablex, Norwood, pp 119–137

    Google Scholar 

  58. Williams LM, Das P, Harris AWF, Liddell BB, Brammer MJ, Olivieri G, Skerrett D, Phillips ML, David AS, Peduto A, Gordon E (2004) Dysregulation of arousal and amygdala-prefrontal systems in paranoid schizophrenia. Am J Psychiatry 161:480–489

    Article  PubMed  Google Scholar 

  59. Weiss EM, Kohler CG, Brensinger CM, Bilker WB, Loughead J, Delazer M, Nolan KA (2007) Gender differences in facial emotion recognition in persons with chronic schizophrenia. Eur Psychiatry 22:116–122

    Article  PubMed  Google Scholar 

  60. Jensen J, Willeit M, Zipursky RB, Savina I, Smith AJ, Menon M, Crawley AP, Kapur S (2008) The formation of abnormal associations in schizophrenia: neural and behavioral evidence. Neuropsychopharmacology 33:473–479

    Article  PubMed  Google Scholar 

  61. Phillips ML, Senior C, David AS (2000) Perception of threat in schizophrenics with persecutory delusions: an investigation using visual scan paths. Psychol Med 30:157–167

    Article  PubMed  CAS  Google Scholar 

  62. Hemsley DR (1996) Schizophrenia: a cognitive model and its implications for psychological intervention. Behav Modif 20:139–169

    Article  PubMed  CAS  Google Scholar 

  63. Surguladze S, Russell T, Kucharska-Pietura K, Travis MJ, Giampietro V, David AS, Phillips ML (2006) A reversal of the normal pattern of parahippocampal response to neutral and fearful faces is associated with reality distortion in schizophrenia. Biol Psychiatry 60:423–431

    Article  PubMed  Google Scholar 

  64. Aleman A, Kahn RS (2005) Strange feelings: do amygdala abnormalities dysregulate the emotional brain in schizophrenia? Prog Neurobiol 77:283–298

    PubMed  Google Scholar 

  65. Hall J, Whalley HC, McKirdy JW, Romaniuk L, McGonigle D, McIntosh AM, Baig BJ, Gountouna VE, Job DE, Donaldson DI, Sprengelmeyer R, Young AW, Johnstone EC, Lawrie SM (2008) Overactivation of fear systems to neutral faces in schizophrenia. Biol Psychiatry 64:70–73

    Article  PubMed  Google Scholar 

  66. Seiferth NY, Pauly K, Habel U, Kellermann T, Shah NJ, Ruhrmann S, Klosterkotter J, Schneider F, Kircher T (2008) Increased neural response related to neutral faces in individuals at risk for psychosis. Neuroimage 40:289–297

    Article  PubMed  Google Scholar 

  67. LeDoux JE (2000) Emotion circuits in the brain. Annu Rev Neurosci 23:155–184

    Article  PubMed  CAS  Google Scholar 

  68. Kapur S, Mizrahi R, Li M (2005) From dopamine to salience to psychosis–linking biology, pharmacology and phenomenology of psychosis. Schizophr Res 79:59–68

    Article  PubMed  Google Scholar 

  69. Kapur S (2003) Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry 160:13–23

    Article  PubMed  Google Scholar 

  70. Rössler W, Angst J, Gamma A, Haker H, Stulz N, Merikangas KR, Ajdacic-Gross V (2011) Reappraisal of the interplay between psychosis and depression symptoms in the pathogenesis of psychotic syndromes: results from a twenty-year prospective community study. Eur Arch Psychiatry Clin Neurosci 261(1):11–19

    Article  PubMed  Google Scholar 

  71. Möller HJ, Falkai P (2011) The psychosis continuum: diagnosis and other phenotypes. Eur Arch Psychiatry Clin Neurosci 261(1):1–2

    Article  PubMed  Google Scholar 

  72. van Os J (2009) A salience dysregulation syndrome. Br J Psychiatry 194:101–103

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the financial support from the Bavarian Research Foundation (Bayerische Forschungsstiftung) within the Neuro-Cognitive Psychology (NCP) Program. DAAD and the German Research Foundation (DFG, IRTG 1328) also provided partial funding for the project. We wish to thank Diana Shkodrova, MD, PhD, for the helpful discussions and for her valuable inputs and useful comments on the study and the manuscript.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Section Neurocognition, Division of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstraße 7, 80336, Munich, Germany

    Evelina Haralanova, Anna Beraldi & Kristina Hennig-Fast

  2. Neuro-Cognitive Psychology, Department of Psychology, Ludwig Maximilian University, Leopoldstr. 13, 80802, Munich, Germany

    Evelina Haralanova, Anna Beraldi & Kristina Hennig-Fast

  3. E-Motion Center, Institute for Cognitive-Affective Neuroscience, 117 Vasil Levsky Str., 1000, Sofia, Bulgaria

    Evelina Haralanova & Svetlozar Haralanov

  4. Department of Psychiatry, Medical University, Sv. G. Sofiiski Str. 1, 1606, Sofia, Bulgaria

    Svetlozar Haralanov

  5. University Hospital of Neurology and Psychiatry, “St. Naum”, Blvd. Tzarigradsko shaussee 4 km, 1113, Sofia, Bulgaria

    Svetlozar Haralanov

  6. Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstr. 7, 80336, Munich, Germany

    Hans-Jürgen Möller

  7. Division of Clinical Psychology and Psychophysiology, Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, Nussbaumstr. 7, 80336, Munich, Germany

    Kristina Hennig-Fast

Authors
  1. Evelina Haralanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Svetlozar Haralanov
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna Beraldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hans-Jürgen Möller
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kristina Hennig-Fast
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kristina Hennig-Fast.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haralanova, E., Haralanov, S., Beraldi, A. et al. Subjective emotional over-arousal to neutral social scenes in paranoid schizophrenia. Eur Arch Psychiatry Clin Neurosci 262, 59–68 (2012). https://doi.org/10.1007/s00406-011-0227-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-011-0227-1

Keywords

Search

Navigation