Regulation of negative affect in schizophrenia: The effectiveness of acceptance versus reappraisal and suppression

Abstract

Although general emotion coping difficulties are well documented in schizophrenia, there has been limited study of specific regulatory strategies such as suppression, reappraisal, and acceptance. In the present study, clinical and control participants were asked to watch video clips selected to elicit negative affect while engaging in one of these three different emotion regulation strategies (counterbalanced), versus a passive viewing condition. The experiential and expressive components of emotion were quantified using self-report and facial electromyography, respectively. A major finding was that, in contrast to control participants, individuals with schizophrenia did not report a greater willingness to reexperience negative emotion after engaging in acceptance. These data are discussed in the context of evidence highlighting the potentially important role of acceptance in understanding affective abnormalities in clinical conditions such as schizophrenia.

Keywords:

• Emotion regulation
• Acceptance
• Reappraisal
• Suppression
• Schizophrenia

Notes

¹Individuals with schizophrenia and schizoaffective disorder did not differ on any demographic variables, or the measures of cognitive or psychological functioning (including depression, anxiety, and stress). Although a caveat of this finding is that the sample may have been underpowered to detect differences, the two groups were combined and are referred to as the schizophrenia group throughout.

²For both positive and negative symptoms, average ratings remained in the questionable to mild range across all three time points. Further, no significant differences were found between total depression, anxiety, or stress scores throughout the duration of the study. Accordingly, average SAPS, SANS, and DASS subscale scores are reported.

³Multiple one-way ANOVAs were conducted in order to compare outcomes on key dependent variables across the four neutral film clips used in the study. No differences were detected between these clips on self-reported levels of negative affect during or after each clip, or on levels of interest or confusion (all ps > .05). Further, no differences were observed between clips with respect to brow or cheek activity (all ps > .05). Data for the four clips were, therefore, combined to represent a mean “neutral condition” score for each dependent variable of interest. As noted previously, pilot testing also showed that the four sad film clips used in this study all yielded similar affective profiles.