Centre for Affective (PO Box 72), Department of Psychological Medicine, Institute of Psychiatry, 16 De Crespigny Park, London SE5 8AF, UK.
Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Melbourne, Victoria, Australia.
Psychiatry Res. 2014 Dec 15;220(1-2):135-44. doi: 10.1016/j.psychres.2014.07.077. Epub 2014 Aug 7.
Our ability to make sense of emotional cues is of paramount importance for understanding state of mind and communicative intent. However, emotional cues often conflict with each other; this presents a significant challenge for people with schizophrenia. We conducted a theoretical review to determine the extent and types of impaired processing of emotion-related conflict in schizophrenia; we evaluated the relationship with medication and symptoms, and considered possible mediatory mechanisms. The literature established that people with schizophrenia demonstrated impaired function: (i) when passively exposed to emotion cues whilst performing an unrelated task, (ii) when selectively attending to one source of emotion cues whilst trying to ignore interference from another source, and (iii) when trying to resolve conflicting emotion cues and judge meta-communicative intent. These deficits showed associations with both negative and positive symptoms. There was limited evidence for antipsychotic medications attenuating impaired emotion perception when there are conflicting cues, with further direct research needed. Impaired attentional control and context processing may underlie some of the observed impairments. Neuroanatomical correlates are likely to involve interhemispheric transfer via the corpus callosum, limbic regions such as the amygdala, and possibly dorsolateral prefrontal and anterior cingulate cortex through their role in conflict processing.
我们理解情绪线索并感知其含义的能力对于了解思维状态和交流意图至关重要。然而，情绪线索常常相互冲突；这对于精神分裂症患者来说是一个巨大的挑战。我们进行了一项理论综述，以确定精神分裂症患者在处理与情绪相关的冲突方面受损的程度和类型；我们评估了与药物和症状的关系，并考虑了可能的中介机制。文献表明，精神分裂症患者表现出以下功能障碍：（i）在执行不相关任务时被动暴露于情绪线索时，（ii）在选择性关注一种情绪线索来源时试图忽略另一种来源的干扰时，以及（iii）在试图解决冲突的情绪线索并判断元交流意图时。这些缺陷与阴性和阳性症状都有关联。有有限的证据表明，在存在冲突线索时，抗精神病药物可以减轻受损的情绪感知，因此需要进一步的直接研究。注意力控制和上下文处理受损可能是观察到的一些损伤的基础。神经解剖学相关性可能涉及通过胼胝体的大脑半球间转移、杏仁核等边缘区域，以及可能通过其在冲突处理中的作用涉及背外侧前额叶和前扣带皮层。
