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The impact of emotion awareness and regulation on social functioning in individuals at clinical high risk for psychosis

Published online by Cambridge University Press:  06 April 2016

D. Kimhy ,
K. E. Gill ,
G. Brucato ,
J. Vakhrusheva ,
L. Arndt ,
J. J. Gross  and
R. R. Girgis
D. Kimhy*
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
K. E. Gill
Affiliation:
Department of Psychology, The Catholic University of America, Washington, DC, USA
G. Brucato
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
J. Vakhrusheva
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
L. Arndt
Affiliation:
New York State Psychiatric Institute, New York, NY, USA
J. J. Gross
Affiliation:
Department of Psychology, Stanford University, Stanford, CA, USA
R. R. Girgis
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA New York State Psychiatric Institute, New York, NY, USA
*
*Address for correspondence: D. Kimhy, Ph.D., Department of Psychiatry, Unit #55, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA. (Email: [email protected])
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Abstract

Background

Social functioning (SF) difficulties are ubiquitous among individuals at clinical high risk for psychosis (CHR), but it is not yet clear why. One possibility is suggested by the observation that effective SF requires adaptive emotion awareness and regulation. Previous reports have documented deficits in emotion awareness and regulation in individuals with schizophrenia, and have shown that such deficits predicted SF. However, it is unknown whether these deficits are present prior to the onset of psychosis or whether they are linked to SF in CHR individuals.

Method

We conducted a cross-sectional comparison of emotion awareness and regulation in 54 individuals at CHR, 87 with schizophrenia and 50 healthy controls (HC). Then, within the CHR group, we examined links between emotion awareness, emotion regulation and SF as indexed by the Global Functioning Scale: Social (Cornblatt et al. 2007).

Results

Group comparisons indicated significant differences between HC and the two clinical groups in their ability to identify and describe feelings, as well as the use of suppression and reappraisal emotion-regulation strategies. Specifically, the CHR and schizophrenia groups displayed comparable deficits in all domains of emotion awareness and emotion regulation. A hierarchical multiple regression analysis indicated that difficulties describing feelings accounted for 23.2% of the SF variance.

Conclusions

The results indicate that CHR individuals display substantial emotion awareness and emotion-regulation deficits, at severity comparable with those observed in individuals with schizophrenia. Such deficits, in particular difficulties describing feelings, predate the onset of psychosis and contribute significantly to poor SF in this population.

Keywords

Alexithymiaclinical high risk for psychosisemotion awarenessschizophreniasocial functioning
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 14 , October 2016 , pp. 2907 - 2918
Copyright
Copyright © Cambridge University Press 2016 

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