Mathematically Modeling Emotion Regulation Abnormalities During Psychotic Experiences in Schizophrenia

Ecological momentary assessment (EMA) was used to examine emotional reactivity and regulation abnormalities during the presence and absence of psychosis. Participants included 28 outpatients with schizophrenia or schizoaffective disorder (SZ) who completed 6 days of EMA. Mathematical models were applied to the EMA data to evaluate stochastic dynamic changes in emotional state and determine how the presence of psychosis influenced the interaction between emotional reactivity and regulation processes across time. Markov chain analysis indicated that although SZ tried to implement emotion regulation strategies frequently during psychotic experiences, those attempts were ineffective at reducing negative emotion from one time point to the next. Network analysis indicated that patients who were less effective at regulating their emotions during psychotic experiences had more dense connections among individual emotions. Findings indicate that psychotic experiences are associated with abnormally strong connections among discrete emotional states that are difficult to regulate despite efforts to do so.