We investigated the relationship between incongruent emotion experience (negative emotion reported in response to positive and neutral stimuli), state negative affect, and response inhibition (a facet of cognitive control) in people with and without schizophrenia. We also tested whether a positive mood induction (the Broad-Minded Affective Coping, or BMAC, procedure) would decrease state negative affect and subsequently decrease incongruent emotion experience in people with schizophrenia. People with schizophrenia or schizoaffective disorder (n=29) reported significantly more state and trait negative affect and more incongruent emotion experience in response to positive and neutral film clips compared to people without schizophrenia (n=26). The BMAC procedure increased positive affect but did not decrease negative affect in all participants nor did it influence reports of incongruent emotion experience in people with schizophrenia. State negative affect, but not response inhibition, predicted incongruent emotion experience in people with schizophrenia. These results indicate that incongruent emotion experience may reflect heightened state negative affect in people with schizophrenia that does not readily diminish in the face of positive experiences.

Critical, intrusive family environments are a predictor of relapse and poor functional outcome in schizophrenia. Reactivity in the autonomic nervous system (ANS) has been proposed as a potential mechanism underlying this link, but little research has examined ANS physiological reactivity in schizophrenia in the context of family interactions. Further, physiological covariation – physiological interdependence between individuals – predicts important relationship and mental health outcomes, yet no work has examined physiological covariation between people with schizophrenia and their family members. The current study investigated physiological reactivity and physiological covariation during a conflict conversation between young adults with schizophrenia (n = 20) and without schizophrenia (n = 29) and their parents. Respiratory sinus arrhythmia (RSA) and inter-beat interval (IBI) were recorded during a 10-minute conversation about an area of conflict in the participants’ relationship. Participants rated relationship qualities and affect, and participants with schizophrenia were rated on symptom severity. Results indicated that young adults with schizophrenia reported higher negative affect after a conflict conversation and had lower average RSA relative to baseline during the conflict conversation compared to young adults without schizophrenia. IBI and RSA covariation were associated with lower parental caring, with the effect of caring on RSA covariation driven by the control group. Within the schizophrenia group, weaker RSA covariation was related to higher negative symptoms. Together, these findings provide novel support for the importance of ANS, particularly PNS, reactivity and covariation in family relationships in people with and without schizophrenia.

While people with schizophrenia report just as much emotion in the presence of emotional evocative stimuli, evidence suggests that they may show deficits in the anticipation of positive emotion. However, no work to date has directly tested this notion utilizing standardized stimuli across multiple methods of measurement. The present study took a multi-method approach by examining reported experience and emotion modulated startle response in people with (n = 27) and without (n = 27) schizophrenia as they anticipated and subsequently viewed evocative pictures. In addition, given that anticipation relies, in part, on our ability to remember the past, we assessed memory for emotional stimuli immediately and one-week later. Results indicated that people with schizophrenia had a deficit in the anticipation of both positive and negative emotion. Furthermore, anticipatory responses, especially to positive cues, were related to symptoms and functioning in schizophrenia. Results also suggested that while delayed recognition of emotional stimuli is intact, those with SZ showed a deficit in immediate recall that was associated with anticipation and cognitive difficulties.

Although public attitudes toward many stigmatized groups have improved in recent decades, this progress has not extended to people living with schizophrenia, leaving them at high risk for social exclusion. Social exclusion influences the way people feel (i.e., affective responses), perceive themselves (i.e., psychological responses), and act (i.e., behavioral responses). For people with schizophrenia, social exclusion results in increased negative affect, similar to those without the disorder; however, the psychological impact lasts longer. Behavioral responses to exclusion can have social repercussions. Although social withdrawal may be a strategy to avoid future exclusion, it can also increase the likelihood of further exclusion, creating a vicious cycle. Despite this, little is known about how people with schizophrenia behaviorally respond to exclusion. Therefore, the aim of this dissertation study was to determine the behavioral responses of people with schizophrenia to exclusion and to investigate factors associated with these responses.

I hypothesized that 1) people with schizophrenia would be more likely to withdraw following social exclusion compared to controls; 2) withdrawal intentions would be greater following exclusion compared to disappointment; 3) withdrawal behavior would be predicted by rejection sensitivity, alternative sources of acceptance, chronicity of exclusion, and perceived fairness; and 4) withdrawal following exclusion would be associated with more negative symptoms and poorer functioning.

People with (n=43) and without (n=43) schizophrenia or schizoaffective disorder played Cyberball - Behavioral Response, a novel version of the exclusion task. Participants (age range: 18-69 years; 48.8% female) responded to social exclusion with affiliative, retaliatory, and withdrawal behaviors within a 2 (Group: Schizophrenia vs. Control) X 3 (Game Type: Exclusion vs. Disappointment vs. Inclusion) mixed design. Participants also reported their social experiences, affective and psychological responses following exclusion, negative symptoms, and functioning.

On survey measures, people with schizophrenia reported heightened rejection sensitivity, fewer alternative sources of acceptance, and more chronic exclusion in daily life compared to controls. They responded to exclusion with more withdrawal and less affiliative behavior than controls, with social exclusion eliciting more of these responses than disappointment. People with schizophrenia experience frequent social exclusion in daily life, and this predicts withdrawal responses to social exclusion. Greater chronicity of exclusion in daily life was linked to worse social functioning and more severe negative symptoms. Findings provide initial evidence of vulnerability to a cycle of exclusion and withdrawal.

The outcomes of decisions we make are integral for guiding our behavior. In this study, we investigated if and how people with and without schizophrenia use positive and negative social outcomes and social partners’ emotional displays to inform decisions to trust as well as whether they could detect reversals in behavior even as emotion displays remained unchanged. Thirty-two people with schizophrenia and 29 control participants completed a task where they decided how much trust to place in social partners showing either a dynamic emotional (smiling, scowling) or neutral display. Interactions were designed to result in either positive (trust reciprocated) or negative (trust abused) outcomes, allowing us to model changes in decisions to trust over the course of repeated interactions. Compared to controls, people with schizophrenia were less sensitive to positive social outcomes as evidence by their placing less trust in trustworthy social partners during initial interactions. On the other hand, people with schizophrenia were more sensitive to negative social outcomes during initial interactions with untrustworthy social partners, placing less trust in these partners compared to controls. Interestingly, people with schizophrenia were just as able as controls to detect reversals in social partners’ behavior as it changed from trustworthy to untrustworthy, but were less able to detect changes in the untrustworthy to trustworthy direction. Importantly, decisions to trust were associated with real-world social functioning. We discuss the implications of these findings for understanding social engagement among people with schizophrenia and the development of psychosocial interventions for social functioning.