Emotion and self in psychotic disorders: Behavioral evidence from an emotional evaluation task using verbal stimuli varying in emotional valence and self-reference

- Psychotic disorders are accompanied by changes in emotional and self-referential processing.
- This study explores the link between the two processes in psychotic patients and healthy controls.
- An emotional evaluation task with emotional and neutral words varying in self-reference was used.
- Words had to be judged in reference to own feelings.
- Patients showed difficulties in implicitly and explicitly linking emotional stimuli to the self.

Background and objectivesPsychotic disorders are accompanied by changes in emotional and self-referential processing. This behavioral study investigates the link between emotional and self-referential processing in 21 psychotic patients with and without symptoms of disordered self-processing and 21 healthy age-matched controls during emotional evaluation of words varying in emotional valence and self-reference.MethodsEmotional and neutral words related to the self of the reader (e.g., “my fear”, “my happiness”, “my books”), to the self of another person, unknown to the reader (e.g., “his fear”, “his happiness”, “his books”) or without person reference (e.g., “the fear”, “the happiness”, “the books”) had to be judged in reference to one's own feelings as positive, negative or neutral.ResultsCompared to healthy controls (HC) psychotic patients with symptoms of self-disorders (PwSD) showed significantly reduced valence congruent judgments in response to self-related (particularly positive and negative) words and no difference between self-, other-, and personally unreferenced positive words. These differences between PwSD and HC were also reflected in post-experimental ratings of subjective experience. Additionally, no reaction time or memory advantage for self-related or emotional words could be found in psychotic patients irrespective of the presence of self-disorders.LimitationsThe results may be preliminary due to the small sample sizes.ConclusionsTaken together, the results argue in favor of a differentiated view regarding changes in emotional experience in psychotic disorders. They provide preliminary evidence that in psychotic disorders changes in emotion and self-processing may be related to the severity of self-disorders thought to underlie disordered thinking and feeling in psychotic patients.