Patients with schizophrenia have intact ability to experience emotion, but empirical evidence suggests that they fail to translate emotional salience into effortful behavior. Previous research in patients with chronic schizophrenia suggests that working memory is important in integrating emotion and behavior.
Dr. CHAN Raymond and his team from the Institute of Psychology of Chinese Academy of Sciences have examined emotion-behavior coupling in patients with first-episode schizophrenia. This work is based on a joint research-clinical programme of early psychosis intervention between Castle Peak Hospital in Hong Kong and Institute of Psychology. Dr. LUI Simon (a former doctoral graduate of Dr. Chan) is the person in-charge of the early psychosis programme.
Participants were 72 patients with first-episode schizophrenia and 61 healthy controls. All participants completed a sophistical behavioral paradigm which elicited their emotion using IAPS pictures and measured their effortful behavior for increasing or decreasing their exposure to the emotion-inducing pictures. Using the Letter-number Span test, patients with first-episode schizophrenia were classified into working memory-impaired and working memory-preserved groups.
The results showed patients with first-episode schizophrenia experienced intact ‘in-the-moment’ emotion, but their emotion was less predictive of the effort expended, compared with controls. The emotion–behavior coupling was significantly weaker in patients with schizophrenia with poor working memory than in those with intact working memory. However, compared with controls, patients with intact working memory also showed substantial emotion–behavior decoupling. In other words, although working memory deficits contribute to defective translation of liking into effortful behavior, schizophrenia alone affects emotion–behavior coupling.
The important findings elucidate the nature of anhedonia and avolition in patients with first-episode schizophrenia. The work is an important addition to growing evidence of emotion-behavior decoupling in schizophrenia. Semantic working memory appears to play a significant but minor role in avolition.
This study was supported by grants from the Strategic Priority Research Programme (B) of the Chinese Academy of Science, the National Nature Science Foundation of China, the Key Laboratory of Mental Health, and the Beijing Training Project for the Leading Talents in S & T. It was also supported by the Philip K. H. Wong Foundation in Hong Kong.
The paper is published in Psychological Medicine.
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