Possible correlations between the deficient affective experience and negative symptoms of psychosis: An exploratory study in (forensic) psychiatric patients

Background: Deficient affective experience (DAE), the affective and perhaps fundamental component of psychopathy, has some resemblance to the core affective disturbances of schizophrenia. There has, however, been little attempt to test relationships between these concepts, but this could be useful because of the high prevalence of schizophrenia among people in forensic mental health services and evidence that the DAE may be a useful predictor of violent behaviour. Aims: Our primary aim was to explore possible correlations between DAE and negative symptoms of schizophrenia and to test the hypotheses that the DAE would differentiate people with and without personality disorder co-morbidity in a sample with psychosis and, separately, people with main diagnoses of personality disorder or schizophrenia. Method: On the basis of an interview and a review of institutional files, DAE total and facet scores were calculated and compared with scores on the negative symptom scale of the Positive and Negative Syndrome Scale among forensic and general psychiatric patients. Partial correlation and rank order coefficients were calculated. Results: We found no correlation between total DAE scores and total negative Positive and Negative Syndrome Scale scores among patients with psychosis, suggesting that the concepts probably do not overlap. Our hypotheses on diagnostic associations with the DAE were partially sustained. DAE scores differentiated psychosis and personality disorder groups but did not differentiate psychosis groups with and without personality pathology. Conclusions and implications: This study, using typical clinical samples, suggested that one aspect of the affective disturbance of schizophrenia has little in common with the deficient emotional experience of psychopath. Measurement of DAE is unlikely to help detect co-morbid personality disorder among people with psychosis, but given our small sample size and the rarity of study in this field, further research would be warranted, perhaps also including a measure of incongruity of affect.

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