Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Schizophr Bull. 2021 Jan 23;47(1):87-96. doi: 10.1093/schbul/sbaa080.
Emotion dysregulation is crucial to both poor social functioning and psychotic symptom formation in patients with schizophrenia. The efficient use of emotion regulation strategies, such as cognitive reappraisal, has been less frequently observed in the early phases of psychotic disorder. It is unknown whether neurophysiological responses related to emotion regulation by cognitive reappraisal are altered in early psychosis.
Fifty-four patients with first-episode psychosis (FEP), 34 subjects at clinical high risk (CHR) for psychosis, and 30 healthy controls (HCs) participated in event-related potential recordings during a validated emotion regulation paradigm to measure the effect of cognitive reappraisal on emotion regulation. Late positive potentials (LPPs), which reflect emotional arousal, were compared across the groups and the 3 conditions (negative, cognitive reappraisal, and neutral). The relationship among LPP modulation by cognitive reappraisal and social/role functioning and severity of psychotic symptoms was investigated in the early psychosis group.
The FEP and CHR participants showed comparably larger LPP amplitudes in the negative and cognitive reappraisal conditions than in the neutral condition, whereas the HCs presented larger LPPs in the negative condition than in the cognitive reappraisal and neutral conditions. LPP modulation by cognitive reappraisal was negatively correlated with positive symptom severity in the FEP patients and with disorganization severity in the CHR subjects.
Inefficient use of cognitive reappraisal may be related to the impaired emotion regulation and psychotic symptoms from the very beginning of psychotic disorder. This study provides the first neurophysiological evidence regarding current concepts of emotion regulation in early psychosis.
情绪调节对于精神分裂症患者的社交功能障碍和精神病症状的形成至关重要。在精神病早期阶段，认知重评等情绪调节策略的有效使用较少被观察到。目前尚不清楚与认知重评相关的情绪调节的神经生理反应是否在早期精神病中发生改变。
54 名首发精神病患者（FEP）、34 名精神病高危患者（CHR）和 30 名健康对照者（HCs）参与了一项经验证的情绪调节范式中的事件相关电位记录，以测量认知重评对情绪调节的影响。晚期正电位（LPP）反映情绪唤醒，在各组和 3 种条件（负性、认知重评和中性）之间进行比较。在早期精神病组中，调查了认知重评对 LPP 调制与社会/角色功能和精神病症状严重程度之间的关系。
FEP 和 CHR 参与者在负性和认知重评条件下的 LPP 振幅明显大于中性条件，而 HCs 在负性条件下的 LPP 明显大于认知重评和中性条件。认知重评对 LPP 的调制与 FEP 患者的阳性症状严重程度和 CHR 患者的混乱严重程度呈负相关。
认知重评的使用效率低下可能与精神病障碍早期的情绪调节受损和精神病症状有关。本研究为早期精神病中情绪调节的现有概念提供了第一个神经生理学证据。
