Emotional awareness in schizophrenia: from assessment to rehabilitation

Emotion recognition has always been a source of great interest in the scientific literature since it allows engaging in functional relationship with other people. The neuroscience approach has provided evidence of a cortical lateralization effect in response to emotional stimuli (Hagemann, Hewig, Naumann, Seifert & Bartussek, 2005; Balconi & Lucchiari, 2006) with a left-lateralized brain activity with respect to positive affect and right for negative affect. The specific asymmetric involvement of prefrontal cortical regions in positive and negative affect was also supported by clinical evidence on patients with damage to the right or left anterior cortex. This effect was also studied in psychiatric populations including patients diagnosed with depression disorder, bipolar disorder and schizophrenia (Gattaz et al. 1992). “Unbalance effect” was observed in these categories of patients. The aim of the current study was to investigate the behavioral and neural correlates of emotional attribution in patients with schizophrenia and to train these patients to restore functional emotional behavior. To explore this field, six patients and ten controls, after being subjected to neuropsychological screening, were assessed while watching positive, neutral, and negative affective pictures by International Affective Picture System (Lang, Bradley, & Cuthbert, 2008) and then their emotional appraisal was measured with SAM. This evaluation procedures were conducted through a "multimethod" approach with NIRS (Near-Infrared Spectroscopy), EEG (electroencephalogram) and autonomic indexes. After this screening phase, six patients will be submitted to neurofeedback training in order to better regulate emotions and their different valence. The purpose of this training is to increase the emotional awareness of these patients and then guide them in a more conscious and functional management of their states, favoring a more functional interemispheric balance. Neurofeedback-induced changes based on EEG result from operant conditioning, and these changes in EEG can allow to assume awareness of specific emotional states.