The Experience and Expression of Emotion in Psychosis-risk

Gupta, Tina

doi:https://doi.org/10.21985/n2-7k2a-4521

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The Experience and Expression of Emotion in Psychosis-risk

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Emotional processing deficits are characteristic of psychotic disorders such as schizophrenia. However, impairments as such are not well understood prior to the onset of psychosis among individuals at clinical high-risk (CHR). This dissertation draws from prominent theories of emotion in schizophrenia and seeks to investigate the experience and expression of emotion in psychosis-risk. The first aim of the study (Aim 1) addressed whether individuals with a CHR syndrome exhibit abnormalities in the experience of positive and negative emotions. To achieve this aim, an evocative film task was employed to a sample of CHR individuals and healthy controls. In this task, participants were asked to provide reports of the experience of positive (i.e., excitement, amusement) and negative (i.e., fear and sadness) emotions in response to video clips intended to evoke these noted emotions. The second aim of the study (Aim 2) was to answer the question do CHR individuals show impairments in positive and negative facial expressions? To answer this question, a multi-modal approach was employed to a sample of CHR individuals and healthy controls in order to assess subtle and micro facial expressions. In this portion of the dissertation, segments of video recorded clinical interviews were submitted into an automated facial analysis software in order to investigate the presence of subtle facial expressions of emotions (e.g., joy, sadness), when compared to controls. To assess micro facial expressivity in this group, facial electromyography (EMG) (i.e., zygomaticus activity which is affiliated with smiling, and corrugator activity which is associated with negative displays of facial expressivity) was collected while individuals viewed the evocative film clip task discussed in Aim 1. Furthermore, facial expressivity during the peak period of emotion (i.e., the period in which there were the highest levels of emotion shown in the video) was assessed in the video clips as well as changes in facial expressivity throughout. An additional aim of this dissertation was to examine associations between facial expressivity and neurocircuitry in order to provide clues regarding the potential causes behind abnormalities in facial expressivity in those at CHR for psychosis (Aim 3). In this portion of the dissertation, associated neural circuitry was assessed using a region-of-interest to region-of-interest resting-state connectivity analysis approach. Here, the goal was to investigate whether emotion circuitry, motor circuitry, or both were related to facial expression abnormalities in this risk group. Aim 4 sought to examine if impairments in the experience (i.e., Aim 1 reports of experience of positive and negative emotions from the evocative film clip task) and expression of emotion (i.e., Aim 2, facial expressivity derived from automated facial analysis and facial electromyography) were associated with social functioning impairments and risk for ultimate conversion to psychosis based off of risk calculator scores. The findings from this dissertation revealed that, when compared to controls, those with a CHR syndrome reported lower levels of excitement in response to the film clip intended to evoke excitement (Aim 1). Furthermore, it was found that those with a CHR syndrome showed alterations in subtle facial expressions during a neutral segment of a clinical interview including blunted joy, but also increased anger expressions derived from automated facial analysis (Aim 2). Similarly, when viewing a film clip intended to evoke excitement, those with a CHR syndrome displayed reduced zygomaticus facial activity. Relatedly, blunting was particularly pronounced during the peak period of the excitement clip (i.e., the most evocative section), but not prior to this peak. Furthermore the CHR group showed less changes in facial expressivity during the excitement film clip as well. In terms of associated neural circuitry (Aim 3), it was found that greater connectivity patterns between motor-motor regions and motor-emotion regions were associated with blunted joy facial expressions in those with a CHR syndrome and this may be particularly the case in those with higher levels of facial expressivity. Finally, alterations in facial expressions derived from automated facial analysis in particular were related to both social functioning impairments and likelihood of conversion (based off of risk calculated scores), while less variability in zygomaticus facial activity when viewing the excitement clip during the evocative film clip task was related to higher risk scores. Taken together, these data provide novel insights into the experience and expression of emotion in those with a CHR syndrome. Findings from this dissertation provide a foundation for further research that is needed in this area. Additionally, results inform early identification efforts, biobehavioral risk markers of psychosis, and shed light on targets for treatments and prevention strategies.

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