Emotions and Psychopathology

COGNITIONANDEMOTION,1999, 13 (5),575± 599

AnnM.KringandJo-AnneBachorowski VanderbiltUniversity, Nashville, USA

Emotionaldisturbancesa recen traltodiversep sychopathologies.I nthis article,we ar guethatt hefu nctionsofemotionareco mparablefo rpersons withandwithoutpsychopathology.However,imp airmentin o neormore componentsofemotionalprocessingdisruptstheachievementofadaptive emotionfunctions.Ad optingatheoreticalconceptualisationofemotional processest hatst ressesa ctivityincen trallymed iatedap proacha ndwithdrawalsystems,we d iscusstheroleo femotioninsever alformsofpsychopathol- ogy,in cludingmajordepression,someoftheanxietydisorders,p sychopathy, andsch izophrenia.Indoingso,we h ighlightthenatureofemotiondistur- bancea ndattendantbehaviouralandcognitived e®cit s.F inally,we d iscuss themeritsofthisap proachfo rconceptualisingemotionaldisturbancein psychopathology.

INTRODUCTION Mostfo rmsofpsychopathologyre¯ ect d isturbancesin a number ofareas, includingemotionalprocessingandemotionalresponding.Althoughem o- tions®gure prominentlyin m anyd isorders,t henature ofemotionaldis- turbanceva riesa mongdisorders.Fo rexample,so meoftheanxiety disorders are markedb ytheexperienceo fintensea nxietyand/orfear, ofteno ccurringint heabsenceo fanobviousprecipitant(e.g.Ba rlow, 1991).By co ntrast,schizophreniais o ftenma rkedb ydiminishedexp res- sionofemotionand,inso mecases,d iminishedexp erienceo femotion(e.g. Kring&Neale,1996). T heseexa mplesillu stratejustt wot ypeso femo- tionaldisturbancein p sychopathology:An excess o fexperiencedem otion andade®cit in t heexpressionofemotion.Inthisarticle,we willa rguethat

Requestsforreprin ts shouldb esentt oeither AnnM .Kring,who is nowat the Department ofPsycho logy,3210 Tolman H all,U niversityofCaliforn ia±Berkeley, Berkeley, CA94720,U SAorJo-AnneBachorowski,D epartmentofPsychology,301 Wilso nHall, VanderbiltU niversity,111 21st Ave. So uth,Nashville,T N37240,U SA;orbye-mail: [email protected]@vanderbilt.edu Duringth epreparationofthisart icle, AnnM .Kringwas supportedin part b yagrant fromtheNationalAlliance forResearch onSch izophrenia andDepression(NARSAD)and Jo-AnneBacho rowskiwas supportedin p art byMH53929-02.

q 1999P sychologyP ress Ltd 576 KRING AND BACHOROWSKI manyofthesed isturbancesre¯ ect a disruptionino neormorecomponents ofemotionalprocessingthat,int urn,interfere withtheachievementof adaptiveemo tionfunctions.F urthermore,n otonlya re disturbedem o- tionalprocessessa lientfeatures ofthesed isorders,t heya re linkedwit h hypothesiseda etiologicalfactorsatbothneurobiologicalandpsychological levels. Emotionsare complexsyst ems thatd evelopedt hrought hecourse of humanevolutionaryh istoryandthatprepare anorganismt oactin responset oenvironmentalstimulia ndchallenges(cf. Keltner &Gross, thisissu e).We viewt heseem otionsystemsasbeingfundamentallylin ked withtwom otivationallya daptivesyst ems typicallyrefer redt oasgoal- directeda pproacha ndwithdrawalsystems.A lthought hespeci®cs o f theoreticalaccountsthatdescribethesesyst emsdiffer, theapproachsys- temh asvariouslyb eenrefer redt oastheBehavioralActivationSystem (Fowles,1980; a lsosee G ray,1987)a ndtheBehavioralFacilitationSystem (Depue&Iacono,1988;D epue,K rauss,& Spoont,1987),wh ereasthe withdrawalsystemh asbeenmo sto ftenid enti®ed a stheBehavioralInhibi- tionSystem(Fo wles,1980; G ray,1976).A thirdsyst em,wh ichwill b e discussedin t hesectiononanxietydisorders,is refer redt obyG raya s theFight-Flightsystem(G ray,1987), a ndrespondstononrewarda nd unconditionedp unishment. We havea doptedt heapproacha ndwithdrawalsystemp erspectivet o describeemotionalprocesseswit hinselect edp sychopathologiesb ecause,in ourestimation,thisa pproachp rovidesa parsimoniousaccountofemo- tionaldisturbanceint hesed isorders.An a lternativea pproachwo uldb eto adoptastrategyt hatemphasisesa discreteemotionsperspective,in wh ich primacywo uldb egivent oanunderstandingofthedisturbanceswit hina particularemotion,sucha ssadnesso ranxiety.Althoughn otclearly articulatedb ymotivationsystemt heorists,d iscreteemotionscanbe alignedwit hactivityineit her anapproacho rawithdrawalsystem.H owever,so meemotionscanalsob emeaningfullylin kedwit hactivityinb oth motivationsystems.Fo rinstance,a ngeris a negativeemo tionwithbeha- viouralcomponentsthatcanrangefro movertaggressiontoactiveavo idance.In a motivationsystemfra mework,itis possibleforthese`` hot’’and ``cold’’varietieso fangert obedifferentiallym ediatedby a ctivityin approacha ndwithdrawalsystems,resp ectively.Arelatedp ointist hat positiveemo tionsare notinvariablya ssociatedwit happroachsyst em activity,norare negativeem otionsalwayslin kedwit hwithdrawalsystem activity.Forinstance,t heexperienceo fthenegativeemo tionofsadnessin depressionhaslargelyb eena ttributedt odisturbancein a napproach motivationsystem. Emotionshavesevera lcomponents,in cludingbehaviouralandexpres- sive,su bjective/experiential,p hysiological,a ndcognitive,a ndmostfu nc- EMOTIONS AND PSYCHOPATHOLOGY 577 tionalaccountsofemotionassumet hattheseco mponentsofemotion operateinrela tivesyn chronyin mo stsit uations.In deed,inn ondisturbed individuals,t heco-ordinateden gagementofthevariousemotioncompo- nentssubservesa number ofadaptiveo rganisationalandmotivational functions(Buck,1994;E kman,1994a,b;Izard,1993a,b;Lang,Br adley, &Cuthbert,1990;M acLean,1993;N esse,1990; Plu tchik,1993).A s examples,so meofthesefu nctionsincludestimulusperceptionandevalua- tion,organisationofmotivatedresp onding,b ehaviouralregulation,and coping.A dditionally,adaptiveco mmunicativefu nctionsincludethemod- i®ab lep roductionofexpressivecu est hatsignalmotivationalstatesa nd behaviouralintentions(Fridlund,1994;cf. Bu ck,1994).I nourestima- tion,theoreticalconceptualisationsofemotionalprocessest hata relinked toactivityincen trallym ediateda pproacha ndwithdrawalsystems (Davidson,1992;L angeta l.,1990) a re especiallyu sefulforintegrating thismu ltiplicityoffunctionswithevidentphylogeneticco ntinuitiesin bothneuroanatomy(M acLean,1993)a ndbehaviour(Davidson,1992; Konorski,1967; L angeta l.,1990). We consider the functions ofemotioninp ersonswithpsychopathology tobecomparablet othosefo rnondisorderedin dividuals.H owever,in manyp sychopathologies,o neormore components ofemotionalproces- singareimpairedin so merespect.Suchd e®cit scanoccur, forinstance,in theperception,experience,in tensity,o rdisplayo femotions.C onsequently, adisorderedin dividual’sab ilitytoachieveo neormoreemotionfunctions ina nadaptivefa shionisim paired.Thus,we positt hatmanyo fthe emotionaldisturbancesin p sychopathologyca nbeconstrueda sde®cit s ino neormore componentsofemotionalprocessingthatdisruptthe adaptiveo utcomeofactivityinap proacha ndwithdrawalsystems. Althoughso metheoristshavesp eculatedab outthepotentiallya daptive functionsofpsychopathologysp eci®ca lly,anddisorderedemo tionalpro- cessesmo re generally(e.g. N esse,1990), t hefunctionaloutcomeo fthese disturbanceswill a lson ecessarilyinvolve t heimpaireda chievementof motivationallysign i®ca ntgoals. Althoughemo tionsplaya rolein m ostt ypeso fpsychopathology,we willd iscuss theroleo femotionino nlya few psychopathologies:U ni- polardepression,someoftheanxietydisorders, psychopathy,andschi- zophrenia.We choset oincludethisp articulargroupofdisordersfor severalreasons.First,emotionaldisturbancesa re salientfeatures inea ch oftheseco nditions.Second,there isa fairlywell-ch aracterisedb odyof theoryandempiricalresearchsu pportingtheroleo femotionaldistur- bancesin t hesed isorders.F inally,b yelaboratingontheroleo femotions int hesefo urexemplars, we are ablet oextractp rinciplesab outhow emotionsin¯uence,in teractwit h,andcontributetopsychopathology more generally. 578 KRING AND BACHOROWSKI UNIPOLARDEPRESSION

Thecardinalemotionalsymptomsofunipolardepressionincludesadness andanhedonia(i.e. a de®cit in t hecapacitytoexperiencep leasure). Both symptomscanbecharacteriseda scomparativelyen duringmoodstatesa s wella sphasicem otionalreactions,a ndhaveb eenco nstruedasoutcomesof dysregulatedactivity(i.e.excessive va riability)inanapproachmotivational system(C lark&Watson,1991;C lark,Watson,&Mineka,1994;D epueet al.,1987; D epue&Iacono,1988; Fo wles,1994; H enriques,G lowacki,& Davidson,1994;Tellegen ,1985).Ot her symptomsassociatedwit hdepression,includingcomorbida nxietyandguilt,are more closelyrela tedt o withdrawalsystema ctivity(Clarket a l.,1994; Tellegen, 1985). Somesupport forconsideringthattheemotionalfeatures ofdepression re¯ect d isturbancesin b othapproacha ndwithdrawalsystems comes from theconceptuallinksthathaveb eenm adebetweent heset wosyst emsand levelso fpositivea ndnegativea ffect(C lark& Watson,1991;C larket a l., 1994;Wa tson,Clark,&Carey,1988).Wh enmeasuredwit hthePositivea nd NegativeAffect Schedule:G eneral(Watson,Clark,&Tellegen,1988), levelso fpositivea ffecta ndnegativea ffecta re construeda sre¯ect ing positionsalongtwob roadtemperamentdimensions.T hus,d ifferenceso n eachd imensionare associatedn otonlywit hcharacteristicmo odsand emotionalresponses,b utalsowit hparticularcognitivest ylesa ndperson- alitytraits,su chasextraversionandneuroticism.Per sonswithlowlevelso f positivea ffecta reapttoexperienceemotionssucha ssadnessa nddullness, whereaspersonswithhighlevels o fnegativea ffectfreq uentlyexp erience emotionssucha sanxiety,gu ilt,andhostility.Cumulativeem piricalevi- dencesu pportsthepositionthatthisp articulartemperamentcombination isco rrelatedwit hdepression,withlowp ositivea ffectsh owingsomespe- ci®cit ytodepressionandthegeneraldistress characteristicofhighn egative affectrelat edn otonlyt odepression,buttoavarietyofother emotional disorders,a swell. Too urknowledge,n oempiricalinvestigationshaveb eenco nductedt hat simultaneouslyexa minethehypothesiseda ssociationsamongdepression, levelso fpositivea ndnegativea ffect,andapproacha ndwithdrawalsystem disturbance.H owever,D epueandhisco lleagues(D epue,L uciana,Arbisi, Collins,& Leon,1994)d escribedrelationsamongseveralperipheralindices ofcentraldopamineactivity,a neurotransmitter knownt omediatego al- directeda pproachb ehaviour(e.g.L eMoal&Simon,1991),a ndpositive emotionality(Tellegen& Waller,1992), a traitva riablet hatist houghtto indexsen sitivitytosignalso frewarda ndthath asstrongtheoreticallinks withanapproachm otivationsystem(i.e. t heBehavioralFacilitationSys- tem;Depueeta l.,1994). T heseem pirical®ndingsdemonstratethatitmay befeasibletobroadent herangeofexperimentalinquiryin d epressionand EMOTIONS AND PSYCHOPATHOLOGY 579 systematicallyexa minetheconjointin¯uenceo faffectivep redispositions andmotivationsystemd isturbances. Thediverseb ehavioural,co gnitive,p sychophysiological,a ndneuro- chemical®ndingso bservedin d epressionhaveb eenva riouslyrela tedt o depressiveemo tionalsymptoms,d ifferencesin d ispositionalaffect,and disturbeda ctivityinap proacha ndwithdrawalmotivationalsystems.One replicated® ndingthatservesa sanexemplarofanintegrateda pproacht o understandingemotionalde®cit sind epressioninvolvesa symmetricalpat- ternsofelectrocorticalactivationinb rainfro ntallobes.As examples, restingleftfro ntal hypoactivationhasbeeno bservedin b othcurrently depressed(e.g. H enriques& Davidson,1991)a ndpreviouslyb utn ot currentlyd epressedin dividuals(H enriques& Davidson,1990).F urthermore,a dolescentswithdepressedmo thers, agrouppresumedt obeatr isk fordepressionbyvirtueofmaternalclinicalstatus,a lsom anifestgrea ter relativeleft fro ntalhypoactivation(Tomarken,Simien,&Garber,1994). I n contrast,greater relativeleft a nterior hyperactivationhasbeeno bservedin individualsthoughtnottobedispositionallyp ronetodepressionbyvirtue ofreportinghighlevels o fpositivea ffectivity(Tomarken,Davidson, Wheeler,& Doss,1992). Theactivationasymmetrieso bservedin d epressionarehypothesisedt o beonemanifestationofdisturbancein a reward-orienteda pproach system.Sp eci®ca lly,Davidson,Tomarken,andtheirco lleagues(e.g. Davidson,1992;D avidson&Tomarken,1989;H enriques& Davidson, 1990;To marken& Keener,1998) h avep roposedt hatstable,rest ingleft frontalhypoactivationisa diathesisfo rdepressionthatpromotesvu lner- abilitytothebehaviouralandemotionalsequelaeofapproachsyst em de®cit s,su cha stheinabilitytosustaingo al-directedap proachb ehaviour, therelativein capacitytorespondtopositiveem otionalstimuli,t hepro- longedm aintenanceo fnegativea ffect,andself-regulatoryde®cit sint he capacitytousep ositiveeven tstoshiftin topositiveem otionalstates.A s describedb yTomarkena ndKeener (1998),co rroboratingsupport forthe hypothesisedlin kbetweenleft fro ntalhypoactivationandapproachsys- temd isturbanceco mes fromthebehaviouralandpsychologicalfunctions thoughttobesubservedb ythefrontallobes(e.g.F uster,1990; G oldman- Rakic,1987), a longwithevidencet hatthemesocorticolimbicd opaminer- gicsyst emm ediatesa pproachb ehaviour(e.g.St ellar&Stellar, 1985). Adistinctb utsimilarlyin ¯uentiallineofresearchh asprovidedevi- dencet hatparticularcognitiveo rattributionalstylesm ayfu nctionas diathesesfo rdepression.Liket hehemispherica ctivationasymmetry work,availablecogn itivemo delsa re generallyco mpatiblewit haccounts ofdepressionthatemphasised isturbancesin b othapproacha ndwith- drawalmotivationsystems(Fowles,1994). A soneexample,t hehopeless- nessmo del(Ab ramson,Metalsky,& Alloy,1989) p ositsthatt hetendency 580 KRING AND BACHOROWSKI tomakestable,glo balattributionsforimportantnegativelife even tsisa cognitived iathesisfo rahopelessnesssu btypeofdepression.Studies reviewedb yClarkandher colleagues(1994) in dicatethatthish opelessness attributionalstyleis lin kedt onegativeb utnotpositivea ffect,suggesting thatthisco gnitivest yleis n otspeci®c todepressionandmayb emore closelya ssociatedwit hgeneralisedemo tionaldistress andcorresponding disturbancesin a withdrawalmotivationalsystem.Inco ntrast,other empirical®ndings(Jo lly,Dyck,Kramer,& Wherry,1994; cf. A lloy,1991) indicatethatthetripartitein¯uenceo fpositivea ffect,negativea ffect,and thehopelessnessat tributionalstylea re more predictiveo fdepressive symptomsthaneither emotionalorcognitivefeat ures alone.T heseresu lts indicatethatindividualdifferencesin dispositionalaffectt hathavep utative linkstoapproacha ndwithdrawalsystemsare alsoa ssociatedwit ha cognitivest ylet hathasbeenp ostulateda sadiathesisfo ratlea stso me formsofdepression.Thus,fu rther conceptualandempiricalworkis necessarytoteasea part themanner inwh ichd epressedco gnitivest yles arealignedwit hpositivea ndnegativea ffectd imensionsand,int urn,with motivationsystemd isturbances. Unipolardepressionhasbeenlin kedwit hseveralcomponentsofemo- tionalresponding,su cha sbiasesin t heperceptionofandresponset o emotionallysign i®ca ntstimuli.F orinstance,d epressionisa ssociated withselectiveimp airmentsint heabilitytoidentifyfa cialexpressionsof emotionaswella sageneralisedn egativeb iasina ffectd iscrimination(Gur eta l.,1992). F urthermore,d e®cit sint herecognitionoffacialcuest hat signalemotionalstateshaveb eena ssociatedwithlessa daptiveb ehavioural andemotionalresponsesa mongdepressedin dividuals,su cha sgreater avoidanceo fandlesst olerancet othosefa cialcues(Per sad&Polivy, 1993).Accu mulatedevid encesu pportsthecontentionthatdepressionis alsoa ssociatedwit hcognitiveb iasesfo rtheprocessingofemotional stimuli(fo rreviews,see M acLeod&Mathews,1991; M ineka&Sutton, 1992).On ewell-established® ndingist hatd epressionisrela tedt omem- oryb iasesfo rmood-congruentstimuli.T heseb iasesh aveb eenrep orted forbothautomatica ndstrategicm emoryp rocessesa nd,importantly, appeartobespeci®c todepression(Bradley,Mogg,& Williams,1995). Mood-congruentmemorybiases,a longwithprolongedself-fo cusedr umi- nation(Nolen-Hoeksema&Morrow,1993;To marken& Keener,1998) a nd other cognitivevu lnerabilityfactors, sucha sdiscrepanciesb etweena ctual andidealself-representations(e.g.St rauman,1992),m ightcontributeto themaintenanceofdepressedst ates.Evidencet hatmemorybiasesd issipate onremission(MacLeod&Mathews,1991) su ggeststhatsuchb iasesa re statebutnottraitm arkers ofthedisorder. Althoughd escriptivea ccountsofdepressionfrequentlymen tiondimin- ishedfa cialexpressivity,emp iricalinvestigationshaven otsystematically EMOTIONS AND PSYCHOPATHOLOGY 581 examinedt hisco mponentofemotionind epression.However,in terestin vocalexpression,generally,andtheimpacto fmaternaldepressiononchild development,inp articular, havep romptedso meinvestigators tospecify thenature ofexpressivevo calde®cit sind epression.Thespeecho f depresseda dultshasbeenq ualitativelyd escribeda s``¯at’’,``dull’’,and slowin t empo(Buck,1984;H argreaves,St arkweather,& Blacker,1965; Levin,Hall,K night,&Alpert,1985;M urray& Arnott,1993;Sch erer, 1986).Severa lcomparativelyq uantitativea cousticp arameters,su cha s thosed erivedt hrought heanalysiso fdigitisedwavefo rmrepresentations ofspeech,havea lsop rovenu sefulind istinguishingbetweent hespeecho f depresseda ndnondepressedin dividuals.Fo rexample,Bet tes(1988) reportedt hatmothers withself-reportedsym ptomsofdepressionpro- ducedin fant-directedsp eechwit hnarrower pitchco ntours thanwere observedin t heinfant-directedsp eecho fcontrolmothers.Sim ilarly, Kaplan,Bachorowski,a ndZarlengo-Strouse(in p ress) alson otedd iffer- entpatternsofpitchmo dulationandvariabilityint heinfant-directed speecho fmothers withsymptomsofdepression.Importantly,theyfo und thatthisexpressived e®cit wa srelatedt oimpairmentsinin fantassociative learning(see alsoH off, Kaplan,Zarlengo-Strouse,& Bachorowski,1999), suggestingthattheinfant-directedsp eechp roducedb ydepressedca re- giversmay b eonevariablet hatmediatest herelationshipb etweenm ater- naldepressionandcognitive-emotionaldisturbancesin t heirch ildren(e.g. Cohn&Campbell,1992; M urray,1992). Althoughsp eculative,t heexpressivesp eechd e®cit sfrequentlyo bserved ind epressionseemt obeconsistentwithanapproachm otivationsystem disturbance.M anyofthesep roductionde®cit s,su cha sdif® cultyinsp eech initiation,longera ndmorefrequentpauses,a ndanoverallslowerra te,ca n beincludedin t hecluster ofsymptomsreferredt oaspsychomotorretarda- tion.Furthermore,fro maspeechp roductionperspective,t hesesym ptoms are consistentwithdescriptionsofthebehaviouralcharacteristicsa ssociatedwit happroachsyst emd isturbance,su cha sdif® cultyint heinitia- tionofbehaviour. Althought hespeci®c pathwaysa ndmechanismsthat underliesp eecha ndother motorde®cit sind epressionarenotknown,one likelysyst emo finvolvementincludesthebasalganglia,withitsremarkably highco ncentrationofdopamine(Co ÃteÂ&Crutcher,1991) a nditsrolein some ofthemotoraspectsofspeechp roduction(Borden,Harris, & Raphael,1994).

ANXIETYDISORDERS Theanxietydisordersareaheterogenousgroupofdisorders thattypically involvea numberofnegativeem otions,t hemostp rominentbeinganxiety, fear, anddisgust.Althought hedifferentanxietydisorders likelyva ryint he 582 KRING AND BACHOROWSKI extenttowhichva riousemotionalprocessesa redisturbed,thereis agood dealofevidencet hatmost,if notall,o ftheanxietydisorders are characterisedb yheightenedn egativea ffect(e.g. C horpita&Barlow,1998; Clark& Watson,1991;Wa tsoneta l.,1995; Z inbarg& Barlow,1996). Additionally,severaloftheanxietydisordersare alsoa ssociatedwit h behaviouralavoidanceo fthesituationsorstimuliin wh icha nxietyis elicited.Suchb ehaviouralavoidanceis o ftenu sedt ominimisesu bjective feelingsofanxietyorfear, asint hecaseofanindividualwithaphobiao f ¯yingwhostudiouslyavo idsairplanetraveln omatter howinconvenient. Althoughh eightenedn egativea ffectmay b esharedb ymosto fthe anxietydisorders, speci®c emotions,su cha sfear, ®guremoreprominently inso medisorders, sucha sspeci®c phobiasandpanicd isorder,m orethan ino thers.Alt hought heterms``anxiety’’and``fear’’are oftenu sedin ter- changeably,t heset woemo tionscanbedistinguishedco nceptually,emp iri- cally,andclinically(O È hman,1993).Fo rexample,Ba rlow(1988)d escribed anxiety,whichh ereferstoasanxiousapprehension,asamoodstate characterisedb ybothnegativea ffecta ndsomatict ensionthatisa ssociatedwit htheanticipationoffuture dangero rmisfortune.By co ntrast, fearisa nimmediatealarmreactiontoaperceivedt hreatordanger (Barlow,1988).F urthermore,recen tevidencep ointstodistinctn europhy- siologicalpathwaysfo rfear(LeDoux,1995a )andanxiety(Gray,1995). It isim portanttonotethatamongindividualswit hanxietydisorders,t he presenceo fnegativeem otionsisn otdysfunctional per se.Forexample, thefearresponset hatcharacterisesa panicat tackis a notherwisen ormal orfunctionallya daptiveresp onset hatoccursata ninappropriatetime (Barlow,1988,1991). To a ccountfortheseresp onseso ccurringint he absenceo fsigni®ca ntthreat,manyt heoristshavea rguedt hatsomeof theanxietydisorders,su cha spanicd isorder andspeci®c phobias,re¯ ect inappropriateactivationofand/ordisturbancein t hemotivationsystems underlyingthesen egativeemo tions.Ino uranalysis,we willco nsider three oftheanxietydisordersthathaveb eenco nceptuallylin kedt omotivation systems:Pa nicd isorder,sp eci®c phobias,a ndgeneraliseda nxietydisorder. Althougha number ofdifferentetiologicaltheoriesfo rtheset hree anxietydisordershaveem erged,theset heoriesa re markedlysim ilarin thattheyeit her directlyo rindirectlyimp licated isruptionsinwit hdrawal motivationalsystemsasakeyet iologicalcontributor(e.g.Ba rlow,1988; Chorpita&Barlow,1998;G ray,1976,1982; L ang,1995; L angeet a l., 1990).G rayh aspostulatedt hattheneurobiologicallyb asedBeh avioral InhibitionSystem(BIS)isanemotionsystemthatservest oinhibitongoing behaviourinresp onset oconditionedst imulia ssociatedwit hpunishment andfrustrativen onreward(e.g. G ray,1976, 1979, 1982; cf. Wa llace, Bachorowski,& Newman,1991).In a dditiontoinhibitingbehaviour, activityint heBISisa lsorela tedt oincreaseda rousalandincreased EMOTIONS AND PSYCHOPATHOLOGY 583 vigilancet oenvironmentalstimuli.An xiety,a ccordingtoGray,re¯ect s activityint heBIS. Oneprimarysource ofevidencelin kingthissyst em toanxietydisorderscomesfro mstudiessh owingthata nxioliticmed ica- tionsaffectb ehaviourandphysiology(e.g. elect rodermalactivity)believed tobeassociatedwit hinhibitionsystema ctivityinb othanimals(e.g.G ray, 1979)a ndhumans(e.g.L andon,Sher,& Shah,1993).P anic,a ccordingto Gray,re¯ ect sactivityinh isproposedF ight-FlightSystem.Notably,G ray’s Fight-Flightsystemis sim ilartoCannon’sd escriptionoftheemergency (® ghtor¯ight)reaction(e.g.C annon,1929). Barlow’s (1988,1991) mo delsp eci®es t hatanxiousapprehensionis markedb yheighteneda rousal,h ighn egativea ffect,perceptionsofunpre- dictabilityanduncontrollability,a ndworry.Anxiousapprehensionisco n- sideredb yBarlowt obetheprimarych aracteristico fgeneraliseda nxiety disorder.M oreover,a nxiousapprehensioniso ftena dequatelya ssessed usingmeasures ofnegativea ffecto rneuroticism(Ba rlow,1988).Pa nic, accordingtoBarlow,istheclinicalmanifestationoffear. Morespeci®ca lly, panica ttacksarevieweda salarmreactionselicited without exposuretoa particularstimulus.By contrast,thealarmreactionseenin speci®c phobias ist ypicallyelicit edfo llowingexposuretothefearedo bjecto rsituation(see alsoM ineka,1985;M ineka&Cook,1993).K eyco gnitiveco mponentsof Barlow’s theoryare theconceptsofpredictabilityandcontrollability(see alsoG arber,M iller,& Abramson,1980),su chthatindividualswit hvarious anxietydisordersoftenp erceivet hatnegativeeven tsandpanicrea ctions are neither predictablen orcontrollable.Fo rexample,t helikelihoodofa panicd isorder patienthavingapanica ttackfo llowingpharmacological provocationisd ramaticallyred ucedif thepatientistoldaboutthetypeand timecourse oftheeffectsthedrugwillp roduce(Ba rlow,1988).I tis informativet onotethatBarlow’s conceptofanxiousapprehensionshares anumber ofsimilarfeatures withGray’sBeh avioralInhibitionSystem, sucha sheighteneda rousal,p reparationforstress andchallenge,a nd anticipationofaversiveo utcomes.Sim ilarly,Ba rlow’sa larmreaction resemblesG ray’sd escriptionoftheFight-FlightSystem(Fo wles,1994). Athirdrecen tandrelatedtheoreticalcontributionist hetripartitemodel ofanxietyanddepressionproposedb yClarkandWatson(1991).A lthough originallyin tendeda sameanstodistinguisha nxiousanddepressedm ood andanxietyanddepressivesyn dromes,t hemodelh asimplicationsfor speci®c anxietydisorders. Brie¯y, t heirm odelh oldsthatthesymptom overlapint heanxietyandmooddisordersisa ccountedfo rbyageneral marker ofheightenedd ispositionalnegativea ffect.However,ea cho fthese ``distress’’disorders canbedistinguishedb ycharacteristicst hatare believedt oberelativelyu niquetoeach.Speci®ca lly,heightenedso matic arousalandtensioncharacterisesa nxiety.Watsoneta l.(1995) p rovided support forthist ripartitedistinctioninfa ctoranalyticst udiesa cross ®ve 584 KRING AND BACHOROWSKI differentsamples.F urthermore,Wat soneta l.(1988) d emonstratedt hat heightenedn egativea ffectch aracterisedb othpatientswithanxietyand withdepression,whereasloweredp ositivea ffectwa sonlych aracteristic ofthedepressedp atients.Thetripartitemodelis co nsistentwithGray’s BehavioralInhibitionSystemin sofarasheightenedn egativea ffecta nd somatica rousalhaveb eenlin kedt oactivityint heinhibitionsystem. Andasnotedea rlier,Ba rlow’s conceptofanxiousapprehensionisco nsis- tentwithelevatedn egativea ffecto rneuroticism. ItisimportanttonotethatinC larkandWatson’sm odel,n egativea ffect isco nstrueda sthe``temperamentalcore’’ofneuroticism(C larket a l., 1994),wh ichsu ggeststhatnegativea ffectre¯ ect sastable,em otional vulnerabilityfactorforanxiety(anddepression).However,t heextant dataonthisimp ortantsuppositionare lacking.Pro spective,lo ngitudinal studiesa re necessaryt odisentanglet hestateandtraitco ntributionsof negativea ffectt oanxiety.Moreover,a dditionalresearch(e.g. Z inbarg& Barlow,1996)t ofurther elucidateemotionalfactors thatdistinguisht he speci®c anxietydisorders isn eeded. Similartotheliteraturereviewedfo runipolardepression,anumber of theanxietydisordersarealsoch aracterisedb ybiasesin t heperceptionof emotionallysign i®ca ntstimuli.F orexample,a number ofstudiesh ave foundthatpanicd isorder patientsmisperceiveh armlesseven tsorobjects int heenvironmentasthreatening(Barlow,1988;C lark,1988;M cNally, 1990).M oreover,cu mulativeevid encesu ggeststhatanxiouspatientsare more likelyt oattendtothreateningstimulia ndmakeb iasedju dgements aboutthelikelihoodofnegativeo utcomesa swella sthecovariation betweent heseo utcomesa ndfearedst imuli(M athews &MacLeod,1994; Mineka&Sutton,1992;To marken,Mineka,&Cook,1989;To marken, Sutton,&Mineka,1995).T hedirectionalin¯uenceso fthesecogn itive biasesa ndemotionalprocessingare notwellu nderstoodandshouldb e afocusoffuture investigationsonthelinkageb etweenco gnitivea nd emotionalfactorsina nxietydisorders(O È hman,1993). Surprisingly,littleisk nownab outtheexpressiveco mponentofemotion amongpatientswithanxietydisorders,a lthought here isreasontobelieve thatthisco mponentmightbedesynchronousfromotherco mponents,a t leastin sp eci®c phobias.I nastudyo fspider andsnakep hobics,p artici- pantsreportedeq uivalentlyh ighlevels o ffearanddisgust,yetfa cial expressionsofdisgustwere farmore commonthanfacialexpressionsof fear(A.J. Tomarken,personalcommunication,August1994). T his®nding isconsistentwithotherresearchsh owingthatsmallanimalssucha sspiders alsoelicit st rongreportsofdisgusta ndthattheserep ortsofdisgusta re positivelyco rrelatedwit hfearintensityamongphobics(e.g. Wa re,Ja in, Burges,& Davey,1994). M oreover,sp iderphobicsh aveb eenfo undtohave ahigher sensitivitytodisgustt hannonphobics(M erckelbach,deJong, EMOTIONS AND PSYCHOPATHOLOGY 585 Arntz,& Schouten,1993;M ulkens,d eJong,&Merckelbach,1996).T hese ®ndingsh ighlighttheimportanceo fconsideringdiscreteemotionsin additiontobroademotiondimensionswhenco nsideringtheroleo femo- tionint heanxietydisorders,sp eci®ca lly,andpsychopathologyin gen eral.

PSYCHOPATHY Cleckley’s(1941) a uthoritatived escriptionofpsychopathyem phasised de®cien temotionalprocesses,in cludingimpoverishedem otionalreactions,la cko fanxiety,a ndadisjunctionbetweent helexicalandexperien- tialcomponentsofemotioninh isd elineationofthecore features ofthe disorder.A lthoughat tentiontotheseca rdinalemotionalfeatures isn ota- blyab sentfromrecentDSMconceptualisationsofAntisocialPersonality Disorder (Hare,H art,&Harpur, 1991;Su tker,1994; Wid igeret a l.,1996), contemporarytheoreticalaccounts,su pportedb yagrowingcorpusof empirical®ndings,co ntinuetopositt hatem otionaldisturbancesa re bothsalientandfundamentalaspectsofpsychopathy. Followingfromthemanifestd if® cultiest hatpsychopathshavein lea rn- ingfrompunishment,severalinvestigatorshaveexa minedp sychophysio- logicaldisturbancesin n egativeem otions,su chasfearandanxiety,wh ereas othershavefo cusedo nattendantcognitive-behaviouralde®cit s,su cha s poorpassive-avoidancelea rning.U singvariantsofthestartle-probepara- digm,compellingevidencethatpsychopathsrespondtoaversivest imuliin ananomalousfashionhasbeenp rovidedb yPatricka ndhisco lleagues(e.g. Patrick,1994;Pat rick,Bradley,& Lang,1993). In t heseexp eriments,t he amplitudeofeyeblinkstartleresp onset oanaversive,t ask-irrelevantsti- mulus,su cha sa95-decibelwhitenoisea cousticst artle,is useda sanindex ofdefensiveem otionalreactions.Typically,st artleresp onsesa re poten- tiatedd uringinducedfea randother aversivest atesbu tare diminished duringpositiveem otionalstates.In co mparisontocontrols,p sychopaths showcomparablestartlein hibitionduringexposuretopleasantstimulibut importantlyfa ilt oshowstartlep otentiationduringexposure toaversive stimuli.Ad ditionally,associationsbetweenst artlerea ctionsandfactor scores ontheRevisedP sychopathyC hecklist(PC L-R;Hare,1992) su ggest thatdeviantrespondingintheprobeparadigmis linkedt oacorede®cien cy inem otionalprocessesbu tnottoantisocialbehaviourmoregenerally. Anomalousstartlep otentiationinp sychopathshasbeeno bserved despiteverbalreportsthatcorroboratedt heaversiven atureofthestimuli andthatd idn otdiffer fromcontrols’self-rep orts(Patricket a l.,1993). Additionalevidencefo rthis` `semanticd ementia’’(Cleckley,1941), o r discordanceb etweent helinguistica ndexperientialcomponentsofemo- tion,hasbeenfo undwithbothfearimaging(Patrick,Cuthbert,&Lang, 1994)a ndincidentalmemoryp aradigms(Christianson,eta l.,1996). 586 KRING AND BACHOROWSKI Similarly,Williamson,Harpur, andHare (1991)fo undthatalthought he ratedem otionalpleasantnesso fpositive,n egative,a ndneutralwordsdid notdiffer forpsychopathsandnonpsychopaths,p sychopathsdemon- strateda relativefa ilure todifferentiateemotionalandneutralwordsat bothbehaviouralandelectrocorticallevels. Deviantperipheralphysiologicalrespondingtobothactualandantici- patedaver siveeven tshasbeenro utinelyo bservedwit hpsychopathicsa m- ples.Fo rexample,d ifferencesin severa lindiceso felectrodermalactivity duringclassicalaversiveco nditioningparadigmsa ndint heanticipationof noxiousstimulih aveb eend emonstrated(e.g. H are,1978; Sid dle& Trasler, 1981;fo rareview,see1994). Su chd ifferencesa reconsistentwiththewell- recognisedb ehaviouraldif® cultyofpsychopathstolearntowithhold respondingino rder toavoidp unishment(Fowles,1994; Pat terson& Newman,1993).Begin ningwiththeclassicwo rkofLykken(1957), in ves- tigatorshaveco nsistentlyd emonstratedt hisp assive-avoidanced e®cit in a varietyofbehaviouralcontexts.R esearchco nductedb yNewmanandhis colleagues(e.g.Ar nett,Smith,&Newman,1997;N ewman,1987;N ewman &Kosson,1986;N ewman,Patterson,Howland,&Nichols,1990) h as elucidatedt hecontextsthata re especiallylikely t oengender passive- avoidanced e®cit sinp sychopaths.Inparticular, avoidancelea rningdefi- citsare mostrea dilya pparentwhent hebehaviouralparadigma lsop ro- motesa ppetitiveresp ondingforreward.Insu chjo intrewarda nd punishmentcontexts,p sychopathsfailt omodulatebehaviouralrespond- ingina nadaptivefa shionint hattheyfailtolearntowithholdresp onding ino rder toavoidp unishment. Thetheoreticalmodelsa dvancedby Fo wles(1980, 1994) a ndby Newmanandhisco lleagues(G orenstein& Newman,1980;N ewman, 1998;Pa tterson&Newman,1993)at tempttoaccountforthediverse behaviouralandpsychophysiological®ndingsa ssociatedwit hpsychopathy.Althoughb oththeoristsgenerallya dhere toanapproach-withdrawal motivationsystemco nceptualisation,withspeci®c recourse toGray’s (1978,1982, 1987) n europsychologicaltheory,thedifferencesb etween theirp erspectiveshave p otentiallyim portantimplicationsforunderstand- ingtheemotionalandbehaviouralfeatures observedin p sychopathy. Fowles’(1980, 1994; cf. Q uay,1993) p erspectiveis t hatp sychopathic de®cit sarelargelya ttributabletoaweakorde®cien tBehavioralInhibition System(BIS). Normally,cu esfo rpunishmentacta sinputstotheBIS,a nd variousbehavioralandemotionalconsequencesen sue.In co ntrast,aweak BISmeansthatcuesfo rpunishmentare lesslikely t oactivatetheBIS.In theabsenceo fBISengagement,theadaptiveseq uelaeofBISactivity, includingtheinhibitionofongoingbehaviour, re¯ect ion,andtheexperi- enceo fanxiety,will n otoccur. Thus,t hebehaviouralandpsychophysio- logicalanomaliesa ssociatedwit hpsychopathyarethought oariseb ecause EMOTIONS AND PSYCHOPATHOLOGY 587 thepsychologicalprocessest hatwouldn ormallyfu nctiontomotivate adaptiveb ehaviouralandemotionalrespondinginresp onset ocuesfo r punishmentdonotoccur. Althoughn otaspivotaltohisfr amework, Fowles(1994) h asspeculatedt hatpsychopathymay a lsoinvo lvea strong oroveractiveBeh avioralActivationSystem(BAS). As describedb yArnett,Smith,andNewman(1997),t wogen eral modelsh aveb eenp roposedb yNewmanandhisco lleagues.T he®rst model(G orenstein& Newman,1980),wh ichst resses septal-hippocampal systemd isturbancesa sunderlyingthedisinhibitedb ehaviourassociated withpsychopathy,isco nsistentwithastrongBAS.T hesecondmodel (Newman,1998;Pa tterson&Newman,1993;cf. N ewman&Wallace, 1993a,b),whichh asbeent heprimaryfocusofempiricalinvestigations conductedb ythisgro up,p roposest hatafundamentaldisturbancein psychopathyis a de®cit in resp onsem odulation.Speci®ca lly,p sycho- pathsare thoughttohaved if® cultysuspendingreward-oriented approachb ehaviourino rder toaccommodatefeed backfro mtheenvir- onment.Thatis, r ather thanemphasisingimpairmentineit her activa- tionorinhibitionsystems,t hism odelp redictsthata primary disturbancein p sychopathyis a de®cit in t hereciprocalinhibitionof activationandinhibitionsystems.A lthoughN ewmanemphasisesin for- mation-processingcharacteristics,su cha stheallocationofattentionto motivationallysign i®ca ntstimuli,t hism odelca nalsoa ccountforsome ofthenotableem otionalfeatures ofpsychopathy,in cludinglowfea rand lowanxiety(see Newman,1998,fo radetailedexa minationofmodelso f psychopathy). Theaforementionedt heoreticalapproachesrea dilya ccountfor many ofthediversefea tures associatedwit hpsychopathy,a lthougha detailed applicationofeachm odelt othevariousbehaviouralandpsychophysio- logical®ndingsa ssociatedwit hpsychopathylea dstodistinctionsthat canonlyb eresolvedt hroughfu rther empiricalwork.Tod ate,few empiricalinvestigationshavesp eci®ca llyt estedt hesem odelsa scompet- inghypotheses.O neexceptionare thestudiesco nductedb yArnetteta l. (1997),wh otestedt heweak-BIS, strong-BAS,a ndmodulationde®cit modelswit hbothpassive-a ndactive-avoidancep aradigms.Although therewa ssomeevid encein su pportofallt hreein terpretations,t he ®ndingswere bestexp lainedwit hrecourset othestrong-BAS andpoor responsemo dulationapproaches:P sychopathsdemonstratedexa ggerated respondingtoreward,andthisap proacha ctivationsubsequentlyin ter- feredwit htheirab ilitytoinhibitresp ondingtopunishmentcues.A s theseinvest igatorsnote,it will b eimportanttomore explicitlya ttend toemotionalcharacteristics,su cha sde®cit sinem pathya ndanxiety(e.g. Levenson,Kiehl,& Fitzpatrick,1995),in a comprehensivea ccountof psychopathy. 588 KRING AND BACHOROWSKI SCHIZOPHRENIA

Althoughn ottypicallyt houghtofasan``emotional’’disorder per se, more recentempiricalresearchin sch izophreniah asidenti®ed a number ofemotionaldisturbancesin p ersonsdiagnosedwit hthisd isorder. Unlikethedisordersreviewedso fa r, however,t heemotionaldistur- bancesin schizo phreniah aven otoftenb eenco nstruedwit hint he approach-withdrawalframework.Ona more generallevel,h owever, Fowles(1992, 1994) h ashypothesisedt hata ctivityinb oththeBehavioral InhibitionandBehavioralActivationSystemsisrela tedt othenonspeci®c geneticliab ilityforthedisorder.F urthermore,Fowles h assuggestedt hat activation(andperhapsoveractivity)in t heBASmayb eassociatedwit h thepositivesym ptoms ofschizophrenia(e.g. h allucinations,d elusions), whereasactivityint heBISinco njunctionwithunderactivationofthe BASmayb eassociatedwit hsomeofthenegativesymp toms(e.g.wit h- drawal,la cko fspontaneity).U nfortunately,thelinkageb etweent hese systemsandspeci®c emotionaldisturbancesin sch izophreniaa re notyet wellu nderstood. Oneofthemostsa lientemotionaldisturbancesa mongschizophrenic patientsappears tobetheird iminishedexp ressionofemotion.Recent studieso fthelinkagebetweenexp ressiveb ehaviourandexperiencedem o- tioninsch izophreniah aveco n®rmedt hehistoricalwritingso fBleuler (1911/1950)a ndKraepelin(1904), wh onotedt hatschizophrenicp atients seemedt oexperiencea widerangeo femotionsyetd idn otoftend isplay themo utwardly.Thatis,co mparedt ononpatients,sch izophrenicp atients showlesso bservablefa cialexpressiondespitereportingequallyin tense amountsofexperiencedemo tion(e.g.Beren baum&Oltmanns,1992; Dworkin,Clark,Amador, &Gorman,1996;D workinet a l.,1993; Krause,St eimer-Krause,& Hufnagel,1992; K ring&Earnst,inp ress; Kring,K err, Smith,&Neale,1993; K ring&Neale,1996). Im portantly, thisdiminishedexp ressivitydoesnotappeartobeafunctionofneuroleptic medicationside-effects(Kring&Earnst,inp ress), anditis n otlimitedt o speci®c emotions. Althoughsch izophrenicp atientsare lessexp ressivet hannonpatients, theirem otionalresponsep ro®leis n otdevoido ffacialexpression.Indeed, comparedt ononpatients,sch izophrenicp atientsdemonstratesimilaror greater micro-expressivefa cialbehavour(assessedvia elect romyography; EMG)inresp onset oemotional®lms(M attes,Sch neider,H eimann,& Birbaumer,1995), p ictures offacialexpressions(Kring,K err, &Earnst, 1999),a ndwhiled iscussingpleasantandunpleasantevents(Matteset a l., 1995).T hus,sch izophrenicp atients’overt exp ressiveb ehaviouris dampened,yett heirrep ortsofexperiencedem otionaswella stheir EMGrespondingare similartononpatients.T hisr aisest heinteresting EMOTIONS AND PSYCHOPATHOLOGY 589 possibilitythatschizophrenicp atientshavea differentthresholdfo rprodu- cingobservabled isplays.Su cha thresholdmo delwo uldp redictt hat patients’exp ressiveb ehaviourwouldb eobservablein resp onset ostimuli ofsuf® cientintensity(Ekman,1992). There isrea sontobelievet hata tleastso meschizophrenicp atients mightalsoh avered uctionsinexp eriencedem otion,particularlyp leasant emotions.I ndeed,anhedoniah asbeenp ositedt obeacentralfeature of schizophreniab ysometheorists(e.g.M eehl,1962; R ado,1962).Sim ilarto thediscussionondepressionearlier,Fowles (1992, 1994) h aspostulated thatanhedoniain sch izophreniare¯ ect sadisturbancein t heBehavioral ActivationSystem.To t heextentthatpositivea ffectre¯ ect sactivityint he activationsystem,schizophrenicp atientswithanhedoniash ouldma nifest decreasedp ositivea ffect.Consistentwiththisrea soning,Bla nchard, Mueser,a ndBellack(1998) fo undthatschizophrenicp atientsreported greater traitn egativea ffectb utlesst raitp ositivea ffectt hannonpatients. Moreover,a nhedoniawa sassociatedwit hlowpositivea ffecta ndhigh negativea ffectin t hissa mple.T hese® ndingsa re alsoco nsistentwitha recentmeta-analysisin dicatingthatschizophrenicpatientsreportincreased neuroticisma nddecreasedext raversionrelativet ocontrols(Berenbaum& Fujita,1994). Another lineofinvestigationonemotioninsch izophreniah asfound thatchronicallyill sch izophrenicp atientsdolesswell o ntasksofemotion perception(facialandvocal) thannonpatients(e.g.K err &Neale,1993; Mueser eta l.,1996; Sa lem,K ring,& Kerr, 1996).H owever,it is important tonotethatthisd e®cit d oesn otappeartobespeci®c toemotionpercep- tion.Rather,t heschizophrenicp atientsint hesest udiesm anifesteda more generalisedd e®cit in p erceivingfacesa ndvoices.O nerecentstudyo f acutelyill sch izophrenicp atientsdidn ot®ndevidencefo remotionpercep- tionde®cit s(e.g.Bella ck,Blanchard,&Mueser,1996), a ndthisresu lth as ledso metospeculatethatantipsychoticm edicationsmayb ebetter ableto ameliorateperceptionde®cit s(includingemotionperception)among acutelyill bu tnotmore chronicallyd isturbedp atients(Mueser eta l., 1996).A lternatively,andperhapsmore likely,itm ayb ethecaset hat emotionperceptionde®cit s(andemotionaldisturbancem ore generally) are presentino nlya subseto fpatientswithschizophrenia.Indeed,the heterogeneityofschizophreniah asledm anyresea rchers tohypothesise thatschizophreniais n otonediseaseen tity,bu trather acompilationof multipled iseaseen tities,ea chwit hdifferentaetiologies(e.g. C arpenter, Buchanan,Kirkpatrick,Tamminga,&Wood,1993). Consistentwiththismu ltipled iseasem odel,C arpenter andcolleagues (e.g.C arpenter eta l.,1993; C arpenter,H einrichs,& Wagman,1988)h ave arguedt hatsch izophrenicp atientswhohaveen duringandprimary negativesymp toms (i.e.d e®cit symp toms) representadistincta etiologic 590 KRING AND BACHOROWSKI subtype.F urthermore,t heseinvest igators hypothesisedt hatdysfunction involvingfrontalcortexa ndlimbicst ructures mightaccountforde®cit symptomatology(e.g. Bu chananeta l.,1994; Ta mmingaet a l.,1992). Interestingly,t heessenceo fde®cit symp toms isb asedo nKraepelin’s (1919/1971,p. 74) n otionofanavolitionalprocess,d escribeda s``. .. emotionaldullness,fa ilure ofmentalactivities,lo ss ofmasteryover vo li- tion,ofendeavor, andofab ilityforindependentaction’’,andthusnot surprisinglya number ofthede®cit symp tomsinvolveem otionalfeatures (e.g.d iminishedem otionalrange,cu rbingofinterests,a ndrestricted affect).Thepresenceo fthesefea tures suggeststhatthesep atientsmight notonlyexh ibitd iminishedem otionalexpression,butalsod iminished emotionalexperience(E arnst& Kring,1999). M oreover,t hebehaviours comprisingde®cit symp toms alsosu ggestu nderactivationoftheBeha- vioralActivationSystem. Althoughco gnitived e®cit sare alsop rominentfeatures ofschizophrenia,thelinkageb etweenco gnitivea ndemotionalfactors isn otwell understoodandisa nimportantdirectionforfuture research.This linkageca nbeempiricallyt estedu singthestartle-probeparadigmwh ich isa relativelyn onverbalmethodformeasuringactivationofemotionand motivationsystems(Langeta l.,1990; N eale,Bla nchard,Kerr, Kring,& Smith,1998).

CONCLUSION We haveco nsideredt henature ofemotionaldisturbancein d iversep sychopathologies,a ndwe havea rguedt hatthefunctionsofemotionsare comparableinp ersonswithandwithoutpsychopathology.However,t hese functionsare notreadilya chieveda mongindividualswit hpsychopathol- ogyd uetoimpairmentsino neormorecomponentsofemotionalproces- sing.F orin stance,t heinabilityofdepresseda ndschizophrenicpatientsto accuratelyp erceivefa cialexpressionsofemotionino therscanbeexpected tointerfere withtheircap acitytoeffectivelyresp ondtothoseso cioemo- tionalcues. Recourset otheapproach-withdrawalmotivationheuristich asseveral importantadvantages.O neindicationoftheexplanatoryb readthofthis frameworklies in it sabilitytoaccountforthede®cit sthatareassociated withdifferentcomponentsofemotionalprocesseswit hina particular disorder.T heutilityoftheframeworkis a lsod emonstratedb yitsability toaccountfortheemotionalandbehaviouralimpairmentstypicalof disordersthathavem arkedlyd ifferentsymptompictures.F urthermore, thisp erspectiverea dilyin corporatesd iversemet hodologiesa ndlevelso f analysis,in cludingsymptomdescriptions,co gnitivest yles,a ndpsychophy- siologicalresponding. EMOTIONS AND PSYCHOPATHOLOGY 591 Advancementsinb othneuroimagingtechniquesandtheabilitytoalter selectivelyregu latoryactivityinp articularneurophysiologicalsystemsare havinganimmediateim pacto nourunderstandingofvariousmental disorders.Fo rinvestigatorsofpsychopathology,so meofwhatisp articu- larlyexcit ingaboutthesea dvancementsist hepromiset hattheyh oldfo r ourabilitytospecifyt helinkagesa mongneuropathology,n euroregulation, emotionalprocesses,a ndmaladaptiveb ehaviour. Inourprogresst owards thisgo al,t heapproach-withdrawalframeworkco ntinuest obeapractical unifyingtool.M oreover,in p art becauseo fitsconsiderationofphyloge- neticco ntinuitiesin mo tivation-behavioursystems,t hemotivationsystem perspectivem akesit p ossiblet oderivet establep redictionsaboutdisrup- tionsint heachievementofadaptive,m otivationallysign i®ca ntgoalst hat occura saconsequenceo fprimaryim pairmentsino neormore emotion components.Fo rexample,a depression-relatedd isturbancein t heproso- dic,exp ressiveco mponentsofspeechca nconsequentlyb eexpectedt o produceim pairmentsint heabilitytoprovidevocalsignalsab outmotiva- tionalstatetoothers. Althoughwe contendthatactivityina pproacha ndwithdrawalsystems underliesmo tivatedb ehaviour, andthatdisturbancesin t hesesyst emscan produceserio usemotionaldysfunction,we acknowledget hatthisfr ame- workd oesn otfullya ccountfortherangeo femotiondisturbancesin psychopathology.Forexample,t hedisjunctionamongemotionresponse componentsinsch izophreniais n otreadilya ccountedfo rbythisfr amework.It isa lsot hecaset hatthepathologicalexperiencea ndexpression ofparticulardiscreteemotionsgivesrise t osomeoftheuniquefeatures observedwit hinva riousdisorders.F urthermore,t heexactways in wh ich thediscreteemotionsare derivedfro mor``fallo utof’’broadmotiva- tionalsystems are notknown.Thiscrit icismis p articularlyreleva ntfor anxietydisorders,wh ichin volvea number ofdifferentnegativeem otions (Tomarken& Hollon,1991).H owever,recen tneurophysiologicaland behaviouraldatamayb ethestartingplacefo rsomed e®n itivea nswers in thisrega rd.Theresearchco nductedb yLeDoux(e.g.1995a ,b),whohas madesigni®ca ntcontributionstoanunderstandingoftheneurophysiolo- gicalpathwaysinvo lvedin fea r, andtheworko fGray(e.g. 1987, 1995), whohasprovidedsim ilarlyin ¯uentialevidencerega rdingpathwaysfo r anxiety,a re exemplars ofsuchresea rch.Perhapsthemostp roductive approacht ostudyingemotionaldisturbancein p sychopathologyis o ne thatexplicitlyco nsidersspeci®c emotionswithint hemotivationsystem framework. Another shortcomingoftheapplicationofthemotivationsystem frameworkis t hatit d oesn otreadilya ccommodatethedynamicso f emotionexpressioninso cialinteraction,whichca narguablyb econ- sideredt he``emotionalsignature’’ofpsychopathology.Forexample, 592 KRING AND BACHOROWSKI interactingwithanonexpressivesch izophrenicpatientisboundtoevokea widevarietyofresponsesfro maninteractionpartner.Sim ilarly,thefailure ofadepressedin dividualtorecogniserea dilyp ositiveem otionalcuesin others further constrainssocialcommunication.Insh ort,manyo fthe emotionaldisturbancesevid entinp sychopathologywill evo keem otional responsesin o thers(e.g.H ooley& Teasdale,1989; Jo iner,Alfa no,& Metalsky,1992). T heseresp onses,wh ether theyb epositiveo rnegative, likelym ediatethedevelopmentandmaintenanceo fsocialrelationshipsin disorderedin dividuals,a ndtheym aya lsoser vet omaintainem otional disturbancesin p sychopathology(K eltner,M of® tt,&Stouthamer-Loeber, 1995). Insu mmary,emo tionalprocesses® gure prominentlyin p sychopathology.Yet,surprisinglylit tleemp iricalresearchh assystematicallyexa mined themanner inwh ichd isturbedco mponentsofemotionalprocessesin ter- fere withadaptiveb ehaviourinin dividualswiththesed isorders.Ou rreview ofthislit erature suggeststhatonefoundationforsuchsyst ematicexa m- inations,t heapproacha ndwithdrawalmotivationsystemfra mework, providesa meansbywhicht helinkagesa mongemotionandother mani- festationsofpsychopathologyca nbeelucidated.

Manuscriptreceived 2March 1999

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