Emotional responses to psychosocial stress in schizophrenia: the role of individual differences in affective traits and coping

Despite the well-established association between psychosocial stress and symptom exacerbation in schizophrenia, factors that account for variability in stress reactivity among individuals with this disorder are unknown. This study examined the association between affective traits, coping style, and neurocognitive functioning and subjective emotional responses during putatively stressful social interactions among individuals with schizophrenia. Self-reported mood was assessed in male schizophrenia outpatients (n=36) and matched nonpsychiatric controls (n=15) during a role-play test (RPT) comprised of simulated social encounters requiring assertive or affiliative skills. During the RPT, schizophrenia patients and controls reported similar elevations in negative mood and decreases in positive mood as compared to baseline mood during assertion scenes. Affiliation scenes resulted only in similar decreases in positive mood across groups as compared to baseline mood. Among schizophrenia patients, trait negative affectivity (NA) and maladaptive coping style accounted for one quarter of the variance in negative mood during the assertion RPTs, and these relationships held after controlling for baseline mood, clinical symptoms, and neurocognitive functioning. Results provide preliminary support for the validity of the social RPT as a paradigm for examining psychosocial stress in schizophrenia and suggest that trait negative affectivity and maladaptive coping are associated with individual differences in emotional responses to psychosocial stressors in schizophrenia.