Patterns of emotional experience in schizophrenia: differences in emotional response to visual stimuli are associated with clinical presentation and functional outcome.

The current study examined whether patterns of emotional response are differentially associated with symptom presentation and functional outcome in individuals with schizophrenia. Participants included 49 outpatients with schizophrenia and 50 demographically matched controls. All participants rated their emotional response to 131 images from the International Affective Picture Systems (IAPS) library on both arousal and valence scales. Stimuli were split into categories of positive versus negatively valenced stimuli based on control subject ratings. Cluster analysis was used to assess whether there were reliably distinct patterns of emotional response within the patient sample. Follow-up discriminant function analysis indicated that these groups were adequately separated. Sixty percent of the individuals with schizophrenia rated valence and arousal similarly to healthy subjects, while 40% displayed an atypical profile. Schizophrenia sub-groups classified by these two emotional response styles significantly differed on measures of functional outcome, severity of negative symptoms, and self-reported anhedonia. Findings are discussed in relation to current theories of emotional experience in schizophrenia.