Delusions, memory and negative affect in schizophrenia and schizoaffective disorder

Bleuler suggested that delusions result from a breakdown in the balance of affect and thought (1911/1950). He believed that disruption of cognitive processes (e.g., associative pathways) along with the excessive influence of affect on cognition could lead to errors in thought, resulting in delusional ideation. Subsequent theories also suggested a central role for the influence of emotion in the formation of delusions. However, while the role of emotion in delusions has consistently been acknowledged, relatively little research has explored how affect may contribute to the development and/or maintenance of delusions.; In the current study, both behavioral and psychophysiological measures of memory were used to assess memory deficits and affective biases in individuals with schizophrenia and schizoaffective disorder. Specifically, participants were asked to encode and subsequently recall positive, neutral and negative images. Following recall, participants were asked to identify the previously seen images from among a group of previously unseen images. Delusion symptomatology was assessed prior to testing, and both state and trait negative affect was assessed at time of testing.; Results of the study provide compelling evidence that among individuals with schizophrenia and schizoaffective disorder, those with grandiose and religious delusions have a bias for the recall of positive information. Independent of this delusion-congruent positive bias, a strong negative recall bias was also found across patients, the vast majority of whom had a history of persecutory delusions. Moreover, the strength of affective memory biases were positively correlated with overall recall deficits, and recall deficits were likewise related to self-reported negative affect.; The presented findings support three critical relationships: (1) individuals with schizophrenia and schizoaffective disorder exhibit delusion-congruent affective memory biases that are governed by retrieval processes; (2) affective biases are strongest in patients who are most impaired in overall memory performance; (3) memory performance, and retrieval processes in particular, are most impaired in individuals currently experiencing negative affect, including anxiety, depression and hostility.