Looking on the bright side: the neural basis of emotion processing and regulation in groups at increased risk for psychosis

Research has shown that patients with schizophrenia experience difficulties with emotion processing and regulation. Lower activation in various emotion processing and regulation regions are thought to underlie these difficulties. In this thesis we examined whether these difficulties are already present in groups at increased risk for developing psychosis. To this extent, functional and structural neural correlates, related to emotion processing and regulation, were examined in individuals at increased risk for developing psychosis.
The results showed that difficulties with identifying and verbalizing emotions were associated with the risk for developing psychosis. Lower activation in, amongst others, an emotion attention system, including the amygdale and occipital cortex, is possibly underlying these difficulties. Furthermore, the results revealed that individuals at ultra-high risk for developing psychosis had lower activation in the prefrontal cortex during emotion regulation. This lower activation pattern was not found in individuals with a slightly increased risk for developing psychosis. These results indicate that specifically the ultra-high risk group might have a lower neural capacity to regulate emotions.
To conclude, difficulties in emotion processing and regulation do not seem to be solely disease-related, but may be part and parcel of the vulnerability for psychosis. Further research is necessary to examine whether the lower activation underlying these difficulties may predict the transition toward psychosis.