Emotions and Psychopathology
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COGNITION ANDEMOTION, 1999, 13 (5),575± 599 Emotions and Psychopathology 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 ndwithdra- walsystems,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, CA 94720,U SAo rJo-AnneBachorowski,D epartmentofPsychology,301 Wilso nHall, VanderbiltU niversity,111 21st Ave. So uth,Nashville,T N37240,U SA;o rbye-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 (Gray,1987), a ndrespondstononrewarda nd unconditionedp unishment. We havea doptedt heapproacha ndwithdrawalsystem perspectivet 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 ow- ever,so meemotionscanalsob emeaningfullylin kedwit hactivityinb oth motivationsystems.Fo rinstance,a ngeris a negativeemo tionwithbeha- viouralcomponentsthatcanrangefro movertaggressiontoactiveavo id- ance.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 tionalaccountsofemotionassume thattheseco 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 hefunctionaloutcome ofthese 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 (Clark&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 hdepres- sion,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