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ObjectivesEvidence suggests that emotional awareness—the ability to identify and label emotions—may be impaired in schizophrenia and related to positive symptom severity. Exposure to childhood maltreatment is a risk factor for both low emotional awareness and positive symptoms.MethodsThe current investigation examines associations between a performance-based measure of emotional awareness, positive symptom severity, and childhood maltreatment exposure in 44 individuals with a schizophrenia-spectrum disorder and 48 healthy comparison participants using the electronic Levels of Emotional Awareness Scale (eLEAS), Positive and Negative Syndrome Scale (PANSS) and Childhood Trauma Questionnaire (CTQ).ResultsPatients demonstrated significant deficits in emotional awareness overall, which was true for both self and others. In patients, lower emotional awareness was significantly associated with more severe positive symptoms. Emotional awareness was significantly impaired in patients with schizophrenia with self-reported maltreatment exposure, relative to other groups. Severity of maltreatment was not significantly associated with emotional awareness or positive symptoms when looking continuously, and there was no significant indirect effect.ConclusionThese data suggest that emotional awareness impairments observed in schizophrenia may be exacerbated by exposure to childhood maltreatment, possibly putting individuals at greater risk for experiencing positive symptoms of psychosis.

BackgroundDisembodiment and socio-emotional deficits are core features of the schizophrenia spectrum from the prodromal stages to chronic illness. A recent study documented anomalous emotional embodiment in individuals with schizophrenia. Although bodily self disturbances have been shown to precede and predict psychosis onset in at-risk populations, the etiology of anomalous emotional embodiment remains largely unexplored. The present study investigated bodily maps of emotions in relation to schizotypy to extend our understanding of embodied emotions in the schizophrenia spectrum.MethodsA total of 419 participants (312 female; 19.50 ± 1.22 years) completed a topographical body mapping task where they reported patterns of embodiment experienced in the context of eleven different emotions and a neutral state (EmBODY). Embodied emotions were investigated in relation to multidimensional schizotypy.ResultsIndividuals with elevated negative schizotypy experienced embodied emotions with higher intensity (r = 0.16, p = 0.003) but lower clarity (i.e., endorsing activation and deactivation in the same bodily location; β = −0.28, 95% CI [−0.54, −0.03], Z = 2.25, p=0.02) and endorsed more incongruent bodily sensations of emotions (i.e., reporting bodily activation in the context of a low-arousal emotion, r = 0.12, p = 0.05; reporting bodily deactivation in the context of high-arousal emotions, r = 0.13, p = 0.02). In line with the anomalous emotional embodiment documented in individuals with schizophrenia, some of these differences were particularly notable for low-arousal emotions.DiscussionThese results reveal negative schizotypy as a significant correlate of differences in emotional embodiment. More work is needed to link these differences to the anomalous bodily sensations of emotions documented in schizophrenia and assess their functional impact.

Schizophrenia is associated with self-disturbances and anomalous embodiment of emotion such that the distinct patterns of bodily sensations that typically accompany specific emotions are disrupted. Previous evidence indicated that cultural factors might shape the embodiment of emotion and therefore influence the subjective experience of schizophrenia.We investigated embodiment of emotion in individuals with schizophrenia (SZ) and matched control participants (CO) from Korea (26 ​K-SZ and 26 ​K–CO) and the USA (26 US-SZ and US-26 CO), using a topographical mapping task that requires participants to indicate the locations of bodily sensations that accompany 14 distinct emotions. We found that emotion-related bodily sensations, especially for low-arousal emotions, were diminished in SZ compared to CO in both cultures. Cultural differences emerged in the embodiment of sadness, shame and disgust such that the patterns of bodily sensations associated with these emotions were more similar between SZ and CO in the Korean sample than in the US sample.These findings suggest that emotional embodiment anomalies are present in SZ regardless of culture, supporting the universality of bodily self-disturbances in this population. However, there are culture-specific features of embodied emotional experiences that may be important to consider for future research and treatment.

Bodily self disturbances are core features of schizophrenia. Body ownership, one component of the bodily self, can be assessed with the Rubber Hand Illusion (RHI), which is induced by a synchronous brushing of a visible fake hand and one's own occluded hand. Schizophrenia is associated with increased RHI strength and diminished body ownership. This study examined RHI in relation to schizotypy to extend our understanding of self-disturbances in the schizophrenia-spectrum.Ninety-seven college students completed the RHI task and self-report questionnaires. Regressions were used to assess the RHI strength in relation to the 3 schizotypy factors (positive, negative, disorganized). We also examined the correlations between self-reported bodily self disturbances and RHI strength.Positive schizotypy predicted a stronger subjective experience of the RHI, whereas negative schizotypy predicted weakened RHI susceptibility. Questionnaire measures of self-disturbances correlated with stronger RHI. In sum, we confirmed the link between positive schizotypy and the subjective experience of the RHI, which suggests a weakened sense of body ownership. Interestingly, we also found a relationship between negative schizotypy and reduced RHI, which implies strengthened body ownership. These results also underscore the complexity of the link between the phenomenological experience of bodily disturbances and the experimentally measured sense of body ownership.