Do emotions drive psychosis?
Journal Title: Psilogos - Year 2012, Vol 10, Issue 2
Abstract
Introduction: How important is the emotional life of persons who manifest psychotic symptoms? Aims: The aim of this paper is to review evidence on a causal role for emotions in psychotic processes. Methods: Selective review of literature on affective symptoms in psychoses, on emotions in the production of psychotic symptoms and on dopaminergic models of psychosis. Results: Affective symptoms are relevant across psychoses. Persons with schizophrenia have high levels of emotional reactivity and the intensification of negative affects not only is associated with but also precedes the intensification of psychotic symptoms, which is evidence that negative emotions drive the course of psychotic symptoms. Negative self‑representations are central in psychotic processes and can be the link between negative emotions and psychosis. Evidence favours the notion that persecutory delusions are consistent with negative affects and self‑representations, while grandiose delusions are consistent with a defensive amplification of positive affects and self‑representations. Shame has been proposed as the core emotional experience of psychosis, one in which the self becomes vulnerable to the external world, which is consistent with persecutory experiences. Assaults on the self, under the form of hostility in the family environment and society, are strong predictors of relapse and development of schizophrenia. Assaults on the self which induce social defeat are also strong stimulants of mesolimbic dopaminergic pathways, whose hyperactivity is associated with acute psychotic episodes and the experience of “aberrant salience”, put forward as a dopaminergic model of psychosis. Conclusions: The “defeat of the self” emerges as a central link that binds the experience of negative emotions to the expression of psychotic symptoms and its psychological and neurobiological correlates. The hypothesis gains support that the emotions related to that defeat control the expression of a vulnerability to defeat and thus drive the course of psychosis.
Authors and Affiliations
João Ribeiro
Keywords
Related Articles
- EP ID EP146103
- DOI -
- Views 115
- Downloads 0
Editorial to Volume 9
Agitation, Agression and Violence in the Psychiatric Emergency of Hospital Curry Cabral. Some Thoughts.
This is an article that compiles the oral communication presented at the Symposium of the Department of Psychiatry of Hospital Fernando Fonseca focused on “Emergency Psychiatry”. From the author’s experience as a psychia...
Manifestações Neurológicas e Psiquiátricas: de Mãos Dadas no Serviço de Urgência – a Perspectiva do Neurologista
O trabalho de neurologistas e psiquiatras num serviço de urgência hospitalar é habitualmente realizado em circunstâncias complexas que podem dificultar o processo diagnóstico, em particular quando coexistem co‑morbilidad...
Comorbidity in Emergency Room: the Psychiatrist’s Perspective
The author puts forward some considerations about the psychiatric practice in the emergency room of a general hospital. Clinical practice in the emergency room should be highlighted by collaborative work between several...
Situações de Comorbilidade em Urgência – a Perspectiva de um Psiquiatra
Baseada na sua experiência a autora faz uma reflexão sobre a prática psiquiátrica no Serviço de Urgência do Hospital Geral. Este é um trabalho que deve ser fortemente articulado com outras áreas de especialidade, em que...