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Altered Emotion Processing Linked With Poor Psychosis Outcomes

November 19, 2019

In a large sample of people at high risk for psychosis, baseline abnormalities in recognizing negative emotion were associated with a low level of overall functioning at a 12-month follow-up.

Decreased gray matter volume in brain regions involved in processing anger and fear was also linked with lower functioning at follow-up. Researchers published their findings online in JAMA Psychiatry.

“Overall, these findings suggest that emotional dysfunction and related brain regions may play a role in the development of adverse functional outcomes in individuals at increased risk for psychosis,” researchers wrote.

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The case-control study included 213 people at clinical high risk for psychosis and 52 healthy controls. Researchers assessed emotion recognition using the Degraded Facial Affect Recognition Task and used magnetic resonance imaging (MRI) scans to measure gray matter volume in the medial prefrontal cortex, amygdala, hippocampus, and insula. Twelve months later, participants were evaluated for transition to psychosis and level of overall functioning.

Compared with participants at high risk for psychosis with a poor outcome, those with a good functional outcome showed statistically significant positive associations between anger recognition and hippocampal volume and between fear recognition and medial prefrontal cortex volume, the study found.

“These findings have potential implications for the stratification of individuals at clinical high risk according to subsequent outcomes and suggest that functional outcomes might be improved by interventions that target socioemotional processing,” researchers wrote.

—Jolynn Tumolo


Modinos G, Kempton MJ, Tognin S, et al. Association of adverse outcomes with emotion processing and its neural substrate in individuals at clinical high risk for psychosis. JAMA Psychiatry. 2019 November 13;[Epub ahead of print].

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